The nurse must have factual knowledge of each drug given, the reasons for use of the drug, the drug's general action, the more common adverse reactions associated with the drug, special precautions in administration (if any), and the normal dose ranges.
Some drugs may be given frequently; the nurse becomes familiar with pharmacologic information about a specific drug. Other drugs may be given less frequently, or a new drug may be introduced, requiring the nurse to obtain information from reliable sources, such as the drug package insert or the hospital department of pharmacy. It is of utmost importance too check current and approved references for all drug information.
It also is important for the nurse to take patient considerations, such as allergy history, previous adverse reactions, patient comments, and change in patient condition, into account before administering the drug. Before giving any drug for the first time, the nurse should ask the patient about any known allergies and any family history of allergies. This not only includes allergies to drugs but also to food, pollen, animals, and so on. Patients with a personal or family history of allergies are more likely to experience additional allergies and must be monitored closely.
If the patient makes any statement about the drug or if there is any change in the patient, these situations are carefully considered before the drug is given. Examples of situations that require consideration before a drug is given include:
• Problems that may be associated with the drug, such as nausea, dizziness, ringing in the ears, and difficulty walking. Any comments made by the patient may indicate the occurrence of an adverse reaction. The nurse should withhold the drug until references are consulted and the primary caregiver contacted. The decision to withhold the drug must have a sound rationale and must be based on knowledge of pharmacology.
• Comments stating that the drug looks different from the one previously received, that the drug was just given by another nurse, or that the patient thought the primary care provider discontinued the drug therapy.
• A change in the patient's condition, a change in one or more vital signs, or the appearance of new symptoms. Depending on the drug being administered and the patient's diagnosis, these changes may indicate that the drug should be withheld and the primary care provider contacted.
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