Transcript Chapter 12 - papademas.net

Chapter 12
Information Basic to
Administering Drugs
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Information Nursing Handbook
• Generic and trade names
• Classification and category
• Side and adverse effects
• Pregnancy category
• Dosage and route
• Action
• Indications
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Information Nursing Handbook (cont.)
• Contraindications and precautions
• Interactions and incompatibilities
• Nursing implications
• Signs of effectiveness
• Patient teaching
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Generic and Trade Name
• Generic name: one official name
• Trade name: several brand names
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Classification and Category
• Drug classification: categorizes drugs by the way they
act against diseases or disorders
• Drug category: way drugs work at the molecular, tissue,
or body system level
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Side Effects and Adverse Effects
• Side effect: nontherapeutic reactions to drug
• Adverse effect: nontherapeutic effect
– May be harmful
– Require lowering the dosage or discontinuing the
drug
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Pregnancy Category
• A: no risk to the fetus in any trimester
• B: no adverse effect demonstrated in animals; no human
studies available
• C:
– studies with animals show adverse reaction
– no human studies available
– given only after risks to fetus considered
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Pregnancy Category (cont.)
• D: definite fetal risk and only given when risk to fetus is
life threatening
• X: absolute fetus abnormality and not given
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Action and Indication
• Action: how drug works
• Indication: reason for using the drug
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Contraindication and Precautions
• Terms used in which the drug should be given with
caution or not given at all
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Incompatibilities
• Chemical: produces a visible sign
• Physical: may not give visible sign
• When in doubt, do not mix
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Nursing Implications
• Whether drug should be taken with or without food
• What specific vital signs to monitor
• What lab values may be affected by the drug or ordered
to check drug’s effectiveness or toxicity
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Pharmacokinetics
• Absorption
• Distribution
• Biotransformation
• Excretion
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Absorption Factors
• Degree of stomach acidity
• Time required for stomach to empty
• Whether food is present
• Amount of contact with villi in small intestine
• Flow of blood to villi
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Distribution, Biotransformation, Excretion
• Distribution: drug’s movement through body fluids
• Biotransformation: chemical change of drug into a form
that can be excreted
• Excretion: process by which the body removes a drug
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Factors Affect Drug Action
• Weight
• Age
• Pathologic conditions
• Hypersensitivity to a drug
• Psychological and emotional state
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Question
What is distribution of a medication?
A. Hypersensitivity to a drug
B. Drug’s movement through body fluids
C. Chemical change of drug into a form that can be
excreted
D. Process by which the body removes a drug
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Answer
B. Drug’s movement through body fluids
• A. Factor affecting drug action: Hypersensitivity to a
drug
• B. Distribution: drug’s movement through body fluids
• C. Biotransformation: chemical change of drug into a
form that can be excreted
• D. Excretion: process by which the body removes a
drug
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Half Life and Therapeutic Range
• Half Life: time required for half of the drug to be
excreted
• Therapeutic range: quantity of drug in the blood or
serum to be effective
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Law
• Criminal: offenses against general public detrimental to
society as whole
• Civil: legal rights and duties of private persons
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Malpractice
• Nurse owed the patient a special duty of care
• Nurse failed to meet required standards
• Claim harm or injury resulted because nurse did not
meet required standard
• Claim of damages for which compensation is sought
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Ethical Principles in Drug Administration
• Provide services with respect for the patient’s human
dignity and uniqueness
• Safeguard patient’s right to privacy
• Act to safeguard patient from incompetent, unethical, or
illegal practice
• Assume responsibility and accountability for nursing
judgments and actions
• Maintain competence in nursing
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Autonomy and Truthfulness
• Autonomy: self-determination
• Truthfulness: obligation not to lie
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Beneficence and Nonmaleficience
• Beneficence: nurse should act in patient’s best interests
• Nonmaleficience: nurse must not inflict harm on the
patient and must prevent harm whenever possible
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Confidentiality, Justice, Fidelity
• Confidentiality: respect information nurse learns from
professional involvement with patients
• Justice: maintain high standard of care
• Fidelity: keep promises made to the patient
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Question
Is the following statement true or false?
• Nonmaleficience occurs when the nurse does not
inflict harm on the patient and prevents harm
whenever possible.
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Answer
True
• Nonmaleficience occurs when the nurse does not inflict
harm on the patient and prevents harm whenever
possible.
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Three Checks When Preparing
Medications
• Removing medication
• Before pouring or opening medication
• Before replacing container or giving unit dose
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Six Rights Before Administering
Medications
• Medication
• Patient
• Dosage
• Route
• Time
• Documentation
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Types of Orders
• Standing
– With termination
– Without termination
• PRN
• Single dose
• State
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Specific Points Helpful in Giving
Medications
• Orders for physicians and healthcare providers
• Knowledge base
• Medication safety
• Oral medications: tablets and capsules
• Liquid medications
• Giving medications
• Charting
• Evaluation
• Medication errors
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Medication Errors
• Prevent them
• Don’t make them
• Don’t be in a hurry
• If you do make them, learn from your mistakes and don’t
make them again
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