Nursing 104

N104: Essentials of Nursing Care – Health Safety Study Guide 8.4 Factors Affecting Medication Safety Physical Factors There are several physical factors that the nurse must assess that will affect a patient’s ability to take and metabolize medications. • General physical condition: The patient’s height and weight will affect the dosage of the medication that should be given. If the patient has difficulty swallowing pills, special adaptations and precautions may have to be taken. The patient with poor eyesight must be taught how to setup and give their medications. • Nutrition: Many drugs may interact with foods. The nurse must know what foods should be avoided for any drug the patient is taking. This information must also be included in the patient’s teaching plan. • Drug allergies: A patient’s drug allergies must be determined and documented in the patient’s record. The pharmacy must also be made aware of this information; often, drugs are so closely related to each other that an allergy to one medication should alert the nurse to the potential problems with related medications. • Alcohol use: Many medications should not be taken when a patient will be drinking alcohol. The nurse must ensure that the patient understands these limitations. • Disease process: Certain diseases may inhibit or potentiate the action of a drug. Particularly for patients with liver or kidney disease, the nurse must be aware of the potential for toxicity or decreased efficacy related to drug metabolism or excretion. • Gender: Men and women metabolize medications differently and circulating hormones may affect the way drugs are metabolized. Psychological Factors A patient’s psychological status can affect his readiness to learn about and comply with medication regimens. There are several psychological factors that can influence medication safety: • Patient’s expectations: Studies on the placebo effect have shown that a patient’s expectations about what a medicine will do for them will often have a significant effect on the actual results the patient experiences. If the patient feels that a medication will work, it is very likely that it will work. • 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.

©2018

Achieve

Page 121

of 134