NURS 2516 Clinical Medications Worksheets

(You will need to make additional copies of these forms)

Generic Name Trade Name Classification Dose Route Time/frequency

fluticason Flovent Corticosteroids 440 mcg INH BID
Route
up to 440 mcg
bid
Peak Onset Duration For IV meds, compatibility with IV drips and /or solutions
1-4 wk Within 24 hr unknown N/A
Mechanism of action and indications Nursing Implications (what to focus on)
(Why med ordered) Contraindications/warnings/interactions
COPD (maintenance/prophylactic; long-term control) Should be avoided in patients with known hypersensitivity or
intolerance. Use cautiously in pts with Underlying
P immunosuppression (due to disease or concurrent therapy)
o Common side effects
t Headache, dysphonia, hoarseness, oropharyngeal fungal
e infections, Budesonide: flu-like syndrome
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Interactions with other patient drugs, OTC or herbal
medicines (ask patient specifically)
None for this pt
Nursing Process- Assessment
(Pre-administration assessment)
Monitor respiratory status and lung sounds. Pulmonary
function tests may be assessed periodically during and
for several months after a transfer from systemic to
inhalation corticosteroids
Allow at least 1 min between inhalations of aerosol
medication
Lab value alterations caused by medicine
Periodic adrenal function tests may be ordered to assess degree
of hypothalamic-pituitary-adrenal (HPA) axis suppression in
chronic therapy. May cause ↑ serum and urine glucose
concentrations if significant absorption occurs
Be sure to teach the patient the following about this
medication
Advise patient to take medication as directed. Take missed doses as soon as remembered
unless almost time for next dose. Advise patient not to discontinue medication without
consulting health care professional; gradual decrease is required. Advise patients using
inhalation corticosteroids and bronchodilator to use bronchodilator first and to allow 5 min
to elapse before administering the corticosteroid, unless otherwise directed by health care
professional. Advise patient to notify physician if sore throat or sore mouth occurs.
Metered-Dose Inhaler: Instruct patient in the proper use of the metered-dose inhaler. Most
inhalers require priming before first use. There are 3 methods of using a metered-dose
inhaler. Shake inhaler well. (1) Take a drink of water to moisten the throat; place the inhaler
mouthpiece 2 finger-widths away from mouth; tilt head back slightly; while activating
inhaler, take a slow, deep breath for 3-5 sec, hold the breath for 10 sec, and breathe out
slowly. (2) Exhale, close lips firmly around mouthpiece, administer during 2nd half of
inhalation, and hold breath for as long as possible to ensure deep instillation of medication.
(3) Use a spacer. Consult health care professional to determine method desired before
instruction. Allow 1-2 min between inhalations. Rinse mouth with water or mouthwash after
each use to minimize fungal infections, dry mouth, and hoarseness. Wash inhalation
assembly at least daily in warm running water (see Appendix B )
Assessment Evaluation
Why would you hold or not give this Check after giving
med? Management of the symptoms of chronic
Assess patients changing from systemic COPD
Prevention of pulmonary damage that
corticosteroids to inhalation corticosteroids for results from chronic asthma
signs of adrenal insufficiency (anorexia,
nausea, weakness, fatigue, hypotension,
hypoglycemia) during initial therapy and
periods of stress. If these signs appear, notify
physician or other health care professional
immediately; condition may be life-
threatening. Monitor for withdrawal
symptoms (joint or muscular pain, lassitude,
depression) during withdrawal from oral
corticosteroids