Okay, so we've talked that what
a nurse does in assessing,
diagnosing, and planning the medication plan.
Now it's time to implement it.
There's a decision that the nurse has to make,
and that's whether to give the
medication exactly as it's ordered,
or you might determine that it's not safe for the
patient to get the medication at this point,
and so you hold the medication and
contact the health care provider.
So, part of implementation is
your decision if the medication
should be administered exactly as it's
ordered, or holding the medication
because it's unsafe for the patient to receive it,
and our responsibility is to
notify the healthcare provider
and discuss what the next best
step is to keep that patient safe.
Finally, in the nursing process and clinical
decision making, there's the evaluation.
Now, I'm part of the team that is responsible
for evaluating the effectiveness
of the medication.
You'll work with the health
care provider, the pharmacist,
and therapist to make sure that this
medication is doing what we want it to do.
Now that's all of the steps of the nursing process
and how we use them in clinical decision-making.
So, as you're putting in the hard work
of studying drugs in pharmacology,
remember, this is really what
you're preparing yourself to do:
to know how to safely assess,
diagnose, plan, implement or not,
and evaluate that
medication treatment plan.
So let's talk about some examples
of common evaluations that you do.
If I have a Level Of Pain patient,
I have someone who comes in with chest pain
or abdominal pain or any type of pain,
I'm going to assess their pain,
usually using a scale of 1 to 10.
So if you have a patient who
admits with pain, you ask them,
"Hey, on a scale of 1 to 10,
with 1 being pretty light pain,
and 10 being the most excruciating
pain you've ever experienced,
what number is this level of pain?"
Then after I give the medication, depending
on which route I give it, oral or IV,
I come back at the appropriate time and ask
the patient to give me another number.
Now, sometimes, patients can get
frustrated with this because they think,
"I just want you to take my pain away,"
but it's really important to
try to walk them through
how to give you a number or a level of pain,
so you can evaluate if you're
effectively treating their pain.
Now, cultural insensitivity.
This will be really fun when
we look at the antibiotics.
I'll show you how to look at
the lab work and make sure
that your patient is on the right antibiotic,
or the right drug for the right bug.
We look at a CBC.
Now this is when it's really fun to look at lab work
and make sure you can tell if there's
an improvement in infection.
If their white cell count is elevated,
we know that's a sign of infection.
So we'll want that white cell count
to be coming down back to normal
if we know that the medication is effective.
Sometimes we look at urine
output with diuretic therapy.
So we look at a total intake and output to see
if we have a patient who we think
is in fluid volume overload
that we want to monitor that they're having
a result from that diuretic therapy.
Now, we talked about pain in the first example,
but chest pain is a particular type of emergency.
When a patient is having chest
pain, we're risking heart muscle,
so it's really important that
we get a number from them
and we give nitroglycerin
to help relieve that pain
and we get a number after we give the medication.