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Pharm Notes II

Pharm Notes II - Nurse's Role in Drug Therapy 1 Storage...

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1/25/2008 Nurse's Role in Drug Therapy 1. Storage, preparation and administration 2. Promotion and observation for intended effect 3. Prevention, detection and minimization of side effects and interactions 4. Client education Nurses are liable for their actions, omissions, and duties that they delegate to others If you follow all correct procedures and the patient still dies, the law protects you Nurses must be advised of the law, institutional policies, and ethical codes Three conditions must be met before nurse can administer medications 1. Order must be valid and up-to-date 2. Nurse must be licensed 3. Must know purpose, action, effect, dose, major side and toxic effects of drug, and teaching Rights of Medication Administration 1. Right medication 2. Right patient (check wristband) 3. Right dose 4. Right time (usually ok within an hour) 5. Right route 6. (Patient's) right to know re: med 7. (Patient's) right to refuse med Nursing Actions that Facilitate Proper Medication 1. Don't administer drugs that you haven't prepared (or been present when it's prepared) 2. Listen to client if they question medication 3. Right to refuse to administer medication if you don't think it's the right dose, or there are other problems you have knowledge of 4. Record administration of each dose ASAP 5. Observe for side effects Nursing Process/Drug Therapy 1. Assessment 1.1. Taking a drug history (allergies, etc. NKDA = no known drug allergies, current meds and what they're taken for, meds that have been discontinued within last 6 months, OTC medications, alcohol and smoking, caffeine,) 1.2. Assess for intended effects 1.3. Assess for interactions 2. Nursing Diagnosis 2.1. Example: knowledge deficit r/t med. for HTN 3. Planning 4. Intervention 4.1. Promote intended effect 4.2. Assist patient to cope with side effects 4.3. Teaching 4.4. Storage, preparation, administration 5. Evaluation Type of Drug Orders
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Routine - drugs should be administered on a regular basis until discontinued PRN - only as necessary, nurse uses judgment Single - administered only once at a certain time STAT - single orders administered immediately Protocol - set of criteria that serves as a directive under which medication may be delivered Pharmacokinetics Magnitude of drug response is dependent on dose and timing course of administration Three phases of drug activity 1. Pharmaceutical phase 1.1. Disintegration of dosage form (pills, liquids, etc.) 1.2. Dissolution of drug - time in which the drug goes into solution 2. Pharmacokinetic phase 2.1. Absorption - must be absorbed to have desired effect 2.2. Distribution - to sites of action or storage areas 2.3. Metabolism - to break down products 2.4. Excretion 3. Pharmacodynamic phase 3.1. Drug-receptor 3.2. Interaction Properties Influencing Pharmacokinetic Activity 1. Physiochemical properties of drugs 1.1. ionized (polar) form is usually water soluble and DOES NOT READILY diffuse through cell membranes 1.2. nonionized (nonpolar) form is more lipid soluble and is MORE APT to cross cell membrane 2. Physiochemical properties of cell membranes 2.1. Passive transport - doesn't require energy
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