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Nursing Management of DruInstructor: Marta Coleman, MS

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Nursing Management

•Nurses use knowledge about the d(core drug knowledge) and knowleabout the patient (core patientariables) to ma!imi"e the therape

e#ects o$ the drug, minimi"e theaderse e#ects o$ the drug, and prpatient and $amil% education o$ thedrug&

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Core Drug Knowledge

•Pharmacotherapeutics: the desired, theraeffect of the drug

•Pharmacokinetics: the changes that occu

drug while it is inside the body

•Pharmacodynamics: the effects of the dru

the body

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Core Drug Knowledge (cont.

•Contraindications and precautions: the conditions which the drug should not be used or must be use

carefully with monitoring

• !d"erse effects: the unintended and usually unde

effects that may occur with the use of the drug•Drug interactions: the effects that may occur when

drug is gi"en along with another drug, food, or sub

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Core Patient #ariables

•$ealth status: o"erall health of the patient•%ife span and gender: age and gender 

•%ifestyle, diet, and habits: occupation, finances

substance use, e&ercise

•'n"ironment: where will the drug be administe

•Culture and inherited traits: cultural beliefs

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Nursing Management of

Drug Therapy: process of

planning and implementingactions that ma&imie the

therapeutic effects and

minimie ad"erse effects.

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Managing Drug Therapy

Using the Nursing

Process: !ssessment

Diagnosis

)utcome *dentification

Planning *nter"ention'"aluation

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 !ssessment: Core Drug Knowledge

•Current medications a patient is taking•*nteraction between medications

•+se of resources to identify drugs that are unfa

•+se of prototype drugs to increase understand

different medications

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 !ssessment: Core Drug Knowled

• Prototype Drug

• ypical of a medication within a drug class

• ypically the first drug of a class

• Drug has similar characteristics to all drugs in a class o

• Pro"ides a systematic way to increase knowledge of m

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 !ssessment: Core Patient #ariables

• hree -ources of !ssessment Data

•he patient inter"iew and history

• )penended /uestions

• Components of the Patient *nter"iew (0o& 1.1, p. 2

•he physical e&amination

• -3- !llergy: rash, hi"es, itching, redness, swelling, difficulty breathing

anaphylactic shock.

•he medical record

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 !ssessment: Core Patient #ariab

• Patient *nter"iew and $istory• $ealth status

– !ssess functioning of body systems and organs

• %ife span and gender 

– 4eeded to plan patient education on drug therapy

• %ifestyle, diet, and habits

– Can cause potential effect on drug therapy

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 !ssessment: Core Patient #ariab

• Patient *nter"iew and $istory (cont.• Environment

– he patient5s adherence to the drug regimen

– Potential risks from the therapy where the drug will be administere

• Culture and inherited traits

– !ffect the patient5s acceptance of prescribed drug therapy

– 6eligious or cultural practices

– 7enetic "ariations

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 !ssessment: Core Patient #ariab

• Physical '&amination

• 8ocus on health status, life span, and gender 

• Comprehensi"e

• Physical assessment of each body system

• #ital signs

• $eight and weight

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 !ssessment: Core Patient #ariables

• 9edical 6ecord

• he medical record pro"ides information about the patient5

status, lifestyle, diet, habits, and en"ironment

• %aboratory test and diagnostic test results

• 0ody systems at risk for or contributing to ad"erse effects (able 1

• Drug $istory• Components of a Drug $istory (0o& 1.;, p.2

• Past 9edical 6ecords

• Patients may forget drug reactions, past illnesses, family histories

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Diagnosis < )utcome *dentification:Core Patient #ariables

• Purpose of Data Collection

• *nterpretation of data based on their rele"ance to drug therapy

• he nurse uses the drug knowledge and patient "ariables to determine

significant drug interactions.

• Nursing 'iagnosis• 6eflect a current, actual problem or the risk for de"eloping a problem r

therapy (0o& 1.=, p. >• Diagnoses may reflect effects of drugs

• Nursing utcomes

• )utcomes determine the desired results.

• )utcomes are based on data collected.

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Planning: Core Patient #ariables

• 9a&imiing herapeutic 'ffects• o ma&imie the therapeutic effects of any gi"en drug thera

nurse must know what the desired therapeutic effects are a

they are achie"ed

• !dminister the drug in a manner that will promote its absorption

• !dminister the drug at the appropriate inter"als to attain a therape

• 9onitor laboratory "alues

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Planning: Core Patient #ariables

• 9inimiing !d"erse 'ffects

• #erify the patient5s allergies

• !ssess for contraindication for the drug therapy

• !dminister the drug in a manner consistent with standard safety p

• 9onitor the patient and rele"ant laboratory findings

• Discontinue or withhold a drug based on assessment or laboratory

• 6eport e"idence of ad"erse effects to the prescriber • 9odify administration techni/ues, when appropriate

• *mplement appropriate assessment for certain drugs to detect the

ad"erse effects

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*nter"ention: Core Drug Knowledge

•+nderstand the drug5s response•0asics of teaching patient and family about drug ther

–4ame of the drug

–6eason the drug was prescribed (pharmacotherap

–*ntended effect of the drug (pharmacodynamics

– !d"erse effects that need to be reported

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*nter"ention: Core Patient #ariables

• Patient Education (0o& 1.?, p. 11 Patient 'ducation 7uidelin

• Health status– !cti"ities that must be performed while the patient recei"es the drug

• Life span and gender 

– !d"erse effects on a de"eloping fetus

– +sed for patient education

• Lifestyle diet and ha!its– Changes the patient may need to make during drug therapy

• Environment

– o promote effecti"e selfmanaged drug therapy (0o& 1.2, p. 11

• Culture and inherited traits

– Consider cultural issues and modify content or presentation accordingly

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'"aluation

•9easures the patient5s progress•Consider whether the drug achie"ed the desired effec

•)utcomes that are not achie"ed

–6eassess to identify barriers to success

•9ust identify the reason behind any treatment failure