Transcript Pharmacology and the Nursing Process, 4th ed. Lilley/Harrington

Chapter 1
THE NURSING PROCESS
AND DRUG THERAPY
DSN
Copyright © 2014 by Mosby, an imprint of Elsevier
Inc.
KEVIN DOBI, MS, APRN
The Nursing Process
2
 A research-based organizational framework for
professional nursing practice
 Ensures the delivery of thorough, individualized, and
quality nursing care to patients
 Requires critical thinking
 Ongoing and constantly evolving process
Copyright © 2014 by Mosby, an imprint of Elsevier
Inc.
Five Steps of the Nursing Process
3
 Assessment
 Nursing diagnosis
 Planning
 Goals
 Outcome criteria
 Implementation including patient education
 Evaluation
Copyright © 2014 by Mosby, an imprint of Elsevier
Inc.
Assessment
4
 Data collection, review, and analysis
 Medication profile
 Any and all drug use
 Prescriptions
 Over-the-counter medications
 Vitamins, herbs, and supplements
 Compliance and adherence
Copyright © 2014 by Mosby, an imprint of Elsevier
Inc.
Classroom Response Question
5
The nurse answers a patient’s call light and finds the
patient sitting up in bed and requesting pain medication.
What will the nurse do first?
A.Check the orders and give the patient the requested
pain medication.
B.Provide comfort measures to the patient.
C.Assess the patient’s pain and pain level.
D.Evaluate the effectiveness of previous pain
medications.
Copyright © 2014 by Mosby, an imprint of Elsevier
Inc.
Nursing Diagnosis
6
 Nursing diagnoses are used to communicate and share
information about the patient and the patient
experience
 Common nursing diagnoses related to drug therapy
include:



Deficient knowledge
Risk for injury
Noncompliance
Copyright © 2014 by Mosby, an imprint of Elsevier
Inc.
Nursing Diagnosis
7
 Three-step process:
 Human response to illness, injury, or significant change
 Factors related to the response (“related to”)
 Listing of cues, clues, evidence, or other data that support the
nurse’s claim for the diagnosis (“as evidenced by”)
Copyright © 2014 by Mosby, an imprint of Elsevier
Inc.
Planning
8
 Identification of goals and outcome criteria
 Goals
 Objective, measurable, and realistic with an established time
period for achievement of the outcomes that are specifically
stated in the outcome criteria
 Outcome criteria
 Concrete descriptions of patient goals
Copyright © 2014 by Mosby, an imprint of Elsevier
Inc.
Classroom Response Question
9
The patient’s medication administration record lists two
antiepileptic medications that are due at 0900, but the
patient is NPO for a barium study. The nurse’s coworker
suggests giving the medications via IV because the patient
is NPO. What will the nurse do?
A.Give the medications PO with a small sip of water.
B.Give the medications via the IV route because the
patient is NPO.
C.Hold the medications until after the test is completed.
D.Call the health care provider to clarify the instructions.
Copyright © 2014 by Mosby, an imprint of Elsevier
Inc.
Implementation
10
 Initiation and completion of specific nursing actions as
defined by the nursing diagnoses, goals, and outcome
criteria
 Independent, collaborative, dependent
Copyright © 2014 by Mosby, an imprint of Elsevier
Inc.
The “Six Rights” of
Medication Administration
11
 Right drug
 Right dose
 Right time
 Right route
 Right patient
 Right documentation
Copyright © 2014 by Mosby, an imprint of Elsevier
Inc.
Classroom Response Question
12
The day shift charge nurse is making rounds. A patient tells
the nurse that the night shift nurse never gave him his
medication, which was due at 2100. What will the nurse do
first to determine whether the medication was given?
A.
B.
C.
D.
Call the night nurse at home
Check the medication administration record
Call the pharmacy
Review the nurse’s notes
Copyright © 2014 by Mosby, an imprint of Elsevier
Inc.
Evaluation
13
 Ongoing part of the nursing process
 Determining the status of the goals and
outcomes of care
 Monitoring the patient’s response to drug therapy

Expected and unexpected responses
 Clear concise documentation
Copyright © 2014 by Mosby, an imprint of Elsevier
Inc.
Classroom Response Question
14
A nurse makes an error when administering medications to a
patient. Which action by the nurse requires the supervising
nurse to intervene? The nurse
A.
B.
C.
D.
completes an incident report.
informs the prescriber of the error.
documents adverse effects to the medication error.
records completion of an incident report in the medical
chart.
Copyright © 2014 by Mosby, an imprint of Elsevier
Inc.