Nursing Practice in Canada and Drug Therapy Flashcards
An 86yr old patient is being discharged home on digitalis therapy and has little information regarding the medication. Which of the following statements best reflects a realistic goal or outcome of patient teaching activities?
a) The patient will call the physician if adverse effects occur.
b) Patient will state all the symptoms of digitalis toxicity.
c) The nurse will provide teaching about the drug’s adverse effects.
d) Patient and patient’s daughter will state the correct dosing and administration of the drug.
a) The patient will call the physician if adverse effects occur.
What is the most appropriate response to a patient who informs a nurse she does not share want to share the information about the drugs she takes at home?
a) “We are just asking to make sure you don’t have any drug allergies”.
b) “It sounds like something you’re taking, you don’t want us to know about”.
c) “This information about will not become part of you medical record, but we need to know so that we can monitor your responses to therapy while you’re here”.
d) “Information about the drugs you’re taking at home, including natural health products, is important for safe administration of drugs while you are here and will be kept confidential”.
d) “Information about the drugs you’re taking at home, including natural health products, is important for safe administration of drugs while you are here and will be kept confidential”.
A patient’s chart includes an order that reads: Lanoxin 0.025mcg once daily at 0900. which of the following statements is true regarding the dosage route for this drug is correct?
a) Drug should only be given orally
b) Drug should be given IV
c) Drug should be given via transdermal route
d) Dosage route should never be assumed when the order does not specify route.
d) Dosage route should never be assumed when the order does not specify route.
Which of the questions is most effective in compiling a drug history for a patient?
a) “What childhood diseases did you have?”
b) “Do you have a family history of heart disease?”
c) “Do you depend on sleeping pills to get to sleep?”
d) “When you take your pain medication, does it relieve your pain?”
d) “When you take your pain medication, does it relieve your pain?”
A 77yr old male who has been diagnosed with an upper respiratory infection tells the nurse that he is allergic to penicillin. Which of the following would be the most appropriate response?
a) “That is to be expected - lots of people are allergic to penicillin”.
b) “What type of reaction did you have when you took penicillin?”
c) “This allergy is not a major concern because it is given so commonly”.
d) “Drug allergies don’t usually occur in older individuals because they have built up resistance”.
b) “What type of reaction did you have when you took penicillin?”
What are crucial responsibilities of the nurse when implementing drug therapy?
Nurses are responsible for being adequately informed about both the patient and the drug before implementing drug therapy. Nurses must assess patients before giving any medication and must then: (1) observe each individual’s response to the drug therapy; (2) determine any other actions to be implemented; and (3) continue to assess, teach, and work collaboratively with pharmacists and diligently with the patient to enhance adherence at home. Carrying out the nursing process with astute and thorough assessment, nursing diagnoses, planning, implementation, and evaluation is as critical to safe nursing care in drug therapy as it is to the overall nursing care of patients. Being efficient, safe, and knowledgeable about patients and their medications, using correct administration techniques, and constantly monitoring patients and all other sources of data also are important to safe and effective drug therapy.
When medications were administered during the night shift, a patient refused to take his 0200 dose of an antibiotic, claiming he had just taken it. What actions by the nurse would ensure sound decision making and maintain patient safety?
Whenever a patient questions a particular medication or mentions something about the medication that is not in accordance with what the nurse thinks, the nurse should always be prudent—stop, recheck the doctor’s order against the medication administration record or profile, and check the dispensing system or medication record or profile to determine whether a dose was given and signed off by another nurse. As a nurse, you should never ignore a patient’s concerns or assume that the patient is unknowledgeable about a medication; always double-check to be safe. If all records and orders have been checked, and the nurse is certain that the drug has not been given, the nurse should then proceed with medication administration. A simple explanation could then be given to the patient. If the patient continues to refuse the medication, this should be documented in the nurses’ notes and reported to the appropriate individual.
During a busy shift, you note that the chart of your newly admitted patient has a few orders for medications and diagnostic tests, taken by the telephone by another nurse. You were otw to the patient’s room to do the assessment when the unit secretary tells you that one of the orders reads: Lasix 20mg, stat. What should you do first? How do you go about administering this drug? Explain.
- Because this is a newly admitted patient, the nurse should first perform an assessment before giving any medications. However, because the order is “stat” (meaning “give immediately”), this assessment has to be a brief, focused assessment. Assess the patient’s vital signs (blood pressure, pulse, respirations, temperature) and level of consciousness. Check for signs of fluid retention (pedal edema), ask about urine output and function, and listen to breath and heart sounds. Also, assess for drug allergies and other drug reactions. However, this stat order is missing something—the route. Never assume the route via which a medication is to be given. Even though this patient was just admitted and may or may not have an intravenous line, it is important to clarify the route by which this drug should be given. The order was a telephone order taken by another nurse, so you can ask that nurse whether a route was specified when she spoke to the physician. If not, the physician must be contacted right away for clarification. To streamline the process, the order can be checked by another nurse while you are performing the assessment.
