N104: Essentials of Nursing Care - Health Safety

N104: Essentials of Nursing Care – Health Safety Study Guide Medications are expensive, so patients who are financially disadvantaged may not fill prescriptions or may take the medications less often than prescribed. Because this group may not seek health care until a disease is further along, the financially disadvantaged or thosewithout insurance may require more complex and expensive medications. The nurse must assess the patient’s ability to obtain medication or consult case management to assist in getting prescriptions filled. Cultural and Religious Factors Different cultures and religions have widely varying beliefs about medications. In addition, they may promote the use of herbs, which can cause interactions with prescription or over-the-counter (OTC) medications. It is critical that the nurse determine all drugs (herbs, vitamins, minerals, OTC, and prescription) that the patient is taking. Cultural differences may also exist in a patient’s desire to use other alternative treatments before beginning a medication regimen. 8.5 The Nursing Process and Medication Safety Assessment Assessment related to medication safety must include an accurate history and physical exam. • History: o A complete and accurate health history will assist the nurse in understanding the patient's knowledge about health and medications, in addition to any conditions that may affect the effectiveness of medications. The nurse must obtain information about:  Acute or chronic health problems that the patient may be suffering from  Allergies to medications or foods; food allergies are critical because many medications use food substances (e.g., eggs) as a base  The medications the patient is taking; this should include all herbs, minerals, vitamins, OTC medications, and prescriptionmedicines; the nurse must document the drug, dose, frequency of use, time of last dose, and route  The patient's knowledge about the drugs being taken • Physical exam: o The patient's general health status must be assessed to determine the sufficiency of the current drug therapy. o Nutritional status should be assessed to determine if there are issues that might change absorption of medications. o The patient's vital signs should be taken to determine a baseline for comparing therapeutic or adverse effects of drugs. o Any cognitive impairment should be identified to ensure the patient is able to understand and follow a medication regimen. • Psychological exam: o The patient's motivation to follow a regimen must be determined.

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