Nur 1210 Medication Administration Basic Principles 1, Chapt. 31

NUR 1210 Medication Administration Basic Principles 1, Chapt. 31 Page 1 of 10 IatrogenicDisease:CausedbythedrugthatisgiventoPT Ex.WhenapatientisgivenaBroadAntibiotic,itwillkillALLtheFlora(Bacteria)inthebodyIncludingtheGOODbacteriaandpatientcangetThrush,orCdifetc.Drugs Nomenclature(Name):o Chemicalname:precisedescriptionofchemmakeupo Genericname:ThenameoftheDrugthatreferstotheCHEMICALMAKEUPoftheDrugo Officialname:Howitislistedinpublicationso TradeName:ListedbyManufacturer,theTrademarkedNameofaDrug Preparation:Pill,Capsule,Tablet,IV,Injection,orTransdermaletc. TherapeuticEffect:Howthedrugworksonthebodyo Ex.Insulinwilllowerthebloodsugar PharmacologicEffect:EffectdrugshaveontheOrgans&SystemsoftheBody Classification:Howthedrugworksonthebodyo TherapeuticClass:WhatconditionthedrugwillTreat Accordingtothesymptomsofthedrugo Ex.Antipyrexia(AntiFever)Medication Accordingtoclinicalcondition:Whateffectthedrugwillhaveonthebodyo Ex.Antihypertensive,Anticonvulsive,Antidiabetico PharmacologicClass:Whateffectthedrugwillhaveonthebody Ex.ActiveFactorXInhibitor:WillpreventbloodclotsbyblockingtheactivityofclottingfactorXMechanicsofdrugaction Pharmacodynamics:Whatthebodydoeswiththemedication Pharmacokinetics:Whatdoesthepatientbodydotothedrugo Absorption:Processofwhichthedrugisabsorbedfromtheentrysitetothe Routeofadministration:o PO:Bymoutho IM:InjectionintoMuscle Givenwith2.5-3Needleat90o IV:Mostdangerousandfastestactingroute Cannotbereversedorstopped Mostdependabledosage Drugsolubility:Howquicklythedrugisabsorbedo LiquidwillabsorbquickerthanasoliddrugNUR 1210 Medication Administration Basic Principles 1, Chapt. 31 Page 2 of 10 o CapsulesmustdeterioratefirstandpassthroughtheGITracttobeabsorbedo Canbeplacedinoilorsolidproteinwillo ClearinsulinisFASTACTING,cloudyinsulinhasSolidproteininitandslowsitdown Distribution:Thedrugwillactonaspecificorganorspotinthebodyo Drugsfortheliver,willgotheliverandtreattheissue Metabolism(AKA:Biotransformation,Detoxification):Thebreakdownofthedrugtoanactiveformo PrimarysitefordrugmetabolismistheLIVER! Excretion:Onceitisbrokendown,thebodywillexcretetheDrugo MostofthedrugswetakeareexcretedbytheKidneyso Wherethedrugisadministered,itcanbeexcreted.ExtheLungso RoutsofExcretionofDrugs: Kidneys Lungsaretherouteinhalation&excretionofanastaticdrugs Intestine GIisusedtootoexcretedrugs SalvatoryGlands SweatGlandswillalsoexcretethedrugswetake MammaryGlandswillexcretedrugstooFactorsAffectingDrugAction: Developmental:o Childdosewillalwaysbedifferentthananadultsdoseo ElderlydosemaybeadjustedduetoGFRataslowerrate Zyrtecisa10mgpill,PTover65dosesmustbe5mg.theirkidneycannotprocessthedrug Weight:Therapeuticaffect=DoseisbasedonHealthyman18-65weighting165lbso Iftheyareheaver,theywillneedalargerdose Psychological:Patientsexpectationsoftheeffectsofadrugwillaffecttheresponseofthemedicationo Feelingofthemedicationwillinfluencetheeffectofthemedicationo Placebo:Pharmacologicalinactivesubstance CanbegivenbecausetheyareexpectinganoutcomefromthedrugNUR 1210 Medication Administration Basic Principles 1, Chapt. 