Transcript Nursing Implications

MEDICATION
ADMINISTRATION
Drugs affecting the Special Senses
and the Reproductive system
Drugs affecting the Repro
system…Review of female repro
Male repro…review
Drugs affecting female repro
Contraceptives: May be a synthetic
oestrogen or progesterone or a combination
of the both
Primary use is contraceptive, but may also
be used for menstrual problems and to treat
acne in young women
Adverse Affects
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Depends on the drug
Nausea, vomiting, weight gain
Oedema, bloating,
Amenorrhea, abnormal bleeding, breast
tenderness, post-pill infertility
 Decreased libido, headache, dizziness,
anorexia, jaundice, skin pigmentation
(chloasma), depression.
Precautions/contraindications
In women with a history of
Thrombophlebitis, breast/endometrial
cancer, CVA or heart disease.
Nursing implications
 Take at the same time each day; a missed pill
should be taken within 12 hours.
 If pill missed completely, additional
contraceptive should be used for 5-7 days
 Yearly cervical smear and professional breast
exam
 BSE after each period.
 First 3 months, dual contraceptives
 Report adverse affects
 Discontinue 6 wks prior to elective surgery
Female Hormones
Oestrogen or progesterone used for
menopausal syndrome,
primary amenorrhea, breast cancer, ovarian
failure and endometriosis.
Oestrogen used to treat prostate problems.
Adverse affects
Depending on drug used
GI problems, headache, dizziness,
depression, hypertension, fluid retention,
Amenorrhea, breakthrough bleeding,
cervical erosion, thrush, libido changes,
Weight gain ,leg cramps, excessive thirst.
Precautions/contraindications
Should be used with care with women who
have a history of
Thrombophlebitis, breast Ca, stroke,
myocardial infarction
Hypertension, obesity, heavy smokers.
Nursing Implications
 Warn re weight gain
 No smoking
 Monitor glucose levels
 Health exam of female, and regular monitoring
 Clients who have not had a hysterectomy should also be
given progesterone with their oestrogen
 Monitor fluid retention
 Monitor hypertension
 Rotate transidermal patches
 Vaginal creams should be inserted deep into the vagina
towards the sacrum.
Adverse affects continued
Increased risk of breast cancer
Hormones via IM – deep into muscle, and
rotate sites.
Clients checked for pregnancy first.
Eg. Clomid, danazol
Male Hormones
(androgens/antiandrgens)
Used for hypogonadism, eunuchoidism,
gynaecomastia, prostate Ca.
Androgens may also be used for Breast Ca
in females.
Other drugs used to treat erectile
dysfunction.
Adverse affects
Tiredness, inability to concentrate
Reduces libido, depression
Impaired spermatogenesis, gynaecomastia,
impotence, decreased ejaculation
Frequent or persistent erections, priapism,
altered lipid levels.
Precautions/contraindications
Should not be used during pregnancy
Not used in people with prostate Ca
Pregnancy/lactation
Nursing Implications
Spermatogenesis should be checked before
meds are commenced (may take 6-20
months to return to normal after treatment)
Regular prostate exam
Monitor blood lipid levels and liver
function
Patch sites should be rotated and do not
apply over bony prominences
Pregnancy and Lactation
Generic and trade name
Action
Dose
Use
Stability
Compatibility
Adverse affects
Pregnancy and Lactation
Interactions
Precautions
Nursing implications
Under the above headings, research in the
MIMS…the following drugs
Drugs
Epilem
Hydrallazine
Maxalon
Ventolin
Pethidine
Progesterone
Drugs affecting eye,ear and
special senses
Ophthalmic Drugs
Include antibiotics, antifungals,anti
virals,steroids,and anesthetics
Mydriatics(dilate the eye)
Cycloplegics( prevent accommodation)
Miotics constrict the pupil
Lubricants for dry eyes
Adverse affects
Include photophobia,burning,stinging,
infections,lid edema,allergic
reaction,visual probs such as blurring,.
Systemic ….bitter taste,headache,
hyper/hypotnsion,tachycardia,dyspnoea,res
tlessness, confusion,flushing, sweating.
Precautions/contraindications
Mydraitcs contraindicated in narrow angle
glaucoma
Miotics should be used with care if intra
ocular lens insitu
Take care with steroids and diabetes
mellitus as may increase intra ocular
pressure or cataract formation
OK with pregnancy and B/F
Nursing implications
 Ointments and creams should only be used for that
purpose.
 Wash hands.
 Eye drops instilled in middle of lower lid and creams are
instilled in the lower lid from inner canthus to outer
canthus.
 Check which drop for which eye.. May use different
drops for both eyes.
 Do not touch eye or lid with the dropper.
 Write the date of opening..discard 7days if in hosp and 28
if at home.
Implications cont….
Clean eye …saline or water.
Check manufacturers instructions.
Should not drive if pupils are dilated.
Local anesthetic…do not rub and protect
the cornea.
Remove contact lenses.
Solutions should be clear and kept at room
temp.
Otic drugs
Include analgesics, anesthetics, anti
infective, steroids, wax softeners
Adverse affects
Allergic reactions,burning sensation
Precautions
 May be used safely in most clients
Nursing implications
 Keep at room temp
 Ensure ear canal is straightened
 Wash hands
 Keep head on the unaffected side for 2-3 mins
 Do not use steroids if ruptured eardrum
 Refer to page 218 for trade/generic activity
Drugs affecting the Nose
Include anti-infective,steroids,
decongestants,anticholinergics and
antihistamines.
Sprays,aerosols,drops, creams jellies,gases
and nasal prongs.
Adverse affects
Headache, stinging, excessive drying of the
nasal mucosa, ulceration of the nasal
mucosa, post-nasal drip, irritation, burning,
sinusitis, sneezing.
Precautions
Hypertension and cardiac clients should
take care.
Nursing implications
 Avoid contact with the eyes.
 Blow the nose before instilling.
 Breathe through mouth while instilling
medications.
 Shake containers well.wash spray after use.
 Nasal decongestants should not be used for
longer than 2 weeks.
 Refer to page 220 for generic/trade activity.
Mouth and throat
Include anti-infective, ulcers,or
inflammation.
Lozenge,mouth wash,
paints,drops,gels,and lotions.
Adverse affects
 Bad taste in mouth, numbness.
Nursing implications
 If painful ulcers, use analgesic before eating.
 Remove dentures.
 Do not drink immediately after instilling.
 Use mouth wash before and after eating.
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