Pharmacology for Dyspnea - Crackles/Rales -myassignmenthelp.com

Question: Discuss about thePharmacology for Dyspnea, Crackles/Rales and Hypertension. Answer: The two considerations the nurse would keep in mind regarding administration of albumin are as follows- The nurse is supposed to monitor vital signs of the patients before administration of albumin. In addition, monitoring of CVP, and intake and output before and throughout therapy is crucial. In case the patient is found to suffer from fever, hypotension or tachycardia, the infusion is to be stopped, and the physician is to be noted immediately. The nurse is supposed to carry out an assessment for the signs of vascular overload. Such a condition is demonstrated by elevated CVP, dyspnea, crackles/rales, hypertension, and venous distension after administration of albumin (Black, 2016). If the patient is suffering from the concurrent condition of severe renal failure, the nurse might question the order for albumin. According to Caironi et al., (2014) albumin is to be used with caution in patients who are suffering from renal failure as there is a high chance of possible accumulation of aluminum in the body. Albumin has been found to be having trace amounts of aluminum which when accumulated in patients suffering from chronic renal insufficiencies leads to toxic manifestations. Such manifestations include vitamin D-refractory osteodystrophy, hypercalcemia, anaemia, and severe progressive encephalopathy. The potential risk is to be considered in regards to the anticipated benefits that the patient would receive. Increase in blood pressure and blood volume would indicate that the albumin administration has been successful. Further, the urinary output would be increased that is a reflection of mobilization of fluid from extravascular tissues. Albumin infusion provides colloidal oncotic pressure that is helpful in mobilizing fluid into the intravascular space from the intravascular tissues. Bodhi is to be assessed for conditions such as a headache, fluid overload, hypertension, increased salivation, tachycardia, vomiting, nausea, back pain, chills, flushing and fever. Serum sodium levels for the patient are to be monitored thoroughly. The rationale is that higher concentration of serum sodium levels might be observed in the patient after administration of albumin. Infusion of serum albumin might lead to false higher concentration of alkaline phosphatase levels. In addition, hematocrit and hemoglobin levels are to be determined (Caironi et al., 2015). Bodhi is also to be explained about the purpose of administering albumin. He is also to be instructed to report signs and symptoms of hypersensitivity reactions if suffered by him. Most importantly, he is to be educated to address his condition of impaired liver functioning. Bodhi has a history of alcoholism, and therefore he is to be educated to quit alcohol consumption. The association between alcoholism and liver functioning impairment is to be explained to the patient. Liver injury is known to be a result of direct toxicity due to metabolic by-products of alcohol and by inflammation caused as a result of these byproducts. The patient is also to be educated about the importance of maintaining a diet plan. Protein intake is to be restricted to the patient in addition to decreased salt consumption. Self-care for seeping fluids is important in order to reduce the risk of infection (Butcher et al., 2018). References Black, B. (2016).Professional Nursing-E-Book: Concepts Challenges. Elsevier Health Sciences. Butcher, H. K., Bulechek, G. M., Dochterman, J. M. M., Wagner, C. (2018).Nursing Interventions classification (NIC)-E-Book. Elsevier Health Sciences. Caironi, P., Langer, T., Gattinoni, L. (2015). Albumin in critically ill patients: the ideal colloid?.Current opinion in critical care,21(4), 302-308. Caironi, P., Tognoni, G., Masson, S., Fumagalli, R., Pesenti, A., Romero, M., ... Iapichino, G. (2014). Albumin replacement in patients with severe sepsis or septic shock.New England Journal of Medicine,370(15), 1412-1421.