Lung sounds

As part of the preadministration assessment, the nurse assesses the patient s blood pressure, pulse, and congestion before administering a decongestant. The nurse assesses lung sounds and bronchial secretions, which are noted in the patient s record. It is important to obtain a history of the use of these products, including die name of the product used and die frequency of use. 

During tiie ongoing assessment, tiie nurse assesses the respiratory status every 4 hours and whenever tiie drug is administered. The nurse notes the respiratory rate, lung sounds, and use of accessory muscles in breathing, hi addition, tiie nurse keeps a careful record of the intake and output and reports any imbalance, which may indicate a fluid overload or excessive diuresis. It is important to monitor any patient with a history of cardiovascular problems for chest pain and changes in the electrocardiogram. The primary health care provider may order periodic pulmonary function tests, particularly for patients with emphysema or bronchitis, to help monitor respiratory status. 

Before administering the drug, the nurse assesses the respiratory status of the patient. The nurse documents lung sounds, amount of dyspnea (if any), and consistency of sputum (if present). A description of the sputum is important as a baseline for future comparison. 

The nurse should assess patients receiving the calcium channel blockers for signs of CHF dyspnea, weight gain, peripheral edema, abnormal lung sounds (crackles/rales), and jugular vein distention. Any symptoms of CHF are reported immediately to the primary healtii care provider. 

Before starting an IV infusion containing ritodrine or terbutaline, the nurse obtains the patient s vital signs. The nurse auscultates lung sounds to provide a baseline assessment. The nurse places the patient on a monitoring device to determine uterine contractions and the FHR before and during administration. 

Assess the patient s general appearance, use of accessory muscles, respiratory rate, heart rate, lung sounds, pulsus paradoxus, PEF, and oxygen saturation. 

Physical signs may include hypotension tachycardia, bradycardia, irregular or no pulse cyanosis hypothermia and distant or absent heart and lung sounds. 

IV then based on response 250 g/48 h max Peds. 0.5—1 g/kg/dose inf at 0.05-0.1 g/min Caution [C, ] Sev e anemia cardiac, renal, or h atic insuff d/t protein load h5 pCTVolemia Contra CHF Disp Soln SE Chills, fevCT, CHF, tach, -1- BP, hypervolemia Interactions At5 pical Rxns W/ ACEI w/hold 24 h prior to plasma administration EMS May cause pulm edema, monitor resp status/lung sounds OD May cause circulatory ov load (T venous pressure) or pulm edema slow flow to KVO and evaluate... 

Metaproterenol (Alupent, Metaprel) [Bronchodilator/ Beta-Adrenergic Agonist] Uses Asthma reversible bronchospasm Action Sympathomimetic bronchodilator Dose Adults. Neb 0.2-0.3 mL in 2.5-3.0 mL of NS Peds. Neb 0.1-0.2 mL/kg of a 5% soln in 2.5 mL NS Caution [C, /-] Contra Tach, other arrhythmias Disp Aerosol 0.65 mg/inhal soln for inhal 0.4, 0.6% tabs 10, 20 mg syrup 10 mg/5 mL SE Nervousness, tremors (common), tach, HTN Interactions T Effects W/ sympathomimetic drugs, xanthines T risk of arrhythmias W/ cardiac glycosides, halothane, levodopa, theophylline, thyroid hormones T HTN W/ MAOIs effects W/ BBs EMS Separate additional aerosol use by 5 min fewer 3i effects than isoproterenol longer-acting monitor lung sounds before/after administration... 

Assess cardiac and respiratory status including rate, depth, rhythm, type of respirations, and quality and rate of pulse. Assess lung sounds for rhonchi, wheezing, and rales. 

Patients exhibit a gurgling lung sound (rhonchi) both on inspiration and expiration. The excess mucus blocks the airway causing a build up of carbon dioxide in the blood (hypercapnia) and a decrease in oxygen (hypoxemia) which leads to respiratory acidosis. 

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