Nursing Process Focus:

Patients Receiving Amiodarone (Cardarone)

Assessment Potential Nursing Diagnoses

Prior to administration: • Decreased Cardiac Output, related to
• Assess for ventricular fibrillation, recurrent cardiac arrhythmias
unstable ventricular tachycardia (initially • Risk for Injury, related to adverse effects
and throughout therapy.) of drug
• Obtain complete health history, especially • Impaired Gas Exchange, related to
cardiac and liver disease, lung disorders, pulmonary damage secondary to side
and eye disorders including blood studies: effects of drug
liver function tests. Obtain baseline eye • Risk for Imbalanced Nutrition, related to
exam. gastrointestinal distress secondary to side
• Obtain patient’s drug history to determine effects of drug
possible drug interactions and allergies.
Planning: Patient Goals and Expected Outcomes
The patient will:
• Demonstrate ability to measure own pulse.
• Describe the need to change positions slowly to prevent postural hypotension.
• Remain free of physical injury.
• Maintain adequate nutrition.
• Demonstrate adequate respiratory function.
Implementation
Interventions and (Rationales) Patient Education/Discharge Planning
*Auscultate lung sounds frequently. *Advise patient to notify the health care
(Pulmonary toxicity can occur and may be provider at the first sign of shortness of breath
fatal. Occurs most frequently with oral dosing or cough.
because absorption is highly variable. Lung
tissue (which receives good blood flow)
appears to receive a greater effect from the
medication.)
*Monitor heart rate and rhythm. (May worsen *Instruct patient to report change in heart rate
the arrhythmia it is trying to treat. May also and rhythm to health care provider.
cause bradycardia, heart block and cardiac
arrest because it slows conduction and
increases the refractory period.)
*Monitor liver enzymes. (Drug may cause Instruct patient:
liver disease because this medication has a • in signs and symptoms of liver disease
high lipid solubility and is distributed such as jaundice, right upper quadrant pain,
extensively to the liver.) dark urine and clay colored stool.
• to report these symptoms to health care
provider immediately.
*Observe for changes in visual acuity *Instruct patient to report any vision changes
(May cause optic neuritis which may lead to to the health care provider immediately.
blindness. This is caused by corneal
microdeposits.)
*Monitor blood pressure throughout drug Instruct patient:
therapy. (Hypotension is common early in • to change positions slowly to reduce
therapy and is related to the dilating action of incidence of dizziness.
this medication on peripheral blood vessels.) • to monitor blood pressure and report
abnormalities to the health care provider.
*Observe for occurrence of common side Instruct patient:
effects. (Common side effects include • to take medication with food to minimize
dizziness, headache, insomnia related to the gastrointestinal distress.
antiadrenergic properties of this medication. • to cover the skin well when in direct
Gastrointestinal distress and photosensitivity sunlight and to wear sunglasses. The
also commonly occur.) elderly are particularly sensitive to the
sun.
*Monitor for concurrent digoxin and Advise patient:
anticoagulant use. Amiodarone increases • to report changes in cardiac rhythm.
digoxin levels in the blood and enhances the • to report occurrence of abnormal bleeding
actions of anticoagulants. or bruising.
Evaluation of Outcome Criteria
Evaluate the effectiveness of drug therapy by confirming that patient goals and expected
outcomes are met (see “Planning”).