31 Page 3 of 10 Pathology:PresenceofaDiseaseo Anydiseasethatwillaffecthowandwhenthedrugwillbeabsorbedand/orexcretedo Examples: KidneyDisease:Drugcannotbeexcretedproperly LiverDisease:Drugcannotbemetabolizedproperly GIDisease:Drugcannotbeabsorbedproperly TimeofAdministration:o Circadiancyclescanaffecthowthedrugreactstothebodyo Somedrugsneedtobetakenwithfood Emptystomachwillincreasetheabsorptionrate Somemedicationsneedtobegivenwithfoodinthestomach,somemaycauseissuesinthestomachandGItract Somemedicationsneedtobegivenonanemptystomach;Bestgivenat0700 Foodwilldelaytheabsorptionofmedicationo SomeneedtobegivenatcertaintimesAdversedrugeffects: Sideeffects:Predictableandunavoidableo Producedatausualtherapeuticdose Percocet:PTwillbeSleepy Adverseeffects:Unintentional,Undesirable,Unpredictableo CanoccurinMinutestoHourso IatrogenicDisease:CausedbythedrugthatisgiventoPTo Drugallergy:CausedinPTswhohavehadpreviouslyadministratedandcreatedanallergyo CanrangefromMildtoSeriouso Rash,Nausea,Diarrheao Drugtolerance:Bodybecomesaccustomtoparticulardrugoveraperiodoftimeo HigherdosesmaybeneededifPThasbeentakingtheDrugforalongperiodoftimeo Cumulativeeffect:Whenthebodycannotmetabolizeordetoxifythedrugbeforetheseconddoseisgiveno PreviousdrugisstillpresentinbodywhenSeconddoseisGiveno WillhappenwhenPThasaLiverofKidneyProblemo Interaction:Howonedrugwillaffectanotherdrug Antagonistic(1+1=1):o Whenyougivetwodrugs,andoneneutralizedtheotheroneo Maalox&Tetracyclinewhengiventogethertheybothwillnotworko Narcan&Morphine:NarcanwillneutralizetheeffectofMorphineNUR 1210 Medication Administration Basic Principles 1, Chapt. 31 Page 4 of 10 Synergistic(1+1=3):o Alcohol&Barbiturateso Aspirin&Coumadin Idiosyncratic:WhenPTreactionisdifferentthandesiredaffecto Patientstakebenzodiazepineandgetshypero Patientdrinkscoffeeandisverytired Anaphylactic:Lifethreatingallergicreactiono Signsof: Constrictionofbronchial EdemaofPharynx,Wheezing,ShortofBreathingMedicationOrders:Dr.NP,orPAwillwritetheOrder NODRUGCANBEGIVENWITHOUTANORDER Writtenonaspecificform:eitherelectronicorhandwritteno WillbecomepartofthepermeantrecordofthePT AlldrugsthatPatienttakesathomeWILLbediscontinuedwhenthePatientcomesintotheHospital WhenPatientbringsMedicationstothehospital,wemustsendthemedicationhomeo IfPThasnofamily:Wewillsendittosecurity,andtheywillplaceitinasafeandPTcanpickuponthewayhomeo IfDrugisexpensive,wewillsendittothepharmacy,anditwillbeplaceinapyxis TypesofOrders:o Standing:CarriedoutasspecifieduntilitisCANCLEDbyanotherOrder Ex.PTgetsmedicationfor7days,carryoutfor7days O2canbeorderedStandinganduptoRNDiscretiontoadministerwhenneeded Canbecancelledwhenorderrunsouto PRN:AsNeeded OnlyreceiveswhenPTasksfordrugorifthePTneedsit RequiresajudgmentbythenurseifPTlookslikehe/sheisinpain?Offerpainmedicationo Single:Onlygiven1time Examples: Pre-Opmedication PotassiumisLow?Givenjustonceo STAT:SingleordergivenIMMEDITALYNUR 1210 Medication Administration Basic Principles 1, Chapt. 31 Page 5 of 10 PartsoftheOrderthatMUSTBEonTHEORDER:MAYBEMISSINGONEXAM. Patientname Dateandtime DrugName:Whatdrugistobegiven DrugDosage:Tabs,mL,g,gr,L Route:PO,IV,IM,Liquid,Rectal, Frequency:q4hr,PRN,qd,tid,Pre-Op,STAT,etc.o drugscanbegiven30minBEFORE&30minAFTERtimethatdrugisordered Signature:Whowrotethescriptmustsigno IforderisTO,orVO.WriteTORBorVORBandprovidermustbesignedwithing24hoursProblemswithOrders:Anydrugorderthathasasuspectederror,WEMustBringitup Dose:isthedosemorethantherecommendeddose? Allergies:Patientallergiesmustbeconsidered Ifyoucannotreadtheorder,CALLTHEPHYSICANWHOWROTETHEORDER! StepstoTakeifyouthinktheorderisnotcorrectorcanharmthepatient1) Drugbook:Checkorderandmakesureyourinformationiscorrect2) SupervisororChargeNurse:Youcanaskthemwhatyourquestionis&whatyourconcernis3)