Nursing process nursing diagnosis impaired comfort

Nursing Process: Nursing Diagnosis
•
Impaired Comfort related to IV administration
of amphotericin B
•
Risk for Ineffective Tissue Perfusion: Renal
related to adverse reactions of antifungal
drugs

Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Nursing Process: Planning
Nursing Process: Planning
•
The expected outcome depends on the
reason for administering the antifungal drug
but includes an optimal response to therapy:
–
Patient relates to the management of
adverse reactions and has an
understanding of and compliance with the
prescribed treatment regimen

Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Nursing Process: Implementation
Nursing Process: Implementation
•
Promoting an optimal response therapy:
–
Amphotericin B: Protect IV solution from
exposure to light; administer immediately
after the drug is reconstituted; renal
damage is the most serious adverse
reaction to the use of amphotericin B—
hence, serum creatinine levels and BUN
levels are checked frequently

Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Nursing Process: Implementation (cont.)
Nursing Process: Implementation (cont.)
•
Promoting an optimal response therapy
(cont.):
–
Topical antifungal infection preparations:
Inspect the area at the time of each
topical application; if administered
vaginally, question the patient regarding
any discomfort or other sensations
experienced; evaluate and chart the
patient’s response to therapy daily

Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Nursing Process: Implementation (cont.)
Nursing Process: Implementation (cont.)
•
Monitoring and managing patient needs:
–
Impaired comfort: Medication
administration
•
Use precautions when administering
amphotericin B intravenously; inform
before the drug is given that the side
effects can be uncomfortable; provide
warm blankets; reassure that the
medications administered before the
antifungal are to help ease the reaction

Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Nursing Process: Implementation (cont.)
Nursing Process: Implementation (cont.)
•
Monitoring and managing patient needs
(cont.):
–
Risk for ineffective tissue perfusion: Renal
•
Carefully monitor fluid intake and
output, serum creatinine levels, and
BUN levels
•
Gerontologic alert: Fluconazole

Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Nursing Process: Implementation (cont.)
Nursing Process: Implementation (cont.)
•
Educating the patient and family:
–
For topical antifungal drugs include the
importance of cleanliness and using the
correct ointment amount in the
prescribed frequency in the teaching
plan
–
For ringworm infections advise keeping
towels and facecloths used for bathing
separate from those of other family
members

Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Nursing Process: Implementation (cont.)
Nursing Process: Implementation (cont.)
•
Educating the patient and family (cont.):
–
Teach drug-specific points for the
following drugs
•
Flucytosine; griseofulvin; ketoconazole;
itraconazole; miconazole