NAME OF CLASSIFICATIO MECHANISM INDICATIONS CONTRAINDICATION ADVERSE EFFECTS SIDE EFFECTS

DRUG N OF ACTION Salbutamol and S Coughing

Combivent ipratropium Allergy to ipratropium headache Coughing
Generic Anti-asthmatic UDVs belong bromide car related nausea headache
Name: and for COPD Contain two to the family of medicines, e.g. Change in sense nausea
Ipratropium Preparations. active medications atropine. of taste Change in sense
+ Ingredients, known Fast, abnormal heart dizziness of taste
Salbutamol Ipratropium asbronchodilators rhythms dryness of mouth dizziness
Brand Name: bromide . (tachyarrhythmias). nervousness dryness of mout
Atrovent And salbutamol Together, they are Heart disease tremor nervousness
Sulphate, both used to treat characterized by Angioedema tremor
Dosage and of chronic thickening of the (swelling Angioedema
Frequency: Which are obstructive internal heart muscle of the face, lips, (swelling
Nebulization Bronchodilator pulmonary and a blockage inside or of the face, lips,
Q4 s disease the heart eyelids) or
Combivent (COPD), a chronic (hypertrophic bronchospasm, eyelids)
UDVs lung disease that obstructive paradoxical or bronchospasm,
Are used to makes it difficult cardiomyopathy). hypersensitivity paradoxical or
treat to This medicine is not induced(shortness hypersensitivity
people breathe. These recommended for of induced(shortne
suffering medications work children and breath; wheezing) of breath;
From chronic in adolescents under 12 chest discomfort wheezing)
Obstructive different ways to years of age, as there or chest discomfor
Pulmonary open the airways is no information pain or pain irregular
disease, and make regarding its safety irregular heartbeat
Who require breathing and efficacy in this heartbeat oropharyngeal
regular easier. age group. oropharyngeal edema (swelling
Treatment with Pregnancy edema (swelling of the mouth or
Ipratropium Breastfeeding of the throat) skin rash
and mouth or throat)
Salbutamol. skin rash NURSING
Salbutamol RESPONSIBI-
belongs TIES
To a group of >Instruct client t
Medicines Discontinue the
called use
Short-acting of Duavent and
beta 2 institute
Agonists. It appropriate
works by acting symptomatic
on receptors in therapy in cases
the lungs called of
beta 2 overdosage.
receptors. >Ipratropium
Stimulation of bromide-
these receptors salbutamol
causes the combination can
muscles in the produce
 airways to paradoxical
relax, allowing bronchospasm
the airways to that
open. can be life-
Ipratropium threatening If it
bromide is a occurs,
type of discontinue
medicine the preparation
known as an immediately and
antimuscarinic institute
bronchodilator. alternative
It works by therapy.
blocking
different types
of receptors,
called
muscarinic
receptors,
which are
found on the
muscle
surrounding
the airways in
the lungs.
Stimulation of
these receptors
by a natural
chemical called
acetylcholine
normally
causes the
muscle in the
airways to
contract,

