Lehne Book: Chapter 2 - Pharm App in Nursing

Question 1

What does contraindication mean?

Answer 1

A contraindication is a specific situation in which a drug, procedure, or surgery should not be used because it may be harmful to the patient.

Question 2

T or F: The nurse can trust the pharmacy to send the correct medication.

Answer 2

False, always double check meds before administering them.

Question 3

T or F: The nurse serves as a line of defense against medication errors.

Answer 3

True. Even if a dr prescribes a medicine that can cause harm, it is your responsibility to protect the patient!

Question 4

What are the three basic goals for preadministration (of drugs) assessment?

Answer 4

1. collect baseline data needed to evaluate therapeutic and adverse responses. (condition, weight, agec cond. of liver,BP, etc)
2. Identify High Risk Patients (allergies, genetic factors, pregnant, old age, premature?)
3. Assessing the patient’s capacity for self-care (can they pay for medication? administer for themselves? forgetful?)

Question 5

______ is leakage of a fluid out of its container. example: IV fluid leakage.

Answer 5

Extravasation DELETE IN MIDTERM CARD DECK

Question 6

You should know the specific indication for which the drug is being used. Why?

Answer 6

Depending on which indication used for (headache vs inflammation in the case of aspirin), the dosage changes. Without knowing what indication, you cannot double check the dose nor evaluate for the proper response to the dosage given. ie, given for pain, check for pain change, if no change you change dose. If it’s for inflammation, a change in pain is not necessarily going to tell you if the inflammation has decreased.

Question 7

What is a PRN (pro re nata) medication order?

Answer 7

One in which the nurse has discretion regarding how much drug to give and when to give it (pro re nata = as needed)

Question 8

There are four major components to implementing a care plan:

1. Drug administration
2. interventions to enhance therapeutic effects (exercise AND cholesterol med)
3. interventions to minimize adverse effects and interactions (know side effects, foods that block absorption etc.)

and #4 ______________________

Answer 8

Patient education!!!

Question 9

Over the course of drug therapy, patient must be evaluated. We check for

1) therapeutic response (is the drug working),
2) adverse reactions/interactions,
3) interventions to promote effects and
4) ________________

Answer 9

interventions to minimize adverse effects.

Question 10

The nurse is responsible for educating the patient. List some areas we are responsible for.

(Some examples are: Who to contact in the event that the patient has a reaction, duration of treatment, method of storage….)

Answer 10

1. Drug name and therapeutic category (penicillin - antibiotic)
2. Dosage size (take one pill)
3. Dosing schedule (take on pill each day for five days in the morning)
4. Route and technique of administration (Insert vaginal cream into vagina while lying on your side…etc.
5. expected therapeutic response and when it should develop (you will experience a decrease in itching after two days of use).
6. nondrug measures to enhance therapeutic effects (if you walk for 30 minutes a day you will decrease stiffness in your hips from rheumatoid arthritis).
7. Duration of treatment (you will be on this drug for 7 days)
8. method of drug storage
9. Symptoms of major adverse effects and measure to minimize discomfort and harm (This drug is known to cause stomach issues. Please be sure to eat before taking the medication).
10. Major adverse drug-drug and food-drug reactions (Do not take this with grapefruit because it neutralizes the drug. Don’t take aspirin with warfarin because your blood will become to thin and you are at high risk for bleeding out).
11. Who to contact if experience any reactions or a lack of therapeutic effect.

Question 11

What are the steps in the nursing process?

Answer 11

nursing process Lehne pg. 9

1) assessment (Roy has two levels
2) analysis of the assessment aka nursing diagnosis
3) planning (setting of goals)
4) implementation aka nursing intervention
f) evaluation (and modify when necessary)

Question 12

Why is obtaining baseline data needed in order to evaluate therapeutic effect and adverse effects?

Answer 12

In order to know if we have produced the response we are looking for, we need to est. a baseline to measure against. Same goes for adverse effects we do not expect. Of course hair loss while undergoing chemo is expected… but if liver dysfunction exists and we had no baseline, we cannot tell if it was pre existing.