Pharmacology and Nursing Practice

Application of Pharmacology in Nursing Practice

1. Why should a student nurse learn about drugs?
1.1. Motivation for studying Pharmacology
1.2. Essential for nursing practice
1.3. Worthwhile investment
1.4. Much more required than the six ight!s
1.4.1. ight "rug
1.4.#. Patient
1.4.$. "ose
1.4.4. oute
1.4.%. &ime
1.4.'. "ocumentation
2. Evolution of Nursing Responsiilities Regarding !rugs
#.1. (orrect administration) *ithout additional inter+entions) cannot ensure
that treatment *ill result in the therapeutic ob,ecti+e
#.#. Proper deli+ery is only the beginning of a nurse!s responsibility
#.$. Nurses - physicians - pharmacists participate in a system of chec.s and
balances designed to promote beneficial effects and to minimi/e harm.
2.". #he nurse must $now %
#.4.1. What medications are appropriate for the patient *hat drugs are
contraindicated for the patient
#.4.#. &he probable consequences of the interaction bet*een drug and
patient
#.%. &he nurse!s role as ad+ocate0
2.&.1. 'ollows the patient(s status most closely
2.&.2. !etect mista$es made y pharmacists and prescriers
2.&.3. 'irst memer of the health care team to oserve and evaluate drug
responses and intervene if re)uired
2.&.". Must $now the response that a medication is li$ely to elicit
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Pharmacology and Nursing Practice
2.&.&. *ast line of defense for the patient
2.&.+. Ethically and legally unacceptale to administer a drug that is harmful to
the patient , even though the medication has een prescried y a licensed
prescrier and dispensed y a licensed pharmacist
$. Application of pharmacology in Patient (are
3.1. #wo ma-or areas in which pharmacologic $nowledge can e applied%
3.1.1. Patient care
3.1.2. Patient education
3.2. Pre.administration assessment
3.3. !osage and minimi/ing administration
3.". Evaluating and promoting therapeutic effects
3.&. 0dverse effects
3.+. Minimi/ing adverse interactions
3.1. Ma$ing PRN decisions
4. Pre1administration Assessment
".1. Managing to2icity
".1.1. 3ollecting aseline data
4.1.1.1. Needed to e+aluate therapeutic responses and ad+erse effects.
4.1.#. 2dentifying high1ris. patients
".1.2.1. *iver and $idney impairment
".1.2.2. 4enetic factors
".1.2.3. !rug allergies
".1.2.". Pregnancy
".1.2.&. Elderly and pediatric
".1.2.+. #ools%
".1.2.+.1. Patients history5
".1.2.+.2. Physical e2amination
".1.2.+.3. *aoratory results
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Pharmacology and Nursing Practice
%. "osage and administration
%.1. (ertain drugs ha+e more than one indication.
&.2. !osage may differ depending on which indication the drug is used for.
&.3. Many drugs can e administered y more than one route.
&.". !osage may differ depending on the route selected.
&.&. 3ertain 67 agents an cause severe local in-ury if 67 e2travagates
%.'. ead the medication order carefully.
%.3. 4erify the identity of the patient
%.5. ead the medication label carefully.
%.6. 4erify dosage calculations.
&.18. 6mplement any special handing the drug may re)uire.
&.11. !on(t administer any drug if you don(t understand the reason for its use.
'. 7+aluation therapeutic responses0
+.1. 9ne of the most important aspects of drug therapy
'.#. Must .no* the rationale for treatment and the nature and time course of
the intended response
+.3. 3annot effectively evaluate a drug with multiple applications if the intended use
is not $nown
'.4. Promoting patient adherence
+.".1. 0lso $nown as compliance or concordance
+.".2. E2tent to which a patient(s ehavior coincides with medical advice
'.%. 2mplementing nondrug measures
+.&.1. !rug therapy can often e enhanced y nondrug measures.
+.&.2. :iofeedac$5 emotional support5 weight reduction5 smo$ing cessation5
sodium restriction5 etc.
3. Minimi/ing Ad+erse 7ffects
1.1. 0ll drugs have the potential to produce undesired effects.
3.#. Al*ays .no* the follo*ing 0
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Pharmacology and Nursing Practice
3.#.1. &he ma,or ad+erse effects the drug can produce
3.#.#. &he time *hen these reactions are li.ely to occur
3.#.$. 7arly signs that an ad+erse reaction is de+eloping
3.#.4. 2nter+entions that can minimi/e discomfort and harm
5. Minimi/ing ad+erse interactions
5.1. &a.e a thorough drug history.
