N104: Essentials of Nursing Care - Health Safety

N104: Essentials of Nursing Care – Health Safety Study Guide • Palliative, when the intent is to provide relief of symptoms without actually curing the disease (e.g., using pain killers for the patient with a fractured arm, while immobilizationof the fracture allows the body to heal). • Restorative, when the intent is to return the body to health or promote betterhealth without necessarily curing a specific disease (e.g., through the use of vitamins and minerals). • Diagnostic, when the intent is to use the medication to make a medical diagnosis (e.g., through the use of contrast material when doing CTscans). Undesired Actions or Effects Any medication can cause undesired actions or effects, even when the medication is given correctly. The prudent nurse must be aware of the potential for undesired effects and must be prepared to intervene if necessary. Undesired effects are often classified as the following: • Additive effects are when the effects of two drugs add together resulting in potential toxicity. • Adverse effects are extreme effects of the medication that may warrant discontinuation of the medication. • Allergic reactions are immunologic responses to the medication and may range in intensity from a simple rash to anaphylaxis. An allergic reaction typically warrants discontinuation of the medication. • Antagonistic effects are when one medication counteracts the effects of another. This may be either intentional, such as when Narcan is given to counteract a narcotic overdose, or unintentional, such as when a stimulant is taken with nitroglycerin. The result might be that the beneficial effects of the nitroglycerin are negated and the patient’s blood pressure rises. • Drug tolerance exists when a patient has a diminished response to a medication and requires higher than normal doses to achieve a therapeutic effect. • Idiosyncratic effects are those effects that may be experienced by an individual but are totally different from any expected side effect for the drug. For example, most people experience drowsiness from diphenhydramine; however, some people have the idiosyncratic effect of hyperactivity from the drug. It is not uncommon for pediatric patients to have idiosyncratic effects from medications. • Side effects are unintended secondary effects that are typically predictable and peculiar to a drug or classification of drugs. For example, many antibiotics have a common side effect of vaginal yeast infections in women. • Toxic effects are those that result from the body’s inability to metabolize a medication either due to overdose of the medication or the buildup of the medication because of the body’s inability to excrete it. 8.2 Medication Administration "Five-Plus-Five" Rights of Administration It is the duty and responsibility of the nurse to ensure healthcare quality and patient safety. According to the Institute of Medicine, medical errors cause as many as 98,000 deaths a year. Every time a nurse Achieve Test Prep Page 115 of 135 ©2017