Professional Documents
Culture Documents
Assessment
Collect data that used to identify the patients needs Analysis of data Data collected through interviews, observations, lab reports, other sources
Nursing Diagnosis
Nursing Diagnosis: A statement that describes the human response (health state or actual/potential altered interaction pattern) of an individual or group which the nurse can legally identify and for which the nurse can order the definitive interventions to maintain the health state or to reduce, eliminate or prevent alterations
Diagnosing
Planning
Establish priorities Determine appropriate interventions Set expected patient outcomes
Implementation
Carry out plan that was developed in the planning stage
Evaluation
Evaluate patients response to interventions and re-work plan when necessary
Pharmacologic Principles
Pharmacogenetics Toxicology-
Definitions: Pharmaceutics-
Pharmacologic Principles
DOSAGE FORMS-1
Tablets: Scored EC: SR: ER: XR:
DOSAGE FORMS-2
Capsules: Colace- soft shell temazepam-hard shell
DOSAGE FORMS-3
Troches (lozenges)-solid dosage forms, usually disc shaped, dissolved slowly in mouth -- designed to release medication that exerts antiseptic or anesthetic effect on mouth tissues or throat, e.g. zinc or Cepacol lozenges
DOSAGE FORMS-4
Suppositories: dosage form to be inserted in external body orifices, e.g. rectum, vagina, or urethra --effects may be localized or systemic --suppositories are usually coated with cocoa butter
DOSAGE FORMS-5
Solutions: clear liquid preparation containing one or more solvents --syrups: --elixirs: --tinctures: --douche:
DOSAGE FORMS-6
Suspensions: liquid dosage forms that solid drug particles are suspended in suitable liquid medium -- usually administered orally or topically e.g. milk of magnesia
DOSAGE FORMS-7
Emulsions: dispersions of fine droplets of an oil in water or water in oil --e.g.---
DOSAGE FORMS-8
Semisolids: used primarily for skin --e.g. creams and gels, petrolatum Topical Patches: nitroglycerin, estrogen, clonidine, fentanyl, scopolamine, nicotine --medication is released slowly Implants: capsule-like object is surgically implanted, e.g. Norplant
Pharmacologic Principles
History of Drugs
Natural Products Foxglove plant
Chemical: 7 chloro, 1,3 dihydro, 1 methyl, 5 phenyl, etc Generic: diazepam Brand name: Valium Function: sedation Body system: Nervous Chemical/Pharmacological
Classification of Drugs
Types of Therapy
Acute Maintenance Supplemental Palliative Supportive Prophylactic
Systemic vs local effects Oral/Enteral Topical Parenteral - subcutaneous - Intramuscular - Intradermal - Intravenous
Routes of Administration
Intramuscular injection
Subcutaneous Injection
Passive Diffusion
Pharmacodynamics
-- study of biochemical and physiologic interactions of drugs -- examine physiochemical properties of drugs and their pharmacologic interactions with suitable body receptors
Drug-receptor interaction
Drug Action
Dose Response Curve Half-life Recommended Dose Therapeutic Index Therapeutic Blood Levels
Unwanted Effects
Side Effects Adverse Reactions Predictible Unpredictible -Idiosyncratic - Allergic - Anaphylactic
Drug Interactions
Other Considerations
Federal Food & Drug Act of 1906 Shirley Amendment of 1912(amended the FF&D Act of 1906) Harrison-Narcotic Act of 1914 Federal Food, Drug, & Cosmetic Act of 1938 (amended the 1906 Act) Durham-Humphrey Amendment of 1951 Kefauver-Harris Amendment of 1962 (amended the FFD&C Act of 1938) Controlled Substance Act of 1970 Orphan Drug Act of 1983 1991: Accelerated Drug Approval
Regulation of Drugs
Food and Drug Administration (FDA) Drug Testing - informed consent - Investigational New Drug
Legal Classifications
Prescription Non-prescription (OTC) Controlled Substances
-Class 1 -Class 2 -Class 3 -Class 4 -Class 5
Cultural Considerations
African Asian Hispanic European Native American Western
General impact of medication errors Nursing measures to prevent medication errors Consequences of medication errors to nurses Preventing and responding to errors Notification of patient regarding errors An ounce of prevention
Rights of Administration
drug route dose time patient documentation to refuse
Medication orders must have: - name of patient - date order was written - name of drug - Dosage including size, frequency, # of doses - Route of delivery - signature of prescriber
Administration of Drugs
Administration of Drugs
Medication Misadventures
OTC drugs
-Food, Drug, & Cosmetic Act (1938-Durham-Humphrey Amendments (1951) -Kefauver-Harris Amendments (1962) -OTC Drug Review (1972)
Herbal Products
Herbs Safety & Education Epidemiology
Opiods
Opiod analgesics Morphine Codeine Heroin
Stimulants
Amphetamines Cocaine
Depressants
Benzodiazepines Barbiturates
Alcohol (ETOH)
Beer Wine Whiskey Rum Champagne
Nicotine
Cigarettes Tobacco