Patient Assessment Lectures Flashcards
What is the purpose of patient assessment?
Consistent and systemic process used to meet drug related needs of patients with self-care
What are the three steps of patient assessment?
Information gathering
Integrate all patient information
Develop a plan of care/make appropriate recommendations
What are key to patient assessment?
Good communication: listening, questioning, non-verbal communication
Uses of your senses: sight, sound, smell, touch, taste
What does communication involve?
Active listening (making time, avoiding distractions, focus)
Utilize active listening techniques
Express understanding
Empathy
What does speaking and questioning involve?
Asses what the patient already knows
Assess the patients needs/concerns
Explain reasoning for personal questions
Gethering necessary information to make the most appropriate recommendation
Need to knows: other meds, disease states, allergies/drug reactions
Do’s of questioning?
Be concise, complete appropriate Develop rapport Show respect ask one at a time use open-ended questions
Don’ts of questioning?
Ask unnecessary questions Be arrogant, too loud, too quiet Use medical terminology Ask leading questions Use closes ended questions
What does QuEST stand for?
Quickly and accurately assess the patient
Establish that the patient is an appropriate self-care candidate
Suggest appropriate self-care stragies
Talk with the patient
What is SCHOLAR-MAC?
Scholar: ask about current complants
Medications
Allergies
Conditions
What does SCHOLAR stand for?
Symptoms Characteristics: Siutation History Onset Location Aggravating factors Remiting factors
When should you make referrals?
Symptoms are too severe to be endured without diagnosis and treatment
minor symptoms but they are presistent
Repeatedly returning symptoms
What to do if a referral is necessary?
Do not alarm the patient Explain your reasoning Specify the urgency General care measure to follow and OTC if necessary
What should be review before suggesting a OTC (drug-related variables)?
Dosage forms available What ingredients are in the OTC Expected ADR Effectiveness Price
You always want to match what two things when suggesting an OTC
Drug-related variables with patient related variables
What are some patient related variables?
Age, allergies, gender, other diseases, ability to pay, preferences of patient
What should you think about in special populations?
Different PK/PDs
Elderly: dentures, vision
Pediatrics: NOT just little adults
Pregnant: Safe meds
What are some geriatric issues?
Often have multiple disease states Take multiple prescription medications Have a tendency to self-treat Limited income Are more prone to ADR
How should you approach dosing in pediatrics?
Most labels give dose based on age
Most OTCs recommend for those over two years old
Most accurate: weight based
What should you pay attention to for dosage forms?
Most children (4-7) can’t swallow tablets
Medications can be crushed or open and put in small amount of food or drink (EXCEPT enteric-coated or time release)
Elixirs contain alcohol
Syrups have high amounts of sugars
Suspensions are usually preferred
Should you use household teaspoons?
NO, always use medication dosage devices
Should you just hand over medication devices?
NO SHOW THE PATIENT HOW TO USE THEM
What are medication issues with pregnant or lactating females?
Medication can cause great risk
Teratogenic risk, potential to cross the placenta
Classification A means what?
Adequate/well controlled studies in women
Not shown to increase risk of abnormalities
Classification B means what?
Animal reproduction –> no human
- No evidence of impared fertility or harm to fetus
Animal and human
- adverse events in animals but not humans
Classification C means what?
Animal reproduction –> no humans
- evidence of adverse effect on fetus
- benefits may out weigh the risks
No animal studies
Classification D means what?
Human data
Drug can cause fetal harm
Benefits may outweigh the risks
Classification X means what?
Animal or human reports and/or marketing experience
- Fetal abnormalities demonstrated
Risk way outweigh the benefits
