Nursing Diagnosis and The Nursing Process Quiz

Nursing Process

• The Nursing Process is a research-supported organizational framework for professional nursing practice.
• It ensures the delivery of thorough, individualized, and quality nursing care to patients.
• The process requires critical thinking and is an ongoing and constantly evolving process.

Five Steps of the Nursing Process

• Assessment: Data collection, review, and analysis of medication profile, including all drug use, prescriptions, allergies, over-the-counter medications, vitamins, herbs, and supplements.
• Diagnosis: A problem statement, as evidenced by and related to, which involves diagnosing a patient.
• Planning: Identification of goals and outcome criteria, with specific goals being objective, measurable, and relatable with an established time period for achievement.
• Implementation: Initiation and completion of specific nursing actions as defined by the human needs statement, goals, and outcome criteria.
• Evaluation: Ongoing part of the nursing process, determining the status of the goals and outcomes of care, monitoring the patient's response to drug therapy, and expected and unexpected outcomes.

The "Rights" of Medication

• Right drug: Ensuring the correct medication is administered.
• Right dose: Ensuring the correct dose of medication is administered.
• Right time: Ensuring medication is administered at the correct time.
• Right route: Ensuring medication is administered through the correct route.
• Right patient: Ensuring the correct patient receives the medication.
• Right documentation: Ensuring accurate and complete documentation of medication administration.
• Right reason or indication: Ensuring medication is administered for the correct reason or indication.
• Right response: Ensuring the patient's response to medication is monitored and evaluated.
• Right to refuse: Ensuring the patient's right to refuse medication is respected.

Medication Errors

• Medication errors are any preventable event that may cause or lead to inappropriate medication use or patient harm.
• Errors can be patient-related or system-related.

Drug Classification

• Drugs are grouped together based on similar properties, such as structure or therapeutic use.
• Examples of drug classifications include beta blockers and antibiotics.

Pharmacologic Principles

• Pharmaceutics: The study of how various drug forms influence the way in which the drug affects the body.
• Pharmacokinetics: The study of what happens to a drug from the time it is put into the body until the parent drug and all metabolites have left the body.
• Pharmacodynamics: The study of what the drug does to the body.
• Pharmacogenomics: The study of drugs changing a person's DNA.

Pharmacotherapeutics

• The clinical use of drugs to prevent and treat diseases.
• Defines principles of drug actions, including the cellular processes that change in response to the presence of drug molecules.
• Drugs are organized into pharmacologic classes.

Types of Therapy

• Acute therapy: Involves intensive therapy drug treatment and is implemented in the acutely ill or critically ill.
• Maintenance therapy: Used for the treatment of chronic illnesses.
• Supplemental therapy: Also known as replacement therapy, supplies the body with a substance needed to maintain normal function.
• Palliative therapy: Focuses on providing patients with relief from the symptoms of pain and stress of a serious illness.
• Supportive therapy: Maintains the integrity of body functions while the patient is recovering from illness or trauma.
• Prophylactic/empirical therapy: Provided to prevent illness or other undesirable outcome during planned events.

Monitoring

• Evaluating the clinical response requires familiarity with both the drug's intended therapeutic action and its unintended effects.
• Therapeutic action: The desired effect of a drug, such as reduced blood pressure following administration of antihypertensive drugs.
• Adverse effects: Undesirable effects that are a direct response to one or more drugs.
• Cumulative effects: An effect that occurs when several successive doses of a medication are administered or when absorption of a medication occurs faster than excretion or metabolism.
• Therapeutic index: The ratio between the toxic and therapeutic concentrations of a drug.
• Drug concentration: The length of time the concentration of a drug in the blood or tissues is sufficient to elicit a response.
• Patient conditions: How the patient is responding to the medication.

Drug Interactions

• Additive effects: The combined effect of two or more drugs is equal to the sum of their individual effects.
• Synergistic effects: The combined effect of two or more drugs is greater than the sum of their individual effects.
• Antagonistic effects: The combined effect of two or more drugs is less than the sum of their individual effects.### Nursing Process
• The five steps of the nursing process:
  • Assessment: Data collection, review, and analysis
  • Diagnosis: A problem statement, as evidenced by and related to
  • Planning: Identification of goals and outcome criteria
  • Implementation: Initiation and completion of specific nursing actions
  • Evaluation: Ongoing part of the nursing process, determining the status of goals and outcomes of care

Medication Administration

• The "Rights" of Medication:
  • Right drug
  • Right dose
  • Right Time
  • Right route
  • Right patient
  • Right documentation
  • Right reason or indication
  • Right response
  • Right to refuse
• Medication Errors: Any preventable event that may cause or lead to inappropriate medication use or patient harm

