Medication Considerations

Cultural Considerations & Pharmacogenetics

  • Pharmacogenetics: Analysis of a patient's DNA to determine the most effective medications based on their genetic makeup, improving medication selection across diverse populations.

Nursing Process & Critical Thinking

  • Varied Symptoms: Recognize that patients may present with diverse and unique symptoms.
  • Critical Thinking: Engage in critical thinking to determine appropriate nursing interventions.
  • Non-Pharmacological Interventions: Implement non-pharmacological interventions (e.g., comfort measures for pain) while awaiting medication orders or effects.
  • Provider Consultation: Consult with healthcare providers to seek guidance on medication-related issues.

Medication Administration Record (MAR)

  • Reviewing the MAR: Utilize the MAR to verify and administer medications safely.
  • Comprehensive Information Gathering: Collect thorough information regarding a patient's medication use:
    • Prescribed medications.
    • Over-the-counter medications.
    • Vitamins, herbs, and supplements.
  • Assessment of Medication Adherence: Evaluate if patients are taking medications as prescribed, including dosage and timing.

Compliance vs. Adherence

  • Negative Undertones: Be aware of the negative connotations associated with the terms "compliance" and "noncompliance."
  • Underlying Factors: Investigate underlying reasons for nonadherence:
    • Medication costs.
    • Adverse side effects (e.g., dizziness, cough).
    • Access to pharmacy.
  • Patient-Centered Approach: Adopt a patient-centered approach by inquiring about challenges and concerns rather than labeling patients as noncompliant.

Electronic Medical Records (EMR) & Medication Reconciliation

  • Comment Sections: Utilize comment sections in EMR systems (e.g., Northern Light EMR, EPIC) to document specific patient circumstances affecting medication adherence.
  • Medication Reconciliation: Conduct medication reconciliation to gather information on:
    • Last dose taken to prevent over or under-dosing.
    • Reasons for missed doses to assess medication-related issues.

Dosage Forms Considerations

  • Alternative Routes: Consider alternative medication routes (e.g., injections, dissolving tablets) if a patient vomits after taking an oral pill, on a case-by-case basis.

Nursing Process: Assessment

  • Assessment: The first step in the nursing process is to assess the patient's condition thoroughly.
  • Pain Assessment: For patients experiencing pain, assess the following:
    • Pain level on a scale of 1 to 10.
    • Location of the pain.
    • Duration of the pain.
    • Factors that alleviate or exacerbate the pain.
  • Comfort Measures: Provide comfort measures while awaiting medication administration.