PHARM EXAM 2.docx - NURS1132 EXAM 2 Unit II III IV Lehne...

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NURS1132 EXAM 2 Unit II, III, IV Lehne Chp. 1-4 Application of Pharmacology in Patient Care Preadministration assessment o Assessing their vital signs and labs o Review all of the drugs. Look at the original order sheet Dosage and administration o Make sure the dosages are within the range Evaluating and promoting therapeutic effects Minimizing adverse effects Minimizing adverse interactions Making PRN decisions o i.e., the patient has a pain med every 4 hours. You assess the pt and their BP is low or their O 2 is low. If this is the case, you won’t give the medication. o i.e., the patient is to get Lasix and their K+ is low. You will hold that diuretic! Managing toxicity o i.e. dilatin and digoxin levels are measured on patients o if they are toxic on certain meds, you will hold that drug Preadministration Assessment Collecting baseline data Needed to evaluate therapeutic responses and adverse effects Identifying high-risk patients o Know labs! o Liver and kidney impairment Liver and kidney values for drugs metabolized in those areas o Genetic factors o Drug allergies o Pregnancy o Elderly and pediatrics o Tools: patient history, physical exam, and lab results Dosage and Administration Certain drugs have more than one indication. o Beta blockers for BP and to control HR Dosage may differ depending on which indication the drug is used for. Many drugs can be administered by more than one route. Dosage may differ depending on the route selected. Certain IV agents can cause severe local injury if IV infiltrates/extravates. o I.e., If giving Ca++ IV and it infiltrates, skin will start to necrosis Read the medication order carefully. Verify the identity of the patient. o Name and DOB – checking their bracelet as they verbalize
Read the medication label carefully. Verify dosage calculations. Implement any special handling the drug may require. Don’t administer any drug if you don’t understand the reason for its use. Teaching Clients About Meds Imperative for preventing errors o It’s their right to know what they’re getting o Also, to know the side effects. Tell them the biggest problems to look for first. i.e., if a patient is on Abx and they begin having 3 or more loose stools per day, you want to be concerned about C. diff This helps prevent adverse reactions Improves adherence Include the following: o Brand and generic names, explanation of amount, explanation of timing for dose, measuring devices, and route Follow up on teaching o Always follow up 30 minutes to an hour Evaluating and Promoting Therapeutic Effects Evaluating therapeutic responses o One of the most important aspects of drug therapy o Must know the rationale for treatment and the nature and time course of the intended response o Tell them that you will return to check up on their response to the drug therapy Pain, V/S, etc.

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