Respiratory rates

M,E oral 0.2-1 ThioglycoHc acid 73 ptosis, decrease respiratory rate. 21... 

The gas is also toxie as exemplified by Table 5.29. Furthermore, the inereased respiratory rate may eause inereased amounts of other toxie gases, e.g. earbon monoxide in fires, to be inhaled. 

To evaluate die patient s response to tiierapy, and depending on die drug administered, die nurse may check die patient s blood pressure every hour, inquire whether pain has been relieved, or monitor die pulse every 15 minutes. After evaluation, certain otiier decisions may need to be made and plans of action implemented. For example, die nurse may need to notify die primary health care provider of a marked change in a patient s pulse and respiratory rate after a drug was administered, or die nurse may need to change die bed linen because sweating occurred after a drug used to lower die patient s elevated temperature was administered. 

The nurse monitors Hie temperature, pulse, respiratory rate, and blood pressure every 4 hours or as ordered by Hie primary healfli care provider. If fever is present and Hie patient s temperature suddenly increases or if Hie temperature was normal and suddenly increases, the nurse contacts Hie primary healHi care provider immediately. 

An ongoing assessment is important during therapy widi die tetracyclines, macrolides, and lincosamides. The nurse should take vital signs every 4 hours or as ordered by die primary health care provider. The nurse must notify the primary health care provider if tiiere are changes in the vital signs, such as a significant drop in blood pressure, an increase in die pulse or respiratory rate, or a sudden increase in temperature. 

When an aminoglycoside is being administered, it is important to monitor the patient s respiratory rate because neuromuscular blockade has been reported with the administration of these dragp. The nurse reports any changes in the respiratory rate or rhythm to the primary health care provider because immediate treatment may be necessary. 

Respiratory-depressant effects on respiratory rate (caused by a reduced sensitivity of the respiratory center to carbon dioxide)... 

One of the major hazards of narcotic administration is respiratory depression, widi a decrease in the respiratory rate and depth. The most common adverse reactions include light-headedness, dizziness, sedation, constipation, anorexia, nausea, vomiting, and sweating. When diese effects occur, die primary healdi care provider may lower die dose in an effort to eliminate or decrease die intensity of die adverse reaction. Otiier adverse reactions tiiat may be seen witii die administration of an agonist narcotic analgesic include ... 

It is especially important for the nurse to assess the type, location, and intensity of pain before administering the narcotic analgesic. Immediately before preparing a narcotic analgesic for administration, the nurse assesses the patient s blood pressure, pulse, and respiratory rate. 

The nurse obtains the blood pressure, pulse, and respiratory rate 20 to 30 minutes after the drug is administered intramuscularly or subcutaneously, 30 or more minutes if the drug is given orally, and in 5 to 10 minutes if the drug is given intravenously (IV). 

Narcotic analgesics can produce serious or potentially fatal respiratory depression if given too frequently or in an excessive dose. Respiratory depression may occur in patients receiving a normal dose if the patient is vulnerable (ie, in weakened state or debilitated state). Elderly, cachectic, or debilitated patients may have a reduced initial dose until die response of the drug is known. If the respiratory rate is 10/min or below, the nurse must monitor die patient at frequent intervals and notify the primary health care provider immediately. 

Fentanyl transdermal is a transdermal system that is effective in the management of the severe pain associated with cancer. The transdermal system allows for a timed-release patch containing the drug fentanyl to be activated over a 72-hour period. A small number of patients may require systems applied every 48 hours. The nurse monitors for adverse effects in the same manner as for other narcotic analgesics (eg, the nurse notifies the primary health care provider if the respiratory rate is 10/min or less). 

A significant decrease in the respiratory rate or a respiratory rate of 10/min or below... 

Fhtients receiving long-term opioid therapy rarely have problems with respiratory depression. In instances where respiratory depression occurs, administration of a narcotic antagonist (see Chap. 20) may be ordered by die primary health care provider if die respiratory rate continues to fall. 

