Nursing Implications
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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
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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