NURS 1566 Clinical Form 3: Clinical Medications Worksheets (You will need to make additional copies of these forms

) Generic Name Trade Name Combivent Albuterol Peak
60-90 min

Classification
bronchodilators

Dose 103 mcg

Route INH

Time/frequency TID

Onset
5-15 min

Duration
3-6 hr

Normal dosage range 2 inhalations q 4-6 hrs or 2 inhalations 15 minutes before exercise For IV meds, compatibility with IV drips and/or solutions N/A Nursing Implications (what to focus on) Contraindications/warnings/interactions
Excess inhaler use may lead to tolerance and paradoxical bronchospasm

Why is your patient getting this medication Hypoxia Mechanism of action and indications (Why med ordered)
binds to beta 2 adrenergic receptors in airway smooth muscle, leading to activation of adenyl cyclase and increased levels of cAMP. Increases in cAMP kinases, which inhibit the phosphorylation of myosin and decrease intracellular calcium, Decreased calcium relaxes smooth muscle airways with subsequent bronchodilation. Used as a bronchodilator.

Common side effects
nervousness, restlessness, tremor, headache, chest pain, palpitations

Interactions with other patient drugs, OTC or herbal medicines (ask patient specifically) Risk of hypokalemia increased with concurrent use of potassium-losing diuretics, Use with caffeine increases stimulant effect.

Lab value alterations caused by medicine
May cause transient ↓ in serum potassium concentrations with nebulization or higher-than-recommended doses

Be sure to teach the patient the following about this medication
Instruct patient to contact health care professional immediately if shortness of breath is not relieved by medication or is accompanied by diaphoresis, dizziness, palpitations, or chest pain Inform patient that albuterol may cause an unusual or bad taste and to rinse mouth after use

Nursing Process- Assessment (Pre-administration assessment)
Assess lung sounds, pulse, and blood pressure before administration and during peak of medication. Note amount, color, and character of sputum produced

Assessment Why would you hold or not give this med?
Observe for paradoxical bronchospasm (wheezing). If condition occurs, withhold medication and notify physician or other health care professional immediately

Evaluation Check after giving
Prevention or relief of bronchospasm

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