ETHINYL ESTRADIOL

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(eth’in-il ess-tra-dye’ole)
Estinyl, Feminone
Classifications: hormones and synthetic substitutes; estrogen
Prototype: Estradiol
Pregnancy Category: X

NURSING IMPLICATIONS

Assessment & Drug Effects

• Check BP on a regular basis in patients with conditions that may be influenced by fluid retention (migraine, cardiac or kidney dysfunction, asthma, epilepsy, hypertension).
• Supplement pyridoxine (vitamin B₆) in patients on long-term therapy, especially if undernourished; levels are lowered by estrogens.

Patient & Family Education

• Be aware that risk of blood clot formation is high. Notify physician immediately of positive Homan’s sign (calf pain upon foot flexion) and the following symptoms of thromboembolic disorders: Tenderness, pain, swelling, and redness in extremity; sudden, severe headache or chest pain, slurring of speech; change in vision; sudden shortness of breath. If physician is not available, go to the nearest emergency room.
• Report severe abdominal pain and tenderness, or abdominal mass.
• Determine weight under standard conditions 1 or 2 times/wk and report sudden weight gain or other signs of fluid retention.
• Notify physician of yellow skin and sclera, pruritus, dark urine, and light-colored stools; history of jaundice in pregnancy increases the possibility of estrogen-induced jaundice. Estrogen therapy is usually interrupted pending clinical investigation.
• Abrupt withdrawal of vitamin C may lead to breakthrough bleeding; high vitamin C intake (e.g., 1 g/d) may increase ethinyl estradiol levels.
• Report symptoms of vaginal candidiasis (thick, white, curd-like secretions and inflamed congested introitus) to permit appropriate treatment.
• Note: Estrogen-induced feminization and impotence in male patients are reversible with termination of therapy.
• Decrease caffeine intake from sources such as tea, coffee, and cola; estrogenic depression of caffeine metabolism may cause caffeinism.
• Do not breast feed while taking this drug.

 

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• CORTICOSTEROIDS NURSING IMPLICATIONS Assessment & Drug Effects Establish baseline and continuing data on BP, weight, fluid and electrolyte balance, and blood glucose. Lab tests: Periodic serum electrolytes blood glucose, Hct and Hgb, platelet count, and WBC with differential. Monitor for
• HYDROCORTISONE (hye-droe-kor’ti-sone) Aeroseb-HC, Alphaderm, Cetacort, Cortaid, Cort-Dome, Cortenema, Cortril, Dermacort, Dermolate, Hydrocortone, Hytone, Proctocort, Rectocort , Synacort HYDROCORTISONE ACETATE Anusol HC, CaldeCort, Carmol HC, Colifoam, Cortaid, Cortamed, Cort-Dome, Cortef Acetate, Corticaine, Cortifoam, Cortiment , Epifoam, Hydrocortone Acetate HYDROCORTISONE CYPIONATE Cortef Fluid HYDROCORTISONE SODIUM PHOSPHATE Hydrocortone Phosphate HYDROCORTISONE SODIUM SUCCINATE A-Hydrocort, Solu-Cortef HYDROCORTISONE VALERATE Westcort Classifications: skin and mucous membrane agent; antiinflammatory; synthetic hormone; adrenal corticosteroids; glucocorticoid; mineralocorticoid Pregnancy Category: C NURSING IMPLICATIONS Assessment
• VASOPRESSIN INJECTION (vay-soe-press’in) Pitressin Classifications: hormones and synthetic substitutes; pituitary (antidiuretic) Pregnancy Category: X NURSING IMPLICATIONS Assessment & Drug Effects Monitor infants and children closely. They are more susceptible to volume disturbances (such as sudden reversal of polyuria) than adults. Establish baseline data of BP, weight, I&O pattern and
• PREDNISONE (pred’ni-sone) Apo-Prednisone , Deltasone, Meticorten, Orasone, Panasol, Prednicen-M, Sterapred, Winpred  Classifications: hormones and synthetic substitutes; adrenal corticosteroid; glucocorticoid Pregnancy Category: C   NURSING IMPLICATIONS Assessment & Drug Effects Establish baseline and continuing data regarding BP, I&O ratio and pattern, weight, and sleep pattern. Start flow chart as reference for planning individualized
• DIGOXIN (di-jox’in) Lanoxicaps, Lanoxin Classifications: cardiovascular agent; cardiac glycoside; antiarrhythmic Pregnancy Category: A NURSING IMPLICATIONS Assessment & Drug Effects Be familiar with patient’s baseline data (e.g., quality of peripheral pulses, blood pressure, clinical symptoms, serum electrolytes, creatinine clearance) as a foundation for making assessments. Lab tests: Baseline and