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Chapter 5

Chapter Nine and Chapter Five Readings.docx

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Health Sciences
Kirsten Culver

Pharmacology Textbook Readings- Chapter Nine and Chapter Five Chapter Nine; Medication Incidents and Risk Reduction • Adverse drug reaction; undesired and unexpected client response to an administered medication • Medication errors; situations where the wrong drug or medication is prescribed or given, the medication is improperly administered, or an incorrect dosage or protocol is used • The Canadian Medication Incident Reporting and Prevention System funded by Health Canada, is a new national medication incident reporting and prevention system  aimed at promoting an open, “blame-free,” non-punitive system that encourages healthcare practitioners to voluntarily report medication incidents • An ADR report should be filed whenever an ADR is suspected; confirmation of the ADR is not required • Categorizing Medication Errors  no error error; no harm error; harm error; death • Harm; impairment of the physical, emotional or psychological function or structure of the body and/or pain resulting therefrom • Monitoring; to observe or record relevant physiological or psychological signs • Intervention; may include change in therapy or active medical/surgical treatment • Intervention necessary to sustain life; includes cardiovascular and respiratory support (e.g. CPR, defibrillation, intubation) • Standard of professional practice; specifies the skills and learning that are expected to be possessed by members of a profession • Standards of care; the actions that a reasonable and prudent nurse with equivalent preparation would do under similar circumstances • Medication incidents are the most common cause of morbidity and preventable death within hospitals • An error can alert nurses and healthcare administrators to the fact that a new policy or procedures needs to be implemented to reduce or eliminate medication incidents • Documenting and reporting incidents document in the client’s medical records completing a written incident report reporting at the national level • Factors Contributing to Medication Incidents omitting one of the eight rights of drug administration giving medications based on verbal orders or phone orders, which may be misinterpreted or go undocumented • Four steps of Nursing Process to Prevent Medication Incidents 1) assessment (i.e. allergies, current health concerns, renal and liver function) 2) planning (i.e. question unclear orders, do not accept verbal orders) 3) implementation (i.e. avoid distractions, focus entirely on the task) 4) evaluation (i.e. asses the client for expected outcomes determine if any adverse effects have occurred) • Provide Client Education keep a lifetime record of all medications and natural health products taken know what side effects to be reported immediately do not use expired medications Chapter Five: Pharmodynamics • Pharmacodynamics and Inter-Individual Variability • Refers to how a drug changes in the body • Inter-individual variability in clients can be understood by examining a frequency distribution curve • Frequency distribution curve; graphical representation of the number of individuals responding to a drug at different doses • Therapeutic Index = Lethal Dose /Eff50tive Dose 50 • The curve does not show the magnitude of the response • ED50 is the dose required to produce a specific therapeutic response in 50% of a group of clients • By observing the client, taking vital signs and monitoring associated laboratory data, the skill of the nurse is critical in determining whether the average do
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