Administration Of The Pethidine To Jordan †MyAssignmenthelp.com

Questions: 1.This response is to include the nursing responsibilities and associated rationales prior to the administration of the pethidine to Jordan, the legal nursing responsibilities and associated rationales related to the administration of pethidine to Jordan, and the nursing responsibilities and associated rationales after administering pethidine to Jordan. 2.Describe the structural and functional changes that occur in the patheogenesis of Crohns disease that led to Jordans weight loss and the development of the stricture in Jordans ileum. 3.Describe the characteristics of the intravenous fluid that was ordered for Jordan, and the rationale, related to Jordans specific fluid balance status, for the administration of this intravenous fluid to Jordan. Answers: 1.Pethidine, is a synthetic narcotic analgesic. It is known to compete for the same receptors in the central nervous system as morphine. It poses the risk of addiction, and is comparable to morphine with respect to sedative and tranquilizing effects. However, it is known to produce respiratory depression and analgesia of shorter duration, and induces less smooth muscle spasms (WHO, 2017). It is preferred over morphine for managing inflammatory bowel disorders. The followingnursing responsibilities and rationales are suggested for Pithidine (Perry, Potter, Ostendorf, 2015): Nursing responsibilities and associated rationales prior administration of Pethidine: Prior to administration it the nurse should perform an assessment for any possible adverse reactions. It is also necessary to pay attention to the patients medical history including any allergies, renal, mental, biliary, and any other disorders. Also, the nurse should take into account the physiological laboratory results including CBC, creatinine, liver function tests, and electrolytic balance. It is also imperative for the nurses to obtain the patients drug history so as to determine any possible adverse interactions with drug and any other allergic reactions. Hence, the importantnursing responsibilities involve: Check for drug or herbal interactions Check for allergies Assess baseline physiologic parameters Nursing responsibilities and associated rationales related to administration of Pethidine During drug administration of Pithidine the nurses need to monitor patients vital signs, such as cardiac output, depth and rate of respiration and pulse oximetry as opioids tends to interact with brain receptors, and central venous pressure. The nurses should monitor liver enzyme activity and observe the patient for any signs of abdominal distention, rigidity, and tenderness. It is also important to look for any possible side effects such as light-headedness, dizziness, sedation, nausea, sweating, hypothermia and vomiting. The drug may reduce peristaltic activity, resulting in constipation. The nurses need to stay with the patient till the medication has been consumed, so as to ensure the medication has been taken, look for any immediate adverse affects, and provide the necessary assistance. The nurses also need to monitor the neurological status, and interview the patient about pain. The nurses also need to respect the patients refusal of medication, and need to take action accordin gly in case of refusal. However, being an opioid, Pithidine runs the risk of development of dependence, and tolerance to desired effects. Therefore, the dosage consumption should be kept under supervision. Nursing responsibilities and associated rationales after administration of Pethidine Post administration it is the responsibility of the nurse to properly document the administration of medication. The data regarding patients response to drug treatment needs to be documented. The patient needs to be enquired to note any decrease in symptoms for which the medication has been prescribed. The evaluation process involves monitoring for evidences of any therapeutic effects, adverse reactions, side effects, and other physical responses such as heart rhythm, urine output, and blood pressure. The nurses also need to monitor the injection sites for any inflammation, numbness, bleeding, pain or bruise. The nurses also need to evaluate the patients understanding of medication and self administration. 2. Weight loss is one the common symptoms of Crohns disease, which is associated with inflammation in ileum and jejunum. Inflammation in ileum results in discomfort, due to which the patients eat less. The bowel lumen area thus becomes partially obstructed and inflamed due to which the patients lose weight (Hopkins Medicine, 2013). In context of the given patient, Jordan, presents development of stricture which has led to bowel obstruction in his terminal ileum, due to which he is not able to intake varied diet. Due to such complication the patient has lost weight. Development of stricture is the characteristic feature of Crohns disease. The stricture development has been remarked as a sign of efforts of the gastrointestinal tract to heal itself in case of an injury. However, in case of ineffective healing of the organ, the tissue repair precedes maintenance of organ function. This paves way for the formation of strictures, presents large number of smooth muscles cells along with large amounts of collagen. The fibroblasts migrate and proliferate in the area of inflammation, leading to production of collagenous matrix, a characteristic feature of wound healing process. However, in case of chronically inflamed ileum in Crohns disease, the tissue remodelling results in irreversible changes in the smooth muscles phenotype, and the collagen cross linking. The chronicity of inflammation is thus majorly responsible for loss of mucosal compliance, contraction, and mural thickening (Chang et al., 2015; Graham, 1995). This accumulation of abnormal collag en results on symptoms of obstruction which causes narrowing of the lumen, and ultimately causes weight loss. 3. Hartmanns solution was ordered for Jordan. It consists of lactated Ringers solution, named after the US paediatrician who used lactate as a buffer so as to prevent acidosis in septic children. The Hartmanns solution is used for peri-operative maintenance, as the lactate is metabolized to bicarbonate (Svensn Rodhe, 2013). The active ingredients consist of sodium chloride, sodium lactate, calcium chloride dehydrate, and potassium chloride. This multiple electrolyte intravenous solution is meant for restoration of the electrolytic balance in the body, and hydration. This combination of the multiple electrolytic solutions with sodium lactate acts as an alkalinising agent, and helps normalize physiological pH. Sodium being a major cation of extracellular fluid helps maintain the osmotic pressure of body fluids, chloride a major anion of extracellular fluid complements sodium cation maintain acid base balance, electrodynamic character and isotonicity of cells. Potassium a major cation of extracellular fluid, along with calcium also helps maintain fluid composition in body and cell membrane and capillary permeability (Baxter Health Care, 2014). Hence, administration of Hartmanns solution proved to be essential for preventing dehydration, maintain electrolyte imbalance, as the patient is not capable of tolerating oral fluids. References: Baxter Health Care. (2014). Compound sodium lactate (Hartmanns) and modified Hartmanns solution intravenous infusion. Retrieved March 19, 2018, from https://www.baxterhealthcare.com.au/downloads/healthcare_professionals/cmi_pi/compound_sodium_lactate_pi.pdf Chang, C. W., Wong, J. M., Tung, C. C., Shih, I. L., Wang, H. Y., Wei, S. . (2015). Intestinal Stricture in Crohns Disease. Intestinal Research, 13(1), 1926. Graham, M. F. (1995). Pathogenesis of Intestinal Strictures in Crohns Disease-An Update. Inflammatory Bowel Diseases, 1, 220227. Hopkins Medicine. (2013). Crohns Disease. Retrieved March 19, 2018, from https://www.hopkinsmedicine.org/gastroenterology_hepatology/_pdfs/small_large_intestine/crohns_disease.pdf Perry, A. G., Potter, P. A., Ostendorf, W. (2015). Nursing Interventions Clinical Skills. Elsevier Health Sciences. Svensn, C., Rodhe, P. (2013). Intravascular volume replacement therapy. In Pharmacology and Physiology for Anesthesia (pp. 574592). Elsevier Health Sciences. WHO. (2017). Essential medicines and health products information portal a World Health Organization resource. Retrieved March 17, 2018, from https://apps.who.int/medicinedocs/en/d/Jh2929e/7.2.html