Chapter 4:

The Nursing Process in Drug

Therapy and Patient Safety

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Nursing: Art and Science
 Assuming increasing responsibilities
 Holistic
 Nurse is a key health care provider
 Integrate knowledge of the
o Basic sciences
o Social sciences
o Education
o Other disciplines
 Applying the nursing process

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Nursing Process
 Assessment
o Data gathering: history, physical assessment,wholistic
 Nursing Diagnosis
o Drawing a conclusion from the assessment data that was
gathered
 Planning/Implementation
o Formulation of a plan of care that includes actions to
improve or maintain the patient’s health
 Evaluations
o Determining if the plan of care was effective at either
maintaining or improving the patient’s health

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Assessment
 History
o Chronic Conditions
o Drug Use
o Allergies
o Level of Education and Understanding
o Social Supports
o Financial Supports
o Pattern of Past Health Care

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Physical Assessment
 Weight
 Age
 Physical Parameters Related to Disease or Drug Effects

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Nursing Diagnosis #1

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Nursing Diagnosis #2

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Implementation
 Synthesizing information into nursing diagnoses to plan patient
care
 Setting goals
 Desired patient outcomes
o Effective response to drug therapy
o Minimization of adverse effects
o Understanding of the drug regimen

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Interventions
 Three Types of Nursing Interventions
o Drug administration
o Provision of comfort measures
o Patient/family education

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Comfort Measures
 Help the patient cope with the effects of drug therapy
 Nurse is in a unique position for this
 Patient more likely to be compliant

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Promoting Drug Therapy
 Placebo Effect
 Managing Adverse Effect
 Lifestyle Adjustment

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Patient and Family Education
 Cornerstone of drug therapy
 Nurses are the primary educators about medications

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Evaluation
 Part of the continuing process of patient care
 Leads to changes in assessment, diagnosis, and intervention

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Proper Drug Administration
(The Rights of safe administration)

 Patient
 Drug
 Storage
 Route
 Dosage
 Preparation
 Timing
 Documentation

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Prevention of Medication Errors
 “To Err is Human”
 Drug Regimen Process
 Series of Checks
o Nurse’s Role
o Patient’s Role
 Reporting of Medication Errors

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Elements of Patient Teaching
 Name, dose, and action of drug
 Timing of administration
 Special storage and preparation instructions
 Specific OTC drugs or alternative therapies to avoid
 Special comfort or safety measures
 Specific points about drug toxicity
 Specific warnings about drug discontinuation

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Question #1
What of the following needs to be included in a physician’s order
for a patient so the nurse can use the “rights of safe
administration” when administering medication?
a. Patient’s weight
b. Patient’s drug history
c. Patient’s name
d. Patient’s address

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Answer to Question #1
c. Patient’s name

Rationale: The physician’s order for a drug needs to include

information that allows the nurse to administer the
medication according to the seven “rights” to ensure safe and
effective drug administration. These are correct drug and
patient, correct storage of drug, correct and most effective
route, correct dosage, correct preparation, correct timing,
and correct recording of administration.

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