Drugs for Chapter 50 Potter and Perry Surgical Client

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Drugs for Chapter 50 Potter and Perry Surgical Client
2013-12-08 19:50:12
Davis info chapter 50

drug info for Chapter 50 for final
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  1. Robinul 

    what is the generic name?
  2. Robinul 

    What is the drugs classification?
    Antispasmodic - An antispasmodic is a drug or an herb that suppresses muscle spasms.

    Anticholinergics - An anticholinergic agent is a substance that blocks the neurotransmitter acetylcholine in the central and the peripheral nervous system
  3. Robinul 

    Purpose or rational for client use.
    Control of Secretions during Surgery
  4. Robinul 
    safe dosage range
    IM (Adults): 4.4 mcg/kg 30–60 min preop (not to exceed 0.1 mg).

    • IM (Children >2 yr): 4.4 mcg/kg 30 – 60 min
    • preop.

    • IM (Children <2 yr): 4.4 – 8.8 mcg/kg 30 – 60
    • min preop.
  5. Robinul
    Main side effects
    • CNS: headache, confusion, drowsiness. 
    • EENT: nasal congestion, blurred vision, cycloplegia, dry eyes, mydriasis.
    • CV: tachycardia, orthostatic hypotension,
    • palpitations.
    • GI: dry mouth, vomiting, constipation.
    • GU: urinary hesitancy, urinary retention.
    • Derm: flushing.
  6. Robinul
    nursing considerations
    • Assessment
    • ● Assess heart rate, BP, and respiratory rate before
    • and periodically during parenteral therapy.
    • ● Monitor intake and output ratios in geriatric or
    • surgical patients; glycopyrrolate may cause urinary retention. Instruct patient to void before parenteral administration.
    • ●  Assess patient routinely for abdominal distention and auscultate for bowel sounds. If constipation becomes a problem, increasing fluids and adding bulk to the diet may help alleviate the constipating effects of the drug.
    • ●  Periodic intraocular pressure determinations
    • should be made for patients receiving long-term therapy.
    • ●  Pedi: Monitor amount and frequency of drooling periodically during therapy.
    • ●  Assess for hyperexcitability, a paradoxical re-
    • sponse that may occur in children.
    • ●  LabTestConsiderations:Antagonizeseffects
    • of pentagastrin and histamine during the gastric
    • acid secretion test. Avoid administration for 24 hr preceding the test.
    • ●  May cause decreased uric acid levels inpatients with gout or hyperuricemia.
    • ●  Toxicity and Overdose:If overdose occurs,
    • neostigmine is the antidote.
  7. Robinul
  8. Phenergan
    what is the generic name
  9. Phenergan
    what is its classification?
    • Therapeutic: antiemetics, antihistamines, sedative/hypnotics
    • Pharmacologic: phenothiazines
  10. Phenergan
    safe dosage range
    • Sedation
    • PO, Rect, IM, IV (Adults): 25–50 mg; may repeat q 4–6 hr if needed.
    • PO, Rect, IM (Children >2 yr): 0.5 – 1 mg/kg
    • (not to exceed 50 mg) q 6 hr as needed.
  11. Phenergan
    Main side effects
    • CNS: NEUROLEPTIC MALIGNANT SYNDROME, confusion, disorientation, sedation, dizziness, extrapyramidal reactions, fatigue, insomnia, nervousness.
    • EENT:blurred vision, diplopia, tinnitus. CV: bradycardia, hypertension, hypotension, tachycardia.
    • GI: constipation, drug-induced hepatitis, dry mouth.
    • Derm: photosensitivity, severe tissue necrosis upon infiltration at IV site, rashes.
    • Hemat: blood dyscrasias.
  12. Phenergan
    Nursing considerations
    • Assessment
    • Monitor BP,pulse,and respiratory rate frequently
    • in patients receiving IV doses.
    • Assess level of sedation after administration.
    • Risk of sedation and respiratory depression are increased when administered concurrently with
    • other drugs that cause CNS depression.
    • Monitor patient for onset of extra pyramidal side effects (akathisia—restlessness; dystonia—
