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Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc. 1 Chapter 1 Pharmacology and the Nursing Process in LPN.

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Presentation on theme: "Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc. 1 Chapter 1 Pharmacology and the Nursing Process in LPN."— Presentation transcript:

1 Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc. 1 Chapter 1 Pharmacology and the Nursing Process in LPN Practice

2 Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc. 2 Chapter 1 Lesson 1.1

3 Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc. 3 Learning Objectives List the five steps of the nursing process Identify subjective and objective data

4 Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc. 4 Five Steps of the Nursing Process 1.Assessment 2.Diagnosis 3.Planning 4.Implementation 5.Evaluation

5 Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc. 5 The Nursing Process

6 Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc. 6 Responsibilities Dictated by licensure and experience RN: licensure and authority to carry out all steps of the nursing process LPN/LVN: working under the supervision of the RN; assess, implement, and evaluate with guidance

7 Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc. 7 Assessment Gathering information to develop a database, or record, from which all nursing process plans develop Requires skill and expertise of the nurse

8 Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc. 8 Assessment (cont.) Two types of data: Subjective data: obtained through questioning; information that cannot be measured Objective data: obtained through observation; information that is observed or could be verified by another

9 Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc. 9 Sources of Information Patient Family Medical Records History Health Care Providers Lab Reports

10 Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc. 10 Sources of Information (cont.) Techniques used to obtain objective data: Inspection = close observation Palpation = feeling Percussion = detecting differences in vibrations through the skin Auscultation = listening with a stethoscope

11 Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc. 11 Drug History Assessment Helpful information to be used in planning drug therapy: –Symptoms, signs, or diseases that explain need for medication –Current (and sometimes past) use of medications and drugs –Problems with drug therapy

12 Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc. 12 Chapter 1 Lesson 1.2

13 Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc. 13 Learning Objectives Discuss how the nursing process is used in administering medications

14 Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc. 14 Diagnosis A conclusion about what the patients problems are. The physician makes a medical diagnosis. The nurse makes a nursing diagnosis.

15 Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc. 15 Diagnosis (cont.) To make a nursing diagnosis ask: –What are the major problems for the patient? –What procedures or medications will the patient require? –What special knowledge or equipment is required to give these medications? –What special concerns or cultural beliefs does the patient have? –What does the patient understand?

16 Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc. 16 Diagnosis (cont.) Once the nursing diagnosis is made, a plan of care is initiated that includes patient and nurse involvement. Goals are established.

17 Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc. 17 Planning Patient goals –Help the patient learn about a medication and how to use it properly. Nursing goals –Help the nurse plan what equipment or procedures are needed to administer a medication.

18 Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc. 18 Four Steps of Planning 1.Determine the reason for each medication to be given. 2.Learn information regarding the medication. 3.Plan for special storage, techniques, or equipment. 4.Develop a patient teaching plan.

19 Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc. 19 Four Steps of Planning (cont.) Prior to medication administration, critical thinking is essential to: –Verify the accuracy of the medication by checking the medication record against the physicians original order. –Determine whether the type of medication and dosage are appropriate for the patient.

20 Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc. 20 Planning If the nurse determines: –the medication order is unclear or appears incorrect –the patients condition would decline with the medication –the physician did not have all the relevant information needed before writing the order –there is a change in patient condition The medication is HELD until the order is clarified.

21 Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc. 21 Chapter 1 Lesson 1.3

22 Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc. 22 Learning Objectives List specific nursing activities related to assessing, diagnosing, planning, implementing, and evaluating the patient's response to medications

23 Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc. 23 Implementation Six Rights of Medication Administration 1. Right drug 2. Right time 3. Right dose 4. Right patient 5. Right route 6. Right documentation

24 Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc. 24 Right Drug Drug label is verified three times 1. Before taking the drug from the unit dose cart or shelf 2. Before preparing the prescribed dose 3. Before replacing the medication on the shelf or before administering it to the patient

25 Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc. 25 Right Time Considerations: –Action of the medication –Hospital policies –Patient routines

26 Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc. 26 Right Dose Considerations: –Age –Weight –Health status –Recent changes in health status

27 Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc. 27 Right Patient It is critical to identify patients using objective data such as ID number, name, date of birth. Many patients are at risk for misidentification; for example, those unable to effectively communicate with the nurse (pediatric, geriatric, critically ill, confused, non-English speaking patients).

28 Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc. 28 Right Route Routes alter effects of medications. Nurses must not alter the route prescribed for a medication without a physicians order.

29 Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc. 29 Right Documentation If it isnt documented, it wasnt given. Nurses should only document what they have given. Document accurately after the medication is administered.

30 Elsevier items and derived items © 2010, 2006, 2003, 2000 by Mosby, an imprint of Elsevier Inc. 30 Evaluation Have therapeutic effects from the medication been seen? Have any side effects from the medication been seen? Have any allergic responses from the medication been seen?


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