Muscle spasm, fever, nausea, vomiting, kicking movements, weakness, depression, body aches, weight loss, severe backache, abdominal and leg pains, hot and cold flashes, insomnia, repetitive sneezing, increased blood pressure, respiratory rate, and heart rate... 

Ms. Taylor is receiving meperidine for postoperative pain management. In assessing Ms. Taylor approximately 20 minutes after receiving an injection of meperidine, the nurse discovers Ms. Taylor s vital signs are blood pressure 100150 mm Hg, pulse rate 100 bpm, and respiratory rate 10 /min. Determine what action, if any, the nurse should take. 

Before the administration of naloxone, the nurse obtains the blood pressure, pulse, and respiratory rate and reviews the record for the drug suspected of causing the overdosage. If there is sufficient time, the nurse also should review the initial health history, allergy history, and current treatment modalities. 

As part of the ongoing assessment during the administration of naloxone, the nurse monitors the blood pressure, pulse, and respiratory rate at frequent intervals, usually every 5 minutes, until the patient responds. After the patient has shown response to the drug, the nurse monitors vital signs every 5 to 15 minutes. The nurse should notify tlie primary healdi care provider if any adverse drug reactions occur because additional medical treatment may be needed. The nurse monitors die respiratory rate, rhydun, and depdi pulse blood pressure and level of consciousness until the effects of die narcotics wear off. 

D Risk for Impaired Gas Exchange related to decreased respiratory rate... 

The expected outcome for the patient widi respiratory depression is an optimal response to tiierapy, which essentially is a return to normal respiratory rate, rhydun, and depdi. 

When naloxone is used to reverse respiratory depression and the resulting somnolence, the drug is given stow IV push until the respiratory rate begins to increase and somnolence abates Giving a rapid bolus wilt cause withdrawal and return of intense pain. 

The patient s respiratory rate, rhydun, and depth are normal. 

When a patient is to receive an adrenergic agent for shock, the nurse obtains the blood pressure, pulse rate and quality, and respiratory rate and rhythm. The nurse assesses the patient s symptoms, problems, or needs before administering the drug and records any subjective or objective data on the patient s chart. In emergencies, the nurse must make assessments quickly and accurately. This information provides an important database that is used during treatment. 

The nurse withholdsthe drug and notifiesthe primary health care provider if any one or more vital signs significantly varies from the database, if the respiratory rate is 10/min or below, or if the patient appearslethargic. In addition, it is important to determine if there are any factors (eg, noise, lights pain, discomfort) that would interfere with steep and whether these maybe controlled or eliminated. 

ANALEPTICS. When a CNS stimulant is prescribed for respiratory depression, initial patient assessments will include the blood pressure, pulse, and respiratory rate. It is important to note the depth of the respirations and any pattern to the respiratory rate, such as shallow respirations or alternating deep and shallow respirations. The nurse reviews recent laboratory tests (if any), such as arterial blood gas studies. Before administering the drug, the nurse ensures that the patient has a patent airway. Oxygen is usually administered before, during, and after drug administration. 

ANOREXIANTS When an anorexiant or amphetamine is used as part of the treatment of obesity, the drug is usually prescribed for outpatient use The nurse obtains and records the blood pressure, pulse, respiratory rate, and weight before therapy is started. 

ANALEPTICS. After administration of an analeptic, the nurse carefully monitors the patient s respiratory rate and pattern until the respirations return to normal. The nurse monitors the level of consciousness, the blood pressure and pulse rate at 5- to 15-minute intervals or as ordered by the primary health care provider. The nurse may draw blood for arterial blood gas analysis at intervals to determine the effectiveness of the analeptic, as well as the need for additional drug therapy. It is... 

C. decreased respiratory rate, weight gain, bradycardia... 

It is important for the nurse to note the presence of suicidal thoughts. The nurse accurately documents in the patient s record and reports to the primary health care provider any statements concerning suicide and the ability of the patient to carry out any suicide intentions. The nurse performs a physical assessment, which includes obtaining blood pressure measurements on both arms with the patient in a sitting position, pulse, respiratory rate, and weight. 

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