PHARMA-THE NURSING PROCESS
The Nursing Process is crucial
for safe medication
administration.
“Crucial of the greatest
significance in determining
an outcome”
PHARMACOLOGY AND THE
NURSING PROCESS
Draws together all of the aspects of the patient:
Physical, Cultural, Cognitive, Spiritual, and Sexual.
These aspects allow for a more holistic approach to
patient care.
NURSING PROCESS
A research-based organizational framework for
professional nursing practice
Central to all nursing care
Encompasses all steps taken by the nurse in caring for
a patient
Ongoing and constantly evolving process
Critical thinking Flexibility is important
THE NURSING PROCESS
The Nursing Process
• Assessment
• Nursing diagnosis
• Planning – Goals – Outcome criteria
• Implementation
• Evaluation
Nursing Process Assessment
• Data collection -Subjective, objective - Accurate
Nursing Process Nursing diagnosis
• Decision about the need/problem (actual or at risk for)
Three parts
• Human response to illness
• “related to”
• “as evidenced by”
NURSING PROCESS NURSING DIAGNOSIS
• critical thinking
• creativity
• accurate data collection
• It is a statement about the patient’s status and
will guide nursing interventions
NURSING PROCESS PLANNING
• Identification of goals -Must be patient-centered
• Outcome criteria -Must be SMART -have a time
frame
• Prioritization
NURSING PROCESS
IMPLEMENTATION
• Initiation and completion of the nursing care plan as
defined by the nursing diagnoses and outcome criteria
NURSING PROCESS
EVALUATION
• Ongoing part of the nursing process
• Determining the status of the goals and outcomes
of care
THE NURSING PROCESS AND
MEDICATION ADMINISTRATION
ASSESSMENT
1. Health Status
Diagnostic Tests, lab values allergies
Medication History
pattern of health care – Prescriptions experiences/ illnesses – OTCs level
of education – Herbals understanding of the disease – Responses to
medications process (therapeutic and adverse financial support responses)
2. Physical assessment – age and weight social support at home chronic
conditions
THE NURSING PROCESS AND MEDICATION
ADMINISTRATION NURSING DIAGNOSIS
• Human response to illness (actual or risk) – drug
therapy may only be a small part of the total patient
picture – or, at times it may be an all-consuming
factor in the patient’s life
• Drug therapy is incorporated into the total picture
THE NURSING PROCESS AND
MEDICATION ADMINISTRATION
PLANNING
1. Identification of possible interactions knowledge
of the prescribed medication over-the-counter (OTC)
drugs, herbs
2. Client and family education level of patient
understanding of disease level of education
3. Gather equipment, review procedures, safety
measures timing and frequency of drugs storage of
drugs This phase leads to the provision of safe
effective medication administration.
THE NURSING PROCESS AND
MEDICATION ADMINISTRATION
IMPLEMENTATION
1. Maximizing therapeutic effect
2. Minimizing adverse effects provide comfort
measures and help pt. cope with the therapeutic or
adverse effects of a drug
3. 10 rights of medication administration
THE NURSING PROCESS AND
MEDICATION ADMINISTRATION
EVALUATION
• Monitoring the patient’s response to drug therapy
1. Expected outcome
2. Unexpected outcome
SIX ELEMENTS OF A DRUG ORDER
1. Name of the patient
2. Date order is written (start/ stop dates may be ordered)
3. Name of medication
4. Dosage includes size, frequency, and number of doses
5. Route of delivery
6. Signature of the prescriber
Medication Card Bed
# Ward Name of Patient Medication
Frequency Date ordered Signature
EXAMPLE:
JANUARY 16, 2012 AT 3:30PM PATIENT JUAN DELA CRUZ IS ADMITTED AT WARD F
BED # 2. THE PATIENT IS HOOKED WITH 1 L D5LR AT 30 GTTS/MIN, ON LEFT
CEPHALIC VEIN. START CEFUROXIME 750MG, Q8H, ANST. F2 WARD F 12 DELA
CRUZ, JUAN 8 CEFUROXIME (ZINACEF) 750 MG 4 Q 8 H ANST (+/- ) 1/16/12 LMN 23
DRUG ORDERS CATEGORIES
Standing Order – Maybe an ongoing order – Maybe given
for a specific # of doses/days – May have special instructions
– May include PRN orders
One-time – Given 1x, at a specific time
PRN orders – Given at client’s request and nurse’s judgement
Stat orders – Given at once, immediately
RIGHT ROUTE
Nursing Implications:
1. Assess ability to swallow before administration. 39
2. Do not crush/mix medications in other substances without consulting the
pharmacist.
• Don’t mix with sweet substances to “trick” children.
• Don’t mix in an infant’s formula feeding.
3. Use aseptic technique when preparing and administering drugs.
Sterile technique is required with parenteral route.
4. Administer at the appropriate site.
5. Stay with client until oral drugs have been swallowed.
6. If it is necessary to combine medication with another substance, explain this to
the client.
RIGHT PATIENT
Nurse must verify the client’s identity before any drug
administration.
Verify by checking the identification bracelet. – Some institutions
put the client’s photo on his/her health record.
Distinguish between 2 clients with same last name – Have
warnings highlighted in bright color on ID tools, such as
medication cards, bracelet or Kardex.
Some institutions have ID bracelets coded for allergy status. –
Nurse must be aware of this policy.
RIGHT DOCUMENTATION
Requires the nurse immediately record the appropriate
information about the drug administered.
Name of drug – Dose and route of administration
Time and data of administration
Nurse’s initial/signature
Response to medication, including unexpected reactions,
should also be recorded, according to institution policy.
RIGHT TO REFUSE THE MEDICATION
• Client can and do refuse to take a medication.
• It is the nurse’s responsibility to determine, when
possible, the reason for refusal and to take reasonable
measures to facilitate the client’s taking of
medication.
NURSING ACTIONS WHEN CLIENT REFUSES TO
TAKE MEDICATIONS:
Explain the risk of refusing to take the medication, and
reinforce the reason for the medication.
When the medication is refused, this refusal should be
documented immediately.
Inform the nurse manager or health care provider when
an omission and refusal to take medication pose a
specific threat to the client.
“RIGHTS” …… DO YOU
THINK PATIENTS HAVE
OTHER MEDICATION
“RIGHTS”?
WHAT ADDITIONAL SYSTEMS WOULD YOU
LIKE TO SEE IN PLACE TO ENSURE SAFE
DRUG ADMINISTRATION?
WHAT TO AVOID DURING DRUG
ADMINISTRATION?
Do not recap needle, use universal precaution.
Do not mix drug with large amount of food or
beverage or foods that are contraindicated.
THANK YOU
