What are the side effects and toxicity of the drug?
A side effect is a physiological response in the patient’s body that is not re-
lated to the drug’s primary action. Some side effects are beneficial while side
effects—such as nausea and vomiting—are undesirable. By knowing a drug’s
possible side effects, the nurse can prepare to manage them before the patient is
given the drug.
The nurse must also know the toxicity of a drug. A drug’s toxicity is the drug
concentration in plasma and accumulation in tissues that exceeds the drug’s
therapeutic range.
What signs and symptoms must be monitored?
The nurse must note the signs and symptoms that indicate the patient is having
an adverse reaction to a drug or that the drug has reached toxic levels. These
indications may not be present for minutes, hours, and even days after the drug
is administered.
What must a patient know about the drug?
Many drugs are self-administered by patients after they leave the healthcare
facility. Therefore it is important that the nurse identify information about the
drug that the patient needs to know to properly administer the drug.
Is the drug available? Has the drug expired?
How much does the drug cost?The drug that is ordered may not be available in the healthcare facility. The nurse
must make sure the drug is available and make sure that the drug on hand hasn’t
expired if it is available. For example, some healthcare facilities might have a
very low requirement for a particular drug and the stock of the drug might be old
and have passed the expiration date.
The cost of the drug is important to know for a number of reasons. Some drugs
are not covered by the patient’s health insurance because they are expensive. The
insurance company may cover the cost of a similar medication that costs less. In
addition, many patients do not have insurance to cover medications and they can-
not afford to have an expensive prescription filled. Nurses should ask patient’s
about their insurance coverage and if they can afford to buy the medication if they
don’t have coverage. Many patients might stop taking an important medication
because they don’t have enough money.
CHAPTER 3 Pharmacology and the Nursing Process^45