Exam #1 (9/26):
• Nursing Care of the Hospitalized Patient
• Med Administration
• Fluid and Electrolyte Disturbances
• Blood Transfusions (podcast)
Nursing Care of the Hospitalized Patient
Levels of Prevention:
- Primary Prevention
- health promotion efforts/wellness education
- (ex. Flu Shot)
- Secondary Prevention:
- focus on people with health problems or illness and are at risk for developing complica-
tions or worsening conditions
- (ex. chemotherapy)
- Tertiary Prevention:
- Defect/Disability is permanent or irreversible
- Focus is rehabilitation, help people achieve highest level of functioning possible
- (ex. respiratory therapy for pt with emphysema)
Acute Care: (secondary & tertiary care)
- diagnosis and treatment of illness
- patients sicker, more complex, not stable
- limited inpatient days due to managed care
Roles of the Professional Nurse
- Nurse as Caregiver
- hands-on patient care
- delegation
- need to know what other personnel are allowed to do
- make sure they have the knowledge to perform allowed tasks, follow-up to make sure it
was done
Five Rights of Delegation:
- Right task
- Right circumstances
- Right person
- Right direction/communication
,- Right supervision/evaluation
Communication - SBAR
S - situation
B - background
A - assessment
R - recommendation / request
Acute Illness with multiple chronic illnesses - Co-Morbidities
- chronic disease accounts for 70% of deaths in U.S.
- complexity of care
- monitor status/deterioration of acute disease and co-morbidities
- treatment of acute illness may worsen chronic illness
- chronic illness may make it harder to treat acute illness
- interactions of treatments / medications
Contemporary Nursing Practice:
- Complex Health Care Environment
- Clinical Decision Making
- Influences on the Health Care System
- Financing - efforts to provide more cost-effective care
- Changing populations
- aging population; cultural diversity
- Expanding medical knowledge and technology
- Consumerism - more informed clients
Discharge Planning
- begins the moment a patient is admitted to a health care facility
- Case Management
- collaborative process; managing care across multiple settings & multiple levels of care
- involve patients and families
,Medication Administration
Types of Medication Action:
• Therapeutic Effect: expected or predictable physiologic response
• Adverse Effect: unintended/undesirable, often unpredictable severe responses to meds
• Idiosyncratic Reaction: client over-or under reacts to med; or has reaction different from normal
• Side Effect: predictable, unavoidable secondary effect
• Toxic Effect: medication accumulates in the blood stream
• Allergic Reaction: unpredictable response to a med; acts as antigen
Mild Allergic Reaction:
Urticaria: raised; irregular shaped skin eruptions with varying sizes/shapes; eruptions have reddened
margins and pale centers (hives)
Rash: small, raised vesicles that are usually reddened; often distributed over entire body
Pruritus: itching of skin; accompanies most rashes
Rhinitis: inflammation of mucus membranes lining the nose
Types of Medication Action:
- Anaphylaxis (life threatening)
- may occur with first administration or subsequent administrations
Medication Interactions
- occur when one medication modifies the action of another
- a synergistic effect occurs when the combined effect of 2 medications is greater than the effect of the
medications given separately
Medication Dose Responses:
• Serum half-life: time for serum medication concentrated to be halved
• Onset: time it takes for a medication to produce a response
• Peak: time in which a medication reaches its highest effective concentration
• Trough: minimum blood serum concentration before next scheduled dose
• Duration: time during which medication is present in concentration great enough to produce response
• Plateau: blood serum concentration is reached and maintained after repeated fixed doses
, Pharmacologic Concepts:
- Drug Names:
- generic and trade (brand) names
- classification
- indicates effect med has on the body
- medication forms:
- solid, liquid, oral forms, topical, parenteral, instillation into body cavities
6 Rights To Administering Medication:
1. right medication
2. right dose
3. right client
4. right route
5. right time
6. right documentation
Medication Errors:
- can cause or lead to inappropriate medication use or patient harm
- inaccurate prescribing
- administering extra dose or failing to administer a medication
Patient safety first- MUST REPORT
Medication Reconciliation
- compare medications pt took in previous setting to current medication orders
Prevention of Medication Errors:
- 10 rights
- check labels 3 times
- 2 patient identifiers
- no short cuts or work arounds
- “do not disturb”
Components of Medication Orders
- pts full name
- medication name
- dose
- route
- time and frequency of administration
- signature of health care provider
*if orders do not have all components - MUST VERIFY*
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller anyiamgeorge19. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $12.99. You're not tied to anything after your purchase.
