Nursing Process and Client Teaching and Principles of Drug Administration Flashcards
The desired, therapeutic effects of the drug
Pharmacotherapeutics
The changes that occur to the drug while it is inside the body
Pharmacokinetics
The effects of the drug on the body
Pharmacodynamics
Conditions under which the drug should not be used or must be used carefully with monitoring
Contraindications and Precautions
Unintended and usually undesired effects that may occur with use of the drug.
Adverse Effects
Effects that may occur when the drug is given along with another drug, food, or substance
Drug Interactions
The presence of disease, illness, and allergy; chronic conditions causing system or organ dysfunction; diminished memory and mental capacity.
Health Status
Age, physiologic development, reproductive stage, and gender.
Life Span and Gender
Amount of activity and exercise, sleep-wake patterns; occupation; financial resources or access to health insurance coverage; eating preferences and patterns; use or abuse of substances; use of OTC drugs; use of alternative health practices; and ability to read & write.
Lifestyle, Diet, and Habits
Location in which the drug will be administered, such as hospital, home, or long-term care facility; properties of the physical environment that may alters a drug’s action or effect, induce adverse effects from a drug, or set limitations on whether the drug may be administered in that setting; and exposure to potentially harmful substances.
Environment
Religious, social, and ethnic backgrounds that may affect the individual’s receptiveness to drug therapy; also, genetic traits that affect a drug’s pharmacokinetic and pharmacodynamics properties.
Culture and Inherited Traits
NURSING MANAGEMENT OF DRUG THERAPY
- Maximizing therapeutic effect
- Minimizing adverse effects
- Providing patient and family education
CORE DRUG KNOWLEDGE
- Pharmacotherapeutics
- Pharmacokinetics
- Pharmacodynamics
- Contraindications and precautions
- Adverse effects
- Drug interactions
CORE PATIENT KNOWLEDGE
- Health status
- Life span and gender
- Lifestyle, diet, and habits
- Environment
- Culture and inherited traits
are assigned using standard nomenclature established by the International Union of Pure and Applied Chemistry (IUPAC).
CHEMICAL NAMES
describes the chemical substance or pharmacological property of a drug
GENERIC NAME
is the proper name of the drug ingredient or the common name if the ingredient has no proper name
GENERIC NAME
is assigned by the company marketing the drug. The name is usually selected to be short and easy to remember.
TRADE NAME
inhibiting blood clotting
anticoagulants
lowering blood cholesterol
antihyperlipidemics
lowering blood pressure
antihypertensives
restoring normal cardiac rhythm
antidysrhythmics
treating angina
antianginals
The 10 Rights
The Right Client
The Right Drug
The Right Dose
The Right Time
The Right Route
The Right Assessment
The Right Documentation
The Client’s Right to Education
The Right Evaluation
The Client’s Right to Refuse
The Right Client
TWO WAYS TO CHECK:
Checking the client’s identification bracelet.
Having the client state her or his name.
The Right Drug
- Prescriptions may be written on a ____________________ and
filled by a pharmacist at a drug store or hospital pharmacy.
- For institutionalized clients, the drug orders may be written on “____________________” and signed by the duly authorized
person.
prescription pad; order sheets
The Right Drug
- A ____________________ or ________________ for medication must be __________ by the prescribing health care provider within 24 hours.
- The use of ___________________ has added
speed and a safety feature to the order process.
telephone order (TO); verbal order (VO); cosigned; computerized order systems
The components of a drug order:
- Date and time the order is written
- Drug name (generic preferred)
- Drug dosage
- Route of administration
5.Frequency and duration of administration - Any special instructions for withholding or adjusting dosage based on nursing assessment, drug effectiveness, or laboratory results.
- Physician or other health care provider’s signature or name if TO or VO
- Signature if licensed practitioners taking TO or VO
Steps to do if any one of the components is missing:
- The drug _______________ be administered.
- ________________ of the order must be done in a timely manner.
- The health care provider is usually ______________ and the
conversation content documented.
should not; Clarification; contacted
To Avoid Drug Error
Drug label should be read three (3) times:
- At the time of contact with the drug bottle or container.
- Before pouring the drug
- After pouring the drug
Four Categories of Drug Orders:
1.Standing
2.One-Time (Single)
3.PRN (as needed)
4.STAT (at once or now)
Drugs are stored on unit and dispensed to all clients from the same container.
