Medical-surgical Nursing Demystified

(Sean Pound) #1

CHAPTER 2 Respiratory System^103



  • Administer methylxanthines to enhance bronchodilation:

    • aminophylline

    • theophylline (Theo-Dur)



  • Administer diuretics to reduce fluid retention in patients who develop right-
    sided heart failure:

    • furosemide, bumetanide



  • Administer expectorant to help liquefy secretions:

    • guaifenesin



  • Administer antibiotics in acute exacerbation of chronic bronchitis:

    • selected by culture and sensitivity study or given empirically



  • Administer antacid, H2 blocker, or proton pump inhibitor to decrease the
    amount of acid in stomach, reducing possible ulcer formation due to stress
    of disease or medication effects.

    • antacids: aluminum hydroxide/magnesium hydroxide, calcium carbonate

    • H2 blockers: ranitidine, famotidine, nizatidine, cimetidine

    • proton pump inhibitors: omeprazole, lansoprazole, esomeprazole, rabepra-
      zole, pantoprazole



  • Administer vaccines—to decrease chances of infection:

    • influenza

    • pneumonia



  • Give 3 liters of fluid per day to help liquefy secretions

  • Oxygen: 2 liters per minute via nasal canula to help meet body’s needs; low
    flow rates help reduce dyspnea while avoiding CO 2 retention.

  • Increase protein, calories, and vitamin C in diet to meet body’s needs.

  • Administer the incentive spirometer or flutter valve to encourage coughing
    and expelling of mucous.

  • Nocturnal negative pressure ventilation used for hypercapnic (elevated CO 2
    levels) patients.


NURSING DIAGNOSES



  • Ineffective airway clearance

  • Activity intolerance

  • Ineffective breathing pattern

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