Nurse's Pocket Guide

isk for POISONING
Do not take medications prescribed for another person.
Coordinate care when multiple healthcare providers are
involved to limit number of prescriptions/dosage levels.
NURSING PRIORITY NO.3.To promote wellness (Teaching/Discharge
Considerations):
• Review drug side effects/potential interactions with client/
SO(s). Discuss use of OTC drugs/herbal supplements and
possibilities of misuse, drug interactions, and overdosing as
with vitamin megadosing, and so forth.
• Obtain lab tests (e.g., prothrombin time/INR for Coumadin;
drug levels for dilantin, digoxin) at regular intervals to ascertain
that circulating blood levels are within therapeutic
range.
• Review periodic lab tests performed to monitor for adverse
drug effect (e.g., liver function tests when lipid-lowering
agents [statins] are prescribed, or renal/thyroid function and
serum glucose levels for antimanics [lithium]).
• Discuss vitamins (especially those containing iron) that can
be poisonous to children if taken in large doses.
• Review common analgesic safety (e.g., acetaminophen is an
ingredient in many OTC medications and unintentional overdose
can occur).
• Ask healthcare provider/pharmacist about any considered
medications if pregnant, nursing, or planning to become pregnant
as some drugs are dangerous to fetus or nursing infant.
• Provide list of emergency numbers (i.e., local/national poison
control numbers, physician’s office) to be placed by telephone
for use if poisoning occurs.
• Encourage parent to place safety stickers on drugs/chemicals
to warn children of harmful contents.
• Discuss use of ipecac syrup in home. The use of ipecac is controversial
as it may delay appropriate medical treatment
(e.g., reduce the effectiveness of activated charcoal/oral
antidotes) or be used inappropriately with adverse effects.
Therefore, use in the home without direct advice from poison
control professionals is not recommended.
• Refer substance abuser to detoxification programs, inpatient/outpatient
rehabilitation, counseling, support groups,
and psychotherapy.
• Encourage emergency measures, awareness, and education
(e.g., CPR/first aid class, community safety programs, ways to
access emergency medical personnel).
• Institute community programs to assist individuals to identify
and correct risk factors in own environment.
Information in brackets added by the authors to clarify and enhance
the use of nursing diagnoses.
526 Cultural Collaborative Community/Home Care