Page 429 - Critical Care Nursing Demystified

414 CRITICAL CARE NURSING DeMYSTIFIED

5 TABLE 9–5 Medications That Can Be Used in Hematologic Needs (Continued)

Medication Action Uses Precautions
Intropin Increases BP Used for 1. Fluid resuscitation
(dopamine) by systemic hypovolemic should be
vasoconstriction shock implemented before
dopamine
2. Check the VS
frequently during
initial therapy then
every 15 minutes
thereafter
Drotrecogin Severe sepsis with Combats 1. Check frequently for
alpha (Xigris) evidence of three thrombosis, bleeding (epistaxis,
Activated or more SIRS inflammation, hematemesis,
protein C criteria or and fibrinolysis hematuria,
evidence of MOSD in septic ecchymoses, and
shock hematomas)
Prevents 2. Monitor baseline Hgb
secondary and Hct, coagulation
organ profiles, and
dysfunction urinalysis
3. May prolong aPTT, Downloaded by [ Faculty of Nursing, Chiangmai University 5.62.158.117] at [07/18/16]. Copyright © McGraw-Hill Global Education Holdings, LLC. Not to be redistributed or modified in any way without permission.
so not a reliable
indicator of clotting
abilities
4. Contraindicated in
hypersensitivity
to drug, active
internal bleeding,
hemorrhagic stroke
(within 3 months),
recent (3 months)
intracranial or spinal
surgery or trauma;
use of epidural
catheter; intracranial
tumor or mass lesion
5. Further evidence of
effectiveness is
required before
it becomes the
standard of care