WEEK 1: Nursing 🞄 Interventions may
independent, collaborative, or
be
Practice inCanada & dependent upon a physician’s
order
Drug Therapy 🞄 Adhere
administration
to safe medication
standards and
practices
The 10 Rights of
Nursing Process Medication Administration (Lilley)
• research-based organizational 🞄 Right drug
framework 🞄 Right dose
🞄 Right time
• central to all nursing care 🞄 Right route
• Encompasses all steps taken by the 🞄 Right patient
nurse in caring for a patient 🞄 Right reason
• Uses a flexible, adaptable, and 🞄 Right documentation
adjustable process to develop effective 🞄 Right evaluation (assessment)
solutions to meet patient needs 🞄 Right patient education
• Involves critical thinking, knowledge, 🞄 Right to refuse
andskill Another “Right”:
5 Phases of the Nursing Process Constant System Analysis
1. Assessment 🞄 Ensures a “double-check”
2. Nursing diagnosis/ NANDA 🞄 Includes the entire “system” of
3. Planning medication administration (ordering,
🞄 Goals dispensing, preparing, administering,
🞄 Outcome criteria documenting)
4. Implementation 🞄 Involves the physician, nurse, nursing
5. Evaluation unit, and pharmacy department
🞄 Requires educating patients
Nursing Process: Assessment Other “Rights”
Assessment of patient and drug • Proper drug storage
🞄 Data collection • Accurate dosage calculation
🞄 Subjective • Accurate dosage preparation
🞄 Objective • Careful checking of transcription of orders
🞄 Medication profile • Patient safety
🞄 Prescriptions • Close consideration of special situations
🞄 Intake of alcohol, tobacco, • Prevention and reporting of
and caffeine medication errors
🞄 Over-the-counter drugs (OTCs) • Monitoring for therapeutic effects,
🞄 Natural health products adverse effects, toxic effects
🞄 Responses to 6 Elements of a Drug Order
medications 1. Patient's name
(therapeutic and 2. Date the order is written
adverse responses) 3. Name of medication
The Nursing Process: Planning 4. Dosage (includes size, frequency,
🞄 Based on NANDA/ nursing diagnosis and number of doses)
🞄 Identification of goals and outcome 5. Route of administration
criteria 6. Signature of the prescriber
🞄 Must be specific and Components of a Prescription
measurable(SMART) 🞄 Patient’s name, address, health insurance
🞄 Must be patient-centred number (or identification number)
🞄 Time frame 🞄 Date prescription was written
🞄 Prioritization 🞄 The Rx symbol, meaning “take thou”
The Nursing Process: 🞄 Medication name, dosage, and strength
Implementation 🞄 Route of administration
🞄 Initiate and complete the collaborative
plan of care as defined by the nursing
diagnoses and outcome criteria
, PNP301 Final Exam Guide 2020
🞄 Dispensing instructions for the pharmacist 🞄 drug’s chemical composition and molecular
🞄 Directions for administration to be structure
given to the patient Generic name (nonproprietary name)
🞄 Number of refills 🞄 approved by Health Canada under the
🞄 Signature of the prescriber Foodand Drugs Act and Food and Drug
Regulations
Trade name (proprietary name)
🞄 registered trademark and its use is
restricted by the patent owner (usually
themanufacturer)
🞄 Drug Categories
• Over the Counter (OTC)
• Drug that can be purchased
without a prescription in which
theconsumer can diagnose,
treat, and evaluate; includes
natural health care products
• Prescription
• Drug that requires a
prescription to dispense; health
care practitioner prescribes and
dispensed by pharmacy
• Controlled Substances
• Prescribed medication that has
abuse potential; includes
narcotics, amphetamines,
medical marijuana,
benzodiazepines, etc; lists illicit
drugs that have risk of abuse
• Pharmacological Principles
🞂 Pharmacokinetics- the movement of
drugswithin the body
🞂 Pharmacodynamics-mechanism of
Who Can order?
interactions of drugs at their sites of activity
Controlled Act Who can order?