    • muscle spasms and twisting motions; pseudo parkinsonism—mask-like face, rigidity, tremors, drooling, shuffling gait, dysphagia).
    • Notify health care professional if these symptoms occur.
    • Monitor for development of neurolepticmalignant syndrome (fever, respiratory distress, tachycardia, seizures, diaphoresis, hypertension or hypotension, pallor, tiredness, severe muscle stiffness, loss of bladder control). Notify healthcare professional immediately if these symptoms
    • occur.
    • Geri:Assess for adverse anticholinergic effects
    • (delirium, acute confusion, dizziness, dry mouth, blurred vision, urinary retention, constipation, tachycardia).
    • Allergy:Assess allergy symptoms (rhinitis,con-
    • junctivitis, hives) before and periodically
    • throughout course of therapy.
    • Antiemetic:Assess patient for nausea and vomiting before and after administration.
    • IV: High Alert: If administered IV, assess for
    • burning and pain at IV site; may cause severe tissue injury. Avoid IV administration, if possible.
    • If pain occurs, discontinue administration immediately.
    • Lab Test Considerations:May cause false positive or false-negative pregnancy test results.
    • Evaluate CBC periodically during chronic therapy; blood dyscrasias may occur.
    • May cause q serum glucose.
    • May cause false-negative results in skin tests using allergen extracts. Promethazine should be
    • discontinued 72 hr before the test.
  13. Phenergan
    PO, IM
  14. Versed
    Generic/trade name
  15. Versed 
    • Therapeutic: anti-anxiety agents, sedative/
    • hypnotics
    • Pharmacologic: benzodiazepines
  16. versed
    purpose/rational for client use
    • PO: Pre-procedural sedation and anxiolysis in pediatric patients.
    • IM, IV: Preoperative sedation/ anxiolysis/amnesia.
    • IV: Provides sedation/anxiolysis/amnesia during therapeutic, diagnostic, or radiographic procedures (conscious sedation): Aids in the induction of anesthesia and as part of balanced anesthesia, As a continuous infusion, provides sedation of mechanically ventilated patients during anesthesia or in a critical care setting, Status epilepticus.
  17. Versed 
    safe dosage range
    • Preoperative Sedation/Anxiolysis/Amnesia 
    • PO (Children 6 mo–16 yr): 0.25–0.5 mg/kg,
    • may require up to 1 mg/kg (dose should not exceed20mg);patients with cardiac/respiratory compromise or concurrent CNS depressants 0.25 mg/kg.
    • IM (Adults Otherwise Healthy and <60 yr): 0.07 – 0.08 mg/kg 1 hr before surgery (usual dose 5
    • mg).
    • IM (Adults >,= 60 yr, Debilitated or Chronically
    • Ill): 0.02 – 0.03 mg/kg 1 hr before surgery (usual dose 1–3 mg).
    • IM (Children): 0.1–0.15 mg/kg up to 0.5 mg/kg
    • 30 – 60 min prior to procedure; not to exceed 10mg/dose.
  18. Versed 
    main side effects
    • CNS: agitation, drowsiness, excess sedation, headache.
    • EENT: blurred vision.
    • Resp: APNEA, LARYNGOSPASM, RESPIRATORY DEPRESSION, bronchospasm, coughing.
    • CV: CARDIAC ARREST, arrhythmias.
    • GI:hiccups, nausea, vomiting. Derm: rashes. Local: phlebitis at IV site, pain at IM sit
  19. Versed
    Nursing Considerations
    • Assessment
    • ●  Assess level of sedation and level of consciousness throughout and for 2–6 hr following administration.
    • ●  Monitor BP,pulse,and respiration continuously
    • during IV administration. Oxygen and resuscita-
    • tive equipment should be immediately  available.
    • ●  Toxicity and Overdose:If overdose occurs,
    • monitor pulse, respiration, and BP continuously.
    • Maintain patent airway and assist ventilation as
    • needed. If hypotension occurs, treatment in-
    • cludes IV fluids, repositioning, and vasopressors.
    • ●  The effects of midazolam can be reversed with flumazenil (Romazicon).
  20. Versed
    • IM
    • PO
    • Intranasal
    • IV