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NURSING PROCESS in DRUG THERAPY

The nursing process ensures safe and effective drug therapy. Assessment involves collecting a patient's history, including medical conditions and current medications, and performing a physical exam. Nursing diagnoses identify actual or potential issues related to drug therapy. Implementation includes proper administration, managing side effects, and educating patients and families. Evaluation assesses therapeutic response, side effects, and interactions on an ongoing basis to determine if changes are needed to optimize care.

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Michiko Ciriaco
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0% found this document useful (0 votes)
285 views4 pages

NURSING PROCESS in DRUG THERAPY

The nursing process ensures safe and effective drug therapy. Assessment involves collecting a patient's history, including medical conditions and current medications, and performing a physical exam. Nursing diagnoses identify actual or potential issues related to drug therapy. Implementation includes proper administration, managing side effects, and educating patients and families. Evaluation assesses therapeutic response, side effects, and interactions on an ongoing basis to determine if changes are needed to optimize care.

Uploaded by

Michiko Ciriaco
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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NURSING PROCESS in DRUG THERAPY

Application of the nursing process with drug therapy ensures that the patient receives the best, safest, most efficient, scientifically
based, holistic care.

ASSESSMENT

A. PATIENT'S HISTORY
To promote safe & effective use of the drug.
Prevent adverse effects.
Identify clinically important drug–drug, drug–food, or drug–alternative therapy interactions & medication errors.

History of Chronic Conditions


= can affect the pharmacokinetics & pharmacodynamics of a drug
= certain conditions may be contraindicated to the use of a drug & may require cautious use or dose adjustment

History of Drug Use


= prescription drugs, OTC drugs, street drugs, alcohol, nicotine, alternative therapies, & caffeine may impact a drug’s effect
= always ask specifically about all types of medications that the patient might use including contraceptives

History of Allergies
= past exposure to a drug or other allergens can provoke a future reaction or necessitate the need for cautious use of the drug,
food, or animal product

Level of Education and Understanding


= provides a baseline from which the nurse can determine the appropriate types of teaching information to use with the patient
= stress, disease, & environmental factors can all affect a patient’s learning readiness and ability

Social and Financial Support


= discharge planning involves determining what support is available to the patient at home
= financial constraints may cause a patient not to follow a prescribed drug regimen
= referral to appropriate community resources must be considered

Pattern of Healthcare
= knowing how a patient seeks health care provides the nurse with valuable information to include when preparing the patient’s
teaching plan

B. PHYSICAL EXAMINATION
To determine if any conditions exist that would be contraindicated to a drug.
To develop a baseline for evaluating the effectiveness of the drug and the occurrence of any adverse effects.

Weight
= to determine whether the recommended drug dose is appropriate
= the recommended dose is based on a 150-pound adult man
= patients who are much lighter or much heavier often need a dose adjustment

Age
= patients at the extremes of the age spectrum — children and older adults — often require dose adjustments based on the
functional level of the liver and kidneys, the responsiveness of other organs, & other existing medical conditions
= a child’s age & developmental level will also alert the nurse to possible problems with drug delivery, such as the ability to
swallow pills or follow directions related to other delivery methods

Physical Parameters Related to Disease or Drug Effects


= provides a baseline level to which future assessments can be compared to determine the effects of drug therapy

NURSING DIAGNOSIS
A statement of the patient’s status from a nursing perspective.
The nurse analyzes the info gathered during assessment to arrive at some conclusions that lead to a goal & a set of interventions.
It shows actual or potential alterations in patient function based on the assessment of the clinical situation.
Diagnoses that are related to drug therapy must be incorporated into a total picture of the patient.

IMPLEMENTATION
Interventions involve ensuring effective response to drug therapy, minimizing adverse effects, & understanding the drug regimen.

3 TYPES OF NURSING INTERVENTIONS:

1. Proper Drug Administration


Correct drug and patient Correct dose and preparation
Correct storage of drug Correct timing
Correct and most effective route Correct recording of administration

2. Comfort Measures
A patient is more likely to be compliant with a drug regimen if the effects of the therapy are not too uncomfortable or
overwhelming.

