Day 6 Medication Aide
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certified medication aide class for nurse aides to administer non-parenteral medication in long term care facilities. Hawkeye Community College Community Education in Waterloo, Iowa.
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Day 6 Medication Aide
- 2. RESPIRATORY SYSTEM • Upper respiratory tract • Nose • Sinuses • Naso-pharynx • Pharynx • Tonsils • Eustachian tubes • larynx • Lower respiratory tract • Larynx • Trachea • Bronchi • Bronchioles • Alveoli
- 3. COMMON CONDITIONS AFFECTING THE RESPIRATORY SYSTEM • URI • Rhinitis • COPD (asthma, bronchitis, emphysema, reactive airway disease) • Sinusitis, tonsilitis
- 4. DECONGESTANTS • Used to shrink nasal mucous membranes, help reduce fluid secretions • Common side affects • Nervousness • Rebound engorgement • Elevated blood pressure • Elevated glucose levels • Nursing precautions • Monitor BP • Limit use of nasal sprays, drops to 5 days • Examples • Allerest • Beconase • Sudafed • Flonase • Nasocort • Sinex, Neo-Synephrine • Afrin
- 5. ANTIHISTAMINES • Common side affects • Drowsiness & sedation • Dry mouth • Lower blood pressure • Urinary retention • Nursing precautions • Avoid alcohol • Examples • Benylin • Zyrtec vestaril • Seldene • Hismanal • Chor-trimeton • Tavist • Allegra • Atrovent • Claritin • Phenergan • Used to decrease nasopharyngeal secretions, relieve symptoms of allergies, common cold
- 6. ANTI-INFLAMMATORY AGENTS • Anti-inflammatory agent • Used with a decongestant or a anti-histamine • Nasalcrom • Intra-nasal cortico-steroids • Reduce nasal symptoms of allergic rhinitis • Used with decongestants • Flonase • Nasacort AG • Beconase
- 7. DRUG THERAPY FOR LOWER RESPIRATORY DISEASES • Signs and symptoms • Lung congestion • Cough Expectorants, antitussives, broncho-dilators, mucolytic agents
- 8. DRUG THERAPY FOR UPPER RESPIRATORY DISEASES • Signs and symptoms of URI • Nasal itching • Sneezing • Rhinorrhea • Tearing • Itchy eyes Antihistamines and decongestants Anti-inflammatory agents and steroids
- 9. EXPECTORANTS • Used to loosen bronchial secretions to be eliminated with coughing • Common side affects • Nausea • Vertigo • Drowsiness • Sedation • Nursing precautions • Avoid alcohol, hypnotics, narcotics • Encourage additional fluids • Monitor BP as directed • Examples • Robitussin (guaifenesin) • SSKI (potassium iodine)
- 10. ANTITUSSIVES • Used to suppress cough • Common side affects • Nausea, vomiting • Headache • Drowsiness & sedation • Nursing precautions • Hydration is best expectorant • Observe color of bronchial secretions • Do not give fluid or food for 20 minutes after administration • Codeine is the most constipating • Examples • Guaifenesin (Robitussin) • SSKI • Tusstat (diphenhydramine)Benadryl • Hycodan • Tessalon Perles
- 11. BRONCHO-DILATORS • Relaxes the smooth muscle of the trachea-bronchial tree • Used with anti-inflammatory agents • Singulair • Accolate • Cortico-steroids are most effective as used by inhalation • Azmacort • Advair(a powder given by diskus) • Nsg. Precaution • S/E are usually dose related • Give with food & a full glass of water • Provide for safety & prevention of falls • Give according to manufacturing directions
- 12. CONT. • Side effects • Tachycardia/palpitations • Tremors • Nervousness • Nausea/vomiting • Dizziness • Proventil • Alupent • Maxair • Brethine • Atrovent • Spiriva(dry powder given by inhalation)
- 13. XANTHINE DERIVATIVE- BRONCHODILATOR • Act on smooth muscle to dilate the bronchi • Goal is easier breathing with less effort • Theolair • Bronkodyl
