Ppt chapter 01-1

Chapter 1
Nursing Management of Drug
Therapy
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Question
• ______________ are the changes that occur to the drug
while it is inside the body.
– A. Pharmacotherapeutics
– B. Pharmacokinetics
– C. Pharmacodynamics

Answer
• B. Pharmacokinetics
• Rationale: Pharmacokinetics are the changes that
occur to the drug while in the body.

Core Drug Knowledge
• Pharmacotherapeutics: the desired, therapeutic effect
of the drug
· Pharmacokinetics: the changes that occur to the drug
while it is inside the body
· Pharmacodynamics: the effects of the drug on the
body

Core Drug Knowledge (cont.)
· Contraindications and precautions: the conditions
under which the drug should not be used or must be
used carefully with monitoring
· Adverse effects: the unintended and usually undesired
effects that may occur with the use of the drug
· Drug interactions: the effects that may occur when the
drug is given along with another drug, food, or substance

Core Patient Variables
• Health status: overall health of the patient
• Life span and gender: age and gender
• Lifestyle, diet, and habits: occupation, finances,
substance use, exercise
• Environment: where will the drug be administered
• Culture and inherited traits: cultural beliefs

Nursing Management of Drug Therapy
• Maximize the therapeutic effects of a drug
• Minimize the adverse effects of a drug
• Provide patient and family education

Management of Drug Therapies

Health Care Settings
• Hospitals
• Long-term care facilities
• Outpatient centers and clinics
• Health care providers’ offices
• Patients’ homes

Managing Drug Therapy Using the Nursing
Process

Question
• What percentage of the population in the United States
takes at least one medication in a month?
– A. 10%
– B. 25%
– C. 33%
– D. 45%

Answer
• D. 45%
• Rationale: In any given month, almost 45% of the
U.S. population will receive one prescription drug.
This percentage is higher in the aging population.

Drug Usage in the United States
• Approximately 45% of the population receives one drug
in any given month.
• Prescription drug use increases with each age group.
• Approximately 85% of adults aged 65 and older are
receiving one prescription per month.
• Almost 50% of adults aged 65 and older are receiving
three or more prescriptions a month.

Assessment: Core Drug Knowledge
• Current medications a patient is taking
• Interaction between medications
• Use of resources to identify drugs that are unfamiliar
• Use of prototype drugs to increase understanding of
different medications

Prototype Drug
• Typical of a medication within a drug class
• Typically the first drug of a class
• Drug has similar characteristics to all drugs in a class of
drugs
• Provides a systematic way to increase knowledge of
medications

Three Sources of Assessment Data
• The patient interview and history
• The physical examination
• The medical record

Patient Interview and History
• Health status
– Assess functioning of body systems and organs
• Life span and gender
– Needed to plan patient education on drug therapy
• Lifestyle, diet, and habits
– Can cause potential effect on drug therapy

Patient Interview and History (cont.)
• Environment
– The patient’s adherence to the drug regimen
– Potential risks from the therapy where the drug will
be administered
• Culture and inherited traits
– Affect the patient’s acceptance of prescribed drug
therapy

Question
• Objective data are the data collected from the patient’s
story.
– A. True
– B. False

Answer
• B. False
• Rationale: Subjective data are what the patient tells
the nurse; objective data are the data the nurse
collects by completing a physical examination of the
patient.

Physical Examination
• Focus on health status, life span, and gender
• Comprehensive
• Physical assessment of each body system
• Vital signs
• Height and weight

Medical Record
• The medical record provides information about the
patient’s health status, lifestyle, diet, habits, and
environment.
• Laboratory test and diagnostic test results
• Drug history

Purpose of Data Collection
• Interpretation of data based on their relevance to drug
therapy
• The nurse uses the drug knowledge and patient variables
to determine any significant drug interactions.

Nursing Diagnosis
• North America Nursing Diagnosis Association (NANDA)
• Reflect a current, actual problem or the risk for
developing a problem related to drug therapy
• Diagnoses may reflect effects of drugs.
• Nursing diagnoses are highly individualized.

Nursing Outcomes
• Outcomes determine the desired results.
• Outcomes are based on data collected.
• Outcomes are specific to the patient’s drug regimen.

Maximizing Therapeutic Effects
• Administer the drug in a manner that will promote its
absorption
• Administer the drug at the appropriate time
• Monitor laboratory values

Minimizing Adverse Effects
• Verify the patient’s allergies
• Assess for contraindication for the drug therapy
• Administer the drug in a manner consistent with standard
safety protocols
• Monitor the patient and relevant laboratory findings
• Discontinue or withhold a drug based on assessment or
laboratory findings

Minimizing Adverse Effects (cont.)
• Report evidence of adverse effects to the prescriber
• Modify administration techniques, when appropriate
• Implement appropriate assessment for certain drugs to
detect the onset of adverse effects

Core Drug Knowledge
• Understand the drug’s response
• Basics of teaching patient and family about drug therapy
– Name of the drug
– Reason the drug was prescribed
(pharmacotherapeutics)
– Intended effect of the drug (pharmacodynamics)
– Important adverse effects that may occur

Core Patient Variables
• Health status
– Activities that must be performed while the patient
receives the drug
• Life span and gender
– Adverse effects on a developing fetus
– Used for patient education

Core Patient Variables (cont.)
• Lifestyle, diet, and habits
– Changes the patient may need to make during drug
therapy
• Environment
– To promote effective self-managed drug therapy
• Culture and inherited traits
– Consider cultural issues and modify content or
presentation accordingly

Evaluation
• Measures the patient’s progress
• Consider whether the drug achieved the desired effect
• Outcomes that are not achieved
– Reassess to identify barriers to success
• Must identify the reason behind any treatment failure

Ppt chapter 01-1

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