Fundamentals of Nursing: Notes-004 April 4, 2009

FUNDAMENTALS OF NURSING REVIEW

ADMINISTRATION OF MEDICATIONS 1. DRUG NOMENCLATURE and FORMS A. Names I. Chemical Name provides an exact description of the drugs composition. An example of chemical name acetylsalicylic known common as Aspirin II. Generic Name is given by the manufacturer who first develops the drug before it receives official approval. Protected by law, the generic name is given before a drug receives official publications. III. Official Name is the name under which drug is listed in official publication IV. Trade, Brand or Propriety Name is the name under which a manufacturer markets. B. Classification Nurses categorized medications with similar characteristics by their class. Drug classification indicates the effects on a body system, the symptoms relieved or the desired effect. Each class contains drugs prescribed for similar types of health problems. The physical and chemical composition of drugs within a class is not necessarily the same. A drug may also belong to more than one class. For example, aspirin is an analgesic and antipyretic and an anti-inflammatory drug. C. Forms Drugs are available in a variety of forms preparations. The form of the drug determines its route o administration. For example, a capsule is taken orally and a solution may be given intravenously. The composition drug is designed to enhance its absorption and metabolism within the body. Many drugs are available in several forms such as tablets, capsules, elixirs and suppositories. When administering a medication, the nurse must be certain to give the metabolism in the proper form.

-1-

Fundamentals of Nursing: Notes-004 April 4, 2009 D. Principles in Administering Medications I. Observe the 7 RIGHTS of Drug Administration: a. Right Drug b. Right Dose c. Right Time d. Right Route e. Right Patient f. Right Recording g. Right Approach II. Practice asepsis III. Nurses who administer medications are responsible for their own actions. Question any order that you can consider incorrect. IV. Be knowledgeable about medications that you administer V. Keep narcotics & barbiturates in locked place VI. Use only medications that are in clearly labeled containers VII. Return liquid that are cloudy or have changed in color to the pharmacy

VIII. Before administering a medication, identify the client correctly IX. Do not leave the medication at the bedside X. If the client vomits after taking an oral medication, report this to the nurse in charge and/or physician XI. Preoperative medications are usually discontinued during the post operative period unless ordered to be continued XII. When a medication is omitted for any reason, record the fact together with the reason

-2-

Fundamentals of Nursing: Notes-004 April 4, 2009 XIII. When a medication error is made, report immediately to the nurse in charge and/or physician. 2. BASIC HUMAN NEEDS A. Abraham Maslow developed the five (5) levels of human needs: I. Physiologic Needs needs such as air, food, water, shelter, rest, sleep, activity and temperature maintenance are crucial for survival II. Safety and Security Needs the need for safety has both physical and physiologic aspects III. Love and Belonging Needs the third level of needs includes giving and receiving affection, attaining a place in a group and maintaining the feeling of belonging IV. Self-Esteem Needs the individual needs both selfesteem and esteem from others V. Self-Actualization when the need for self-esteem is satisfied, the individual strives for self-actualization, the innate need to develop ones maximum potential and realize ones abilities and qualities B. Maslows Characteristics of a Self-Actualized Person I. Is realistic, sees life clearly and is objective about his or her observations II. Judges people correctly III. Has superior perception, is more decisive IV. Has a clear notion of right or wrong V. Is usually accurate in predicting future events VI. Understands art, music, politics and philosophy VII. Possesses humility, listens to others carefully VIII. Is dedicated to some work, task, duty or vocation IX. Is highly creative, flexible, spontaneous, courageous, and willing to make mistakes X. Is open to new ideas XI. Is self-confident and has self-respect XII. Has low degree of self-conflict; personality is integrated

