Test 1 - Lecture 3 Flashcards
Six Rights of Medication
- ) Right drug
- ) Right patient
- ) Right dose
- ) Right route
- ) Right time
- ) Right documentation
Assessment
What the drug does? Head to toe assessment and Vitals Ask questions Is patient on other meds? LOC? Check labs High risk (Kidney problems)
Three sources of assessment
The patient interview and history (subjective data)
The physical examination (objective data)
The medical record
1 Nursing diagnosis of medication
Knowledge deficit
Nursing diagnosis for antihypertensives
Risk for injury
Nursing process step for Deadline established to evaluate drug effects
Planning
Nursing process step for History of an allergy to a drug
Assessment
Nursing process step for Instillation of eye drops
Implementation
Nursing process step for writing expected outcomes with the patient
Planning
Nursing process step for observing a patient demonstrate proper self-medication with insulin
Evaluation
Nursing process step for risk for injury due to the medication’s sedating effects
Diagnosis
Nursing process step for recording secondary effects of medication
Evaluation
Polypharm
on multiple drugs
Most misused drugs
ADD meds
Noncomplience
Why are they not taking?
Get to the root
True or False: The margin between desired therapeutic effects and adverse consequences of the drug therapy is called the therapeutic index.
False: drug therapy is called the risk benefit ratio
True or False: Nonadherence is the inability to follow a recommended drug therapy regimen
True
True or false: A patient who responds with hyperactivity to a drug that normally causes sedation has an adverse effect known as idiosyncratic excitement.
False: Paradoxical excitement
True or False: A geriatric patient is also known as an older adult
True
True or False: The practice of one patient taking several drugs simultaneously is called drug abuse
False: Polypharmacy not drug abuse
True or False: An older adult is any patient older than 65 years with a debilitating medical problem
False: Frail elderly not older adult
True or False: Matching the patients previous drug therapy with their currently prescribed therapy is called medication reconciliation
True
Summarize the normal physiologic changes with age that affect absorption in an elderly patient receiving drug therapy.
Increased gastric pH levels, slowed blood flow, decreased GI motility, and reduced surface area of the GI tract
Summarize the normal physiologic changes with age that affect distribution in an elderly patient receiving drug therapy.
Decreased body mass, reduced levels of plasma albumin, less effective blood-brain barrier, declining cardiac output, extreme changes in body weight, poor nutrition or dehydration, inactivity or extended bed rest.
Summarize the normal physiologic changes with age that affect metabolism in an elderly patient receiving drug therapy.
Decreased size of the liver. decreased number of metabolically active hepatocytes, decreased blood flow to the liver, decreased ability to remove many bi-products, and overall efficiency of the liver is reduced.
Summarize the normal physiologic changes with age that affect excretion in an elderly patient receiving drug therapy.
Decreased glomerular filtration rate, decreased renal tubular secretion, and decreased renal blood flow.
Because of age related changes of the body, absorption of drugs in the elderly patient
Delays onset of action
In the elderly patient, the dosage of fat-soluble drugs may need to be _____ to avoid toxicity.
Decreased
What may occur as a result of physiologic changes in the elderly patient’s metabolism.
Increased half life. In the elderly phase 1 metabolism slows resulting in the extended half lives of many drugs.
Planning - First Step
Identify desired goal or outcome
Identify specific evaluation criteria to be used to determine if outcome has been met
Planning - Second step
Develop a list of interventions
Specific nursing actions designed to achieve desire goal
Interventions based on research evidence to promote evidence-based nursing practice
Implementation
Puts nursing plan into action
Knowledge, skills, and principles applied to achieve desired outcome
Involves drug administration based on interventions developed in planning phase
Maximize therapeutic response and prevent adverse events
Subject to modification
Includes providing patient teaching
Documentation is an essential part of the implementation phase
Interventions make up plan of care tailored to the individual patient
Digoxen
Narrow therapeutic window. Must do apical pulse for 1 full minute before giving.
Lasix
Give over 2 minutes or may give hearing loss or drop patient blood pressure.
Evaluation
Compares current health status with desired outcome
Determines if plan of care is appropriate or needs modification
Used to determine drug efficacy or adverse effects
Questions to ask yourself in the evaluation phase
Was the outcome or goal achieved?
Was the nursing management effective?
If not, what went wrong?`
1 question we should ask our self when giving a drug
Why is the drug ordered?
Other questions we should ask our self when giving a drug
Is pt on lowest dose possible?
Simplify treatment
“Start low and go slow”
