Nursing Process and Prescription Components

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Questions and Answers

What is the primary purpose of the 'Right Reason' in medication administration?

To ensure the medication is given at the correct dosage.

To ensure the medication is given at the correct time.

To ensure the patient understands the purpose of the medication.

To confirm the medication is appropriate for the patient's condition. (correct)

Which phase of the nursing process involves identifying patient needs and concerns?

Diagnosis

Planning

Implementation

Assessment (correct)

In the context of medication administration, what is considered 'Right Documentation'?

Recording the medication's name, dosage, and route of administration.

Documenting any patient allergies or adverse reactions to medications.

Recording the patient's vital signs before and after medication administration.

All of the above. (correct)

Which of the following components is NOT typically included in a written prescription?

Patient's age (A) Signup and view all the answers

What is the primary purpose of the 'First Pass Effect' in pharmacology?

To determine the bioavailability of a drug. (C) Signup and view all the answers

Which phase of the nursing process focuses on developing a plan of action to address identified patient needs?

Planning (B) Signup and view all the answers

What is the most appropriate action when a medication error occurs?

Both B and C. (D) Signup and view all the answers

Which of the following is NOT considered a component of the 'Nine Rights' of medication administration?

Right Cost (D) Signup and view all the answers

What is the primary disadvantage of oral medication compared to parenteral routes of administration?

It undergoes the first-pass effect in the liver. (C) Signup and view all the answers

Which method of administration provides the fastest onset of action?

Intravenous injection (C) Signup and view all the answers

What is a key characteristic of sublingual drug administration?

It avoids the first-pass metabolism entirely. (A) Signup and view all the answers

Which statement best describes rectal drug administration?

It offers a mixture of first-pass and non-first-pass metabolism. (D) Signup and view all the answers

What is a benefit of parenteral drug administration over enteral administration?

It provides instantaneous effects by bypassing the gastrointestinal tract. (A) Signup and view all the answers

What is one requirement for dietary supplements regarding FDA approval?

They do not need FDA approval. (D) Signup and view all the answers

Which of the following can ginseng potentially alter?

Drug metabolism (D) Signup and view all the answers

What is the primary molecule that transfers genes from parents to offspring?

DNA (B) Signup and view all the answers

Which of these conditions does not affect drug metabolism due to genetic factors?

Common cold (D) Signup and view all the answers

Which organic base is found in RNA but not in DNA?

Uracil (C) Signup and view all the answers

According to safety precautions, which herbal remedies can be potentially harmful?

Some herbal remedies can be harmful or lethal (B) Signup and view all the answers

What does the Medicare Prescription Drug, Improvement, and Modernization Act address?

Insurance benefits for prescription drugs (D) Signup and view all the answers

What must nurses check as an indicator of liver function when dealing with ginseng and prescription drugs?

Liver enzymes (B) Signup and view all the answers

What is the primary advantage of intravenous (IV) administration of drugs?

It does not require absorption since it is injected directly into circulation. (B) Signup and view all the answers

What is a significant factor affecting drug absorption in the body?

The route of administration (A) Signup and view all the answers

What is a common risk for elderly patients taking multiple medications?

Higher risk of drug interactions (A) Signup and view all the answers

Why might infants require lower doses of certain medications?

Infants have lower binding capacity for medications. (A) Signup and view all the answers

What is the first step in medication reconciliation?

Verification of patient medication information (C) Signup and view all the answers

What should be considered when administering medications to patients from different racial backgrounds?

Drug polymorphism and cultural practices (D) Signup and view all the answers

Which route of drug administration is likely to provide the most rapid effects in patients?

Inhalational delivery (A) Signup and view all the answers

What ethical principle requires nurses to avoid withholding information from patients?

Beneficence (A) Signup and view all the answers

What is the purpose of transdermal drug delivery systems?

To maintain a relatively constant rate of drug absorption (B) Signup and view all the answers

How does protein binding affect drug interactions?

It allows for increased competition for binding sites. (A) Signup and view all the answers

Which factor does NOT influence medication effectiveness in pregnant patients?

Administration time of the drug (B) Signup and view all the answers

What method can help patients with memory problems manage their medications?

