Final Blueprint Flashcards
what is the first step to Nursing Process?
Nursing Assessment-Obtain drug history
- lifestyle and beliefs, martial status, ADLs, etc.
- allergic rxns to OTC and prescription drugs/foods
- medical history, including all associated or chronic disorders
- all prescription and OTC drugs including herbal preps
- habits - dietary, exercise, recreational drug use, including alcohol
- sensory deficits, esp those affecting ability to self-adm
- socioeconomic status - age, ed level, occupation, health insurance coverage –Determine baseline measurements needed to monitor safety & efficacy of drug
what is the second step to the nursing process?
Nursing Diagnosis - NANDA
knowledge deficit related to drug therapy, as evidenced by clients:
1) statement of misconception
2) request for information
3) errors in following instructions
4) signs of cognitive impairment
-noncompliance related to drug therapy, as evidenced by acknowledgement of failure to follow regimen by ct
2) failure on objective tests
3) development of complications
4) exacerbation of symptoms
5) failure to improve or progress
6) failure to keep appts
–Examples of other drug-specific nursing diagnoses
1) high risk for injury R/T anticoagulant therapy
2) sexual dysfunction R/T antihypertensive medication
etc.
What is the third step of the nursing process?
Nursing Plan
2 major components - Outcome Criteria and nursing interventions
1. Outcome criteria - states a pt goal, or the desired pt behavior or response to be reached w/ nursing care. It should be measurable and objective, including an action verb and time frame.
2. Nursing interventions - helps pt achieve the goals of outcome criteria.
Ex. Instrust pt to take antibiotic 3 x day until all pills taken
- What is the fourth step to the nursing process?
- Nursing Implementation*
- Adm med as prescribed
2. Monitor ct for therapeutic effect
3. Evaluate serum drug level and results of relevant lab tests
4. Monitor ct for adverse effects, toxicity, and drug interactions, notify physician
5. Teach ct about med and importance of compliance
6. Monitor ct compliance by the following means: - physiologic measurements, such as serum or urine drug level
- judgment by attending physician or other health team member
c. ct self-report
d. pill counts
e. direct observation
what is the last step to the nursing process?
Nursing Evaluation
- Client obtains expected effects of prescribed drug
- Client avoids adverse effects and drug interactions
- Client demonstrates an understanding of his/her med as taught
- Client complies w/ the prescribed therapeutic regimen
what does ADPIE stand for?
Assessment Diagnosis Planning Implementation Evaluation
what are the Rights of Medication Administration?
Right drug Right dose Right patient Right time Right route Right chart or MAR Right to refuse (unless confused) Right to hold (nursing judgment Right reason Right assessment for adm & response to med
Schedule I drugs
drugs have a high abuse potential; no currently accepted medical use in the U.S.; pose unacceptable dangers; illegal
Ex: heroin, LSD, mescaline, mehtaqualone
Schedule II drugs
drugs have high abuse potential, but with currently acceptable therapeutic use. May lead to physical or psychological dependence or both. Written prescriptions required, no telephone renewals.
Ex: fentanyl, meperidine, morphine, codiene, oxycodone, methadone, cecobarbatal
Schedule III durgs
have a lower abuse potential than Schedule I or II. Current acceptable therapeutic use in US. Abuse may lead to moderate or low physical or psychological dependence or both. Prescriptions required to be rewritten after 6 months or 5 refills.
Ex: Drugs containing limited codiene or morphine, nonnarcotic derivatives of barbituric acid, paragoric, tylenol with codiene
Schedule IV drugs
drugs with less abuse potential than schedule III, acceptable therapeutic use in the US. Written or oral prescription required, with refills limited to 5.
Ex: fenobarbital, Valium, Ativan, Chloralhydrate
Schedule V drugs
drugs with lower abuse potential and with currently acceptable therapeutic use in the US.
Ex: cough syrup that contains codiene, lomotil (stops diarrhea), terpinhydrate (anti-tussive)
How does Surface area affect Drug Absorption?
a client with a resected intestine will have reduced absorption of orally administered drugs
How does blood flow affect Drug Absorption?
blood flow in intestine is increased after eating and decreased w/ exercise
How does pain and stress affect Drug Absorption?
these factors decrease absorption; the cause has just not been established
How does GI motility affect Drug Absorption?
high-fat or solid foods delay gastric emptying, retarding absorption or orally administered drugs; anticholinergics decrease intestinal motility, delaying absorption of orally administered drugs)
How does dosage form affect Drug Absorption?
sublingual tabs are absorbed more rapidly than compressed and sustained - release tabs; IM solutions are absorbed more rapidly than IM suspensions and emulsions
what are rapid rate dosage forms?
(seconds to mins): sublingual, IV, inhalation route
what are Intermediate rate dosage forms?
(1-2 hours): oral, Im, or SQ route
what are Slow rate dosage forms?
(hours to days): rectal, sustained release, topical systems
what is an example drug-drug interaction?
tetracycline and antacids
