1/17/2016 winter 2013 1 nursing process and drug therapy chapter one preventing medication errors...
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1/17/2016 Winter The Nursing Process in Drug Therapy Assessment – Drug history Prescription medications Non prescription medications Tums, cough drops, laxatives Social drugs Coffee, tea, alcohol, cola, tobacco Herbal or dietary supplements Ginkgo, glucosamine Problems with current medications ExploreTRANSCRIPT
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Nursing Process and Drug Nursing Process and Drug TherapyTherapy
Chapter OneChapter One
Preventing Medication ErrorsPreventing Medication ErrorsChapter SixChapter Six
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The Nursing Process in Drug TherapyThe Nursing Process in Drug Therapy
Assessment – Assessment – Drug historyDrug history Prescription medicationsPrescription medications Non prescription medicationsNon prescription medications
Tums, cough drops, laxativesTums, cough drops, laxatives Social drugsSocial drugs
Coffee, tea, alcohol, cola, tobaccoCoffee, tea, alcohol, cola, tobacco Herbal or dietary supplementsHerbal or dietary supplements
Ginkgo, glucosamineGinkgo, glucosamine Problems with current medicationsProblems with current medications
ExploreExplore
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The Nursing Process in Drug The Nursing Process in Drug TherapyTherapy
Example: Pt taking Antihypertensive Example: Pt taking Antihypertensive medication every other day rather than daily. medication every other day rather than daily. Now admitted for hypertensive episode.Now admitted for hypertensive episode.
Nursing DiagnosisNursing Diagnosis Knowledge deficit R/T drug therapy regimen as Knowledge deficit R/T drug therapy regimen as
evidenced by underuse of medication severe evidenced by underuse of medication severe hypertensionhypertension
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The Nursing Process in Drug TherapyThe Nursing Process in Drug TherapyPlanPlan
Establish patient goalsEstablish patient goals Patient will take medication as prescribedPatient will take medication as prescribed
Determine outcome criteriaDetermine outcome criteria Patient will maintain a blood pressure between Patient will maintain a blood pressure between
130/80 and 145/92 following two weeks of 130/80 and 145/92 following two weeks of prescribed therapyprescribed therapy
Identify appropriate nursing actionIdentify appropriate nursing action Teach patient about medicationTeach patient about medication Instruct patient on how to monitor his own blood Instruct patient on how to monitor his own blood
pressurepressure
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The Nursing Process in Drug TherapyThe Nursing Process in Drug Therapy
InterventionIntervention Patient educationPatient education
Why is patient not taking the medication every Why is patient not taking the medication every day?day?• CostCost• Side effectsSide effects• ForgettingForgetting
Risks of uncontrolled hypertensionRisks of uncontrolled hypertension Better understanding of how medication worksBetter understanding of how medication works Instruction on how to monitor his own BpInstruction on how to monitor his own Bp
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The Nursing Process in Drug TherapyThe Nursing Process in Drug TherapyEvaluationEvaluation
If possibleIf possible, ALWAYS FOLLOW-UP WITH PATIENT , ALWAYS FOLLOW-UP WITH PATIENT TO REASSESS EFFECTS OF INTERVENTIONTO REASSESS EFFECTS OF INTERVENTION
COMMUNICATE!COMMUNICATE!
Plan further interventions if necessaryPlan further interventions if necessary
Patient Safety
Medication Errors: Preventing and Responding
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SAFE MEDICATION ADMINISTRATIONSAFE MEDICATION ADMINISTRATION
““SIX” RIGHTSSIX” RIGHTSRIGHT MEDICATIONRIGHT MEDICATION
RIGHT DOSERIGHT DOSERIGHT PATIENTRIGHT PATIENT
RIGHT TIMERIGHT TIMERIGHT ROUTERIGHT ROUTE
THE RIGHT OF THE PATIENT TO THE RIGHT OF THE PATIENT TO REFUSEREFUSE
THE RIGHT TO INFORMATION ABOUT THE RIGHT TO INFORMATION ABOUT THE DRUGTHE DRUG
RIGHT DOCUMENTATIONRIGHT DOCUMENTATION
The RIGHT Medication
As the physician prescribedTrade name or generic?Does the drug match the MAR? (medication
administration record)Is the drug appropriate for the patient?
The RIGHT DoseDoes the dose of medication in your hand
agree with the dose on the MAR?Are the mg, mcg, ml the same?
The RIGHT Patient
Have you checked using two patient identifiers? Patient states…verifies BD Patient armband Compare Pt. ID number to MAR
What if there is no arm band?BCMA
The RIGHT Time
AM or PM24 Hour ClockQ4TidBidQidqd
The RIGHT RoutePOIVSC (SQ)TRANSDERMALRECTALIMINSL
DOES IT MAKE SENSE??