Utilizing daily medication containers (C) Signup and view all the answers

What is a crucial step when a medication error is identified?

Documenting the error and notifying the healthcare team (C) Signup and view all the answers

What is the impact of culture on drug therapy?

It can influence the dosage and efficacy of medications. (B) Signup and view all the answers

Study Notes

Components of a Written Prescription

Patient's name
Date the drug order was written
Name of drug(s)
Drug dosage amount
Drug dosage frequency
Route of administration
Prescriber's signature

Documentation of Medication Administration

"Nine Rights": Includes the five rights plus:
- Right documentation
- Right reason/indication (appropriateness of medication use)
- Right response (patient's response to drug)
- Right to refuse
Medication errors should be documented in an accident report, not an "incident report."
Patient's age should already be in the record, and not included on the medication administration documentation.

Steps/Phases of the Nursing Process

Assessment (recognize cues): Organize information meaningfully.
Diagnosis (Human Needs Statements): Analyze cues, prioritize hypotheses, and identify diagnoses.
Planning: Generate solutions by prioritizing nursing diagnoses and specific outcomes.
Implementation/Intervention: Take actions according to nursing diagnoses.
Evaluation: Monitor patient's therapeutic response to the drug, and its adverse and toxic effects. Assess for first pass effect.

First Pass Effect

A pharmacological phenomenon where a medication is metabolized at a specific location in the body (often the liver).
Decreases active drug concentration because the drug is metabolized at that site before reaching systemic circulation or site of action.
Oral medications are absorbed through the gastrointestinal tract, absorbed through the small intestines, and undergo the first-pass effect in the liver before reaching systemic circulation.

Medication Administration Routes

Enteral:
- Oral: Convenient, inexpensive, and safer, and injection is more likely to reverse errors when accidental ingestion occurs.
- Rectal: Good alternative when oral route is not feasible.
- Sublingual: Rapid absorption due to high blood supply in the area under the tongue
- Buccal: Rapid absorption due to oral mucosa between cheek and gum.
Parenteral: Fastest route, injections directly into circulation.
- Intravenous (IV): Fastest absorption as the medication goes directly into the circulation; no absorption required.
- Intramuscular (IM): Often for poorly-soluble drugs given in a depot; absorption takes longer, but the effects come on slowly over time.
- Subcutaneous (subQ): Similar to IM; absorption takes longer.
- Topical: Administered directly to an affected area; lower chance of systemic drug effects.
- Transdermal: Consistently absorbed over a period of days (1-7) and the avoids first-pass metabolism.
- Inhalational: Rapid absorption by direct delivery to the lung tissue.

Cautions When Giving Drugs to Infants and Elderly Patients

Elderly patients with polypharmacy (multiple medications) have a significantly higher risk for drug interactions.
Neonates and infants have lower albumin binding, meaning they have lower capacities for drug binding. This requires considering lower doses if possible.

Medication Errors

Errors can occur at any stage (procuring, prescribing, dispensing, and administering).
Reconciliation is important; involves verification, clarification, and reconciliation.

Patient Education

Teach the patient about medication (actions, indications, adverse reactions, cautions, and administration techniques)
Ensure noncompliance is addressed, and the nonadherence to the instructions given is acknowledged and acted upon.
Address considerations for the elderly and adult with memory problems, and ensure memory issues are accounted for in medication instructions.
Make sure the patient fully understands how to correctly take the medications.

Protein Binding

Medications that bind to proteins in the body may compete with each other for binding sites.
This may increase toxicity and affect how each drug works.

Drug Polymorphism and Race/Culture

Certain factors (age, gender, race, body composition) may affect how drugs are absorbed, distributed, metabolized, and excreted.
Cultural practices and dietary habits should also be considered.
Knowledge of cultural factors and drug reactions is important.

DNA Structure and Function

DNA is the primary molecule for transferring genetic information from parents to offspring.
DNA consists of four nitrogenous bases: adenine (A), guanine (G), thymine (T), and cytosine (C). -RNA has similar components but T is replaced with U.

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Description

Test your knowledge on the essential components of a written prescription, including patient details and medication specifics. Additionally, explore the steps of the nursing process and the Nine Rights of medication administration. This quiz will help reinforce your understanding of nursing documentation.