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NURS1132 EXAM 2Unit II, III, IVLehne Chp. 1-4Application of Pharmacology in Patient Care Preadministration assessmentoAssessing their vital signs and labsoReview all of the drugs. Look at the original order sheetDosage and administrationoMake sure the dosages are within the rangeEvaluating and promoting therapeutic effectsMinimizing adverse effectsMinimizing adverse interactionsMaking PRN decisionsoi.e., the patient has a pain med every 4 hours. You assess the pt and their BP is low or their O2is low. If this is the case, you won’t give the medication.oi.e., the patient is to get Lasix and their K+ is low. You will hold that diuretic!Managing toxicityoi.e. dilatin and digoxin levels are measured on patientsoif they are toxic on certain meds, you will hold that drugPreadministration AssessmentCollecting baseline dataNeeded to evaluate therapeutic responses and adverse effectsIdentifying high-risk patientsoKnow labs! oLiver and kidney impairmentLiver and kidney values for drugs metabolized in those areasoGenetic factorsoDrug allergiesoPregnancyoElderly and pediatricsoTools: patient history, physical exam, and lab resultsDosage and AdministrationCertain drugs have more than one indication.oBeta blockers for BP and to control HRDosage 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.oI.e., If giving Ca++ IV and it infiltrates, skin will start to necrosis Read the medication order carefully.Verify the identity of the patient.oName 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 MedsImperative for preventing errorsoIt’s their right to know what they’re gettingoAlso, 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. diffThis helps prevent adverse reactionsImproves adherenceInclude the following: oBrand and generic names, explanation of amount, explanation of timing for dose, measuring devices, and routeFollow up on teachingoAlways follow up 30 minutes to an hourEvaluating and Promoting Therapeutic EffectsEvaluating therapeutic responsesoOne of the most important aspects of drug therapyoMust know the rationale for treatment and the nature and time course of the intended responseoTell them that you will return to check up on their response to the drug therapyPain, V/S, etc.