Nursing Diagnosis and Interventions for Patient Receiving Alpha-Specific Adrenergic Agonists
α特异性肾上腺素能激动剂使用者的护理诊断及措施
Nursing Diagnosis 护理诊断
Nursing diagnoses related to drug therapy might include the following:
与药物疗法相关的护理诊断如下：
Disturbed sensory perception (visual, kinesthetic, tactile) related to CNS effects
感官知觉紊乱（视觉、动觉、触觉），与CNS效应有关
Discomfort related to GI and GU effects of the drug and pupil dilation causing sensitivity to light
不适，与药物的GI、GU效应和瞳孔扩张引起光敏感有关
Risk for injury related to CNS or CV effects of the drug and potential for extravasation
损伤危险，与药物的CNS或CV效应和潜在外溢有关
Decreased cardiac output related to blood pressure changes, arrhythmias, or vasoconstriction
心排血量下降，与血压变化、心律失常或血管收缩有关
Deficient knowledge regarding drug therapy
知识缺乏，与药物疗法有关
Interventions 措施
Do not discontinue the drug abruptly because sudden withdrawal can result in rebound hypertension, arrhythmias, flushing, and even hypertensive encephalopathy and death; taper drug over 2 to 4 days.
Do not discontinue the drug before surgery; mark the patient’s chart and monitor blood pressure carefully during surgery. Sympathetic stimulation may alter the normal response to anesthesia, as well as recovery from anesthesia.
Monitor blood pressure, orthostatic blood pressure, pulse, rhythm, and cardiac output regularly, even with ophthalmic preparations, to adjust dose or discontinue the drug if CV effects are severe.
定期监测血压、直立性血压、脉搏、节律和心排血量，即使是使用眼药时，CV效应严重时调整剂量或停药
When giving phenylephrine intravenously, ensure that an alpha-blocking agent is readily available to counteract the effects in case severe reaction occurs; infiltrate any area of extravasation with phentolamine within 12 hours after extravasation to preserve tissue.
Arrange for supportive care and comfort measures, including rest and environmental control, to decrease CNS irritation; analgesics for headache to relieve discomfort; safety measures, such as use of side rails and assistance with ambulation if CNS effects occur, to protect the patient from injury; and protective measures if CNS effects are severe.
Provide thorough patient teaching about drug name, dose, and schedule for administration; technique for administration if appropriate; measures to prevent potential adverse effects such as voiding before taking the drug and use of bowel-training activities if constipation is a problem; safety measures such as avoiding driving and operating dangerous machinery if CNS effects occur and getting up and down slowly if orthostatic hypotension is an issue; warning signs of problems; and importance of monitoring and follow-up to improve compliance and ensure safe and effective use of the drug.
The client who is pregnant tells the clinic nurse that she has been using Preparation H (phenylephrine and cocoa butter), an OTC medication, for hemorrhoids. Which information should the nurse teach the client? Select all that apply.
A. “Apply the ointment after a bath but before drying the area.”
B. “Do not use the medication because of possible harm to the fetus.”
C. “Suppositories may be used up to four times a day for symptom relief.”
D. “Tucks (witch hazel) works better than Preparation H for hemorrhoids.”
E. “Avoid having a bowel movement for 3 hours after insertion of medication.”
奥医教育“在线自测”正式上线，复习练习、效果检验，奥医NCLEX-RN/ISPN题库一站完成。
答案 Answer
ANS: C, E Rationale:
C. The labeling directions for Preparation H state four times a day as part of the safe administration guidelines. The phenylephrine shrinks the size of the hemorrhoids and provides relief from the pain and burning, and the cocoa butter provides some emollient relief for expelling feces.
E. The client should avoid having a bowel movement for 1 to 3 hours after using the medication for maximum effectiveness.
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