NAME OF DRUG CLASSIFICATION MECHANIS INDICATIONS CONRAINDI ADVERSE/SIDE

Generic name: Sympathomimetic, M OF Bronchospasm in CATIONS EFFECTS
ALBUTEROL bronchodilator ACTION COPD/Asthma/allergi Tachydysrhythimias, Tremors,
(SALBUTAMOL) Beta 2 c reactions, known dizziness,
INHALER - ORAL agonist hyperkalemia. hypersensitivity. tachycardia.
(al-BUE-ter-ol) causing palpitations,
(sal-BUE-tah- smooth nervousness,
mol) muscle nausea,
relaxation in vomiting.
Brand name: bronchial hyperglycemia,
Proventil, tree increased BP.
Ventolin and
peripheral NURSING
Dosage: vasculature. RESPONSIBILITIE
Adult: 2.5 mg S
solution in
nebulizer over use minimal
10 doses for
minutes or 1-2 minimal periods,;
puffs/inhalations drug
90-180 mcg. tolerance can
Peds-same occur with
dosing. prolonged use
--maintain a beta-
Route: adrenergic
Inhalation blocker on
(nebulizer or standby in case
MDI) cardiac
arrhythmias
Frequency: occur.
2.5 mg/3mL -prepare solution
0.5% solution or for inhalation by
90 meg MDI. diluting 0.5 ml
6ORICULUR
0.5% solution
with 2.5 ml
normal saline;
deliver over 5-
15 minutes by
nebulization
-- do not exceed
recommended
dosage;
administer
pressurized
inhalation drug
forms during
second half of
inspiration,
because the
airways are open
wider and the
aerosol
distribution is
more extensive.
NCP ABOUT CASE SCENARIO
ASSESSMENT NURSING PLANNING NURSING RATIONALE EVALUATION
Subjective: DIAGNOSIS Short Term INTERVENTION •Rapid and SHORT TERM
•“Nahihirapan •Ineffective Goal: Independent shallow GOAL
akong gas exchange • After 4 Assessment: breathing • after 4
huminga at related to hours of •Assess respiratory patterns and hours of
Yung mga anxiety as nursing rate, depth, and effort, hypoventilation nursing
kamay ko evidenced by intervention and abnormal affect gas intervention
nanginginig. shortness of the patient breathing patterns. exchange. the goal was
”As verbalized breath and demonstrate Increased met shows:
by the pt. tingling of improved respiratory the patient
•Complaining fingers. ventilation rate, use of demonstrate
of shortness and accessory improved
of breath and INTERFERENCE adequate muscles, nasal ventilation
tingling in The pt. is oxygenation. flaring, and
fingers retired and abdominal adequate
•He had living alone. breathing, and oxygenation.
anxiety Long Term a look of panic
attacks Goal: •Note blood gas (ABG) in the patient’s Long term
before. Anxiety • After24 results as available eyes may be goal:
hours of and note changes. seen with •After 2days
Objective: nursing hypoxia. of nursing
• The pt.’s intervention: •Increasing intervention
breathing is Shortness of • Manifest PaCO2 and the goal was
shallow and breath and absence of decreasing met shows: •
rapid. tingling of shallow PaO2 are signs Manifest
ABG: fingers. breathing of respiratory absence of
•Ph=7.48 and tingling acidosis and shallow
•Paco2=28 of fingers. hypoxemia. As breathing
•Hco3=22 Impaired gas • Attain the patient’s and tingling
•PaO2=85 exchange. normal condition of fingers.
breathing deteriorates, • Attain
pattern. the respiratory normal
rate will breathing
decrease and pattern.
PaCO2 will • ABG result
begin to turns normal.
increase. Some
patients, such
as those with
COPD, have a
significant
decrease in
pulmonary
reserves, and
additional
THERAPEUTIC physiological
•Position patient with stress may
result in acute
head of bed elevated, respiratory
in a semi-Fowler’s failure.
position (head of bed
at 45 degrees when •Upright
supine) as tolerated. position or
semi-Fowler’s
position allows
increased
thoracic
capacity, full
descent of
EDUCATIVE diaphragm, and
•Encourage slow deep increased lung
breathing exercise. expansion
preventing the
abdominal
contents from
crowding.
•These
DEPENDENT technique
Assessment promotes deep
•Administer inspiration,
medications as which increases
prescribed. oxygenation
and prevents
atelectasis.

•The type
depends on the
etiological
factors of the
problem (e.g.,
antibiotics for
pneumonia,
bronchodilators
for COPD,
anticoagulants
and
thrombolytics
Therapeutic for pulmonary
•Administer embolus,
humidified oxygen analgesics for
through appropriate thoracic pain).
device (e.g., nasal
cannula or face mask
per physician’s order); •A patient with
chronic lung
 disease may
EDUCATIVE need a hypoxic
•Instruct family in drive to
complications of breathe and
disease and may hypo
importance of ventilate during
maintaining medical oxygen
regimen, including therapy.
when to call physician. •Knowledge of
•Maintain an oxygen the family
administration device about the
as ordered, attempting disease is very
to maintain oxygen important to
saturation at 90% or prevent further
greater. complications.

INTERDEPENDENT •Supplemental
oxygen may be
Assessment
required to
•Monitor chest x-ray
maintain
reports.
PaO2  at an
acceptable
level.

EDUCATIVE
•Chest x-ray
•Encourage or assist
studies reveal
with ambulation as
the etiological
per physician’s order.
factors of the
impaired gas
exchange.
THERAPEUTIC
Support family of
patient with chronic
•Ambulation
illness.
facilitates lung
expansion,
secretion
clearance, and
stimulates
deep breathing.
•Severely
compromised
respiratory
functioning
causes fear and
anxiety in
patients and
their families.
Reassurance
from the nurse
can be helpful.