By L. Ugrasal. Columbia International University. 2018.
How- ergic drugs ever buy chloroquine 250 mg free shipping, vasodilators should not be used alone because of the risk • Avoid preventable adverse effects of adrenergic drugs of severe hypotension and further compromising tissue perfu- sion chloroquine 250 mg with mastercard. Interventions For distributive shock characterized by severe vasodilation Use measures to prevent or minimize hypotension and shock. Drug dosage must be carefully titrated to avoid tions, prevent hypoxia, and control other causative factors. The earlier the management, the greater the likelihood of reversing shock and preventing end-organ damage. Guidelines for Management • Assist in recognizing and managing the underlying cause of Hypotension and Shock of shock in a particular client (eg, replacing fluids; pre- venting further loss of blood or other body fluids). These conditions also must be treated if • Titrate adrenergic drug infusions to maintain blood pres- present. In addition, normalizing the blood pH and body sure and tissue perfusion without causing hypertension. Intra-arterial monitoring may be more reliable mended because of their extreme vasoconstrictive effects than cuff blood pressures in shock conditions. Because catecholamine drugs temperature and color closely to assess tissue perfusion. Have phentolamine (Regitine), an alpha- usually are titrated to maintain a low-normal blood pres- adrenergic blocking agent that reverses vasoconstriction, sure. Such titration depends on frequent and accurate readily available in any setting where IV adrenergic drugs blood pressure measurements. If infiltration occurs, instill phentolamine through • Septic shock due to bacterial infection requires appro- the IV catheter prior to removal.
Because gram-positive and anaerobic bacteria are re- • Interview and observe for adverse drug effects discount chloroquine 250 mg free shipping. PRINCIPLES OF THERAPY Indications for use include infections of the urinary tract cheap 250 mg chloroquine free shipping, lower respiratory tract, skin and skin structures, as well as Guidelines Related to Hypersensitivity intra-abdominal and gynecologic infections and septicemia. Adverse effects are similar to those for penicillin, including to Penicillins possible hypersensitivity reactions. Before giving the initial dose of any penicillin prepa- ration, ask the client if he or she has ever taken peni- cillin and, if so, whether an allergic reaction occurred. Nursing Process Penicillin is the most common cause of drug-induced anaphylaxis, a life-threatening hypersensitivity reac- General aspects of the nursing process in antimicrobial tion, and a person known to be hypersensitive should drug therapy, as described in Chapter 33, apply to the client be given another type of antibiotic. In this chapter, only those aspects related specif- sential, a skin test may be helpful in assessing hyper- ically to these drugs are included. Benzylpenicilloyl polylysine (Pre-Pen) or a dilute solution of the penicillin to be administered Assessment (10,000 units/mL) may be applied topically to a skin With penicillins, ask clients whether they have ever taken a scratch made with a sterile needle. If the scratch test is penicillin and, if so, whether they ever had a skin rash, hives, negative (no urticaria, erythema, or pruritus), the prepa- swelling, or difficulty breathing associated with the drug. Allergic reactions, With cephalosporins, ask clients if they have ever taken one including fatal anaphylactic shock, have occurred with of the drugs, as far as they know, and whether they ever had skin tests and after negative skin tests. Naming a few cephalosporins is positive, desensitization can be accomplished by giv- (eg, Ceclor, Keflex, Rocephin, Suprax) may help the client ing gradually increasing doses of penicillin. Because anaphylactic shock may occur with adminis- Nursing Diagnoses tration of the penicillins, especially by parenteral • Risk for Injury: Hypersensitivity reactions with penicillins routes, emergency drugs and equipment must be read- or cephalosporins ily available. Treatment may require parenteral epi- • Risk for Injury: Renal impairment with cephalosporins nephrine, oxygen, and insertion of an endotracheal or • Deficient Knowledge: Correct home care administration tracheostomy tube if laryngeal edema occurs. With penicillins, penicillin G or amoxicillin is the niques to minimize tissue irritation drug of choice in many infections; an antipseudomonal peni- 520 SECTION 6 DRUGS USED TO TREAT INFECTIONS CLIENT TEACHING GUIDELINES Oral Penicillins General Considerations Self- or Caregiver Administration ✔ Do not take any penicillin if you have ever had an allergic ✔ Take most penicillins on an empty stomach, 1 hour be- reaction to penicillin with which you had difficulty breath- fore or 2 hours after a meal. However, some people call a Augmentin can be taken without regard to meals. Drug effectiveness depends on maintaining temperature or after 2 weeks if refrigerated. They are also used for treatment of intra- antistaphylococcal penicillin is indicated in staphylococcal abdominal infections such as pelvic inflammatory disease, infections.