STOCK METHOD
Drugs are packaged in doses for 24 hour by the pharmacy
UNIT DOSE METHOD
When the drug has a ________________ (t1/2), the drug is given once a day. Drugs with a short half-life are given several times a day at specified intervals
long half-life
once a day
OD
twice a day
BID
three times a day
TID
four times a day
QID
every four hours
Q4H
every six hours
Q6H
every eight hours
Q8H
at bedtime / hours of sleep
HS
has the advantages of reducing administration errors and decreasing documentation.
Use of Military Time
Use ____________technique when administering drugs. ___________
technique is required with the parenteral routes.
aseptic; Sterile
Common routes:
Oral, Sublingual, Buccal, Inhalation, Instillation, Suppository and Parenteral (Intradermal (ID), Subcutaneous (SQ or subQ), Intramuscular (IM/IG) and Intravenous (IV).
The Right Documentation
Requires that the nurse immediately record the appropriate information about the drug administered. This includes:
- name of the drug
- the dose
- the route
- the time and date
- the nurse’s initial or signature
Documentation of the client’s response to the medication is required with a variety of medications, such as:
- Narcotics
- Non-narcotic analgesics
- Sedatives
- Antiemetics
- Unexpected reactions to the medication
before meals
ac
ad lib
as desired/directed
morning
AM
capsule
cap
per day
/d
every day
qd
every hour
qh
qhs
bedtime (every night)
qod
every other day
pc
after meals/after eating
PM
afternoon
PO
by mouth/orally
PRN or prn
when needed/necessary
Rx
take
STAT
immediately; at once
tab
tablet
6 Nurses’ Rights When Administering Medications
- Right to a complete and clear order
- Right to have the correct drug, route, and dose dispensed
- Right to have access to information
- Right to have policies to guide safe medication administration
- Right to administer medications safely and to identify problems in the system
- Right to stop, think, and be vigilant when administering medications
Any preventable event that may cause or lead to inappropriate medication use or harm to a patient
Medication Error
Medication errors may occur throughout the cycle:
39% - Ordering
12% - Transcribing
11% - Preparing
38% - Administering
Medication Error
Other contributing factors:
Violation of “10” rights
Lack of drug knowledge
Memory lapses
Transcription
Dispensing
Delivery problems
Inadequate monitoring
Distractions
Staff being overworked
Lack of standardization
Confusing packaging prescription
Equipment failures
Inadequate client history
Poor interdepartmental
communication
Culture of Safety include:
- Use drug references (MIMS, PDR, Drug Guide).
- Contact the health care provider; do not guess about the order.
- Double-check all calculated doses.
- Use leading zero; do not use trailing zero.
- Scan bar code at the point-of-care.
- Avoid verbal orders; if you must take them, repeat outloud to confirm.
Controlled studies in humans show no risk to the fetus.
Category A
No controlled studies have been conducted in humans; animal studies show no risk to the fetus
Category B
No controlled studies have been conducted in animals or humans.
Category C
Evidence of human risk to the fetus exists; however, benefits may outweigh risks in certain situations
Category D
Controlled studies in both animals and humans demonstrate fetal abnormalities; the risk in pregnant women outweighs any possible benefit.
Category X
When the drug has a long half-life (t1/2), the drug is given _____________. Drugs with a short half-life are given ____________________ at specified intervals
once a day; several times a day
Is the time at which the prescribed dose should be administered
The Right Time
Administer drugs at the specified times. Drugs may be given _______________________ the time prescribed if the administration interval is ______________________
30 minutes before or after; more than 2 hours
Antibiotics should be administered at ______________________ throughout a 24-hour period so therapeutic blood levels are maintained
even intervals
Is necessary for adequate or appropriate absorption
The Right Route
Assess the client’s ____________________ before the administration of oral medications.
ability to swallow
Requires the appropriate data be collected before administration of the drug (e.g. Vital Signs, CBG)
The Right Assessment
Requires that the nurse immediately record the appropriate information about the drug administered
The Right Documentation
Requires that the client receive accurate and thorough information about the medication and how it relates to his or her particular situation.
The Right to Education
This right is a principle of INFORMED CONSENT, which based on the individual having the knowledge necessary to make a decision.
The Right to Education
Requires that the effectiveness of the medication be
determined by the client’s response to the medication.
The Right Evaluation