🞂 Pharmacotherapeutics-The use of drugs
Dispensing a drug Physicians, NP, andthe clinical indications for
Dentist administering
Performing a Physician , NP, drugs to prevent and treat diseases
procedure below Dentist, Midwife,
🞂 Toxicity
thedermis or Chiropodist
mucous 🞄 Pharmaceutics
membrane 🞄 The study of how various dosage
forms influence pharmacokinetic
Administering a Physician , NP,
and pharmacodynamic activities
substance by Dentist, Midwife,
🞄 Dosage form design
injection/ inhalation Chiropodist
affectsdissolution
Putting an Physician, NP, 🞄 Pharmacokinetics
instrument, hand or Midwife 🞄 The study of what the body does to
finger into a the drug
specified opening of 🞄 Absorption
the body 🞄 Distribution
🞄 Drug 🞄 Metabolism
🞂 Any chemical that affects the 🞄 Excretion
physiologicalprocesses of a living 🞄 Pharmacokinetics (cont.)
organism 🞄 Absorption
Pharmacology 🞄 Bioavailability
🞂 The study or science of drugs
🞄 Drug Names
Chemical name
, PNP301 Final Exam Guide 2020
🞄 First-pass effect Avoidance of first-pass effects
🞄 Routes: A drug’s route of (except for rectally administered drugs)
administration affects the rate and 🞄 Topical Application
extent of absorption of that drug 🞄 Transdermal (adhesive drug patches)
🞄 Enteral route 🞄 deliver constant amount of drug
🞄 Sublingual and buccal per unit of time for a specified
time
routes period
🞄 Parenteral route: 🞄 Inhalation
intradermally, 🞄 delivered as micrometre-sized
drug
subcutaneously, particles
intravenously, 🞄 absorbed quickly through the
intramuscularly, alveoli
intrathecally, intra- 🞄 Factors That Affect Absorption
articularly, intra-arterially. 🞂 movement of a drug
from
🞄 Topical route its site of administration
🞄 Transdermal route into the bloodstream for
🞄 Inhalation route distribution to the
🞄 Enteral Route 🞄 tissues
vary according to the dosage form and
🞄 The drug is absorbed into the route
systemic circulation through the 🞄 Food or fluids administered with
mucosa of the
stomach, small intestine, or large intestine the drug
🞄 Oral 🞄 Dosage formulation
🞄 Sublingual 🞄 Status of the absorptive
🞄 Buccal 🞄 surface Rate of blood flow to
the small
🞄 Rectal (can also be topical) intestine
🞄 Parenteral Route 🞄 pH of the stomach
🞄 Intravenous (fastest delivery into the blood 🞄 GI motility
circulation) 🞄 Biovailability and Bioequivalence
🞄 Intramuscular 🞄 Bioavailability is a measurement of the
rate
🞄 Subcutaneous and extent to which a drug reaches the
🞄 Intradermal systemic circulation
🞄 Intra-arterial 🞄 Absolute bioavailability compares
the
🞄 Intrathecal- through the theca of the spinal bioavailability of the active drug after
non-
cord (spinal canal) into the subarachnoid IV routes(oral, rectal, transdermal, SQ,
or
space and subdural space sublingual administration), with the
🞄 Intra-articular bioavailability of the same drug given
🞄 Parenteral Route (cont’d) intravenously.
🞄 Absorption from intramuscular (IM) or 🞄 Bioequivalent pertains to a drug that
has
intradermal (ID) sites may be increased by: the same effect on the body as another
🞄 Applying heat to the injection site drug
🞄 Massaging the injection site 🞄 First-Pass Effect
🞄 Most IM injected drugs absorbed 🞄 The metabolism of a drug and its passage
over several hours from the liver into the circulation
🞄 IM Depot drugs are designed for slow 🞂 A drug given via the oral route
may
absorption and may be absorbed over a be extensively metabolized
by the
, PNP301 Final Exam Guide 2020
period of several days to a few months or liver before reaching the
systemic
longer circulation (high first-pass effect)
🞄 Topical Route 🞂 The same drug given parenterally
🞄 Skin (including transdermal patches) bypasses the liver, preventing
the
🞄 Eyes, Ears, Nose, Lungs (inhalation), first-pass effect from taking
place,
Rectum, Vagina and more drug reaches the
Slower onset circulation (ie Sublingual,
Prolonged duration Buccal,
IV)