Post on 26-Mar-2015
1Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc.
Chapter 1Chapter 1
Pharmacology and the Nursing Process in LPN Practice
2Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc.
Chapter 1
Lesson 1.1
3Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc.
Learning ObjectivesLearning Objectives
• List the five steps of the nursing process
• Identify subjective and objective data
4Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc.
Five Steps of the Nursing Process
Five Steps of the Nursing Process
1. Assessment
2. Diagnosis
3. Planning
4. Implementation
5. Evaluation
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The Nursing ProcessThe Nursing Process
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ResponsibilitiesResponsibilities
• Dictated by licensure and experience
RN: licensure and authority to carry out allsteps of the nursing process
LPN/LVN: working under the supervision ofthe RN; assess, implement, and evaluatewith guidance
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AssessmentAssessment
• Gathering information to develop a database, or record, from which all nursing process plans develop
• Requires skill and expertise of the nurse
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Assessment (cont.)Assessment (cont.)
• Two types of data:
Subjective data: obtained through questioning; information that cannot be measured
Objective data: obtained through observation; information that is observed or could be verified by another
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Sources of InformationSources of Information
• Patient
• Family
• Medical Records
• History
• Health Care Providers
• Lab Reports
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Sources of Information (cont.)Sources of Information (cont.)
• Techniques used to obtain objective data:Inspection = close observation
Palpation = feeling
Percussion = detecting differences in
vibrations through the skin
Auscultation = listening with a stethoscope
11Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc.
Drug History AssessmentDrug History Assessment
• Helpful information to be used in planning drug therapy:– Symptoms, signs, or diseases that explain
need for medication– Current (and sometimes past) use of
medications and drugs– Problems with drug therapy
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Chapter 1
Lesson 1.2
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Learning ObjectivesLearning Objectives
• Discuss how the nursing process is used in administering medications
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DiagnosisDiagnosis
A conclusion about what the patient’s
problems are.
• The physician makes a medical diagnosis.• The nurse makes a nursing diagnosis.
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Diagnosis (cont.)Diagnosis (cont.)
To make a nursing diagnosis ask:– What are the major problems for the patient?– What procedures or medications will the
patient require?– What special knowledge or equipment is
required to give these medications?– What special concerns or cultural beliefs does
the patient have?– What does the patient understand?
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Diagnosis (cont.)Diagnosis (cont.)
• Once the nursing diagnosis is made, a plan of care is initiated that includes patient and nurse involvement.
• Goals are established.
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PlanningPlanning
• Patient goals– Help the patient learn about a medication
and how to use it properly.
• Nursing goals– Help the nurse plan what equipment or
procedures are needed to administer a medication.
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Four Steps of Planning Four Steps of Planning
1. Determine the reason for each medication to be given.
2. Learn information regarding the medication.
3. Plan for special storage, techniques, or equipment.
4. Develop a patient teaching plan.
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Four Steps of Planning (cont.) Four Steps of Planning (cont.)
Prior to medication administration,
critical thinking is essential to:– Verify the accuracy of the medication by
checking the medication record against the physician’s original order.
– Determine whether the type of medication and dosage are appropriate for the patient.
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PlanningPlanning
If the nurse determines: – the medication order is unclear or appears
incorrect– the patient’s condition would decline with the
medication– the physician did not have all the relevant
information needed before writing the order– there is a change in patient condition
The medication is HELD until the order isclarified.
21Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc.
Chapter 1
Lesson 1.3
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Learning ObjectivesLearning Objectives
• List specific nursing activities related to assessing, diagnosing, planning, implementing, and evaluating the patient's response to medications
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ImplementationImplementation
• Six Rights of Medication Administration1. Right drug
2. Right time
3. Right dose
4. Right patient
5. Right route
6. Right documentation
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Right DrugRight Drug
• Drug label is verified three times1. Before taking the drug from the unit dose
cart or shelf
2. Before preparing the prescribed dose
3. Before replacing the medication on the shelf or before administering it to the patient
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Right TimeRight Time
Considerations:– Action of the medication– Hospital policies– Patient routines
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Right DoseRight Dose
Considerations:– Age– Weight– Health status– Recent changes in health status
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Right PatientRight Patient
• It is critical to identify patients using objective data such as ID number, name, date of birth.
• Many patients are at risk for misidentification; for example, those unable to effectively communicate with the nurse (pediatric, geriatric, critically ill, confused, non-English speaking patients).
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Right RouteRight Route
• Routes alter effects of medications.
• Nurses must not alter the route prescribed for a medication without a physician’s order.
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Right DocumentationRight Documentation
• If it isn’t documented, it wasn’t given.
• Nurses should only document what they have given.
• Document accurately after the medication is administered.
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EvaluationEvaluation
• Have therapeutic effects from the medication been seen?
• Have any side effects from the medication been seen?
• Have any allergic responses from the medication been seen?