Nursing 220 Pharmacology Module I: General Principles Key Components to Success

1
Nursing 220PharmacologyModule I General
Principles Key Components to Success

• Presented by
• Ronda M. Overdiek, MSN, CCRN, RNC

2
Key Components to Success

• Seven Rights of Drug Administration
• Drug -Time
• Patient -Refuse
• Route -Documentation
• Dose
• Nursing Process
• Assessment
• Diagnosis
• Planning
• Implementation
• Evaluation

3
Seven Rights of Drug Administration

• The Right Drug
• Have more than one name (generic/trade)
• Have similar spellings
• Sound the same

4
Seven Rights of Drug Administration

• The Right Patient
• Look the same
• Names can be the same
• Same diagnosis

5
Seven Rights of Drug Administration

• The Right Route
• Oral
• Parenteral
• Medications entering the body through any route
  other than orally through the GI system.
• SC/SQ, IM, IV
• Mucous Membrane
• Mouth, throat, sublingual, buccal, nose,
  inhalation, GU system, vaginally, rectally.
• Topical
• Skin, eye, ear

6
Seven Rights of Drug Administration

• The Right Dose
• Dosage calculations
• DESIRED (mg)
• (amount of drug) X Concentration
  Dose
• HAVE (mg) (ml) Delivered (ml)
• (amount have on hand)
• D X C DD
• H

7
Dosage Calculations Practice

• The physician has ordered Ampicillin 250 mg IV
  every 12 hours. Ampicillin is supplied as
• 500 mg in 5 ml
• Desired X Concentration Dose
• Have
  Delivered

8
Dosage Calculations Practice

• Desired X Concentration Dose
• Have
  Delivered
• 250 mg X 5 ml 2.5
  ml
• 500 mg

9
Seven Rights of Drug Administration

• The Right Time

10
Seven Rights of Drug Administration

• The Right for the Patient to Refuse

11
Seven Rights of Drug Administration

• The Right Documentation

12
Seven Rights of Drug Administration

• Drug
• Patient
• Route
• Dose
• Time
• Refuse
• Documentation

13
Baseball vs. Nursing
14
The Nursing Process(Wise, 2002)
15
The Nursing ProcessAssessment

• Data collection
• Patients disease history, current health
  problems, needs, strengths, and weaknesses.
• Two Phases
• Verbal (talking/listening)
• Past/current use of medications, level of
  knowledge, compliance.
• Physical Assessment

16
The Nursing ProcessDiagnosis

• Identify the patients actual or potential health
  status
• Diagnostic statement developed from
  objective/subjective information obtained in
  assessment portion
• Examples
• Knowledge deficit related to insufficient
  instruction regarding new antihypertensive
  medication as evidenced by inability to recognize
  antihypertensives.
• Noncompliance related to inability to accept
  diagnosis and treatment regimen as evidenced by
  not taking medication as ordered.

17
The Nursing ProcessPlanning

• Short and long term goals or expected patient
  outcomes are established
• Manner of implementation is determined
• Medication administration
• What observations must be made relative to the
  effect of the medication? Action of the drug on
  the body?
• What route will be used to administer the
  medication?
• Precautions required to administer medication
• Special considerations for patient administration
• Specific nursing measures required to administer
  the medication safely
• Special learning needs required to administer the
  medication at home

18
The Nursing ProcessImplementation

• Nursing care is delivered based on what was
  identified in the planning stage
• Nursing Implementation
• Dependent
• Independent
• Collaborative
• Critical thinking is essential
• Every minute while caring for the patient the
  nurse is analyzing, synthesizing, solving
  problems, setting priorities, and evaluating what
  is being done to and for the patient.
• Patient Teaching

19
The Nursing ProcessEvaluation

• Nurse determines
• Whether the previously established outcome
  criteria have been met
• Whether nursing interventions can be terminated
  or must be reviewed or changed.
• Subjective/objective data gathered
• Medication Administration
• Patient exhibit signs/symptoms that indicate the
  medication is effective/ineffective
• Patient experiencing any secondary effects
• Patient experiencing any drug interactions
• Patient comprehend material previously taught
  about meds
• Patient have the skill to administer meds at home
• Patient taking the medication as prescribed

20
The Nursing Process

• Assessment
• Diagnosis
• Planning
• Implementation
• Evaluation