-3-

Fundamentals of Nursing: Notes-004 April 4, 2009 XIII. Respect self, does not need fame, possesses a feeling of self-control XIV. Is highly independent, desires privacy XV. Can appear remote or detached XVI. is friendly, loving and governed more by inner directives than by society XVII. Can make decisions contrary to popular opinion XVIII. Is problem centered rather than self-centered XIX. Accepts the world for what it is 3. MEETING OXYGENATION NEEDS A. Oxygenation a basic human need & is required to sustain life. B. Cardiovascular Physiology the function of the cardiac system is to deliver oxygen, nutrients, & other substances to the tissues and to remove the waste products of cellular metabolism C. Structure and Function the heart pumps blood through the pulmonary circulation by way of the right ventricle and to the systemic circulation by way of the left ventricle I. Myocardial Pump the pumping action of the heart is essential to maintain oxygen delivery II. Myocardial Blood Flow to maintain adequate blood flow to the pulmonary and systemic circulations, myocardial blood flow must sufficiently supply oxygen and nutrients to the myocardium itself III. Coronary Artery Circulation blood flow to the atria and ventricles does not supply oxygen and nutrients to the myocardium itself. It is the branch of the systemic circulation that supplies oxygen and nutrients and removal of waste from the myocardium IV. Systemic Circulation the arteries and veins of the systemic circulation deliver nutrients and oxygen and remove wastes from the tissues. Oxygenated blood flows from the left ventricle by way of of the aorta and into the large systemic arteries V. Regulation of Blood Flow the amount of blood ejected from the left ventricle each minute is the cardiac output. The circulating volume of blood

-4-

Fundamentals of Nursing: Notes-004 April 4, 2009 changes according to the oxygen and metabolic needs of the body. For example, during exercise, pregnancy and fever, the cardiac output increases but during sleep, the cardiac output decreases. D. Steps in the Process of Oxygenation I. Ventilation process by which gases are moved into and out of the lungs. Adequate ventilation requires coordination of the muscular and elastic properties of the lung and thorax and intact innervation. The major inspiratory muscle is the diaphragm which is innervated by the phrenic nerve. II. Perfusion the primary function of pulmonary circulation is to move blood to and from the alveolar-capillary membrane so that gas exchange can occur III. Exchange of Respiratory Gases respiratory gases are exchanged in the alveoli of the lungs and the capillaries of the body tissues a. Diffusion movement of molecules from an area of higher concentration to an area of lower concentration b. Oxygen Transport delivery depends on the amount of oxygen entering the lungs (ventilation), blood flow to the lungs & tissues (perfusion), adequacy of diffusion & capacity of the blood to carry oxygen. c. Carbon Dioxide Transport carbon dioxide diffuses into RBCs and I rapidly hydrated into carbonic acid because of the presence of carbonic hydrase 4. MEETING NUTRITIONAL NEEDS A. Principles of Nutrition I. Digestion process by which food substances are changed into forms that can be absorbed through cell membranes II. Absorption the taking in of substance by cells or membranes

-5-

Fundamentals of Nursing: Notes-004 April 4, 2009 III. Metabolism sum of all physical and chemical processes by which a living organism is formed and maintained and by which energy is made available IV. Storage some nutrients are stored when not used to provide energy; e.g. carbohydrates are stored either as glycogen or as fat V. Elimination process of discarding unnecessary substances through evaporation, excretion B. Nutrients I. Carbohydrates the primary sources are plant foods Types of Carbohydrates a. Simple (sugars) such as glucose, galactose, and fructose b. Complex such as starches (which are polysaccharides) and fibers (supplies bulk or roughage to the diet) II. Proteins organic substances made up of amino acids III. Lipids organic substances that are insoluble in water but soluble in alcohol and ether. a. Fatty acids the basic structural units of all lipids and are either saturated (all the carbon atoms are filled with hydrogen) or unsaturated (could accommodate more hydrogen than it presently contains) b. Food sources of lipids are animal products (milk, egg yolks and meat) and plants and plant products (seeds, nuts, oils) IV. Vitamins organic compounds not manufactured in the body and needed in small quantities to catalyze metabolic processes a. Water-soluble vitamins include C and Bcomplex vitamins b. Fat-soluble vitamins include A, D, E, and K and these can be stored in limited amounts in the body

-6-

Fundamentals of Nursing: Notes-004 April 4, 2009 V. Minerals compounds that work with other nutrients in maintaining structure and function of the body a. Macronutrients calcium, phosphate, sodium, potassium, chloride, magnesium and sulfur b. Micronutrients (trace elements) iron, iodine, copper, zinc, manganese and fluoride The best sources are vegetables, legumes, milk and some meats VI. Water the bodys most basic nutrient need; it serves as a medium for metabolic reactions within cells and a transporter fro nutrients, waste products and other substances

-7-