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QUESTION
Acute MI
A 55-year-old male client is admitted to the intensive care unit (ICU) with a diagnosis of acute myocardial infarction. He has a T wave inversion and elevation of the ST segment. The EKG indicates myocardial ischemia and necrosis. He is started on lidocaine hydrochloride by IV infusion. He is also given aspirin 325 mg PO, heparin subcutaneous 5,000 units bid, and atenolol (Tenormin) 50 mg PO daily. It should be noted the client received morphine 10 mg IV to relieve chest pain in the emergency room.
What assessments should be made prior to administration of these medications?
What information about the medications should be explained to the client?
For what adverse effects of the medications should the nurse be alert and assess?
no internet sources
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Nursing |
Pages | 3 | Style | APA |
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Answer
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Acute MI
Assessments to be made prior to administration of lidocaine hydrochloride, aspirin 325mg PO, heparin subcutaneous 5,000 units bid, and atenolol (Tenormin) 50mg PO, and morphine 10mg IV
Prior to administration of lidocaine, assessment should be made on health past history, allergies, drugs, acute cardiac problems, reduced function of the liver, and wounds where medication is to be used (Gomella, 2004). Before administering aspirin 325mg, pain and liver function, allergy to aspirin, history of active bleeding, presence of ulcer, and whether the client took aspirin within 24 hours have to be assessed. For heparin, assess the client’s international normalized ratio (INR) (Papich, 2009). For atenolol, blood pressure is assessed; and for morphine, make sure the patient is not in respiratory distress.
Information to be Explained to The Client About the Medications
For lidocaine, instruct the patient to report any signs of unusual palpitations of the heart, and see the doctor or nurse regularly, if he is using medication daily. For client taking aspirin 325mg PO, he should not take ibupfrofen without consulting the doctor, and should report any bleeding noted. For a client taking heparin, he should avoid aspirin, ibuprofen, and report any case of hemorrhage, which is a complication that results from heparin. Additionally, the client may experience hypersensitivity with chills and fever (Papich, 2009). For a client taking atenolol, he should avoid mental health, heart rhythm drugs because they can slow down the rate of the heart; he should report shortness of breath, swelling ankles, fainting, and severe dizziness (Gomella, 2004). The client taking morphine 10mg IV should avoid sedative medicine such as benzodiazepines drugs.
Adverse Effects of the Mediations that the Nurse Should Be Alert and Assess
The adverse side effects for the medication of lidocaine include constipation, vomiting, nausea, and low blood pressure. For aspirin, the adverse effects are hallucination, stomach pain, fever lasting more than three days, gastrointestinal bleeding, and severe nausea. For heparin, the nurse should be wary of possible high bleeding, and hypersensitivity; and for atenolol, likely adverse effects include diarrhea, dizziness, headache, shortness of breath, and constipation. Finally, the nurse should watch for nausea, vomiting, dizziness, dry mouth, and constipation, for morphine 10mg IV prescriptions. To prevent constipation, the client should eat dietary fiber, drink lot of water, and engage in physical exercise (Papich, 2009).
References
Gomella, L. G. (2004). clinician's pocket drug reference. 127-129.
Papich, M. G. (2009). Table of common drugs: approximate dosages. Kirk's current veterinary therapt, 1306-1334.
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