1. The Nursing Process and Pharmacology Jeanelle F. Jimenez RN, BSN, CCRN
Chapter 4
The Nursing Process and Pharmacology
Jeanelle F. Jimenez RN, BSN, CCRN
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2. Objectives
Explain the purpose of the nursing process and methodology used to apply to the study of pharmacology
State the five steps in the nursing process and describe them in terms of a problem-solving method used in nursing practice
Describe the components of the assessment process
Compare current methods used to collect, organize, and analyze information about the health care needs of patients and their significant others
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3. Objectives (cont’d)
Define the term nursing diagnosis and discuss the wording used in formulating nursing diagnosis statements
Define the term collaborative problem
Differentiate between a nursing diagnosis and a medical diagnosis
Differentiate between problems that require formulation of a nursing diagnosis and those categorized as collaborative problems, which may not require nursing diagnosis statements
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4. Objectives (cont’d) Identify the steps in the planning of nursing care
Explain the process of prioritizing individual patient needs using Maslow’s hierarchy of needs
Formulate measurable goal statements for assigned patients in the clinical practice setting
State the behavioral responses around which goal statements revolve when the discharge of a patient is planned
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5. Objectives (cont’d)
Identify the purposes and uses of a patient care plan
Integrate outcome and classification system(s) and critical pathways into care plans
Discuss the use of evidence-based practice in planning for nursing care
Differentiate between nursing interventions and therapeutic outcomes
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6. Objectives (cont’d)
Compare the types of nursing functions classified as dependent, interdependent, and independent, and give examples of each
Describe the evaluation process used to establish whether patient behaviors are consistent with the identified short- or long-term goals
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7. Objectives
State the information that should be obtained as a part of a medication history
Identify primary, secondary, and tertiary sources of information used to build a patient information base
Define the problem
Describe the process that is used to identify factors that could result in patient problems when medications are prescribed
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8. Objectives (cont’d)
Practice developing short- and long-term patient education objectives and have them critiqued by the instructor
Differentiate among dependent, interdependent, and independent nursing actions and give an example of each
Describe the procedure for evaluating the therapeutic outcomes obtained from prescribed therapy
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9. Objectives (cont’d)
Review the content of several drug monographs to identify information that may result in patient problems from the medication therapy
Identify steps used to plan nursing care in relation to a medication regimen prescribed for a patient
Describe an acceptable method of organizing, implementing, and evaluating the patient education delivered
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10. The Nursing Process Foundation for the clinical practice of nursing
Involves:
Assessment
Nursing diagnosis
Planning
Nursing intervention or implementation
Evaluating and recording therapeutic outcomes
How does the nursing process relate to pharmacology?
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11. Holistic Care Needs
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12. Assessment First step in the nursing process
Comprehensive collection of data, including:
Physical examination
Nursing history
Medication history
Professional observation
Assessment is an ongoing process that starts with admission and continues until the patient is discharged from care
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13. Nursing Diagnosis
A clinical judgment about individual, family, or community responses to actual or potential health problems/life processes (NANDA-I)
Actual nursing diagnosis consist of a three-part statement that
Uses a NANDA-I diagnostic label
Has contributing factors
Defines characteristics
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14. Five Types of Nursing Diagnosis
Actual: based on human responses and supported by defining characteristics
Risk/high-risk: patient may be more susceptible to a particular problem
Possible: suspected problems requiring additional data
Wellness: clinical judgment about a transition from one level to a higher level
Syndrome: cluster signs and symptoms to predict certain circumstances or events
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15. Collaborative Problems
Different from nursing diagnoses when the intervention used is to prevent or treat a problem and is worded with potential complication in the diagnosis
Evidence-based practice uses research to impact nursing practice changes; the interventions used in the research findings can be implemented into care plans
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16. Phases of Planning Four phases of a nursing care plan
Setting priorities
Developing measurable goal/outcome statements
Formulating nursing interventions
Formulating anticipated therapeutic outcomes
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17. Phases of Planning (cont’d)
Setting priorities: Identify problems and prioritize which ones are more important and must be attended to first, depending on patient needs
Developing measurable goal statements: Write short- and long-term goals for the patient to be followed when providing care
Formulating nursing interventions and anticipated outcomes: Plan which intervention to use based on anticipated patient behavior
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18. Nursing Intervention or Implementation
Actual process of carrying out the established plan of care
Nursing actions are suggested
Dependent actions: performed by a nurse based on health care provider’s orders
Interdependent actions: implemented with the cooperation of a team
Independent actions: provided by nurse by virtue of education and license
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19. Evaluating and Recording Therapeutic and Expected Outcomes
All care is evaluated against:
Nursing diagnoses (goal statements)
Nursing interventions
Patient responses
Evaluation process involves patient, family, and significant others who provide feedback and help determine goals.
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20. Assessment Three reasons for obtaining a drug history
To evaluate need for medication
To obtain current and past use of over-the-counter medication
To identify problems related to drug therapy
Relies on three sources
Primary source: produced by patient
Secondary sources: relatives, significant others, medical records, lab reports
Tertiary sources: literature to provide background information, diagnostic tests, diet
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21. Nursing Diagnosis and Pharmacology
Nursing diagnoses often can be formulated based on the patient’s drug therapy
Most commonly associated with drug treatment for a disease or adverse effects from drug therapy
Also can originate from pathophysiology caused by drug interactions
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22. Planning Confirm recommended dosage and route of medication
Check that scheduling of administration of medicine is based on the provider’s orders
Teach patients to keep written response records
Educate patients on techniques of self-administration if necessary
Inform on proper storage and refilling of medications
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23. Nursing Intervention or Implementation
Nurses prepare the prescribed medications using procedures to ensure patient safety
Select correct supplies (syringes, etc.)
Verify all aspects before preparation
Collect appropriate data to serve as baseline for later assessments
Administer medication by correct route
Document all aspects of administration
Implement actions to minimize expected side effects
Educate patient as appropriate
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24. Evaluating Therapeutic Outcomes
Evaluation procedure for determining therapeutic outcomes of drug therapy include:
Assessing patient responses to medications
Determining signs and symptoms of recurring illness
Assessing any adverse effects
Determining the patient’s ability to receive education and self-administer medication, as well as the potential for compliance
Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.