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List the "Five Rights of Drug Administration"
- 1. give the Right drug
- 2. to the Right person
- 3. in the Right dose
- 4. by the Right route
- 5. at the Right time
- More recently, a Sixth Right was added:
- Right documentation
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The nursing process - a systematic method of problem solving - is a foundation of all nursing practive
- 5 steps:
- 1. assessment - 3 goals of assesment are to: (1) collect baseline data needed to evaluate therapeutic and adverse responses, (2) identifying high-risk patients, and (3) assessing the pateint's capacity for self care. The first 2 goals are highly specific for each drug
- 2. nursing diagnosis - a clinical judgement about individual, family or comunity responses to actual or potential health problems/life processes. The nursing diagnosis is an actual or potential health problems that nurses are qualified and license to treat.
- 3. planning - this step is when the client goals are set and the intervnetion/actions are determined to meet the established goals. The plan must be individualized for each patient. when creating a care plan, the nurse must define goals, set priorities, identify nursing interventions and establish criteria for evaluating success.
- 4. intervention/implemation - implementation begans with carrying out the interventions identified during planning. implementation is completed by observing and recording the outcomes of treatment. Records should be thorough and precise
- 5. evaluation - determines the degree to which treatment has succeeded. Evaluation is accomplished by analyzing the data collected during implementation. Evaluation should id those interventions that should be continued, those that should be discontinued, and potential new interventions that might be implemented.
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nursing responsibilities with regards to drugs extends far beyond the Six Rights of Drug Administration
You are the patient's last line of defense against medication errors
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The goal of preadministration assessment is to gather data needed for
1. evaluation of therapeutic and adverse effects
2. identification of high-risk patients
3. assessment of the patient's capacity for self-care
The analysis and diagnosis phase of treatment is directed at
1. judging the appropriateness of the prescribed therapy
2. identifying potential health problems treatment might cause and
3. characterizing the patient's capacity for self-care
- planning is directed at
- 1. defining goals
- 2. establishing priorities and
- 3. establishing criteria for evaluating success
- in the evaluation stage, the objective is to evaluate
- 1. therapeutic responses
- 2. adverse reactions and interactions
- 3. patient adherence and
- 4. patient satisfaction with treatment
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dosage and administration
1. read the medication order carefully
2. verify the identity of the patient
3. read the medication label carefully
4. verify dosage calculations
5. implement any special handling the drug may require
6. dont administer any drug if you dont understand the reason for its use
- evaluating the promoting therapeutic effects
- 1. evaluating therapeutic responses
- 2. promoting patient adherence
- 3. implementing non-drug measures
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minimizing adverse effects
1. the major adverse effects the drug can produce
2. the time when these reactions are likely to occur
3. early signs that an adverse reaction is developing
4. interventions that can minimize discomfort and harm
- minimzing adverse interactions
- 1. take a thorough drug history
- 2. advise the patient to avoid OTC drugs that can interact with the prescribed medication
- 3. monitor for adverse interactions known to occur
- 4. be alert for as-yet unknown interactions
- 5. making PRN (pro re nata, latin meaning as needed) decisions
- 6. managing toxicity
- making PRN decisions:
- 1. know the reason for drug use
- 2. be able to assess the patients medication needs
- managing toxicity
- 1. know the early signs of toxicity
- 2. know the procedure for toxiticity management
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