Professional Documents
Culture Documents
2 ● Monitor intake and output ratios and daily weights. Observe patient for peripheral
edema, steady weight gain, rales/crackles, or dyspnea. Notify physician or other
els may bepwhen used with phenytoin, phenobarbital, or rifampin. Mayqrisk health care professional should these occur. PDF Page #2
of tendon rupture when used with fluoroquinolones. ● Children should have periodic evaluations of growth.
● Cerebral Edema: Assess for changes in level of consciousness and headache
Route/Dosage throughout therapy.
PO, IM, IV (Adults): Anti-inflammatory— 0.75– 9 mg daily in divided doses q 6– ● Lab Test Considerations: Monitor serum electrolytes and glucose. May cause
12 hr. Airway edema or extubation— 0.5– 2 mg/kg/day divided q 6 hr; begin 24 hr hyperglycemia, especially in patients with diabetes. Monitor hematologic values,
prior to extubation and continue for 24 hr post-extubation. Cerebral edema— 10 serum electrolytes, and serum and urine glucose in patients on prolonged ther-
mg IV, then 4 mg IM or IV q 6 hr until maximal response achieved, then switch to PO apy. May causepWBC counts. May causepserum potassium and calcium andq
regimen and taper over 5– 7 days. serum sodium concentrations.
PO, IM, IV (Children): Airway edema or extubation— 0.5– 2 mg/kg/day divided ● Guaiac test stools. Promptly report presence of guaiac-positive stools.
q 6 hr; begin 24 hr prior to extubation and continue for 24 hr post-extubation. Anti- ● May causeqserum cholesterol and lipid values. Maypuptake of thyroid 123I or
131
inflammatory— 0.08– 0.3 mg/kg/day or 2.5– 10 mg/m2/day divided q 6– 12 hr. I.
Physiologic replacement— 0.03– 0.15 mg/kg/day or 0.6– 0.75 mg/m2/day divided ● Suppresses reactions to allergy skin tests.
q 6– 12 hr. ● Periodic adrenal function tests may be ordered to assess degree of hypothalamic-
PO (Adults): Suppression test— 1 mg at 11PM or 0.5 mg q 6 hr for 48 hr. pituitary-adrenal axis suppression in systemic and chronic topical therapy.
IV (Children): Chemotherapy induced emesis— 5– 20 mg given 15– 30 min be- ● Dexamethasone Suppression Test: To diagnose Cushing’s syndrome, obtain
fore treatment. Cerebral edema— Loading dose 1– 2 mg/kg followed by 1– 1.5 mg/ baseline cortisol level; administer dexamethasone at 11 PM and obtain cortisol lev-
kg/day divided q 4– 6 hr for 5 days (not to exceed 16 mg/day); then taper over 1– 6 els at 8 AM the next day. Normal response is a decreased cortisol level.
● Alternative method: Obtain baseline 24-hr urine for 17-hydroxycorticosteroid
wk. Bacterial meningitis— 0.6 mg/kg/day divided q 6 hr x 4 days (start at time of
(OHCS) concentrations, then begin 48-hr administration of dexamethasone. Sec-
first antibiotic dose). ond 24-hr urine for 17-OHCS is obtained after 24 hr of dexamethasone.
IV, PO (Adults): Chemotherapy induced emesis— 10– 20 mg given 15– 30 min
before each treatment or 10 mg q 12 hr on each treatment day. Delayed nausea/ Potential Nursing Diagnoses
vomiting— 4– 10 mg PO 1– 2 times/day for 2– 4 days or 8 mg PO q 12 hr for 2 days, Risk for infection (Side Effects)
then 4 mg PO q 12 hr for 2 days or 20 mg PO 1 hr before chemotherapy, then 10 mg Disturbed body image (Side Effects)
PO q 12 hr after chemotherapy, then 8 mg PO q 12 hr for 2 days, then 4 mg PO q 12 hr Implementation
for 2 days. ● If dose is ordered daily or every other day, administer in the morning to coincide
IS (Adults): 0.4– 6 mg/day. with the body’s normal secretion of cortisol.
NURSING IMPLICATIONS ● Periods of stress, such as surgery, may require supplemental systemic corticoste-
roids.
Assessment ● PO: Administer with meals to minimize GI irritation.
● Indicated for many conditions. Assess involved systems before and periodically ● Tablets may be crushed and administered with soft food, chocolate syrup, or fluids
during therapy. for patients with difficulty swallowing.
● Assess for signs of adrenal insufficiency (hypotension, weight loss, weakness, nau- ● Use calibrated measuring device to ensure accurate dosage of liquid forms.
sea, vomiting, anorexia, lethargy, confusion, restlessness) before and periodically ● IM: IM doses should not be administered when rapid effect is desirable. Do not
during therapy. dilute with other solution or admix.
䉷 2015 F.A. Davis Company CONTINUED
Name /bks_53161_deglins_md_disk/dexamethasone 02/12/2014 01:20PM Plate # 0-Composite pg 3 # 3
4
● Instruct patient to inform health care professional if symptoms of underlying dis- PDF Page #4
ease return or worsen.
● Advise patient to carry identification describing disease process and medication
regimen in the event of emergency in which patient cannot relate medical history.
● Explain need for continued medical follow-up to assess effectiveness and possible
side effects of medication. Periodic lab tests and eye exams may be needed.
Evaluation/Desired Outcomes
● Decrease in presenting symptoms with minimal systemic side effects.
● Suppression of the inflammatory and immune responses in autoimmune disor-
ders, allergic reactions, and neoplasms.
● Decrease in intracranial pressure.
● Management of symptoms in adrenal insufficiency.
Why was this drug prescribed for your patient?