Assignment: Medication Management and ADPIE Frame Work
Assignment: Medication Management and ADPIE Frame Work
Question:
Sample Draft Solution:
Application of clinical decision making process:
ADPIE is a framework for clinical decision making for the nurses that provides the nurses with a set of systemtic step by step process, following which the nurse will be able to complete a thorough assessment analysis, diagnosis and intervention implementation in order to address each and every concerns of the patient (Alfaro-LeFevre, 2012). ADPIE stands for assessment, diagnosis, planning, implementation and evaluation in a care scenario. As this assignment focuses majorly on the medication management, only three sections of the ADPIE frame work will be used namely assessment, implementation and evaluation.
Assessment phase:
The first step is the assessment step, where the medical professional attempts to discover the care issue of the patient and establishes a database of the care cues of the patient by interviewing the patient or their family members. Registered nurse will have two core nursing responsibility in this segment of care delivery. The first responsibility of the nurse will be to assess the drug history of the patient, including the prescription drugs and the over-the-counter drugs and the hypersesnsitivity of the patient to drug agents (Inzucchi et al., 2012). The patient had been taking metformin 500mg for her diabetes but she kept forgetting to take her medication, while in admission she had been given metformin, glibenclamide, atorvastatin, and erythromycin for wound infection management. The second responsibility of the nursing professional will be to assess the patient history such as the biographical data, lifestyle and beliefs, sensory and cognitive status as well. In regards to the cultural requirements, the nurse will have to ensure to adhere to the culturally appropriate and traditional approach to care while approaching the patient and be able to provide optimal cultural safety to the patient.
Implementation phase:
In this case, the first responsibility of the registered nurse will be to incorporate constant communication and collaboration with the health care team and follow the “eight rights” of the medication administration, such as right patient, right medication, right dose, right route, right time, right documentation, right reason and right response or all three medications. The second core responsibility will be to analyze the pharmacologic profile of the medication and educate the patient with a detailed account of the medication and how it is helping her. Metformin is a biguanide antihyperglycemic agent which is used mainly for treating the non insulin dependent Diabetes mellitus. The generic name is metformin with brand names Fortamet, Glucophage, Glucophage XR, Glumetza, Riomet.
This is a schedule two drug and for mechanism of action, metformin decreases the blood glucose levels by reducing the hepatic glucose production (Bailey et al., 2010). The side effects of the drugs like abdominal discomfort, cough, decreased appetite, diarrhea, shallow breathing and fever may occur, for which Mavis will need to contact the care facility. Similarly, for Glibenclamide, the generic name is glibenclamide or glyburemide and brand names are Dionil, Glucovance, Glucobene, semi-dionil. Mavis will need to be educated on how the medication binds to the ATP-sensitive potassium channels on the pancreatic cell surface and causes membrane depolarization and stimulation of calcium ion influx inducing the secretion and exocytosis of insulin (Seino et al., 2010).
Mavis will need to be educated on the side of effects of the medixation which are nausea, vomiting, constipation, diarrhea and hypoglycemic attack. Lastly for atorvastatin as well, the generic name is atorvastatin and the brand name is Lipitor. Mavis will need to be educated on how statin group of drugs selectively and competitively inhibits the hepatic enzyme HMG-CoA reductase, in turn increasing hepatic uptake of LDL-C and reducing serum LDL-C concentrations. The education will include the side effects like memory problems or confusion, rhabdomyolysis and autoimmune myopathy, muscle pain, fever or unusual tiredness, changes in urine, etc. with regards to cultural appropriatenessm the registered nurse will need to provide the education in a culturally appropriate manner in a simple language that she will understand preferably taking the assistance of a cultural liaison officer and language interpreter (Kirmayer, 2012).
Evaluation phase:
The third stage of this process is the evaluation where the nursing professional will be needed to evaluate the success of the planning and implementation procedure. In this case, the nurse will have to monitor the response of the patient to the drugs administered, monitor the difference between expected and unexpected responses and assess the therapeutic effects, side effects, adverse effects and toxic effects (Nursingmidwiferyboard.gov.au 2018). This is the last step …