Assessment of Core Patient Variables – health status

Assessment of Core Patient Variables – health status

1. concurrent medical conditions may increase the risk for adverse effects from drug therapy

2. a patient's chronic health condition may also necessitate drug therapy that may interact with other drug therapy or promote adverse effects

Assessment of Core Patient Variables – life span & gender

1. young children and older adults have livers & kidneys that do not function as well as those of young adults

2. older adults are more likely to be receiving polypharmacy for mulitple chronic illnesses and thus are more likely to experience drug interactions

3. adverse effects from drug therapy taken by a pregnant woman may affect the unborn child

Assessment of Core Patient Variables – lifestyle, diet, and habits

1. use of tobacco, alcohol, caffeine, street drugs, or over-the-counter herbs and botanicals may influence the effects of drug therapy

2. the nurse should remember to ask patients about diet and other habits when performing a drug history or when providing patient education on prescribed drug therapy

Assessment of Core Patient Variables – environment

1. some antibiotics can cause the adverse effect of photosensitivity

2. drugs (such as anticholinergics, belladonna alkaloids) reduce the body's tolerance to heat or inhibit the body's ability to reduce temperature by perspiration

Assessment of Core Patient Variables – environment can also play a role in the early detection of adverse effects

1. receiving drug therapy under close supervision (some only given in hospital setting)

2. receiving drug therapy in a community setting (some home healthcare nurses can give chemotherapy)

Assessment of Core Patient Variables – culture and inherited traits

1. researchers are beginning to study responses to drug therapy that are genetically determined in various ethnic and racial populations

2. these responses may place the patient at greater risk for adverse effects or drug interactions than the rest of the global population

Planning & Intervention – Maximizing Therapeutic Effects

1. when drug interactions are intentional and desirable, the nurse needs to give the drugs at the prescribed time intervals

2. when drug interactions are not desired, but both drugs are needed for therapy, the doses must be administered at different times to promote the therapeutic effect of each drug

Minimizing Adverse Effects

1. to help protect the pt from serious adverse effects & drug interactions, nurse must obtain health history

2. throughout therapy, the patient should be monitored for signs and symptoms of interactions and adverse effects and for alterations in health status that increase the risk for adverse effects

Providing Patient and Family Education – before & throughout drug therapy, the nurse needs to inform pt and family about adverse effects & drug interactions

Ongoing Assessment and Evaluation

1. during drug therapy, the nurse continues to monitor for adverse effects and drug interactions, including allergic responses

2. the nurse should also consider the possibility of a drug interaction each time a new drug is added to the treatment plan

3. if none of these effects occurs and the therapeutic effect has been achieved, drug therapy is evaluated as successful