- 14. MUCOLYTIC AGENTS • Used to reduce the stickiness and thickness of pulmonary secretions • Common side affects • Dry mouth • Restlessness • Elevated blood pressure • Nursing precautions • Note the person’s cough- productive/nonproductive • Sputum • Monitor vitals • Examples • Mucomyst (acetylcysteine)
- 15. ANTIBIOTICS • Used to treat infections in respiratory tract • Common side affects • Diarrhea • Rash • nausea • Nursing precautions • Do not give food, mild products, antacids, with tetracycline product • Observe for allergic reaction (rash) • Full course of therapy required • Examples • Amoxil • Cipro • Vibramycin
- 16. COMMON CONDITIONS OF GI SYSTEM • GERD (Gastro-esophageal reflux disease) • Dysphagia • Stomatitis • Stomach ulcer • Gastritis • Gallstones • Hemorrhoids • Colon cancer • Cirrhosis • Nausea, vomiting • Diarrhea, vomiting • Diarrhea • Bowel incontinence • Constipation • Hypokalemia • Hyponatremia
- 17. GERD • Heartburn is the most common • S/S include chest pain when lying down • Hoarseness in the morning • Dysphagia • Choking sensation • Feeling like food is stuck or the throat is tight • Dry cough, sore throat or bad breath • Risk factors • Being over- weight • Alcohol use • Pregnancy • Smoking • Hiatal hernia
- 18. CONT • Treatment: Life-style changes, meds to promote emptying of the stomach or reduce stomach acid production • Life style changes • No smoking or alcohol • Losing weight • Eating small meals • Wearing loose belts & loose fitting clothing • Not lying down for 3 hrs. after meals • Raising the HOB 5-8 “
- 19. CONT. • Meds Antacids (give other drugs 1 hr before or 2 hrs, after the antacid • S/E constipation or diarrhea • Edema or S/S of heart failure(meds are high in sodium) • Coffee ground emesis & bloody or black tarry stools • Meds include Gelusil • Maalox • Mylanta • Riopan • Tums • MOM
- 20. HISTAMINE RECEPTOR ANTAGONISTS • Blocks the secretion of gastric juices • Give with food or milk • S/E Dizziness, HA, sleepiness • Diarrhea, constipation • Confusion, slurred speech, hallucinations • Anorexia, N/V jaundice(liver toxicity) • Tagamet • Pepcid • Axid • Zantac
- 21. G-I PROSTAGLADIN • Inhibits gastric acid secretion • Used to treat gastric ulcers from NSAIDS or aspirin • Cytotec (give with food) • Proton Pump Inhibitors-blocks gastric acid production • Prevacid • Prilosec • Nexium • Coating agent-protects the duodenal ulcer from gastric juices • Give on empty stomach • Carafate • S/E constipation
- 22. PROKINETIC AGENTS • Stimulates stomach movement or motility • Reduces acid reflux • Empties stomach faster • Increases GI peristalsis • Prevents vomiting with CA therapy • S/E Drowsiness, fatigue, dizziness(provide for safety) • Restlessness, abnormal tongue movements • Reglan give 30 min before meals & @ bedtime
- 23. ANTISPASMOTIC AGENTS • Decreases gastric juices & GI motility • Decreases perspiration & oral & bronchial secretions • Dilates pupils & causes blurred vision • Constipation & urinary retention • Tachycardia & palpitations • Orthostatic hypotension • Confusion, delusions, nightmares, hallucinations • Nsg. Precautions-Monitor BP & heart rate for 1 min. for irregularity • Atropine, Bentylol, Pro-Banthine & scopolamine
- 24. NAUSEA, VOMITING, RETCHING, CONSTIPATION, FECAL IMPACTION, DIARRHEA • Nausea- sensation of abdominal discomfort • Vomiting- means expelling stomach contents through the mouth (emesis). • Retching- involuntary, labored, spasmodic contractions of the abdominal and respiratory muscles without vomitus (dry heaves). • Constipation- passage of a hard, dry stool. • Fecal impaction- prolonged retention and buildup of feces in the rectum. • Diarrhea- frequent passage of liquid stools.
