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Chapter 12 Information Basic to Administering Drugs 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 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 Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Generic and Trade Name • Generic name: one official name • Trade name: several brand names 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 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 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 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 Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Action and Indication • Action: how drug works • Indication: reason for using the drug 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 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 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 Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Pharmacokinetics • Absorption • Distribution • Biotransformation • Excretion 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 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 Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Factors Affect Drug Action • Weight • Age • Pathologic conditions • Hypersensitivity to a drug • Psychological and emotional state 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 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 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 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 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 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 Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Autonomy and Truthfulness • Autonomy: self-determination • Truthfulness: obligation not to lie 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 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 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. 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. 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 Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Six Rights Before Administering Medications • Medication • Patient • Dosage • Route • Time • Documentation Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Types of Orders • Standing – With termination – Without termination • PRN • Single dose • State 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 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 Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins