This assignment provides the opportunity for students to apply pharmacology knowledge. You will be assessed on how you apply an understanding of the following general learning outcomes:
• Examine medication measurements using various systems of measurements (amount/quantity)
• Examine selected herbal medications, including their effects, side effects, and interactions with other drugs
• Examine nursing implications and responsibilities related to medication administration
Instructions
• Read the case study (p. 2) and answer the following questions based on the rights of medication administration.
o For each medication ordered clearly identify the following
Right medication & Right reason:
o Patient’s medical diagnosis that relates to the medication
o The mechanism of action (effect)
o The pharmacological class
Right dose:
• Calculate the ordered dosage (show calculation)
• Identify if the dosage is safe (provide rationale)
Right time:
• indicate if the drug is ordered at the right time and frequency
Right route:
• Identify the abbreviations indicated in the order
Right patient:
• Indicate how you would verify you have the right patient
Right documentation:
• Indicate when documentation would occur
Right assessment:
• Identify 1 priority pre-assessment for each medication
• Identify 1 priority post-assessment for each medication
Right patient education
• Indicate 1 teaching point for each medication (from the Nursing 2019 Drug Handbook)
Right to refuse:
• Provide one NANDA diagnosis based on a patient refusing their medication (see p. 109 in Lilley et al.)
• Include 1 diagnosis statement
• Include 1 outcome statement
• Include 1 intervention
o Herbal:
Explain the patient teaching that would be done for the herbal
Explain why this teaching is important
Use your required readings for this assignment.
o The 10 rights of medication administration are in Lilley et al.
o Drug specific information in Wolters Kluwer Nursing 2019 Drug Handbook
o Refer to herbal links listed in Moodle if available OR to the Wolters Kluwer
Nursing 2019 Drug Handbook
o Nurse’s Pocket Guide (15 ed) Doenges, Moorhouse, & Murr. (2019).
Assignment Requirements:
• Assignment must be typed
• Include a title page and reference page
• Maximum 2 pages using assignment template
• Follow APA format for title page, reference page and citations
• No PDF submissions, zip files or Google docs
• See marking guide p. 2
Case Study
Mr. Sims
You are a Practical Nurse working in continuing care and have been assigned Mr. Sims, 40
years old. Mr. Sims has refused his Lasix as he does not like how it makes him feel.
Primary medical diagnoses: Exacerbation of congestive heart failure (CHF)
History: Mr. Sims currently has a cold and is using goldenseal (0.5 mL po tid) to manage
his symptoms. He weighs 95 kg and is 196 cm in height.
Doctors’ Orders: Medications
• Digoxin (Lanoxin) 0.125 mg po once daily maintenance
• Furosemide (Lasix) 20 mg po once a day at hs
Medications Available on Unit:
• Digoxin 0.25 mg tablets
• Lasix 20 mg tablets
Marking Guide
Criteria Mark & Comments
Indicates the following for each medication:
• Right medication & Right reason (6)
• Right dose (4)
• Right time (2)
• Right route (2)
• Right patient (1)
• Right documentation (1)
• Right assessment (4)
• Right patient education (2)
• Right to refuse (NANDA) (3)
25 marks
Teaching provided for herbal and rationale for
why this teaching is important
4 marks
APA
3 marks
Total for Assignment:
/32
Youmay use this templatefor the assignment.
In terms of APA, you are only being marked for the title page, in-text citations and referencepage. Therefore, in order to fit your answers into the template the not to exceed 2 pages, you may use a 10 font and single spacing. However —– 4 page submission will not be penalized.
Example Case Study
You are a Practical Nurse and have been assigned Mr. Smith, 60 years old.
Primary diagnoses: Moderate osteoarthritis to left knee
History: Constipation
Doctors’ Orders:
Medications ordered:
Medications Available on Unit:
Right Medication and Reason
Medical Diagnosis Aspirin: Moderate osteoarthritis of the left knee Colace: insert answer Mechanism of Action Aspirin: The analgesic effect may “result from interference with the prostaglandins involved in pain.” Inhibit synthesis of prostaglandins peripherally and possibly centrally”. (in-text citation) Colace: insert answer with in-text citation Pharmacological Class Aspirin: Salicylates (in -text citation) Colace: insert answerwith in-text citation Right Dose Aspirin: Dose ordered by the doctor is a safe dose. The doctor’s order is 500 mg PO four times a day. The total amount of aspirin administered in 24 hours is 2000 mg or 2 g. Pain adult P.O: The safe dose is “324 -1000 mg q 4 hours p.r.n. Not to exceed 4 g/day”. (insert in -text citation) Inflammation adult P.O.: Initially 3 g P.O daily in divided doses”. (insert in-text citation) Drug calculation: Two tablets PO 4 times a day— please do not include your calculation – only the answer Right Time Aspirin: The time was 4 times day or every 6 hours, which is correct for this drug. Aspirin can be given“324 -1000 mg q 4 hours p.r.n. (insert in-text citation) Colace: insert answerwith in-text citation Right Route Aspirin: Administered by the right route. The drug comes in oral form (capsules and tablets)( insert in text citation)There are no indications of swallowing difficulties with this patient. Colace: Insert answer with in-text citation Right Patient Aspirin: (insert answer with in-text citation) Colace: (insert answer with in-text citation) Right Documentation Aspirin: (insert answer with in-text citation) Colace: (insert answer with in-text citation) Right Assessment Often the prior assessment is related to the reason for giving the medication, as well as any potentially life-threatening side effects associated with the medication. Often the post assessment answer is based on the reason the medication was ordered, as well as potential life-threatening side effects I have listed several post assessments for aspirin, but you would ONLY list one. If you list more than 1 pre and post assessment, only the first listed assessment will be marked. Aspirin: Pre – assessment is a pain assessment of the left knee (in-text citation) Aspirin: Post – assessment is a decrease in pain to the left knee. Signs and symptoms of bleeding (in-text citation) Colace: Pre – assessment (insert answer with in-text citation) Colace: Post – assessment (insert answer with in-text citation) Right Education List only 1 teaching point per medication. If you list several teaching points, only the first listed will be marked Aspirin: insert answer with in-text citation) Colace: (insert answer with in-text citation)
Right to Refuse Write ONLY 1 diagnosis. Use NANDA. Must be based on the patient refusing their medication Write ONLY 1 SMART outcome — directly related to your NANDA diagnosis Write ONLY 1 intervention — directly related to your client achieving the SMART outcome you listed Nursing Diagnosis Under this heading write the nursing diagnosis SMART Outcome Under this heading write your outcome. If you write more than 1 outcome, only the first listed will be marked Intervention Under this heading write your intervention. If you write more than 1 intervention, only the first listed will be marked Herbal Reason the patient is taking the herbal medication. What is a possible drug interaction with one other medication ordered. Include the medications involved and the potential interaction. Explain why this is important. Include 1 other teaching point. In text citation are required for all teaching points. There are 4 marks so you should have 4 teaching points |
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