- 25. ANTIEMETICS • Used to relieve nausea & vomiting • Common side affects • Drowsiness • Dizziness • Dry mouth • Headache • Diarrhea • Confusion • Tremors • Blurred vision • Nursing precautions • Safety measures to prevent injury from drowsiness • Orthostatic hypotension precautions • Best if given @ the onset of nausea • Examples • scopolamine (Transderm scop) • meclizine (Antivert) • prochlorperazine (Compazine) • promethazine (Phenergan) • metoclopramide (Reglan) • ondansetron (Zofran) • ohlorpromazine (Thorazine) • diphenhydramine (Benadryl) • hydroxyline (Atarax, Vistaril) • torazepam (Ativan)
- 26. DRUGS FOR N/V • Dopamine Antagonist(blocks the pathway to the vomiting center) • Pnenothiazides(Thorazine, Compazine) • Butyrophenones(Haldol, Reglan) • Seratonan Antagonist(Zofran) • Anti-Choli nergic for motion sickness(Dramamine, Benadry,Atarax, Antivert, Transderm scopalamine) • Cortico-steroids-can be used alone or with other meds • (Decadron(usually only given a few times, so few SE) • Neurokinin-1 Receptor Inhibitor(emend-used with a serotonin antagonist & a cortico-steroid
- 27. LAXATIVES • Used to treat constipation • Common side affects • Nursing precautions • Examples • psyllium (Metamucil) • methylcellulose (Citrucel) • docusate sodium (Colace) • polyethylene (Miralax) • senna (Senokot) • Ducolax • Ex-lax • Peri-colace
- 28. ANTIDIARRHEAL • Used to reduce or stop frequent stools-Local(absorbs excess water, irritants or bacteria causing the diarrhea)-Systemic (reduces peristalsis & GI motility) • Common side affects • Headaches • Upset stomach • Nausea, vomiting • Constipation • Confusion • Blurred vision • Nursing precautions • Observe for changes in stools, stomach cramps, vomiting • Examples • Local-Pepto-bismol & Kaopectate • Systemic-Lomotil, Imodium, & Paregoric
- 29. COMMON CONDITIONS OF THE ENDOCRINE SYSTEM • Thyroid • Hypothyroidism (cretinism- child, myxedema- adult • Hyperthyroidism (Graves disease, thyrotoxicoses) • Parathyroid- tetany • Adrenal • Hypo-Addison’s disease • Hyper- Cushing’s syndrome • Pancreases – diabetes (type I and II) • Gonads- reproductive system
- 30. DIABETES-INSULIN • Ma’s are not allowed to give, except for those working in Ass. Living • Insulin past 30 days from when opened, must be discarded • Cold insulin is uncomfortable, thus you need to rotate in your hands to warm up prior to giving • Is used for Type I or Type 2 if diet & exercise do not control the person’s blood sugar as well as surgery, infections, pregnancy or during increased physical or psychological stress • Always monitor the injection site for redness or irritation
- 31. INSULIN • Common side affects • Refer to signs/symptoms of hypo and hyperglycemia • Nursing precautions • Monitor blood glucose levels • Monitor vital signs (tachycardia in insulin reactions) • Examples • Rapid acting insulin(onset 20 min. Duration to 3-5 hrs.) • Regular • Humalog • Novolog • Short acting insulin(onset ½ hr. Duration5-10 hrs.) • Humulin R • Novolin R • Intermediate acting insulin(onset 1/2hr. Duration 24 hrs.) • Lente • Humulin • Novolin • Humalog • Novolog • Long acting insulin • Used to provide insulin to regulate blood glucose levels • Lantus (Onset Duration 24 hrs.)
- 32. SULFONYLUREA-ORAL HYPO- GLYCEMIC AGENT • Used when the pancreas can still secrete insulin • Low sugars are primary SE • !st generation drugs were produced over 30 yrs. Ago • Side effects are • Nausea, vomiting • Jaundice(liver toxicity) • Abdominal cramps • Rash, itching(allergic reaction) • Sore throat & fever(changes in red & white blood cells)
- 33. CONT. • 1st generation agents(Diabinese, Tolinase, Orinase) 2nd generation agents(Amaryl, Glucotrol, Micronase) Meglitinide agents-stimulates the release of insulin-used with metformin, Prandin TZD- Avandia-Makes muscle & fat cells more sensitive to insulin Alpha-Glucosidase inhibitors-delays glucose absorption (usually used with other meds) Precose Glyset
- 34. DRUG THERAPY FOR THYROID DISEASES • Thyroid Replacement Hormones-treatment for hypothyroid ism(T3 & T4) • Observe for S/S of hyperthyroidism see p. 340 • (Synthroid, Levoxyl, Cytomel, Thyrolar) • Monitor weight • Anti-thyroid Drugs-blocks the formation of t3 & T4 • Observe for S/S of hypothyroidism see p.340 • (PTU, Propacil, Tapazole) • Monitor anorexia & nausea(liver toxicity) • Decreased urine output-bloody or smoky urine(kidney toxicity)
Notes de l'éditeur
- p. 300
- Chapter 24, p. 299-306
- Chapter 24, p. 305-306
- p. 307
- Chapter 24, p. 308-309
- Chapter 24, p. 308-309
- Chapter 34, p. 412, 413, 415
- Chapter 25, p. 316-322 Chapter 26, p. 325-335
- p. 326
- Chapter 26, p. 328-332
- Chapter 26, p. 332-334
- Chapter 26, p. 334-335