Question

you are the home care nurse assigned to visit an 85 years old male patient who was discharged from the with new-onset left-sided heart failure.You arrive at Mr.Smith's house to find that he is having difficulty breathing and appears anxious.You quickly assess Mr.Smith's lungs and find that he has bilateral rhonchi in the upper lobes. Mr.Smith shares that he has not taken his medications this morning. You ask to see the discharge instructions and note that Mr.Smith has seen several specialists and each prescribed a different medication regimen. You begin by determining which medications are due at this time.

answer the following questions. Provide a rational for each answer in the following format.

type the question

Answer:

Rationale

1.which rights would you include in preparing this patient's medications?

2.what measures would be most effective to reduce adverse effects of medication administration?

3.How would the nurse ensure that patient does not have duplicate medication orders and that the patient understands his medication regimen?

Answer 1

1.The "Right Drug" and "Right Time" rights has to be considered when preparing medications for this patient.

As there are multiple medicines, the correct medicine has to be selected and administered

All medication cannot be given at one time or at any time so right timing should be followed to prevent adverse events.

2.Some of the measures which could reduce adverse effects of medication administration are

• Strictly follow the rights of medication administration
• Double check the medication before administration
• Monitor vital signs before administering medication (cardiac disease,respiratory status )
• Identify the high risk level
• Have baseline data of blood investigation to known the possible adverse effects
• Have a through patient details or history (allergies food and medication )
• Inform the patients regarding its effects prior to be aware and cautious to manage self to an extent when there is no help
• Assess the safety of patients and ensure it is there
• Administer via correct route
• Documentation to refuce errors and double dosing

3.The nurse can ensure that the patient doesn't have duplicate medication order by "Medication Reconciliation ".It is a three step process (Verification, Clarification, Reconciliation )

The following things enables that a patient understands his medication regimen by

• Able to differentiate and know the action of medication
• Knows when to take medications in a day
• Understand how many times a day the medication to be taken
• Knows about the side effects and when to report or call for help
• No extra doses without the order of the treating health care providers
• Self reading of BP pulse before taking medications for it