Nursing 104

N104: Essentials of Nursing Care – Health Safety Study Guide 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. 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.

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