Assessment

• Monitor blood pressure, pulse, and respiratory rate frequently in patients receiving IV doses

» Assess level of sedation after administration. Risk of sedation and respiratory depression are increased when administered concurrently with other drugs that cause CNS depression

» Monitor patient for onset of extrapyramidal side effects (akathisia—restlessness; dystonia—muscle spasms and twisting motions; pseudoparkinsonism—mask-like face, rigidity, tremors, drooling, shuffling gait, dysphagia). Notify health care professional if these symptoms occur

• Geri: Assess for adverse anticholinergic effects (delirium, acute confusion, dizziness, dry mouth, blurred vision, urinary retention, constipation, tachycardia)

Allergy

• Assess allergy symptoms (rhinitis, conjunctivitis, hives) before and periodically throughout course of therapy

Antiemetic

• Assess patient for nausea and vomiting before and after administration

IV

• High Alert: If administered IV, assess for burning and pain at IV site; may cause severe tissue injury. Avoid IV administration, if possible. If pain occurs, discontinue administration immediately

Lab Test Considerations

• May cause false-positive or false-negative pregnancy test results

» Evaluate CBC periodically during chronic therapy; blood dyscrasias may occur

» May cause ↑ serum glucose

» May cause false-negative results in skin tests using allergen extracts. Promethazine should be discontinued 72 hr before the test

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