Domains of Learning - Lecture notes 3-4 PDF

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Pharmaceutics for Nursing Pt. II...

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Discuss the importance of patient education in the safe and efficient administration of drugs - Patients need to know - Being able to be informed - Know how to take the drugs and the administration - Less problems with incorrect medication administrations 1. Learning (change in behavior) a. Coping & adapting i. Assist patient, families, and caregivers to 1. Adapt to illness process 2. Prevent illness 3. Maintain health/ wellness 4. Provide safe self-care ii. Professional/ legal responsibility (ANA Scope/ standard of practice) Identify/ describe the domains of learning 1. Cognitive domain (thinking) a. Basic knowledge learned and stored for use b. Previous knowledge and experience used as learning foundation for new information c. Build relationship between previous knowledge and current information d. Recognize need for more info e. Ask questions for clarification f. Make decisions as needed for safe self care 2. Affective domain (expression) a. Intangible in nature b. Feelings c. Needs d. Beliefs e. Values f. Opinions g. Non-verbal 3. Psychomotor domain (doing) a. Return demonstration i. Medication management ii. Injections iii. 3 checks iv. 6 rights

Summarize teaching and learning principles of patient education and drug therapy applicable in a healthcare setting - Teaching & learning session - Consideration of age-related changes - Consideration of language barriers (try to educate in native languages) - Safe administration of medications at home - (teach back) return demonstration w/ equipment - Make sure adequate control environmental factors are okay (lighting, noise, privacy, & odors) - Respect personal space - Watch for distractions (television, cell phones, unrelated discussions) - Make learning fun and simple - Do not wait until last minute to start teaching discharge medications Identify strategies to enhance patient education and reduce barriers to learning - Consider age-related concerns - Accomodate as much as possible for patient - Try to get rid of any distractions and be in optimal position Identify strategies to address common changes related to aging that may affect learning - Cognitive and memory impairments - Small amounts of information at a time - Large print - Pictures - Hearing impairments - Sit on side that best can hear - Don’t shout - Face the patient - Speak slowly - Visual impairment - Large print, black on white, lighting, keep it simple, braille, sign language - Touch impairment - Teaching psychomotor skills

Identify resources that support patient education - Learning resources to aid in deficits that patients may have - Domains of learning - Accomodations - Intrepreters - Sign language

Discuss the process in the development of new drugs and nursing implications 1. Pre-clinical a. Initial test on non-human and cleared for safety in humans (investigational new drug/ IND) i. Used to determine safety and efficacy 2. Phase one a. (research rn) administering investigational drug & monitoring patient w/ timely scheduled frequent data collection i. Timely scheduled frequent data collection 1. Vital signs 2. Urinalysis 3. Blood draw 4. documents 3. Phase two a. Where therapeutic dose range is determined b. Small # of participants w/ disease given to assess effectiveness of treatment and monitor side effects 4. Phase three a. Large sample involved b. Goals: i. Clinical effectiveness ii. Safety and rare side effects iii. Safe dosage range (SDR) 5. *after phase 3 a. New drug application (NDA) filed w/ FDA for approval to market drug until patent expires i. Exclusive rights to market and sell until after ~17 yrs 6. Phase four

a. Post-marketing study (2 yrs) to get more info on 1)therapeutic effects, 2)adverse effects i. Voluntary b. Generate the black box warnings w/ deaths or severe side effects Identify various cultural phenomena affecting use of medication (QSEN/ Pt. Centered Care) Examples: - Some “expect injections and may believe that oral medications are less effective” - Religious fasting can affect med schedules or interfere w/ drug absorption - Cultural concerns about addictive effects of drug therapy can lead to reluctance to take some medications - Some cultural beliefs lead to patients taking only half of their prescribed medications in the belief that the drug or dose is too strong - Rapid acetylators/ slow acetylators = won’t get drug benefits (slow = toxicity) Boundaries of professional practice - Scope of practice - nursing student - Standards of care - Nurse’s roles - Education requirements (NA, LVN, BSN, MSN, DNP, etc) - Minimum safe nursing practice (QSEN) - Disciplinary actions Discuss the American Nurses Association Code of Ethics 1. Autonomy - the ability to make judgment for patient’s interest (fall prevention) 2. Beneficence - promoting good on behalf of the patient (advocacy) 3. Confidentiality - respect of privileged patient info (HIPPA) 4. Justice - fairness in caring for all patients (no prejudice) 5. Nonmaleficence - do not harm when providing care (using safe process) 6. Veracity - being truthful/honest in all care and result of care provided

7. Fidelity - keeping word w/ patient Describe possible impact of genetics on pharmacologic response - Rapid acetylators = rapid metabolism of drug & no benefit - Slow acetylators = high concentration of drug (TOXICITY) - Levels of cytocrome P-450 enzymes = vary among ppl Describe legal implications of sub-standard nursing care - Negligence (not caring to much) - Failure to act in reasonable and prudent manner or failure of the nurse to five the care - Malpractice - Failure of a professional w/ specialized training… to act in a reasonable and prudent way - Accountable for malpractice Describe the variety of factors that influence an individual’s response to medication - Health beliefs - Communication (do they speak the same language?) - Support- family (how does there family support them in the hospital?) - Biologic variation (do they differ in anatomy?) - Drug response (pharmacokinetics/pharmacodynamics) - How will they respond to drug given to them? Discuss the components of drug legislation at state and federal levels - Drug development phases verified by the FDA Provide examples of how drug legislation impacts drug therapy, nursing practice, and nursing process - assess/evaluate patient [pre-, intra-, & post-] med administration - Ensure patient safety - Use identified process leading to medication errors (omission/comission) Discuss ethical principles and how they apply to pharmacology and nursing process - Duty - taking responsibility to do your job

- Breach of duty - failure to take responsibility - Causation - failure to call our situation leading to harm - Damage - harm further requiring further medical intervention Identify ethical principles in making ethical decision - Patient safety - 6 rights - Boundaries of nursing care Describe nursing practice and social media implications - Always be careful of what you say about your patients in public or in social media, because any amount of information about them being told to others is not allowed...