Pharmacology

• Drug Classification: Drugs are grouped together based on similar properties, such as:
  • Structure (e.g., Beta blocker)
  • Therapeutic use (e.g., Antibiotic)
• Pharmacokinetics: The study of what happens to a drug from the time it is put into the body until the parent drug and all metabolites have left the body
  • Absorption: The movement of a drug from its site of administration into the bloodstream for distribution to the tissues
  • Distribution: The transport of a drug by the bloodstream to its site of action
  • Metabolism: The organ most responsible for the metabolism of drugs is the liver
  • Excretion: The elimination of drugs from the body, primarily by the kidney
• Pharmacodynamics: The study of what the drug does to the body
  • Mechanism of action: Drugs can produce actions in several ways, including through receptors, enzymes, and non-selective interactions
  • Drug-receptor relationships: The joining of the drug molecule with a reactive site on the surface of a cell or tissue

Pharmacotherapeutics

• Types of therapy:
  • Acute therapy: Involves intensive therapy for the acutely ill or critically ill
  • Maintenance therapy: Used for the treatment of chronic illnesses
  • Supplemental therapy: Also known as replacement therapy, supplies the body with a substance needed to maintain normal function
  • Palliative therapy: Focuses on providing patients with relief from symptoms and improving quality of life
  • Supportive therapy: Maintains the integrity of body functions while the patient is recovering from illness or trauma
  • Prophylactic/Empirical therapy: Provided to prevent illness or other undesirable outcomes during planned events

Interprofessional Education Collaboration

• Formed in 2009, with the objective of developing core competencies for interprofessional collaborative practice
• Interprofessional education occurs when students from two or more professions learn from and with each other
• Goal: Improve health outcomes### Nursing Process
• Planning: identification of goals and outcome criteria
• Goals: objective, measurable, and relatable with an established time period for achievement of outcomes
• Outcome criteria: concrete descriptions of patient goals and expectations for behavior
• Implementation: initiation and completion of specific nursing actions as defined by the Human needs statement (Nursing diagnosis), goals, and outcome criteria
• Evaluation: ongoing part of the nursing process, determining the status of goals and outcomes of care, and monitoring the patient's response to drug therapy

Medication Administration

• "Rights" of Medication:
  • Right drug
  • Right dose
  • Right time
  • Right route
  • Right patient
  • Right documentation
  • Right reason or indication
  • Right response
  • Right to refuse
• Medication Errors: any preventable event that may cause or lead to inappropriate medication use or patient harm

Drug Classification

• Drugs are grouped together based on similar properties
• Classifications:
  • Structure (e.g., Beta blocker)
  • Therapeutic use (e.g., Antibiotic)

Pharmacologic Principles

• Pharmaceutics: the study of how various drug forms influence the way in which the drug affects the body
• Pharmacokinetics:
  • Absorption: the movement of a drug from its site of administration into the bloodstream for distribution to the tissues
  • Distribution: refers to the transport of a drug by the bloodstream to its site of action
  • Metabolism: the organ most responsible for the metabolism of drugs is the liver
  • Excretion: the elimination of drugs from the body, primarily by the kidneys
• Pharmacodynamics:
  • Mechanism of action: drugs can produce actions (therapeutic affects) in several ways
  • Drug-receptor relationships: the joining of the drug molecule with a reactive site on the surface of a cell or tissue
• Pharmacogenomics: the study of how drugs change a person's DNA
• Pharmacotherapeutics: the clinical use of drugs to prevent and treat diseases

Pharmacokinetic Concepts

• First Pass Effect: a large proportion of a drug that is chemically changed into inactive metabolites by the liver
• Half-Life: the time required for half of a given drug to be removed from the body
• Steady State: a physiologic state in which the amount of drug removed via elimination is equal to the amount of drug absorbed with each dose
• Peak Level: the highest blood level of a drug
• Trough Level: the lowest blood level of a drug
• Toxicity: occurs if the peak blood level of the drug is too high

Therapeutic Applications

• Acute therapy: intensive therapy drug treatment, often needed to sustain life or treat disease
• Maintenance therapy: used for the treatment of chronic illnesses
• Supplemental therapy: supplies the body with a substance needed to maintain normal function
• Palliative therapy: focuses on providing patients with relief from symptoms and improving quality of life
• Supportive therapy: maintains the integrity of body functions while the patient is recovering from illness or trauma
• Prophylactic/Empirical therapy: a drug therapy provided to prevent illness or other undesirable outcome during planned events

Monitoring and Drug Interactions

• Monitoring: evaluating the clinical response requires familiarity with both the drug's intended therapeutic action and its unintended effects
• Therapeutic action: the desired response to a drug
• Adverse effects: undesirable effects that are a direct response to one or more drugs
• Cumulative effects: an effect that occurs when several successive doses of a medication are administered or when absorption of a medication occurs faster than excretion or metabolism
• Therapeutic index: the ratio between the toxic and therapeutic concentrations of a drug
• Drug interactions:
  • Additive effects
  • Synergistic effects
  • Antagonistic effects