5.#. Ad+ise to a+oid 8&( drugs that can interact *ith the prescribed
medication.
5.$. Monitor for ad+erse interactions the patient .no*n to occur.
5.4. 9e alert for as1yet un.no*n interactions.:
6. Ma.ing PN "ecisions
;.1. PRN% pro re nata5 meaning <as needed=
6.#. Nurse has discretion regarding ho* much drug to gi+e and *hen to gi+e it.
6.$. ;no* the reason for drug use.
6.4. 9e able to assess the patient!s medications needs
1<. Managing &oxicity
1<.1. 7arly identification ma.es early inter+ention possible.
1<.#. ;no* the early signs of toxicity.
1<.$. ;no* the procedure for toxicity management.
11. Application of Pharmacology in Patient 7ducation
11.1. !rug name and therapeutic category
11.2. !osage si/e
11.3. !osing schedule
11.". Route and techni)ue of administration
11.&. E2pected therapeutic response and when it should develop
11.+. Nondrug measures to enhance therapeutic responses
11.1. !uration of treatment
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Pharmacology and Nursing Practice
11.>. Method of drug storage
11.;. ?ymptoms of ma-or adverse effects and measures to minimi/e discomfort
and harm
11.18. Ma-or adverse drug.drug and drug.food interactions
11.11. Whom to contact in the event of therapeutic failure5 severe adverse
reactions5 or severe adverse interactions
1#. &eaching "osage and Administration
12.1. 4ive patient the following information%
1#.1.1. Name of drug
1#.1.#. "osage and schedule of administration
1#.1.$. &echnique of administration
1#.1.4. "uration of drug use storage of drug
1$. Application of Pharmacology in Patient 7ducation
1$.1. Promoting therapeutic effects
13.1.1. Nature and time course of e2pected eneficial effects
13.1.2. Recogni/ing treatment failure5 allow for timely alternative therapy
implementation
1$.#. Minimi/ing ad+erse effects
13.2.1. 6nsulin overdose
13.2.2. 0nticancer and infection
13.2.3. ?ome side effects are enign ut disturing5 especially if un$nown
to the patient.
14. Minimi/ing Ad+erse 2nteractions
1".1. Educate patient aout ha/ardous drug.drug and drug.food interactions.
1".1.1. E2ample% phenel/ine and amphetamines or figs
1%. Application of the Nursing Process in "rug &herapy
1&.1. 0pplication of the nursing process conceptual framewor$ in drug therapy
1&.2. @se of modified nursing process format to summari/e nursing implications
in this te2t
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Pharmacology and Nursing Practice
1'. e+ie* of the Nursing Process
1+.1. 0ssessment
1+.2. 0nalysis% Nursing diagnoses
1+.3. Planning
1+.". 6mplementation AinterventionB
1+.&. Evaluation
13. Applying the Nursing Process in "rug &herapy
11.1. Pre.administration assessment
11.2. 0nalysis and nursing diagnoses
11.3. Planning
11.". 6mplementation
11.&. Evaluation
15. Pre1administration Assessment
15.1. (ollection of baseline data to e+aluate therapeutic effects
15.#. (ollection of baseline data to e+aluate ad+erse effects
15.$. 2dentification of high1ris. patients
15.4. Assessment of the patient!s capacity for self1care
16. Analysis and Nursing "iagnoses
1;.1. #hree o-ectives%
16.1.1. =udge the appropriateness of the prescribed regimen
16.1.#. 2dentify potential health problems that the drug might cause.
16.1.$. "etermine the patient!s capacity for self1care
#<. Planning
28.1. !efining goals
28.2. ?etting priorities
28.3. 6dentifying specific interventions
28.3.1. !rug administration
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Pharmacology and Nursing Practice
28.3.2. 6nterventions to enhance therapeutic effects
28.3.3. 6nterventions to minimi/e adverse effects
28.3.". Patient education
28.". Estalishing o-ective criteria for evaluation
#1. 2mplementation
21.1. !rug administration
21.2. Patient education
21.3. 6nterventions to promote therapeutic effects
21.". 6nterventions to minimi/e adverse effects
##. 7+aluation
22.1. #herapeutic responses
22.2. 0dverse drug reactions and interactions
22.3. 0dherence to the prescried regimen
22.". ?atisfaction with treatment
#$. Modified Nursing Process >ormat to ?ummari/e Nursing 2mplications @see
&able #.#A
23.1. Pre.administration assessment
23.2. 6mplementation% administration
23.3. 6mplementation% measures to enhance therapeutic effects
23.". 9ngoing evaluation and interventions
23.&. Patient education
23.+. What aout diagnosis and planningC
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