hyrdrocortisone.docx

8/14/2019 Hyrdrocortisone.docx

1/7

Drug Action Indication Adverse Effect Contraindication NURSINGCONSIDERATION

HYDROCORTISONE

Brand Name: Cortef,

Hydrocortone

CLASSIFICATION:antiasthmatics,corticosteroidsPharmacologic:corticosteroids

(systemic)

PregnancyCategory C

(prednisolone), UK(all others)

Replaceendogenous

cortisoldeficiency

states Also have

potentmineralocortico

id activity

Managementof

adrenocorticalinsufficiency;chronic use in

othersituations is

limited because of

mineralocorticoid activity

CNS: depression,euphoria, headache,

increasedintracranial pressure

(children only), personality changes,

psychoses,restlessness

EENT: cataracts,increased intraocular

pressure CV: hypertension

GI: pepticulceration, anorexia,

nausea, vomiting Derm: acne,decreased wound

healing ,ecchymoses,

fragility, hirsutism, petechiae

Endo: adrenal

suppression,hyperglycemia

F and E : fluidretention (long term

high doses),hypokalemia,hupokalemic

alkalosis Hemat:

Active untreatedinfections (may

be used in patients beingtreated for some

forms ofmeningitis)

Lactation (avoidchronic use)

Known alcohol bisulfate or

tartrazinehypersensitivityor intolerance

(some productscontain theseand should be

avoided insusceptible patients)

Assess patients forsigns of adrenal

insufficiency(hypotension, weight

loss, weakness,nausea, vomiting,anorexia, lethargy,

confusion,restlessness) before

and periodicallyduring therapy

Monitor intake andoutput ratios dailyweighs. Observe

patient for peripheraledema, steady weghtgain, rales/crackes or

dyspnea.


2/7

thromboembolism,thrombophlebitis Metab: weightgain, weight loss MS: muscle

wasting,osteoporosis,

aseptic necrosis of joints, muscle pain Misc: cushingoid

appearance (moonface, buffalo

hump), increasedsusceptibility to

infection


3/7

Drug Action Indication Adverse Effect Contraindication NURSINGCONSIDERATION

SALBUTAMOL

Brand Name: Pronventil, Ventolin

HFA, Vomax

CLASSIFICATION

Therapeutic: broncodilatorsPharmacologic:

adrenergics

Pregnancycategory C

Binds to -adrenargic

receptors in airwaysmooth muscle,

leading toactivation of

adenyl cyclase andincreased levels of

cyclic- 3, 5adenosine

monophosphate(cAMP). Increasesin cAMP activate

kinases, whichinhibit the

phosphorylation ofmyosin and

decreaseintracellular

calcium.Decreased

intracellularcalcium relaxessmooth muscle

airways Relaxation

ofairway smoothmuscle withsubsequent

bronchodilation.

Used as a bronchodilatorto control and

preventreversible

airwayobstructioncaused byasthma or

COPD Inhaln: used

as a quicklyagent for acute bronchospasm

and for prevention of

exercise-induced

bronchospasm PO: uses as a

long termcontrol agent

in patientswith

chronic/persistent

bronchospasm

CNS: nervousness,restlessness,

tremor, headache,insomnia

CV: chest pain, palpitations,

angina,arrhythmias,hypertension

GI: nausea,vomiting Endo:

hyperglycemia

F and E: hypokalemia Neuro: tremor

Hypersensitivity toadrenergic amines

Hypersensitivity tofluorocarbons (some

inhalers)

Assess lung sounds, pulse, and blood pressure before

administration andduring peak of

medication. Noteamount, color, andcharacter of sputum

producedMonitor pulmonaryfunction test before

initiating therapyand periodicallyduring therapy to

determineeffectiveness of

medication


4/7

Drug Actions Indications Adverse effects Contraindications NursingResponsibilities

CEFUROXIME Exerts it bactericidal

effects by binding to an

enzyme orenzymes known

as penicillin- binding proteins(PBPs) involvedin bacterial cellwall synthesiscausing cell

death.

Indicated fortreatment of

patients with mildto moderate severeinfections caused by susceptible

strains of thedesignatedorganisms.

GI: diarrhea, nausea,vomiting, loose stools.CNS: headaches and

dizziness.

Contraindicated to peoplewho have shown type1

hypersensitivity tocefuroxime, or to any

cephalosporin group ofantibiotics.

Assess patient forinfection (vitalsigns, woundappearance,

sputum, urine,stool, and WBC) at beginning of andthroughout therapy

Drug Actions Indications Side effects Contraindications NursingResponsibilities

PARACETAMOL No one is surehow paracetamol

works

Mild pain orfever

Skin rashes Blood disorders

and a swollen pancreas have

occasionallyhappened in

people taking thedrug on a regular basis for a long

time.

Contraindicated in patients hypersensitive to

drug.

Use cautiously in patients with longalcohol use because

therapeutic doses causehepatotoxicity in these

patients

Many OTC and prescription products

containacetaminophen, beaware of this when

calculating total dailydose.

Use liquid form forchildren and patientswho have difficulty

swallowing.

In children do notexceed 5 doses in 24hr.


5/7

CUES NSG.DIAGNOSIS INFERENCE GOALS ANDOBJECTIVES

NSG.INTERVENTION

RATIONALE EVALUATION

S> bakit ba namamagaung kamay nya?

O> patients familyseems to bedetermined to learnabout the patientcondition.

Readiness forenhancedtherapeuticregimenmanagement.

A pattern ofregulating andintegrating intodaily living a

program fortreatment ofillness and itssequelae that issufficient formeeting health-related goals andcan bestrengthened.

Goal: after anhour oftherapeuticcommunicationand nursinginterventions, thefamily will:> assumeresponsibility formanagingtreatment regimen.>demonstrate

proactivemanagement byanticipating and

planning foreventualities ofcondition/potentialcomplications.>determined thecause of thedisease>enumerate someof the way how to

prevent thedisease

Objectives:Identify/ useadditionalresources asappropriate.

Discuss presentresources used byclient.

Identify stepsnecessary to reachdesired health goals.

To note whetherchanges can bearranged.

Understandingthe processenhancescommitment andthe likelihood ofachieving thegoals

Goal met.

The client familyassumesresponsibility formanagingtreatment regimen.


6/7

Drug Actions Indications Adverse effects Contraindications NursingResponsibilities

COMBIVENT Combivent is acombination of

theanticholinergic

bronchodilator,ipratropium-

bromide, and the beta adrenergic bronchodilator,

salbutamolsulfate.

Ipratropiumbromide is aquartermaryammonium

derivative afatropine and is an

anticholinergicdrug which has bronchodilator

properties.SALBUTAMOL

produces bronchodilation

throughstimulation of

beta adrenergicreceptors in

brochial smoothmuscle, thereby

causingrelaxation of

muscle fibers.

For managementof bronchospasm

in patientssuffering from

COPD whorequire regular

treatment ofipratronium

bromide andsalbutamol.

Hypertension,nervousness,

tachycardia, tremor,and palpitations,

fatigue, abdominal pain, dyspepsia,

sinusitis, and dysuria.

In patients withtachyarrhythmias,

hypertropic obstructivecardiomyophathy and

patients with a history ofhypersensitivity to any of

its components or toatropine or its derivatives.

Patient should beinstructed on the proper way of

administering thedrug.

Assess lungsounds, pulse, and

blood pressure before

administration andduring peak of

medication. Noteamount, color, andcharacter of sputum

producedMonitor

pulmonaryfunction test before

initiating therapyand periodicallyduring therapy to

determineeffectiveness of

medication


7/7

hyrdrocortisone.docx

Documents