1. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 12 Information Basic to Administering Drugs

2. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Information Nursing Handbook Generic and trade names Classification and category Side and adverse effects Pregnancy category Dosage and route Action Indications

3. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Information Nursing Handbook (cont.) Contraindications and precautions Interactions and incompatibilities Nursing implications Signs of effectiveness Patient teaching

4. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Generic and Trade Name Generic name: one official name Trade name: several brand names

5. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Classification and Category Drug classification: categorizes drugs by the way they act against diseases or disorders Drug category: way drugs work at the molecular, tissue, or body system level

6. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Side Effects and Adverse Effects Side effect: nontherapeutic reactions to drug Adverse effect: nontherapeutic effect –May be harmful –Require lowering the dosage or discontinuing the drug

7. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Pregnancy Category A: no risk to the fetus in any trimester B: no adverse effect demonstrated in animals; no human studies available C: –studies with animals show adverse reaction –no human studies available –given only after risks to fetus considered

8. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Pregnancy Category (cont.) D: definite fetal risk and only given when risk to fetus is life threatening X: absolute fetus abnormality and not given

9. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Action and Indication Action: how drug works Indication: reason for using the drug

10. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Contraindication and Precautions Terms used in which the drug should be given with caution or not given at all

11. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Incompatibilities Chemical: produces a visible sign Physical: may not give visible sign When in doubt, do not mix

12. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Implications Whether drug should be taken with or without food What specific vital signs to monitor What lab values may be affected by the drug or ordered to check drug’s effectiveness or toxicity

13. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Pharmacokinetics Absorption Distribution Biotransformation Excretion

14. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Absorption Factors Degree of stomach acidity Time required for stomach to empty Whether food is present Amount of contact with villi in small intestine Flow of blood to villi

15. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Distribution, Biotransformation, Excretion Distribution: drug’s movement through body fluids Biotransformation: chemical change of drug into a form that can be excreted Excretion: process by which the body removes a drug

16. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Factors Affect Drug Action Weight Age Pathologic conditions Hypersensitivity to a drug Psychological and emotional state

17. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Question What is distribution of a medication? A. Hypersensitivity to a drug B. Drug’s movement through body fluids C. Chemical change of drug into a form that can be excreted D. Process by which the body removes a drug

18. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer B. Drug’s movement through body fluids A. Factor affecting drug action: Hypersensitivity to a drug B. Distribution: drug’s movement through body fluids C. Biotransformation: chemical change of drug into a form that can be excreted D. Excretion: process by which the body removes a drug

19. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Half Life and Therapeutic Range Half Life: time required for half of the drug to be excreted Therapeutic range: quantity of drug in the blood or serum to be effective

20. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Law Criminal: offenses against general public detrimental to society as whole Civil: legal rights and duties of private persons

21. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Malpractice Nurse owed the patient a special duty of care Nurse failed to meet required standards Claim harm or injury resulted because nurse did not meet required standard Claim of damages for which compensation is sought

22. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Ethical Principles in Drug Administration Provide services with respect for the patient’s human dignity and uniqueness Safeguard patient’s right to privacy Act to safeguard patient from incompetent, unethical, or illegal practice Assume responsibility and accountability for nursing judgments and actions Maintain competence in nursing

23. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Autonomy and Truthfulness Autonomy: self-determination Truthfulness: obligation not to lie

24. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Beneficence and Nonmaleficience Beneficence: nurse should act in patient’s best interests Nonmaleficience: nurse must not inflict harm on the patient and must prevent harm whenever possible

25. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Confidentiality, Justice, Fidelity Confidentiality: respect information nurse learns from professional involvement with patients Justice: maintain high standard of care Fidelity: keep promises made to the patient

26. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Is the following statement true or false? Nonmaleficience occurs when the nurse does not inflict harm on the patient and prevents harm whenever possible.

27. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer True Nonmaleficience occurs when the nurse does not inflict harm on the patient and prevents harm whenever possible.

28. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Three Checks When Preparing Medications Removing medication Before pouring or opening medication Before replacing container or giving unit dose

29. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Six Rights Before Administering Medications Medication Patient Dosage Route Time Documentation

30. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Types of Orders Standing –With termination –Without termination PRN Single dose State

31. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Specific Points Helpful in Giving Medications Orders for physicians and healthcare providers Knowledge base Medication safety Oral medications: tablets and capsules Liquid medications Giving medications Charting Evaluation Medication errors

32. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Medication Errors Prevent them Don’t make them Don’t be in a hurry If you do make them, learn from your mistakes and don’t make them again