Assessment
What age related factors can impair an elderly patient's ability to learn?
hearing, reading level, sensory perception, cognitive impairment, and memory impairment
Multiple drug therapy is called what?
What things would the nurse anticipate the provider monitoring? (think labs)
Polypharmacy
Renal Function
You are providing education on a new medication. What information should you provide to the patient?
1. Reason
2. Potential Side Effects
3. Time Frame of Desired Outcome
4. Dose
The patient is started on Lisinopril for hypertension. How can the nurse determine if a medication had the therapeutic response?
The patient's blood pressure will be reduced from 150/90 to 120/68.
What is genetic predisposition?
How can an individual offset this?
The likelihood of developing a certain disease based on the genetic make-up of a person.(i.e.- Diabetes)
Diet, exercise, no smoking- modifiable risk factors.
When administering medications to a pediatric patient, what information does the nurse need to obtain?
weight in kilograms
When you are evaluating outcomes for learning, what terms would demonstrate a measurable outcome?
Describe, demonstrate, list, identify, discuss, state.
Prior to administration of a medication, the nurse should perform what?
Be aware of the 9 rights of medication administration. Med, Dose, Route, Time, Reason, Patient, Documentation, Reason, Response, and Refuse
What would you do if any of this information was missing? Call the doctor
What if you are interrupted?
What is pharmacokinetics?
The study of how medications move through the human body and what happens to the medication along the way.
In order to maintain confidentiality, who would you share the patient's lab results?
The patient only!
What is..
-Veracity?
-Justice?
-Nonmaleficence?
-Veracity: tell the truth
-Justice: being fair or equal
-Nonmaleficence: No harm
How would you describe the planning stage of the nursing process?
The nurse will identify outcomes based on the patient needs; the plan will identify specific interventions.
What are the pregnancy categories?
A- no risk to human fetus
B-No risk to animal fetus; no info in humans
C-Adverse effects reported in the animal fetus; humans is not available
D-Possible fetal risk in humans has been reported; however, in selected cases consideration of the potential benefit versus risk
X-Fetal abnormalities; positive fetal risk. Not to be used in pregnant women
How would you address this if a female patient was put on one of these meds?
What are the domains of learning?
cognitive- "thinking" portion of the learning process
affective- conduct that expresses feelings, needs, beliefs, values, and opinions.
pyschomotor- "doing" domain (procedure or skill)
What are some examples of these?
Prior to administering medications, what are a couple of other questions that you should ask?
Name and DOB (verify with armband)
Do you have an allergies? If so, what reaction do you have?
What is a high alert medication?
These types of medications have a higher risk for causing harm in patients. Therefore, these patients must be monitored more closely, and often require cosigning and "double checks" prior to administration.
(Example: heparin infusion)
Therapeutic range is concentration of medication in the serum that produces the desired effect for the client without causing toxicity.
Peak-highest
Trough-lowest
If you are unsure of a medication, what should you do prior to administration?
Call the pharmacist or use a drug guide book that was published within the past five years.
Grapefruit juice can ______.
-decrease metabolism of drugs used for erectile dysfunction, estrogens, and some psychotherapeutic drugs.
-increase risk for toxicity of immunosuppressants, HMG COA reductase inhibitors
-increase intensity and duration of caffeine.
What is hepatotoxic?
Liver toxicity
What labs would you monitor? -Liver enzymes (AST, ALT, Alkaline Phosphate)
1. Assess the patient for adverse effects
2. Document
3. Report to the provider or according to policy.
Absorption rates
IV
IM
PO
What is Intradermal?
What is sublingual?
What is transdermal?
How would you approach an individual who is apprehensive about taking a new medication? Are there other alternatives?
-Start off by clarifying the patient's concerns
-Provide risk versus benefits of alternative therapies in question.
What drug administration teaching should you provide for a parent who is caring for a 3 year old who is going home on a liquid seizure medication?
-Take the medication at the scheduled time.
-Use the cup or syringe (young child) that is provided with the medication. Cup should always be flat and measured at eye level.
-Childproof bottle to prevent overdose.
What is pharmacodynamics?
What is pharmacokinetics?
Pharmacodynamics explains what a medication does to the client's body on a cellular level.
Pharmacokinetics of medication includes absorption, distribution, metabolism, and excretion. *Be sure to understand each of these terms.