active recall part II
Nursing Process and Drug Therapy
Assessment
Q: What are the two major components of assessment before administering a medication?
A: History & Physical Examination; Medication History
Q: Why is obtaining a medication history important?
A: To identify prescription drugs, OTC medications, herbal supplements, allergies, interactions, and adherence issues.
Q: What information should be included in a medication history?
A:
Prescription medications
OTC medications
Herbal supplements
Allergies
Previous adverse reactions
Alcohol use
Recreational drug use
Q: Why should a nurse ask about herbal supplements?
A: They can interact with prescription medications and affect drug therapy.
Q: What is the nurse assessing when asking a patient how they take their medications at home?
A: Medication adherence and self-management practices.
Q: Why are allergies important during assessment?
A: To prevent allergic reactions and adverse drug events.
Nursing Diagnosis
Q: What is the purpose of the nursing diagnosis in drug therapy?
A: To identify actual or potential health problems that medications may address.
Q: Is a nursing diagnosis the same as a medical diagnosis?
A: No. Nursing diagnoses focus on patient responses and needs.
Q: Give an example of a nursing diagnosis related to medication therapy.
A: Ineffective Health Management related to medication nonadherence.
Planning
Q: What occurs during the planning phase of the nursing process?
A: Establishing goals and expected outcomes for drug therapy.
Q: What should planned outcomes be?
A: Specific, measurable, patient-centered, and realistic.
Q: Example: A patient begins antihypertensive therapy. What is an appropriate outcome?
A: Blood pressure will remain within the target range.
Implementation
Q: What is the implementation phase of medication therapy?
A: Administering medications and providing patient education.
Q: What are major nursing responsibilities during implementation?
A:
Safe medication administration
Monitoring patient response
Teaching patients and families
Preventing medication errors
Q: What must the nurse verify before administering a medication?
A: The Rights of Medication Administration.
Evaluation
Q: What is evaluated after medication administration?
A: Therapeutic effects, side effects, adverse effects, and goal achievement.
Q: What question should the nurse always ask during evaluation?
A: Did the medication achieve the desired outcome?
Q: If a medication is not effective, what should the nurse do?
A: Reassess the patient and notify the provider as appropriate.
Nursing’s Role in Managing Safe Drug Use
Knowledge Level of the Nurse
Q: Why is pharmacology knowledge important for nurses?
A: To administer medications safely and recognize adverse effects.
Q: What medication information should every nurse know?
A:
Drug name
Indication
Dose
Route
Side effects
Contraindications
Nursing implications
Q: Why must nurses understand drug interactions?
A: To prevent harmful effects and improve patient safety.
Patient and Family Education
Q: What is a major nursing responsibility related to medication education?
A: Teaching patients how to use medications safely.
Q: What information should be included in medication teaching?
A:
Purpose
Dose
Schedule
Side effects
When to contact a provider
Q: Why is patient education important?
A: It improves adherence and reduces medication errors.
Q: What teaching method confirms patient understanding?
A: Teach-back method.
Q: What is the teach-back method?
A: Asking the patient to explain information back in their own words.
Special Issues in Drug Therapy
Polypharmacy
Q: What is polypharmacy?
A: The use of multiple medications, often five or more.
Q: Why is polypharmacy a concern?
A:
Increased adverse effects
Increased drug interactions
Increased medication errors
Q: Which population is most affected by polypharmacy?
A: Older adults.
Q: Why are older adults at higher risk for polypharmacy complications?
A: Multiple chronic conditions and age-related physiologic changes.
NCLEX Tip:
More medications = More opportunities for interactions and toxicity.
Self-Medication
Q: What is self-medication?
A: Using medications without professional guidance.
Q: What types of medications are commonly used for self-medication?
A:
OTC drugs
Herbal supplements
Vitamins
Q: Why can self-medication be dangerous?
A: Drug interactions, overdoses, delayed treatment, and duplicate therapy.
Q: Why should nurses ask specifically about OTC medications?
A: Patients often do not consider them “real medications.”
Misuse of Drugs
Q: What is drug misuse?
A: Using medications incorrectly or for unintended purposes.
Q: Give examples of drug misuse.
A:
Taking someone else’s medication
Taking higher doses than prescribed
Using medications for non-medical reasons
Q: What are potential consequences of drug misuse?
A:
Toxicity
Dependence
Adverse effects
Hospitalization
Medication Adherence
Q: What is medication adherence?
A: Taking medications as prescribed.
Q: What factors commonly reduce adherence?
A:
Cost
Side effects
Complex schedules
Forgetfulness
Poor understanding
Q: What nursing interventions improve adherence?
A:
Simplified schedules
Education
Pill organizers
Written instructions
Follow-up
Q: Why is adherence important?
A: Poor adherence decreases therapeutic outcomes.
Health Literacy
Q: What is health literacy?
A: A patient’s ability to obtain, understand, and use health information.
Q: How does poor health literacy affect medication safety?
A: Increases medication errors and nonadherence.
Q: What strategies improve communication with patients who have low health literacy?
A:
Use simple language
Avoid medical jargon
Use visual aids
Use teach-back
Q: Why should nurses avoid medical jargon?
A: Patients may misunderstand instructions.
AGS Beers Criteria
Q: What are the AGS Beers Criteria?
A: Guidelines identifying potentially inappropriate medications for older adults.
Q: Why were the Beers Criteria developed?
A: To reduce adverse drug events in older adults.
Q: What risks do the Beers Criteria help prevent?
A:
Falls
Confusion
Sedation
Adverse drug reactions
Q: Are medications on the Beers list absolutely contraindicated?
A: No, but they require careful consideration and monitoring.
Q: Why are older adults especially vulnerable to medications on the Beers list?
A: Age-related changes in absorption, distribution, metabolism, and excretion.
Rapid Fire NCLEX Review
Q: Which phase of the nursing process includes obtaining a medication history?
A: Assessment
Q: Which phase determines whether the medication worked?
A: Evaluation
Q: What is the best method to confirm patient understanding?
A: Teach-back
Q: What is the biggest risk of polypharmacy?
A: Drug interactions and adverse effects
Q: What population is most associated with the Beers Criteria?
A: Older adults
Q: What is the goal of patient education?
A: Safe and effective medication use
Q: What is medication adherence?
A: Taking medications as prescribed
Q: What is health literacy?
A: Ability to understand and use health information
Q: Why should nurses ask about OTC medications and herbal supplements?
A: They can cause interactions and affect drug therapy.