Essay Example. John's Treatment Cith Levophed (Norepinephrine)

John Philips is a 37-year-old male. He is divorced and currently unemployed. He lives in an old town with his cousin Paul Philips, who is also his contact person in case of an emergency. His blood type is B+, and he is on Family Health insurance. He was in a car accident and was taken to an emergency while unconscious with low blood pressure and having lost a lot of blood due to a deep wound on his left arm.

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Past Health History

John was hospitalized for two weeks .and was diagnosed with low blood sugar. Hypoglycemia was stabilized. Later, He was put on a diabetic management program. John visited a psychiatric hospital. He was diagnosed with excess stress, which resulted from his divorce, marital status, and shortly after a dismissal letter from his workplace. He was informed about stress-coping ways.

Medical Diagnosis

John had a cut injury on his left arm during the car accident, which caused him to lose blood volume, causing his low blood pressure.

Nursing Diagnosis

John's marital issues and his lack of income stressed him, which made him not adhere to diabetic management and, in turn, caused his dizziness while driving.

Medication Overview

Levophed is classified as a Vasoconstrictor. John was injected with Levophed (Norepinephrine) as a fringe vasoconstrictor to increase systolic contractions' strength and effectiveness (Cunha, n.d.). After that, he was given pints of blood as his arm was being operated on, then levophed was infused afterward to help with blood pressure.

Dosing Guidelines

John had intravenous infused of 4mg of Levophed that had 1,000ml of 5 percent solution containing dextrose added to it. A plastic catheter was inserted through a suitable bore needle, centrally well advanced into his vein. A metering device was put for accuracy in measuring the rate of flow in drops per minute. The average dose ranges from 0.5ml to 1ml per minute (Multon, 2019). His Blood pressure was raised no higher than 40mmHg below the pre-existing pressure. At the same time, his blood pressure was monitored continuously after a couple of minutes.

Contradictions

Levophed should not be administered to patients with low blood volume deficiency except as an emergency. It should be given after completion of blood volume therapy. If administered continuously when the blood volume is small, to maintain blood pressure, it can cause the following conditions; reduced systemic bloodstream, muscle hypoxia, lactate acidosis, visceral vasoconstriction, and decreased renal perfusion (Bryg, 2016).

Nursing Implications

John’s blood pressure was monitored every 2-3 minutes until it stabilizes and for every 5min after that. The dosage of Levophed was titrated according to how John responded. And his urine output was also monitored. It should not decrease to less than 30ml per hour. The IV site was assessed frequently throughout infusion, and John was asked to report headache, dizziness, or pain at the injection. John ECG was continuously observed. His central venous pressure was also measured to show the average right arterial pressure and to estimate the blood amount in his system.

Patient Education Plan

The goal of the teachings was to inform John about the importance of adhering to diabetic medication. And dietary management. He should take his medication effectively as instructed. He should seek medical care if faced with any health complications. In case he feels dizzy while driving, he should stop driving to avoid the accident. He needs to visit the hospital for wound dressing on his arm. And also to get physical therapy to help his arm in the recovery process. He needs to check his blood sugar and blood pressure continuously.

References

Bryg, R. J. (2016, July 27). A Picture Guide to Low Blood Pressure. RxList, pp. 1-20.

Cunha, J. P. (n.d.). Norepinephrine. Retrieved from RxList: http://www.rxlist.com/consumer_norepinephrine_levarterenol_levophed/drugs-condition,htmMulton, C. (2019, April 10). Levophed Dosage. Drugs.com.