Chapter 4:
The Nursing Process in Drug
Therapy and Patient Safety
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Nursing: Art and Science
Assuming increasing responsibilities
Holistic
Nurse is a key health care provider
Integrate knowledge of the
o Basic sciences
o Social sciences
o Education
o Other disciplines
Applying the nursing process
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Nursing Process
Assessment
o Data gathering: history, physical assessment,wholistic
Nursing Diagnosis
o Drawing a conclusion from the assessment data that was
gathered
Planning/Implementation
o Formulation of a plan of care that includes actions to
improve or maintain the patient’s health
Evaluations
o Determining if the plan of care was effective at either
maintaining or improving the patient’s health
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Assessment
History
o Chronic Conditions
o Drug Use
o Allergies
o Level of Education and Understanding
o Social Supports
o Financial Supports
o Pattern of Past Health Care
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Physical Assessment
Weight
Age
Physical Parameters Related to Disease or Drug Effects
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Nursing Diagnosis #1
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Nursing Diagnosis #2
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Implementation
Synthesizing information into nursing diagnoses to plan patient
care
Setting goals
Desired patient outcomes
o Effective response to drug therapy
o Minimization of adverse effects
o Understanding of the drug regimen
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Interventions
Three Types of Nursing Interventions
o Drug administration
o Provision of comfort measures
o Patient/family education
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Comfort Measures
Help the patient cope with the effects of drug therapy
Nurse is in a unique position for this
Patient more likely to be compliant
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Promoting Drug Therapy
Placebo Effect
Managing Adverse Effect
Lifestyle Adjustment
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Patient and Family Education
Cornerstone of drug therapy
Nurses are the primary educators about medications
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Evaluation
Part of the continuing process of patient care
Leads to changes in assessment, diagnosis, and intervention
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Proper Drug Administration
(The Rights of safe administration)
Patient
Drug
Storage
Route
Dosage
Preparation
Timing
Documentation
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Prevention of Medication Errors
“To Err is Human”
Drug Regimen Process
Series of Checks
o Nurse’s Role
o Patient’s Role
Reporting of Medication Errors
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Elements of Patient Teaching
Name, dose, and action of drug
Timing of administration
Special storage and preparation instructions
Specific OTC drugs or alternative therapies to avoid
Special comfort or safety measures
Specific points about drug toxicity
Specific warnings about drug discontinuation
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Question #1
What of the following needs to be included in a physician’s order
for a patient so the nurse can use the “rights of safe
administration” when administering medication?
a. Patient’s weight
b. Patient’s drug history
c. Patient’s name
d. Patient’s address
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Answer to Question #1
c. Patient’s name
Rationale: The physician’s order for a drug needs to include
information that allows the nurse to administer the
medication according to the seven “rights” to ensure safe and
effective drug administration. These are correct drug and
patient, correct storage of drug, correct and most effective
route, correct dosage, correct preparation, correct timing,
and correct recording of administration.
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