Pharmacology and the Nursing Process
Exam Study Guide.
Nursing Process
- A decision-making approach that works as a framework to guide health care deliver.
- Purpose is to identify, diagnose, and treat human responses to health and illness.
- Components are assessment, diagnosis, planning, implementation, and evaluation.
Assessment
- Involves collecting data (both subjective and objective) about the patient, which are used to
identify actual and potential health problems.
- Patient interview, medical/drug histories, physical examination, patient observation, and lab
testing.
- Data collection should detail the patient's symptoms and target the organs most likely to be
affected by drug therapy
Subjective Data
- Based on verbal information from the patient, family members, friends, and other sources,
including symptoms described by, and apparent to, the patient.
- Examples collected that are related to the drug regimen
º Current health history (e.g., difficulty swallowing)
º Patient signs/symptoms
º Current drugs, including OTC drugs, herbal remedies, and nutritional supplements;
doses/frequency of drugs
º Ability to pay/access prescribed drugs
º Medical/surgical history
º Patient's environment and support system
Objective Data
- Signs that are directly measured/detected by a HCP regarding the patient's health.
- Examples that are related to the drug regimen
º Data from physical health assessment
º Lab/diagnostic tests
º Data from the HCP's notes
º Vital signs
º The patient's body language
Pre-Administration Assessment
- Allows HCP's to establish the baseline data needed to individually tailor drug therapy.
- By identifying variables that can affect an individual's responses to drugs, nurses can modify
treatment in an attempt to maximize benefit and minimize harm.
- Four basic goals. First 3 are specific to a particular drug, 4th applies to all drugs but may be
more critical for some drugs than others
1. Establish Baseline Measurements
2. Anticipate Adverse Effects
3. Identify High-Risk Patients
4. Determine self-care capacity
Establish Baseline Measurements
-Drugs are administered to achieve a desired response. ____ of the parameters the drug is being
used to modify need to be determined to evaluate whether this response is achieve.
- Example:
º Taking a patient's BP before administering Lisinopril, an angiotensin-convening enzyme (ACE)
inhibitor prescribed to control hypertension, will help determine whether the drug is effective.
Anticipate Adverse Effects
- All drugs can produce side/adverse effects.
- Usually, the side effects that a drug can produce are known.
- Baseline measurements can help HCPs determine whether a side/adverse effect has occurred
- Example:
º Furosemide, a diuretic, can lower a patient's potassium level. Checking the potassium level
before administration of the drug will help the nurse determine whether this side effect has
occurred.
Identify High-Risk Patients
- Individual characteristics may put a patient at higher risk for experiencing a side/adverse effect.
- The individual characteristics that predispose a patient to an adverse drug effect depend on the
drug under consideration.
- To identify an at-risk patient, the nurse must understand the pharmacology of the drug.
- Example:
º African Americans have a higher incidence of angioedem and cough when prescribed ACE
inhibitors (e.g., Lisinopril) for hypertension than non-African Americans. Knowing this
information helps the nurse prepare for potential side/adverse effects.
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