This document discusses nursing management of drug therapy. It defines nursing management of drug therapy as the process of planning and implementing actions to maximize a drug's therapeutic effects and minimize adverse effects. The nursing process is used, including assessment, nursing diagnosis, planning, intervention, and evaluation. Three main sources of data for assessment are identified as the patient interview and history, physical examination, and medical record. Levels of control on medication administration include the nurse's regulation, employer policies, and individual nurse competence.
About Clinical Trials and Its Potential Benefits of ParticipatingVial Trials
Are you interested in clinical testing and want to learn about its phases and the potential benefits of participating? Then you must go through this blog right here!
About Clinical Trials and Its Potential Benefits of ParticipatingVial Trials
Are you interested in clinical testing and want to learn about its phases and the potential benefits of participating? Then you must go through this blog right here!
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Introduction to daily activities of clinical pharmacist.
Drug therapy monitoring,
Medication chart review
Clinical Progress
Pharmacist intervention
Detection and management of ADRs
Clinical Pharmacy Introduction to Clinical Pharmacy, Concept of clinical pptxraviapr7
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Medication chart review, clinical review., pharmacist intervention
Ward round participation, Medication history and Pharmaceutical care.
Dosing pattern and drug therapy based on Pharmacokinetic & disease pattern
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2. Week 8 Questions:
1. Define the concept of nursing management
of drug therapy.
2. Describe the three main sources of data
used in assessment of core patient variables.
3. Provide examples from each of the "Levels
of Control on Medication Administration"
4. Discussion question
2
3. Outcomes
Students will:
Identify key concepts relevant to nursing
management in pharmacotherapy
Describe the main sources of data used in
assessment of core patient variables
List Levels of Control on Medication
Administration for nurses
3
4. Q #: Define the concept of
nursing management of drug
therapy.
A. Discuss the nursing role and
responsibilities in drug therapy.
B. What are nursing priorities
related to medication
management?
4
5. …..“the process of planning and
implementing actions that will
maximize the therapeutic effects
and minimize the adverse effects
of a drug” (Aschenbrenner &
Venable, 2012, p. 3).
5
Nursing Management of drug therapy is:
7. 7
Core Drug Knowledge
• Pharmacotherapeutics
• Pharmacokinetics
• Pharmacodynamics
• Contraindications and precautions
• Adverse effects
• Drug interactions
8. 8
Core Patient Variables
• Health status
• Life span and gender
• Lifestyle, diet & habits
• Environment
• Culture and inherited traits
9. B. Priorities for medication
management include:
Maximizing the therapeutic effect of a drug
Minimizing adverse effects
Patient and family education
9
10. Q #2 Describe the three main sources of data used
in assessment of core patient variables. What
types of information are determined from each
source?
1. Patient interview and history
2. Physical examination or assessment
3. Medical record (chart)
10
11. 1. Patient interview and history
Patient’s health status
Allergies
Medications
Ask open-ended questions about:
Lifestyle
OTC meds and herbal remedies
11
12. General observations and baseline data
Focused assessment
Age
Developmental ability
Pregnancy status
2. Physical examination or
assessment
12
13. 3. Medical Record (Chart)
Diagnostic test results and lab values
Health status
Primary complaints
Allergies
Previous drug reactions
Past medical history
13
14. Q#4 Give one or two examples from each of the
"Levels of Control on Medication Administration" as it
applies to your clinical practice as a nursing student.
1. Nurse’s (Registered) and Nurse Practitioner’s
Regulation
2. CRNBC Standards, Limits, Conditions
3. Employer Policies
4. Individual Nurse’s (Student’s) Competence
14
15. Q#3: Discussion question:
15
Observe a nurse passing medications in a hospital. If the
opportunity arises you may wish to explore these questions
with a Registered Nurse.
• Describe how the nurse evaluates drug therapy for each
patient.
• Describe nursing management techniques used during
and after the medications are given.
• Were there any additional nursing management
techniques that would have been helpful?
16. References
1. Aschenbrenner, D.S. (2012). Drug Therapy in Nursing (3rd ed.).
Philadelphia, PA: Lippincott Williams & Wilkins.
2. British Columbia Institute of Technology. (2014). BCIT nursing program (3
year) student guidelines, policies and procedures. Retrieved
from http://www.bcit.ca/files/health/nursing/pdf/bsn_policies.pdf
3. College of Registered Nurses of British Columbia. (2013). Practice
support: Medications [CRNBC Publication No. 3]. Retrieved
from https://crnbc.ca/Standards/Lists/StandardResources/3Medicatio
ns.pdf
4. Fraser Health (nd). Medication administration record daily protocol.
Fraser Health Clinical Policy. Retrieved from
http://fhpulse/clinical_resources/clinical_policy_office/Documents/Me
dicationAdministrationRecord(MAR)Daily_Protocol/ARCHIVE/Medicati
on%20Administration%20Record%20(MAR)%20-
%20Daily%20PROTOCOL%2022102013.pdf
5. Perry, A.G., Potter P.A., Ostendorf, W.R. (2014). Clinical Nursing Skills and
Techniques (8th ed). St. Louis., MO: Mosby, Inc.
