The nurse answers a patient's call light and finds the patient sitting up in bed and requesting pain
medication. What will the nurse do first?
A) Check the orders and give the patient the requested pain medication.
B) Provide comfort measures to the patient.
C) Assess the patient's pain and pain level.
D) Evaluate the effectiveness of previous pain medications. - ANSC
Rationale: The nurse should always assess a patient before any intervention. Although the nurse will
check the orders and possibly give the medication (and possibly even perform the actions in responses B
and D), the first priority is assessment.
Common nursing diagnoses related to drug therapy develop from data associated with: - ANSDeficient
knowledge
Risk of injury
Readiness for enhanced knowledge
Various disturbances, deficits, excesses, or impairments in bodily function
Other concerns related to drug therapy
The patient's medication administration record lists two antiepileptic medications that are due at 0900
hours, but the patient is to take nothing by mouth (NPO) for a barium study. The nurse's co-worker
suggests giving the medications intravenously because the patient is NPO. What will the nurse do?
,A) Give the medications orally (PO) with a small sip of water.
B) Give the medications via the intravenous (IV) route because the patient is NPO.
C) Hold the medications until after the test is completed.
D) Call the health care provider to clarify the instructions. - ANSD
Rationale: The dosage for the IV route would not be the same as for the PO route. Holding the
medications may cause drug levels to drop and result in seizure activity, and giving the medications PO
without consent may alter the test results. The nurse must never assume the route of medication
administration and should consult the physician for clarification of the orders.
Implementation - ANSguided by the preceding phases of the nursing process.
Evaluation - ANSSystematic, ongoing, and dynamic part of the nursing process
Two broad categories of ADEs
( adverse drug events ) - ANS- Medication Errors
- Adverse Drug Reactions (ADRs)
Issues Contributing to Medication Errors - ANSProcuring
Prescribing
Transcribing
Dispensing
Administering
Monitoring
Organizational issues
Educational system issues
Sociological factors
Use of abbreviations
Causes of Medication Errors - ANS--Human Factors
Performance deficits
, Knowledge deficits
Miscalculation of dosage
--Communication Mistakes
Illegible handwriting
Inaccuracies or omissions in client hand-off/report
Verbal/telephone orders
--Name Confusion
Look-alike and sound-alike names
SALAD - ANS(sound-alike, look-alike drugs)
LASA - ANS(look-alike, sound-alike)
Near miss - - ANScircumstances or events occurred that could have led to an error.
no- harm error - ANSmedication error that causes no harm
medication error - ANSthat causes harm
critical incident - ANSmedication error that results in serious harm
5 most common causes of med errors - ANS1. incomplete client information
2. unavailable drug information
3. miscommunication of drug orders
4. lack of appropriate drug labeling
5. environmental distractions
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