Cam Therapies, Vitamins, Otc Student

8/2/2019 Cam Therapies, Vitamins, Otc Student

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OTC MEDS,

Herbal & Dietary Supplements,

VITAMINS and MINERALS,

ENTERAL and PARENTERAL DRUG

ADMINISTRATION

NURS 2411

Elizabeth Pratt, MSN, RNC

2010

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_____ of all medications used in the US

Only_____ of the population will consult an MD

before using

Short-term use only

Increases out of pocket expenses

Insurance carriers dont cover the cost if no

prescription required

.

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Over the Counter (OTC) Meds


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Problems with OTC and Alternative

Treatments

Mask the signs and symptoms of

Interact with prescription drugs

.

Taken in greater than recommended dose ->

Surgery clients should stop taking all herbal

supplements 2-3 weeks prior to

If not, bring herbal container for anesthesiologist

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Alternative Therapy Drawbacks

Active ingredient not tested by the

Incidental ingredients are unknown

Patients do not always mention these

therapies to their health care providers

Prescription drug + alternative therapy =

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Controls for Alternative Therapy

Herbal medications and alternative therapiesare not controlled or tested by the FDA

.

Advertisement is not restricted because they

are considered dietary supplements

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Off-Label Medications

Definition

The use of a drug for an indication that is not

approved by the

Occurrence

Commonly takes place in groups of patientsfor whom there is little premarketing testing

Used with 6


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HERBAL SUPPLEMENTS

Come from leaves, bark, berries, roots, gums,

seeds, stems and flowers of plants

Breastfeeding increase supply of milk by

using

Blessed Thistle

Fennel

Nettle Leaf

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ST JOHNS WORT

Not FDA approved

Used to help with depressed moods

Anxiety and/or sleep disorders too

Interacts with anticoagulants and digoxin

May make

Affects other antidepressants

Increases sensitivity to

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Garlic

interferes with hypoglycemia therapy

Cranberry

decreases renal elimination of drugs

Chamomile

increases risk for bleeding w/ other anticoagulants

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BUT I

DONT

LIKEPILLS

FOODS HAVE

VITAMINS!


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Carrot - Enhances blood flow to and

function of the eyes.

Tomato - antioxidants to benefit

heart and fight against certain types

of cancers.

Grapes - help heart and blood


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Walnut - looks like a little brain; helps

develop neuron-transmitters for brain

function.

Kidney Beans Heal and help

maintain kidney function.

Celery, Bok Choy, Rhubarb contain

23% sodium as do bones; these foods

replenish the skeletal needs of the body

specifically targeting bone strength


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Avocadoes, Eggplant and Pears - target the

health and function of the womb and cervix of

the female. Woman eating one avocado a week

balances hormonessheds unwanted birth weight

prevents cervical cancers

Sweet Potatoes - Balances the glycemicindex of diabetics.

Figs -Increase the mobility of male

sperm and the numbers of sperm

to overcome male sterility.


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Olives Assist the health and function of

the ovaries.

Oranges, Grapefruits, and other Citrusfruits - Assist the health of the breasts

Onions and Garlic - clear waste materials

from bodys cells and produce tears.


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Vitamins

Uses Treat vitamin deficiency

Dietary supplements

Specific therapy

Most common adverse effect

GI upset Assess patients general condition


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Vitamin Patient Teaching

Avoid OTC preparations that contain thesame vitamins

Notify MD if unable to tolerate vitaminsdue to GI upset

Teach patient which medications cannotbe taken at the same time with a specificvitamin

Recommend dose to be takenotherwise

client might guess


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VITAMIN INTERACTIONS

E & K CF patients check with MD prior to use

Antacids reduce absorption of vitamin

B12, B6, & C

Tobacco and alcohol reduce vitamin absorption

B6 with oral contraceptives = depression

? PMS

Iron

Alcohol increases iron use

Full glass H20 to prevent constipation

C - use cautiously if prone to kidney stones


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MEGADOSING

Used for

Health promotion/maintenance

Patients with cystic fibrosis

Treating various illnesses Cancer patients

A drug

B3 in large doses decreases triglycerides

Risk toxic accumulation

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ENTERAL DRUGS

Oral Sublingual

Buccal

Liquid Capsules/Tablets

Nasogastric or Gastrostomy Tube

Rectal Give on empty or full stomach?

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So before you give Special assessments

i.e. Lanoxin take 1 minute apical pulse prior to admin.

Swallowing difficulties

Crush one tablet at a time (if it can be)

Exception: Enteric , sustained-release, or long-actingdrugs

Mix in small amount soft food (if not NPO)

Clean the crushing device

Proper position

Excess liquid in cup do not pour back in

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Use calibrated oral syringe for liquid medications

Med through tube confirm correct patient

position and verify tube placement If med to be given on empty stomach stop tube feeding

for usually 30 minutes prior to administration

Amount of fluid for flushing.30 mL

Rectal Meds Contraindications: rectal bleeding/diarrhea

Dont divide dose

Left side with privacy/lubrication

Pt. can request self-administration (remind patients toremove the wrapper)

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PN contraindications

Patient with known allergies to any of thecomponents

PN cautions

Patients w/ unstable cardiovascular status May cause cardiac overload

Patients w/ unstable fluid and electrolyte status

Negative reaction to sudden changes


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SOLUTIONS

Dextrose provides calories and fluids

Saline

hydration 0.9% NS to prime blood tubing and dilute

medications

Parenteral Nutrition


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Use Total Parenteral Nutrition (TPN) to

Administer

Essential proteins

Amino acids

Carbohydrates Vitamins and Minerals

Trace elements

Lipids

Fluids


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PN Adverse Effects IV site irritation or infection

Extravasation of fluid in to the tissues

Fluid volume overload and vascular problems

Electrolyte imbalances

Protein aggregation

Pneumothorax, air emboli

Nausea

Gallstone development


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PN IMPLEMENTATION

Monitor IV or central line d/c site if signs/symptoms of infection or

extravasation occur

TPN Administration guidelines:

Solutions in fridge till ready to use

Check for precipitates prior to using

Change bag after

Use filters


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PN Assessment/Evaluation

Insertion site

Skin hydration

Orientation and Affect Height and Weight

Pulse, BP, Respirations

CBC w/ diff

Glucose levels


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PN ADMINISTRATION

Comfort Measures

Tubing under pillow to decrease

Teaching Plan

what to expect

adverse effects

follow-up tests required

notify MD. D/C PN only after alternate source of

nutrition has been established.

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Cam Therapies, Vitamins, Otc Student