N104: Essentials of Nursing Care - Health Safety

N104: Essentials of Nursing Care – Health Safety Study Guide • Memory or cognitive impairments: If a patient does not have the ability to take in or remember instructions about medications, he will be at high risk for injury. In these cases, the nurse must involve the family or caregiver. or provide the patient with mechanisms that will help the patient remember the instructions. • Anxiety: Anxiety and stress can have a major impact on the patient’s ability to learn. If the patient’s anxiety level is at the severe or panic level, she will probably not be able to learn information about medications. In this case, the nurse must first intervene to lower anxiety levels before beginning any teaching. • Motivation to comply: If a patient is not motivated to manage her own medications, she may not pay attention to the instructions or follow the instructions. In this case, the nurse must first try to identify what is blocking the patient’s motivation and develop a plan to intervene at that level. Developmental Stage Factors The patient’s developmental stage and age will have an impact on medication safety and compliance. • Newborns/infants: Most medications are contraindicated for pregnant women and newborns. Infants typically require smaller doses of medications and may have a more rapid absorption of drugs. Because of this, the very young are at higher risk for drug toxicity. When giving an IM injection to an infant, the gluteus maximus muscle in the buttocks should not be used. Instead, use a site in the front thigh where it is less likely to hit a nerve with the needle. • Early childhood: Young children may be unable to swallow pills and may need liquid medicine or medication given in applesauce, syrup, or some other soft food. The nurse should always be aware of what medications should not be mixed with food. • School age, adolescents, and young adults: During this age range, the chances of allergic reactions to medications may increase. Allergic reactions are more likely to occur when the patient is given a medication that was formerly tolerated well. Teaching for this group should include the identification of reactions and appropriate interventions the child should take. • Middle adult: During middle adulthood, the patient is likely to have more prescriptions for medications for a variety of acute or chronic conditions. The risk for incompatible drugs rises as the number of medications increases. Teaching for this group should include the reason the medication is prescribed and therapeutic and unintended effects that might occur with each medication. • Late adult: In late adulthood, liver, kidney, and gastrointestinal function may be diminished, leading to an increased risk for drug toxicity. The patient is likely to have more prescriptions for medications for a variety of acute or chronic conditions. The risk for incompatible drugs rises as the number of medications increases. If the older patient has diminished cognitive function, she may be at increased risk for taking too little or too much of a medication. Environmental and Socioeconomic Factors Environmental and socioeconomic factors can have a major influence on a patient’s readiness to learn about medications and on his ability to comply with a medication regimen. Temperature extremes can affect how quickly a medication is metabolized and delivered to the tissues. Patients should be taught to avoid extremes of temperature if possible. Many medications may result in photosensitivity, which will make a patient more prone to being sunburned. Patients taking these medications should be cautioned to use sun screen and avoid excessive sun exposure. Achieve Test Prep Page 122 of 135 will work. ©2017

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