PLACEBO EFFECT
= the anticipation that a drug will be helpful has proved to have tremendous impact on the actual success of drug therapy
= the nurse’s attitude & support can be a critical part of drug therapy

MANAGING ADVERSE EFFECTS


= interventions can be directed at promoting patient safety & decreasing the impact of the anticipated adverse effects
= environmental control + safety measures + physical comfort measures

LIFESTYLE ADJUSTMENT
= some medications & their effects require that a patient make changes in his or her lifestyle
= change in lifestyle can affect an individual’s ability to cope & comply with any medical regimen

3. Patient & Family Education


It is essential that they have all of the information necessary to ensure safe & effective drug therapy at home.
In fact, patients are now given written information.

EVALUATION

The patient is continually evaluated for therapeutic response, occurrence of adverse drug effects, and occurrence of drug–drug,
drug–food, drug–alternative therapy, or drug–laboratory test interactions.

The efficacy of the nursing interventions and the education program also are evaluated.

The nurse evaluates the patient simply by reapplying the beginning steps of the nursing process & then analyzing for changes, either
positive or negative.

The process of evaluation may lead to changes in the nursing interventions being used to provide better and safer patient care.

CLIENT EDUCATION ON DRUG THERAPY


ASPECTS OF EDUCATION:

 The purpose of the medication


 The dosage of the medication
 The side effects of the medication
 The possible adverse effects of the medication
 When to call the doctor about any side effects
 How and where the medication should be safely stored, such as in the refrigerator or in a dark place, for example.
 The importance of and the method for checking the medication's label for the name, dose, and expiration date.
 Special instructions such as shaking the medication, taking the medication with meals or bet. meals or on an empty stomach.
 The importance of taking the medication as instructed.
 The need to continue the medication unless the doctor discontinues it.
 Information about foods, supplements, & other medications, including OTC medications and preparations, that can interact with
the ordered medication.

 The safe disposal of unused and expired medications.


 The importance of keeping medications in a secure place that would not place a curious child or a cognitively impaired adult at
risk for taking medications not intended for them.

 The proper and safe disposal of any biohazardous equipment such as used needles that the client uses for insulin and other
medications.

AGE SPECIFIC ROUTE, FORMS & DOSAGE CONSIDERATION

 INFANTS
SYRINGE / DROPPER = for oral liquid medications
VASTUS LATERALIS / RECTUS FEMORIS / VENTROGLUTEAL MUSCLE SITES
= for IM injections
= not the deltoid / gluteus maximus muscles since they have not yet developed

 TODDLERS
SPOON / CUP = for liquid oral medications are given with a spoon
VASTUS LATERALIS / RECTUS FEMORIS / VENTROGLUTEAL MUSCLE SITES = for IM injections
GLUTEUS MAXIMUS = can be used after the toddler has been walking for at least a year

** Flavors can be used to improve the taste of oral medications.


** Dosages continue to be based on kilograms of weight.

 PRE SCHOOL / SCHOOL-AGED CHILDREN


CAPSULES & TABLETS
GLUTEUS MAXIMUS + DELTOID + VASTUS LATERALIS + RECTUS FEMORIS + VENTROGLUTEAL MUSCLE = for IM injections

** Dosages continue to be based on kilograms of weight.

 ADOLESCENTS & ADULTS


Get adult dosages, routes, & forms of medications as prescribed by the physician.

 ELDERLY
Dosages may be decreased because the normal physiological changes of the aging process make them more susceptible to side
effects, adverse drug reactions, & toxicity and over dosages.
RECORDING & REPORTING

 Use double locked cabinets to secure controlled substances.

 Others use more sophisticated bar-coded entry systems to access controlled substances.

 Double locked narcotics cabinet is used.


The contents are counted & checked by the nurse at the beginning of the shift. This count is then compared to the documented
count that was done by the nurse from the prior shift.

 If there are any discrepancies, these are immediately addressed, explored, & corrected if it was a simple oversight or math error.
When the narcotics count cannot be corrected, a report must be filed according to the facility's policies and procedures.

 If a controlled substance is wasted for any reason, either in its entirety or only partially, this waste must be witnessed or
documented by the wasting nurse and another nurse. Both nurses document this wasting.

 Medications that are given, omitted, held, or refused by the patient must be documented.

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