If the patient is receiving itraconazole and antacids, separate administration by 2 hours.
Provide oxygen therapy if needed based on oxygen saturation levels.
Cluster nursing activities to minimize energy expenditure, and allow for frequent rest periods.
Maintain a patent airway; encourage coughing and deep breathing.
Consult with a dietitian and the patient concerning food preferences, and offer soft, bland foods if the oropharynx is affected.
Provide comfort measures. Encourage frequent turning and position changes.
Obtain daily weights.
Assess heart and lung sounds for changes.
Obtain specimens for laboratory testing, including blood cultures and serum electrolyte levels.
Give prescribed drugs. If giving amphotericin B, premedicate the patient with acetaminophen and diphenhydramine to reduce the risk for fever and chills and premedicate with meperidine to prevent rigors.
Obtain specimens for laboratory testing, especially electrolyte levels if the patient is receiving amphotericin B.
Teach the patient the need to watch for early signs of this infection and to seek prompt treatment to help prevent histoplasmosis (for people in endemic areas)
Teach the patient the importance of follow-up care, with chest X-rays at regular intervals and evaluation of renal and liver function every 1 to 2 months if the infection is chronic, and the need for follow-up care on a regular basis for at least 1 year.
Refer a patient with chronic pulmonary or disseminated histoplasmosis for psychological support to cope with long-term treatment.
Refer the patient to a social worker or an occupational therapist, as needed.
