• Assess for history of allergies to any immune suppressant, renal or hepatic impairment, history of neoplasm, concurrent use of cholestyramine, theophylline, phenytoin, other nephrotoxic drugs, digoxin, lovastatin, diltiazem, metoclopramide, nicardipine, amiodarone, androgens, azole antifungals, macrolides; grapefruit juice.
• Review physical examination findings, including orientation, reflexes, affect (neurological); temperature and weight (general); pulse, cardiac auscultation, blood pressure, edema, electrocardiogram (cardiovascular); liver evaluation (GI); and laboratory test results (complete blood count, liver and renal function tests, condition being treated)
Acute Pain related to CNS, GI, flu-like symptoms 急性疼痛，与CNS、GI、流感样症状有关
Risk for Infection related to immune suppression 感染风险，与免疫抑制有关
Imbalanced Nutrition: Less Than Body Requirements related to GI effects
营养失调，低于机体需要，与GI效应有关
Activity Intolerance related to fatigue, drug effects 活动不耐受，与疲劳、药物效应有关
Deficient Knowledge regarding drug therapy 知识缺乏，与药物疗法有关
Implementation 实施
Arrange for laboratory tests before and periodically during therapy.
安排治疗前及治疗期间定期实验室试验
Administer drug as indicated. 按处方给药
Protect patient from exposure to infection. 保护患者，避免感染暴露
Provide supportive and comfort measures to deal with adverse effects.
提供支持和舒适措施，处理不良效应
Monitor nutritional status and intervene as needed. 监测营养状况，必要时进行处理
Provide patient teaching regarding the drugs and their dosage, adverse effects, precautions, and warning signs to report to care provider.
提供患者宣教，包括药物、药物剂量、不良效应、预防措施、需要报告的警示信号
Evaluation 评价
Evaluate drug effects: prevention of transplant rejection, improvement of autoimmune disease.
评价药物效应：移植排斥的预防、自体免疫疾病的改善
Monitor for adverse effects: infection, flu-like symptoms, GI upset, fluid overload, neoplasm.
监测有无不良效应：感染、流感样症状、GI不适、液体过载、肿瘤
Monitor for drug–drug interactions and drug–food interactions.
监测有无药-药相互作用和药-食物相互作用
Evaluate effectiveness of patient teaching program and of comfort and safety measures.
评价患者教育计划、舒适和安全措施的效果
★Vocabulary for Today ★
cholestyramine – n. 考来烯胺
theophylline – n. 茶碱
phenytoin – n. 苯妥英
nephrotoxic – a. 肾毒性的
digoxin – n. 地高辛
lovastatin – n. 洛伐他汀
diltiazem – n. 地尔硫卓
metoclopramide – n. 甲氧氯普胺
nicardipine – n. 尼卡地平
amiodarone – n. 胺碘酮
androgen – n. 雄激素
azole antifungals – n. 唑类抗真菌药
macrolide – n. 大环内酯类
steroid-resistant – a. 激素抵抗型的
allograft – n. 同种异体移植（物）
allograft rejection – 同种异体移植排斥
tumor necrosis factor – 肿瘤坏死因子
keep … in check – 抑制，约束
deactivate – v. 灭活，停用
free-floating – a. 游离漂浮的
epidermal growth factor – 表皮生长因子
HER2 -- epidermal growth factor receptor 2
genetic defect – 遗传缺陷
complement protein – 补体蛋白质
complement complex – 补体复合物
myelocytic leukemia – 髓细胞性白血病
RSV -- respiratory syncytial virus呼吸道合胞病毒
★Video ★
Nursing care policies for tuberculosis
★Test ★
1. The nurse is preparing to administer 0.1 mL of medication intradermally to the client. How much medication would the nurse draw up in the tuberculin (1.0-mL) syringe?
A. A; B. B; C. C; D. D 2. The client is diagnosed with subacute bacterial endocarditis (SBE). Which HCP order should the nurse question? A. Initiate penicillin intravenously. B. Obtain a blood culture and sensitivity (C&S). C. Administer a positive protein derivative (PPD) intradermally. D. Place patient on bedrest with bathroom privileges.
答案 Key to Question
1. B:B Rationale: This is the correct amount of medication to administer to the client intradermally. This is the prescribed dose when administering a purified protein derivative (PPD) intradermal injection to a client who is being tested for possible exposure to tuberculosis (TB). 2. C. Administer a positive protein derivative (PPD) intradermally Rationale: The nurse would question why the HCP is ordering a PPD, which is a tuberculosis (TB) skin test. TB is not a risk factor for developing SBE.
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