Nursing: Professional Responsibility, Safe Administration, and Standards of Practice

Nurses are the last line of defense against errors. The Six Rights of Drug Administration are general guidelines that include giving the right drug to the right patient in the right dose by the right route at the right time and with the right documentation.

The four actions of pharmacokinetics involve absorption, distribution, metabolism, and excretion. Absorption refers to the movement of the drug from the site of administration into the bloodstream. Distribution refers to the movement of the drug from the blood into its desired site of action. Metabolism involves the use of enzymes to alter the structure of the drug, thereby inciting its intended therapeutic effect. Excretion signifies the movement of the drug and its metabolites out of the body. These four aspects of pharmacokinetics influence the therapeutic and toxic concentrations at its sites of action.

Genetics can lead to unexpected differences in reactions to the drug. Pharmacogenomics, the study of how unique genetic makeup can affect individual drug responses, can be applied to either increase or decrease adverse effects and therapeutic responses. For example, if a patient has high rates of drug excretion, the dosage required to reach therapeutic concentrations must be individually assessed and increased.

Prescription drugs are made by and often marketed by pharmaceutical companies, prescribed by doctors, intended for use by one person, and distributed by a pharmacy. Over-the-counter drugs do not require a prescription and can be bought by most of the population at pharmacies. Herbal supplements aim to promote general health while dietary supplements intend to augment dietary function.

Nurses should teach patients which drugs they are taking, the proper dosage, and the purpose of the drug. They should also inform patients of drug presentation and any expected side effects, along with possible adverse drug reactions, and what patients should do in these cases. Nurses should also specify how long the patient should take the medication.

References

Lehne, R. A. (2013). Pharmacology for nursing care. (8th ed., pp. 1-1467).

Potter, P. A., Perry, A. G., Stockert, P. A., & Hall, A. M. (2013). Fundamentals of nursing. (8th ed.). Mosby.