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NUR 202 Midterm Exam.pdf complete
Typology: Exams
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Explain what is involved in each step of the nursing process as it relates to drug therapy - Assess: answer
Diagnosing: Analyze Data, Identify Health Problems, Risks & Strengths, Formulate Diagnostic Statements Planning: Prioritizing problems/ diagnoses, formulate goals/ desired outcomes, select nursing interventions, write nursing interventions Implementing: Reassess the client, determine the nurse's need for assistance, implement the nursing interventions, supervise delegated care, document nursing activities Evaluating: Collect data related to outcomes, compare data with outcomes, relate nursing actions to client goals/ outcomes, draw conclusions about problem status, and continue/ modify/ or terminate the client's care plan
Recognize pharmacotherapeutic factors that contribute to the diagnosis and planning phase of the nursing process - Diagnosis Phase:
-Checking drug with MAR or medication information system when removing it from storage -Checking drug when preparing it, pouring it, taking it out of the unit-dose container, or connecting the IV tubing to bag -Checking drug before administering it to the patient Assessing barriers to learning - -Healthcare agencies are required to provide translation service for patients -If family member is translating, the nurse should be sure that the interpreter first understands and repeats information back to the nurse before translating back to patient -Use pictures, simple drawings, nonverbal cues, and body language when communicating with patient
-Older patients may need teaching materials that are repeated slowly and in small increments (may be necessary to co-teach caregiver) Recognize & Aim of key nursing interventions - Primary Intervention: monitoring drug effects Aim: monitor for therapeutic drug effect, monitor subjective and objective data, monitor for side and adverse effects and attempts to limit those effects How to measure outcomes and revise care - effectiveness of teaching - Evaluation Phase: Compare patient's current health status with desired outcome
-Rate of excretion may increase Recognize the responsibilities of the nurse in administering medications to patients across the lifespan - -Patient drug allergies -Expected action, dose range, side effects of medication, and any precautions -Developmental state of the infant/child/ adolescent -Alterations in the patient's condition or underlying conditions -Patient and family level of understanding of medication Describe physiological and biochemical changes that occur in the older adult, and how these affect pharmacotherapies - Absorption of drugs are slower in older adults: -diminished gastric motility
-decreased blood flow to digestive organs -Increased gastric pH (oral tablets/ capsules that require high levels of acid for absorption may take longer to become available to tissues) Distribution is slower in older adults: -increased body fat -reduced plasma level (therapeutic response is diminished) -less body water (dehydration becomes severe and leads to drug toxicity) -liver malfunction (increase for potential of drug-drug interaction) -decreased cardiac output (slow drug distribution) Metabolism reduced in older adults:
Develop nursing interventions that maximize pharmacotherapeutic outcomes in the older adult. - -Nurse should urge patients to report all prescription and OTC products -Teach patients to use on pharmacy for prescription needs -Avoid stigma that older adults will have physical or cognitive impairment -Older adults have a weakened immune system so encourage vaccinations -use smaller dosages and slowly increase to amount to a safe, effective level Techniques the breast-feeding mother can use to reduce drug exposure in the newborn. - -Administer drug after breast- feeding -Teach mother to avoid alcohol, illicit drugs, tobacco
-Drugs with shorter half-lives are preferable -Drugs with long half-lives should be avoided -Select drugs with high protein-binding ability (less likely to enter through breast milk) -Avoid all OTC herbal, dietary supplements Nursing and pharmacologic implications associated with each pediatric developmental age group. - Preschoolers/Toddlers: -cooperate in taking oral medication if they are crushed or mixed with food/ flavored beverages Middle Childhood: -respiratory infections are most common -able to have choices when taking medications (willing participants)
-All levels of the model may contribute to pharmacotherapeutic outcomes Understanding of Western medicine - -Western medicine incompatible with holistic medicine, total individual is lost in this focus -Western medicine focuses on specific disease, their causes, and treatments -Disease viewed as a malfunction of a specific organ/ system, malfunction of DNA structure -Psychosocial and cultural dimensions are lost in this process Explain how culture and ethnicity can affect pharmacotherapeutic outcomes - Culture and ethnicity are two
interconnected perspectives that can affect pharmacotherapy. Differences in diet, use of CAM therapies, and beliefs about health and disease can influence patient drug response, and genetics Differentiate ethnic from cultural characteristics - Ethnicity: implies that people have a biologic and genetic similarities Culture: a set of beliefs, values, and traditions that provide meaning for an individual or group Gender differences - response to medications - -Adherence to the prescribed medication regimen may be influenced by gender because the side effects are specific to either men or women
