NURS 125 Exam #4 Key Concepts PDF

**Key Concepts for NURS 125 - Exam \#4** 1. **Empiric Therapy** - This type of treatment is administered based on the provider\'s assumption of the most likely cause of symptoms, such as treating a patient for a common cold based on upper respiratory symptoms. 2. *...

**Key Concepts for NURS 125 - Exam \#4** 1. **Empiric Therapy** - This type of treatment is administered based on the provider\'s assumption of the most likely cause of symptoms, such as treating a patient for a common cold based on upper respiratory symptoms. 2. **Respiratory Infections** - **Rhinovirus**: Responsible for about 40% of acute respiratory illnesses and is an RNA virus commonly leading to symptoms of the common cold. 3. **Antihistamines** - **Loratadine (Claritin)**: A nonsedating antihistamine typically used to relieve symptoms of seasonal allergies, such as hay fever, without causing drowsiness. However, higher doses may lead to CNS effects like headache or fatigue. - **Sedating Antihistamines**: E.g., **Diphenhydramine (Benadryl)** is a traditional antihistamine with sedative and anticholinergic effects, commonly used to induce sleep and relieve allergy symptoms. 4. **Decongestants** - Oral decongestants offer prolonged relief without causing rebound congestion (which is a concern with nasal spray decongestants). However, at excessive dosages, systemic side effects like hypertension and palpitations may occur due to alpha-adrenergic stimulation. 5. **Anticholinergics** - Used in respiratory conditions like COPD, anticholinergics may cause adverse effects such as dry mouth, urinary retention, and gastrointestinal discomfort. Patients with narrow-angle glaucoma should avoid these due to the risk of increased intraocular pressure. 6. **Cough Suppressants** - **Benzonatate (Tessalon Perles)**: A nonopioid antitussive that numbs cough receptors in the respiratory system, reducing the urge to cough. - **Guaifenesin (Mucinex)**: Classified as an expectorant, it works by thinning mucus, making it easier to expel. Patients are advised to increase fluid intake to help loosen secretions. 7. **Inhaled Medications for Asthma and COPD** - **Salmeterol (Advair)**: A long-acting beta agonist inhaler intended for daily maintenance in asthma and COPD but not suitable for immediate symptom relief. - **Albuterol**: A short-acting beta2 agonist typically used for immediate relief of bronchospasm in asthma attacks. It relaxes smooth muscle in the airways, providing quick symptom relief. 8. **Leukotriene Receptor Antagonists (LTRAs)** - **Montelukast (Singulair)**: Used as a preventive medication for asthma. It needs to be taken daily on a continuous schedule, even when symptoms are controlled, as it helps reduce inflammation and bronchoconstriction. 9. **Side Effects to Monitor** - **Dextromethorphan**: A nonopioid cough suppressant that works centrally to block the cough reflex. Common side effects include mild dizziness or nausea. - **Theophylline**: A bronchodilator with a narrow therapeutic range. Monitor blood levels, aiming for 10-20 mcg/mL; levels above 20 mcg/mL can lead to toxicity, showing symptoms like nausea, restlessness, or cardiac issues. 10. **Antiemetics for Nausea and Vomiting** - **Ondansetron (Zofran)**: A serotonin blocker used to prevent chemotherapy-induced nausea and vomiting. Often administered 30-60 minutes before treatment to achieve the best results. **Nursing Considerations and Patient Education** - **Fluid Intake**: Encourage patients taking expectorants like guaifenesin to drink plenty of fluids, as hydration helps thin and loosen respiratory secretions. - **Spacer Device**: For patients struggling with inhaler coordination, a spacer device can improve drug delivery by holding the medication briefly before inhalation. - **Oral Hygiene**: Patients using inhaled corticosteroids should rinse their mouth after each use to prevent oral fungal infections (e.g., thrush). - **Antihistamine Side Effects**: Educate patients on the potential for drowsiness with sedating antihistamines, like diphenhydramine, and advise against driving or operating machinery until they understand how the medication affects them. - **Adverse Effects to Report**: Patients on montelukast should be aware of possible neuropsychiatric effects, such as depression or behavioral changes, and report these to the provider if they occur.