Question

3. Pick a medication of your choice. a. Describe the condition it is used for. b. What are the expected results? c. What are the side effects? d. What are the contra-indications for use? e. What are the safety considerations? 4. Describe how to instill 2 ear drops into a child's left ear. 5. What kind of information would you report to your supervisor about medications in a client's home that could indicate a problem? - 6. For clients using oxygen therapy - list 3 (three) things you would do for the client keeping safety in mind 7. Oxygen is one of the ingredients needed for a fire. List 2 (two) safety precautions take when your client is receiving oxygen. 8. What is the difference between how hot and cold therapy work? Give an example to each of what you would use it for. 9. If your client is diabetic and has an ingrown toenail and you are applying warm soak: his foot - what are 2 (two) signs that would indicate to you that there is a problem you would need to report to the nurse? 10. After the foot soak, the client asks you to trim his nails - what is your response an 11. Your client is receiving IV therapy. List 2 (Two) observations under each of the fo categories that you would report to your supervisor as being a problem. a. Site (local) b. Client (systemic)

Answer 1

3. Digoxin

Digoxin is classified as a cardiac glycoside which comes under the brand name Lanoxin and Lanoxicaps.

a. Digoxin is used to treat congestive heart failure, atrial flutter,Paroxysmal atrial tachycardia and atrial fibrillation.

b.  Digoxin reduce heart rate and Increase cardiac output

c The most frequent side effects of Digoxin includes fatigue, bradycardia, anorexia, nausea, vomiting and other common side effects are diarrhea, ECG changes, AV block, SA block, blurred vision, yellow or green vision, and thrombocytopenia. The life threatening side effect is arrhythmias and elcetrolyte imbalances are seen in digoxin toxicity.

d. Digoxin is contraindicated for patients with allergy or hypersensitivity to digoxin, Constrictive pericarditis, AV block, Uncontrolled ventricular arrhythmias, Idiopathic hypertrophic subaortic stenosis, severe mitral valve stenosis, hyperthyroidism, hypothyroidism, Wolff-Parkinson-White syndrome, Adams-Stokes syndrome.

e.The safety considerations are

1.Monitor apical pulse before administration and withhold if pulse less than 60 bpm.

2.Monitor ECG changes for bradycardia and arrythmias.

3.Monitor serum electrolyte levels for potassium, magnesium, and calcium.

4.Monitor renal and hepatic function especially in patients with Renal disease, renal failure, renal impairment and hepatic disease.

5. Monitor serum digoxin level (Therapeutic serum digoxin levels range from 0.5–2 ng/mL) periodically as digoxin has low therapeutic index and can cause toxicity.

6. Monitor digoxin use in geriateric patients for toxicity and titration of dosage.

4. Administration of ear drops

• Wash hands
• clean the outer ear with a facecloth.
• warm the medication to body temperature by holding the bottle inside the palm of hand for a few minutes.
• Let the child lie down on right side or sit down in a way that the left ear is faced up.
• Place the wrist of the hand on the cheek or head and place the dropper/nozzle above the childʼs left ear canal.
• Gently pull the outer flap of the left ear(downward and backward for child less than 3 years and upward and backward child more than 3 years) to open the ear canal.
• Squeeze the dropper slowly and firmly to release two drops of medicine on the side of the ear canal.
• Gently rub the skin in front of the ear to help the drops to run into the ear canal.
• Keep the child in the same position for about 1-2 minutes so the medicine will be absorbed.
• Place a soft cotton plug in the childʼs left ear to avoid leakage of the medicine.
• Replace and tighten the cap of the medication bottle.
• Wash hands and document the procedure.