16
Editor's Notes
According to Aschenbrenner & Venable, 2012, Nursing Management of drug therapy is a process of planning and implement actions to maximize the therapeutic effect of drugs while minimizing adverse effects during drug therapy. To complete this important task the nurse must have excellent ‘Core Drug Knowledge’, utilize a systematic approach to care, consider the core patients variable and practicing according to the CRNBC Professional Standards.
Essentially, this describes use of the nursing process
Assessment and identification: Core drug knowledge and core patient variables
2. Nursing diagnosis based on assessment: identify interactions between core drug knowledge and core patient variables
3. Plan of action: to maximize desired outcome and minimize adverse effects
4. Intervention: strategies to maximize desired effects and minimize adverse effects. Includes patient education.
5. Evaluation: of patient’s progress and determining effectiveness or ineffectiveness and following up with physician as necessary
The nursing role begins by assessing and identifying significant core drug knowledge and core patient variables that may impact direction and efficacy of drug therapy.
Pharmacotherapeutics: what therapeutic effect is desired? E.g. decrease pain, or prevent seizures?
Pharmacokinetics: what happens to the drug when it gets in to the body? E.g. where does it go? How does it get there? How does it get out? Etc.(absorption, distribution, metabolism, excretion)
Pharmacodynamics: what effect does the drug have on the body? E.g. decrease pain but cause constipation?
Contraindications and precautions
Adverse effects
Drug interactions
Health status: presence of disease, illness, allergies, chronic illness, mental capacity
Life span and gender: age, development, reproductive stage, gender
Lifestyle, diet & habits: activity, exercise, sleep, occupation, financial resources, eating patterns, substance use
Environment: location of drug administration
Culture and inherited traits: religious, social and ethnic backgrounds
Maximizing the therapeutic effect of a drug for a patient => ensuring the drug is working optimally and within its intended outcome
Minimizing adverse effects => reducing any negative factors associated with drug and patient
Educating the patient and family members on findings to ensure proper administration and considerations are followed, especially after discharge from hospital
Health status can be assessed by identifying the patient’s cognitive capacity, allergies, presence of disease, and drug history (dosage, lack of adherence, current OTC drug intake).
Life span and gender information determined includes the patient’s age, developmental level, reproductive status, literacy, and ability to understand directions.
Lifestyle, diet, and habits evaluated are occupation, level of physical activity, nutrition and mealtimes, supplement or alternative medicine use, and sleep patterns. Street drug, alcohol, caffeine, or nicotine use should also be assessed.
Environmental factors relay information regarding home environment, living arrangements, and nature of employment. If a medication increases sensitivity to the sun for instance, precaution must be taken if the patient works outdoors.
The patient’s religious beliefs or ethnicity can offer guidance involving culture and inherited traits. Certain people may be averse to taking medications as it does not fit the belief system of their culture.
General observations and baseline data (vital signs, height, weight)
Focused assessment
Approximate age, developmental ability, gender and pregnancy status can also be investigated to form a more accurate picture of patient needs.
Children will metabolize medications differently than adults.
Some medications could affect the fetus or can be transmitted through breast milk.
Identifying and understanding diagnostic test results and lab values.
Health status
Primary complaints
Presence of disease
Allergies
Previous drug reactions
Past medical history
1. Nurse’s (Registered) and Nurse Practitioner’s Regulation: helps to protect the public by ensuring that professional care or service received by the public is competent, ethical and meets the standards that society views as acceptable
The Federal Controlled Drugs and Substances Act describes who can administer narcotics and for what reason (CRNBC, 2012). E.g. This act allows student nurses to administer narcotics under the directive of physicians.
2. CRNBC Standards, Limits, Conditions:
Nurses must check the 7 medication rights at 3 points when dispensing medication
Nurses must provide education to the patient based on the nurse’s assessment of the patient’s ability to understand the information
3. Employer Policies: E.g. Fraser Health Authority policy usually states that medications administered must be documented on the daily MAR
It also states that the MAR has to be verified by comparing it to the previous day’s MAR as well as the past 24 hours of medication orders
4. Individual Nurse’s (Student’s) Competence:
BCIT policy states that level 1 students must have medications checked off by RN or instructor until the instructor states the student may administer medication unsupervised
Anticoagulants, oral hypoglycemic and narcotics must always be co-signed by RN or instructor !!
the CRNBC states that a RN cannot document medications given to a patient by another health care worker (CRNBC, 2013). Student nurses are responsible for documenting the medications given.