NBS II Lecture' material- Part II

Drugs Administration
Part II, September 8th & 15th 2009
By Diah Nita


Medication Orders
Parts of medication orders
Medications supply system
Dosage calculations
Safety measures of preparing drugs
Categories of drug orders



Part of the medication order:
Patient’s name
Date and time
Name of drug
Dosage
Route
Frequency
Signature of order writer


Dosage calculations.
System of measurement:
Metric system
Apothecary system
Household system


Safety measures of preparing drugs:
The nurse give the (1) right medication to the (2) right patients in the (3) right dosage through the (4) right route at the (5) right time.


Categories of Drug Orders
Standing orders
One time/ single orders
PRN orders
STAT orders


Nursing Process
Assessment
Diagnosis
Planning
Outcome expected
Implementations
Evaluation


Assessment
Assessment of subjective data:
Current health history
Client symptom
Current medications
Post health history
Clients environment


Assessment of objective data:
Gross and fine motor control
ROM
Muscle strength
Visual impairment
Laboratory test, diagnostic studies & physical assessment.


Diagnosis
Made based on assessment data
May be actual or potential
Facilitates individualized care plan
More than one applicable nursing diagnosis may be generated.
Common nursing diagnosis of drug therapy:
D:\My Documents\N I T A\KDDK II\Nursing diagnosis.odt


Planning
Characterized by goal setting/ expected outcomes
Effective goal setting qualities:
Client centered
Acceptable to both client & nurse
Realistic and m,measurable
Shared with other health care providers
Realistic deadlines
Identifies components for evaluations.


Outcome Identification
Clinical observations will improve
The patient will receive a dosage that reaches the therapeutic level
The patients will demonstrate education regarding their medication.


Implementations
Nursing actions/ interventions
Client education & teaching
Administration of drug
Assessment of drug effectiveness.


Drug Therapy Teaching
Comprehensive drug & health history
Reason for medical therapy
Expected result
Side effect & adverse reactions
When to notify health care provider
Drug interactions
Required changes in activities of daily livings (ADLs)‏
Demonstration of learning
Medications schedule
Recording system
Discussion & monitoring of access to financial resources
Development & support of backup system
Community resources.


Evaluation
Addressed in the evaluation phase of the nursing process
Evaluation time is depend on the time frame in the goal statement
Ongoing & related to process
If failed ---> determine the reason & revise the plan accordingly.


Literatures
Clinical Pharmacology 9th Edition by P.N Bennett (page 83-86).
Crash Course: Pharmacology by Donald Barnes (page 17-18).
Farmakologi untuk keperawatan by Jan Tambayong (page 1-9).
Fundamental of Nursing: the Art & Science of Nursing Care by Carol Taylor (page 714-772).
Introductory – Clinical Pharmacology 6th Edition by Sallys Roach (page 4-52).
Nurse’s Drug Guide by Samantha Venable (page 14-32).
Nursing Pharmacology Made Incredibly Easy.! (page 1-22)‏
Nursing Procedures Made Incredibly Easy.! (page 177-225).
Pharmacology: A Nursing Process Approach 5th edition by Joyce Lefever Kee (page 14-42).