Chapter 2 Reading: Taking a Thorough Drug History

Chapter 2 Reading Chapter 2 discusses the application of pharmacology in nursing practice and emphasizes the importance of understanding drugs beyond just their administration. The nurse's responsibility extends to anticipating and responding to possible reactions and interactions between the drug and the patient. The chapter also emphasizes the need for nurses to acquire a broad knowledge of pharmacology to effectively contribute to patient care. Bullet points Taking a thorough drug history ● ● ● Advising the patient to avoid over-the-counter drugs that can interact with prescribed medication Monitoring for adverse interactions between drugs Being aware of the possibility of unknown interactions Promoting therapeutic effects ● Enhancing drug therapy with nonpharmacologic measures (breathing exercises, exercise, physical therapy, weight reduction, smoking cessation, sodium restriction) Making PRN decisions ● ● PRN stands for pro re nata (as needed) Assessing the patient's medication needs before administering a PRN drug Evaluating responses to medication ● ● Evaluating therapeutic responses to determine if the drug is producing a benefit or causing harm Knowing the rationale for treatment and the nature and time course of the intended response Minimizing adverse effects ● ● ● ● All drugs have the potential to produce undesired effects Identifying high-risk patients and ensuring proper administration Teaching patients to avoid activities that might precipitate an adverse event Minimizing discomfort and injury through appropriate intervention Administration of glucose to prevent brain damage from insulin-induced hypoglycemia ● ● ● Timely administration of glucose can prevent drug-induced hypoglycemia Early diagnosis and quick response to toxicity is crucial to prevent irreversible injury or death Knowing early signs of toxicity and proper toxicity management is important Application of pharmacology in patient education ● ● ● ● ● Active and informed participation by the patient is essential for successful therapy The nurse plays a role in educating patients about their medications Information to be provided includes drug name, dosage, dosing schedule, route of administration, expected therapeutic response, duration of treatment, and storage method Patients should be informed about possible adverse effects and measures to minimize discomfort and harm Patient education should cover drug-drug and drug-food interactions and whom to contact in case of therapeutic failure or severe adverse reactions Technique of drug administration ● ● ● Patients must be taught how to administer their drugs, especially for unfamiliar routes or techniques Specific instructions should be given for oral medications, including how to take them, whether they can be chewed, taken with fluids, taken with meals, etc. Special attention should be given to patients with disabilities that may make selfmedication difficult Promoting therapeutic effects and minimizing adverse effects ● ● ● Patients should be educated about the expected therapeutic response and when it should develop Nondrug measures to enhance therapeutic responses should be discussed Information about major adverse effects and measures to minimize discomfort and harm should be provided Minimizing adverse drug interactions ● ● Patients should be informed about major drug-drug and drug-food interactions They should also know whom to contact in case of severe adverse interactions Generic Name and Overdose Risk ● ● Taking different prescriptions with the same generic name reduces the risk for overdose Patients should be aware that some medications may require lifelong therapy Dosage and Schedule of Administration ● ● Patients should be instructed on the correct dosage and schedule for taking their medication Some medications may require adjustment of dosage by the patient Drug Storage ● ● ● Patient should be taught how to store medications properly to prevent deterioration Unstable drugs should be stored in a suitable environment, such as refrigeration or a lightproof container All medications should be stored out of reach of children PRN Medications ● ● Patients should be educated on when and how to take PRN (as needed) medications PRN medications are taken based on the patient's condition or symptoms Therapeutic Effects ● ● Patients should be informed about the expected beneficial effects of their medication Knowing the nature and time course of these effects helps patients evaluate treatment success Adherence to Treatment ● ● ● Adherence refers to the extent to which a patient follows their prescribed treatment Patients should be aware that some medications may not produce immediate results Nondrug measures can complement drug therapy in achieving treatment objectives Minimizing Adverse Effects ● ● Patients should be educated on the potential adverse effects of their medication Knowledge of adverse effects helps patients avoid or detect them early The Nursing Process: Assessment ● ● Assessment involves collecting data about the patient to identify health problems Data collection methods include interviews, medical histories, physical examinations, and diagnostic studies Analyzing Information in the Database ● ● Nurses analyze information in the database to determine actual and potential health problems Problems may be physiologic, psychologic, or sociologic