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45 Cards in this Set
- Front
- Back
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6elements to include when getting amedication order¨ |
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What are lab tests and other diagnostic tests needed for any drug therapy? |
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On assessment check current medications and... |
meds in the past that created difficulty include tolerance of those meds, including OTC or fold mes being utilized. |
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Other things to assess include |
patient's oral intake, tolerance of fluids, swallowing ability compliance in the past current and past vital signs |
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3 step process |
What happened? Why did it happen? How do you know? |
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What happened ... |
Looking for the human response to illness, injury, or significant change. |
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Why it happened |
Identify factors related to the patients response |
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How do you know? |
List of clues, cues, evidence that support the accurate description of the human response |
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the 6 rights! To be checked 3 times beforeactually giving medications!!!!!
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§ Right Drug-check med order against label and appropriateness
§ Right Dose-careful attention to decimal points and leading zeros-not trailing § Right Time-policy, properties, dietary, labs, diagnostic tests-give 30 minutes before or after actual time EXCEPT STAT (within 30 minutes of order)…know military time….AVOID abbreviations § Right Route-NEVER assume !!! § Right Patient-2 identifiers---name and birthdate--ALLERGIES Right Documentation-crucial to patient safety—the following should ALWAYS be in the chart for a medication---date, time, name of drug, dose, route, site to give…ALSO, the following should always be in the chart----- if a drug is not given and why, refusal of a medication and reason, actual time drug given. |
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Right Documentation- what should be documented?
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crucial to patient safety—the following should ALWAYS be in the chart for a medication---date, time, name of drug, dose, route, site to give…ALSO, the following should always be in the chart----- if a drug is not given and why, refusal of a medication and reason, actual time drug given.
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Medicationerrors
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a MAJOR problem in healthcare ----- any preventable event that may lead to or cause inappropriate medication use or patient harm while in the control of health care professionals---review “Charting Don’ts
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Evaluation
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systematic, ongoing, and dynamic ---- monitoring the fulfillment of goals NOT interventions ---- the therapeutic response
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Compliance or adherence
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fulfillment of a prescriber’s or caregivers prescribed course of treatment by a patient….
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Non-compliance =
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an informed decision on the part of the patient not to adhere to or follow a therapeutic plan or suggestion
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v Generic name =
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the name given by the US Adopted Names Council….not protected by a trademark
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Adverse drug reaction =
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any unexpected, unintended, undesired, or excessive response to a medication given at therapeutic dosages
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Allergic reaction
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an immunological hypersensitivity reaction resulting from the unusual sensitivity of a patient to a particular medication; a type of adverse reaction event
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Chemical name
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the name that describes the chemical composition and molecular structure of a drug
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Trade name =
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commercial name given to a drug by its manufacturer—registered trademark….shorter and easier to pronounce compared to chemical name
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Contraindication =
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any condition, especially one related to a disease state or other patient characteristic, including current or recent drug therapy, that renders a particular form of treatment improper or undesirable
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Dependence =
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compulsive or chronic need
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Drug =
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chemical
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Drug actions =
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cellular process
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Drug effect =
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reaction
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Drug interaction = v
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enzymatic reaction to one or more drugs together
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Duration of action =
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time of greatest therapeutic action
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v First-pass medications =
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actions <100% because contents stay in liver without getting to circulation---
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Half-Life
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time required for half of administered drug to be eliminated or blood concentration to be reduced by 50%
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Incompatibility
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2 parenteral drugs or solutions undergo a reaction when mixed or given together that results in the chemical deterioration of at least one of the drugs v Onset of action
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Peak effect =
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maximum therapeutic response
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v Pharmaceutics= _�
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science of preparing and dispensing drugs----dissolution(dissolving of solid dosage forms and their absorption)Oral---solid, liquid, enteric-coated, combination, extended-release, immediate-release, SA, CR, XL, XT, granules(in capsules----don’t crush or chew but can be placed on soft foods) Dosage forms….enteral---GI tract(oral, rectal, sublingual, buccal ), parenteral---other than GI tract(intramuscular, intradermal, subcutaneous, intraarterial, intrathecal, intravenous), topical—skin, eyes, ears, nose, lungs, rectum, vagina—slower onset/longer duration…..includes transdermal and inhaled. ---especially nursing considerations.
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v Pharmacodynamics
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study of biochemical and physiological interactions of drugs at their sites of activity pharmacologic interactions with body receptors….what the drug does to the body v
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Pharmacokinetics
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rate of drug distribution among various body compartments after a drug enters the body-----includes absorption(enteral ---oral, rectal)sublingual/buccal, distribution, metabolism, and excretion of drugs…..what the body does to the drugs ----- onset of action, time to peak effect, duration of action
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Pharmacology
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study of drugs |
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Therapeutic effect
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got online..is any good result of a medical treatment |
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Tolerance
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the capacity of the body to endure or become less responsive to a substance (as a drug) or a physiological insult especially with repeated use or exposure
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Toxicity
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is the degree to which a substance can damage an organism
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Toxicology
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the branch of science concerned with the nature, effects, and detection of poisons.
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Trough level =
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lowest level
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1. Explainthe role of pharmacokinetics Pharmacodynamicsincludes the mechanism of action that results in a therapeutic effect ofmedications given……..depending on the disease processes that are effecting the patient’s ability to processthe drug through receptors, enzymes, etc.a
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Pharmacokinetics includes the absorption, distribution, metabolism, and excretion of medications which leads to nursing considerations regarding the half-life, onset, peak, and duration of the effect of the medication given---peak(one hour after giving depending on the medication giving) being most therapeutic and trough(30 minutes before giving) being lowest therapeutic concentration.
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-peak
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(one hour after giving depending on the medication giving) being most therapeutic
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trough
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(30 minutes before giving) being lowest therapeutic concentration.
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1. Listthe responsibilities of the nurse in safely administering medication to anypatient…….
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§ Consider where the patient is in the life process ---neonate to elderly(>65) to dying-----each effects the absorption, distribution, metabolism and excretion
§ Health history § Allergies ---drugs, food, environment ---what kind of reaction? § Vital signs § Assessment findings § Height § Weight § Developmental skills § Medication history (polypharmacy?) § Anxiety § Previous use of prescription, herbal, vitamins, other supplements and OTC drugs in the home § Method of medication administration § Usual response to medications § Resources available § Diet § Sensory, visual, hearing, cognitive or motor skill deficits § Finances § Labs needed § Brown-bag technique _ |
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1. Identifythe components of the wholistic assessment (mind, body, spirit) process forpatients receiving medications, including subjective(what the patient states)and objective(what is observed) data….
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§ All things listed in #4
§ Culturally competent assessment information for physical health and mental health in maintaining, protecting and/or restoring health --- § Spiritual assessment |
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Charting Don’ts·
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