16.11 Evaluating Effects
Open Resources for Nursing (Open RN)
Evaluating the Effects
The nurse is responsible for assessing the client, monitoring lab values, and recognizing side effects and/or adverse effects of medications. Drug dosages should be verified to ensure all are within recommended safe ranges according to the client’s current status, as well as for their potency.
Potency refers to the amount of the drug required to produce the desired effect. A drug that is highly potent may require only a minimal dose to produce a desired therapeutic effect, whereas a drug that has low potency may need to be given at much higher concentrations to produce the same effect. Consider the example of opioid versus nonopioid medications for pain control. Opioid medications often have a much higher potency in smaller doses to produce pain relief; therefore, the overall dose required to produce a therapeutic effect may be much less than that for other analgesics.
The nurse preparing to administer medications must also be cognizant of drug selectivity and monitor for potential side effects and adverse effects. Selectivity refers to the separation between the desired and undesired effects of a drug. Drugs that are selective will search out target sites to create a specific drug action, whereas nonselective drugs may impact many other types of cells and tissues, thus increasing the risk for unintended side effects and/or adverse effects. For example, in Chapter 4 selective and nonselective beta-blockers will be discussed. Selective beta-1 blockers search out specific receptors on the heart to create their effect, whereas nonselective beta-blockers may affect receptors in the lungs in addition to those in the heart, causing potential respiratory side effects like a cough.
A side effect occurs when the drug produces effects other than the intended effect. A side effect, although often unintended, is generally anticipated by the provider and is a known potential consequence of the medication therapy. Examples of common side effects are nausea, vomiting, diarrhea, and drowsiness. In some situations, however, side effects may have a beneficial impact. For example, a side effect of hydrocodone is drowsiness. A client who is having difficulty sleeping due to pain and takes hydrocodone at bedtime may find the drowsiness beneficial in helping them fall asleep.
Conversely, unanticipated effects can occur from medications that are harmful to the client. These harmful occurrences are known as adverse effects. Adverse effects are relatively unpredictable, severe, and are reason to discontinue the medication.[1] For example, an adverse effect of ciprofloxacin is tendon rupture. Adverse effects should be reported to the pharmacy and tracked as a client safety concern according to agency policy.
- This work is a derivative of Principles of Pharmacology by LibreTexts and is licensed under CC BY-NC-SA 4.0 ↵
Learning Activities
(Answers to “Learning Activities” can be found in the “Answer Key” at the end of the book. Answers to interactive activity elements will be provided within the element as immediate feedback.)
Scenario 1
Mr. Jones is a 67-year-old client on the medical-surgical floor who recently underwent a colon resection. See Figure 14.14 for an image of Mr. Jones.[1] He is post-op Day 2 and has been NPO since surgery. He has been receiving IV fluids but has been asking about when he can resume eating.
Questions:
- What assessments should be performed to determine if the client's diet can be progressed?
- What are the first steps during dietary transition from NPO status?
Scenario 2
Mrs. Casey is a 78-year-old widow who recently had a stroke and continues to experience mild right-sided weakness. See Figure 14.15 for an image of Mrs. Casey.[2] She is currently receiving physical therapy in a long-term care facility and ambulates with the assistance of a walker. Mrs. Casey confides, "I am looking forward to going home, but I will miss the three meals a day here."
Her height is 5'2" and she weighs 84 pounds. Her recent lab work results include the following results: Hgb: 8.8 g/dL, WBC 3500, Magnesium 1.4 mg/dL, Albumin 1.0 g/dL
Questions:
- What is Mrs. Casey's BMI and what does this number indicate?
- Analyze Mrs. Casey's recent lab work and interpret the findings.
- Describe focused assessments the nurse should perform regarding Mrs. Casey's nutritional status.
- Create a PES nursing diagnosis statement for Mrs. Casey based on her nutritional status.
- Create a SMART outcome statement for Mrs. Casey.
- Outline planned nutritional interventions for Mrs. Casey while she is at the facility, as well as when she returns home.
- How will you evaluate if your nursing care plan is successful for Mrs. Casey?
Test your knowledge using this NCLEX Next Generation-style bowtie question. You may reset and resubmit your answers to this question an unlimited number of times.[3]
Learning Activities
(Answers to “Learning Activities” can be found in the “Answer Key” at the end of the book. Answers to interactive activity elements will be provided within the element as immediate feedback.)
Scenario 1
Mr. Jones is a 67-year-old client on the medical-surgical floor who recently underwent a colon resection. See Figure 14.14 for an image of Mr. Jones.[4] He is post-op Day 2 and has been NPO since surgery. He has been receiving IV fluids but has been asking about when he can resume eating.
Questions:
- What assessments should be performed to determine if the client's diet can be progressed?
- What are the first steps during dietary transition from NPO status?
Scenario 2
Mrs. Casey is a 78-year-old widow who recently had a stroke and continues to experience mild right-sided weakness. See Figure 14.15 for an image of Mrs. Casey.[5] She is currently receiving physical therapy in a long-term care facility and ambulates with the assistance of a walker. Mrs. Casey confides, "I am looking forward to going home, but I will miss the three meals a day here."
Her height is 5'2" and she weighs 84 pounds. Her recent lab work results include the following results: Hgb: 8.8 g/dL, WBC 3500, Magnesium 1.4 mg/dL, Albumin 1.0 g/dL
Questions:
- What is Mrs. Casey's BMI and what does this number indicate?
- Analyze Mrs. Casey's recent lab work and interpret the findings.
- Describe focused assessments the nurse should perform regarding Mrs. Casey's nutritional status.
- Create a PES nursing diagnosis statement for Mrs. Casey based on her nutritional status.
- Create a SMART outcome statement for Mrs. Casey.
- Outline planned nutritional interventions for Mrs. Casey while she is at the facility, as well as when she returns home.
- How will you evaluate if your nursing care plan is successful for Mrs. Casey?
Test your knowledge using this NCLEX Next Generation-style bowtie question. You may reset and resubmit your answers to this question an unlimited number of times.[6]
