Pharmacology and The Nursing Process

Apply the nursing process to medication administration. Read the following two case study and answer the corresponding questions.

She consumed 2 glasses of wine and shrimp stir-fry, she presented to the emergency room complaining of “Feeling hot and itch all over. Something bad is happening”. Her initial vital signs were

T 99.8 °F temporal, heart rate 100 bpm, respiratory rate 28 bpm, and blood pressure 135/80 mmHg. Her physical assessment noted: • Red skin rash around the face, neck, and hands • Bilateral

wheezing in all lung field • Swelling to the lips • “I am having troubles catching my breath” Assignment:

  1. List the Subjective and Objective assessment findings 2. List two nursing diagnosis with related to and as evident by statements (no not use “at risk for” at this time). 3. Write two planning or

outcome goals for the patient in SMART (specific, measurable, achievable, realistic, and timely) for the patient. i. One must be a short-term goal: the first this to address. ii. The other is a long-

term goal, before patient is discharged.
After being seen by the attending physician, she issues the following medication orders: • Epinephrine 0.3 mg IM Stat • Diphenhydramine 25 mg liquid PO now • Prednisone 20 mg PO now

Assignment: 4. Name three nursing interventions for all three medications (you may not repeat any interventions) 5. Name an assessment findings (one for each medication) that indicate the

medication effectiveness. Following administration of the medications, the following assessment findings are noted: • “I feel jittery, but I can breathe again!” • Heart rate increases to 120 bpm,

respirations decrease to 24 bpm, blood pressure increases to 148/96 • Lung sounds are clear in all fields • Rash to face, neck, and hands is gone • Patient complains of nausea and has emesis of

undigested food.

Assignment: 6. What is the significance of these findings? 7. What would be your follow-up action? 8. Name five teaching points to communicate before the patient’s discharge.
Case Study #2 Pharmacology Nursing Process G.M. is a 50 year-old Caucasian male who presented to the emergency department with chest pain, after playing basketball with his son. He had

no significant medical history before the event and was diagnosis with a myocardial infarction. He responded well to medical management and is set to be discharged today. Your assessment

notes the following: • Vital signs BP 100/65, heart rate 72 bpm, respirations 28 bpm, and temperature 98.9°F. • Normal S1 and S2 heart sounds, electrocardiogram shows normal sinus rhythm with

ST wave elevation. • Skin is warm, dry, with 1+ edema noted in ankles • Lungs sounds are clear • Complains of shortness of breath when walking 100 feet. 02 saturation 94% on room air. •

Complains of mild chest pain after walking 100 feet, but it is relieved after sifting down. • Complains of dizziness when going from laying to sifting and from sifting to standing. Assignment: 1. List

the Subjective and Objective assessment findings 2. List two nursing diagnosis with related to and as evident by statements (one diagnosis may be “at risk for”) 3. Write two planning or outcome

goals for the patient in SMA
achievable, realistic, and timely) for the patient.

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i. One must be a short-term goal: the first this to address. ii. The other is a long-term goal, before patient is discharged. He is going home on the following medications: • Aspirin 325 mg PO daily •

Nitroglycerin 0.3 mg SL pm for chest pain that is not relieved after sitting down, may repeat x if chest pain not relieved after 15 minutes. • Atenolol 50 mg PO BID. Hold if systolic blood pressure

less than 90 mmHg.
Assignment: 4. Name two nursing interventions for all three medications (you may not repeat any interventions) 5. Name an assessment findings (one for each medication) that indicate the

medication effectiveness. 6. What side effects could that patient experience for each medication 7. What adverse effects for each medication does the patient need to report? 8. Name five teaching points for each medication to communicate before the patient’s discharge

Sample Solution

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