lOMoARcPSD|11700591
The Nursing Process
o An organizational framework for the practice of nursing.
Steps:
Assessment
Data collection, review & analysis
Medication profile
Diagnosis
Used to communicate and share info about the patient and the
patient experience
Common diagnoses:
Deficient knowledge
Risk for injury
noncompliance
Planning
Goals - objective, measurable, and realistic with an established
time period for achievement of the outcomes that are specifically stated in
the outcome criteria
Outcome Criteria - concrete description of patient goals
Implementation
Initiation and completion of specific nursing actions as defined
by the nursing diagnoses, goals and outcome criteria
Follow the 6 rights of med administration
Right drug, dose, time, route, patient & documentation
Evaluation
Ongoing part of the nursing process
Determining the status of the goals and outcomes of care
Monitor the patients response to drug therapy
Subjective Data
o Includes all spoken information shared by the patient
o Such as:
Complaints
Problems
Or stated needs
Objective Data
o Includes information available through senses, such as what is seen, felt, heard, and
smelled.
o Among the sources of data are:
The chart
Lab results
Report of diagnostic procedures
Physical assessment
Examination findings
o Examples:
Age
Height
, lOMoARcPSD|11700591
Weight
Allergies
Med profile
Health history
Pharmacokinetics - the study of what the body does to the drug (think MOVEMENT)
o Four major pharmacokinetic processes
Absorption
Bioavailability
First pass effect - the initial metabolism in the liver of a drug absorbed
from the gastrointestinal tract before the drug reaches systemic circulation
through the bloodstream
Different routes
Distribution
Transport of a drug by the bloodstream to its site of action
Albumin is the most common blood protein & carries the majority of
protein-bound drug molecules
Metabolism (Biotransformation)
Biochemical alteration of a drug into an inactive metabolite, more
soluble compound, more potent active metabolite, or a less active metabolite.
Excretion
Elimination of drugs from body
Renal Excretion - Kidneys are a primary source of excretion
o Half-life - time required for 50% of a given drug to be removed from body
Pharmacodynamics - the study of what the drug does to the body
o Mechanism of drug actions in living tissues
o Therapeutic effect
o Mechanism of action (MOA)
Lifespan Considerations
o Fetus
Drugs cross the placenta by diffusion
FDA has implemented pregnancy safety categories
o Infants (Neonatal & Pediatric)
Breastfed infants are at risk for exposure to drugs consumed by the mother
Consider risk-benefit ratio
Pharmacokinetics
Absorption
Gastric pH less acidic until 1-2 yr old
Gastric emptying slowed
IM absorption faster & irregular
Distribution
Greater total body water = lower fat content
Decreased level of protein binding
Immature BBB - more drugs enter brain
Metabolism
The Nursing Process
o An organizational framework for the practice of nursing.
Steps:
Assessment
Data collection, review & analysis
Medication profile
Diagnosis
Used to communicate and share info about the patient and the
patient experience
Common diagnoses:
Deficient knowledge
Risk for injury
noncompliance
Planning
Goals - objective, measurable, and realistic with an established
time period for achievement of the outcomes that are specifically stated in
the outcome criteria
Outcome Criteria - concrete description of patient goals
Implementation
Initiation and completion of specific nursing actions as defined
by the nursing diagnoses, goals and outcome criteria
Follow the 6 rights of med administration
Right drug, dose, time, route, patient & documentation
Evaluation
Ongoing part of the nursing process
Determining the status of the goals and outcomes of care
Monitor the patients response to drug therapy
Subjective Data
o Includes all spoken information shared by the patient
o Such as:
Complaints
Problems
Or stated needs
Objective Data
o Includes information available through senses, such as what is seen, felt, heard, and
smelled.
o Among the sources of data are:
The chart
Lab results
Report of diagnostic procedures
Physical assessment
Examination findings
o Examples:
Age
Height
, lOMoARcPSD|11700591
Weight
Allergies
Med profile
Health history
Pharmacokinetics - the study of what the body does to the drug (think MOVEMENT)
o Four major pharmacokinetic processes
Absorption
Bioavailability
First pass effect - the initial metabolism in the liver of a drug absorbed
from the gastrointestinal tract before the drug reaches systemic circulation
through the bloodstream
Different routes
Distribution
Transport of a drug by the bloodstream to its site of action
Albumin is the most common blood protein & carries the majority of
protein-bound drug molecules
Metabolism (Biotransformation)
Biochemical alteration of a drug into an inactive metabolite, more
soluble compound, more potent active metabolite, or a less active metabolite.
Excretion
Elimination of drugs from body
Renal Excretion - Kidneys are a primary source of excretion
o Half-life - time required for 50% of a given drug to be removed from body
Pharmacodynamics - the study of what the drug does to the body
o Mechanism of drug actions in living tissues
o Therapeutic effect
o Mechanism of action (MOA)
Lifespan Considerations
o Fetus
Drugs cross the placenta by diffusion
FDA has implemented pregnancy safety categories
o Infants (Neonatal & Pediatric)
Breastfed infants are at risk for exposure to drugs consumed by the mother
Consider risk-benefit ratio
Pharmacokinetics
Absorption
Gastric pH less acidic until 1-2 yr old
Gastric emptying slowed
IM absorption faster & irregular
Distribution
Greater total body water = lower fat content
Decreased level of protein binding
Immature BBB - more drugs enter brain
Metabolism
