Medication Management And ADPIE Frame Work

Question:

Discuss the Medication Management Framework and ADPIE Frame Work.

Answer:

Application Of The Clinical Decision Making Process

ADPIE provides nurses with a framework for clinical decisions making. This allows them to follow a series of systematic steps that will allow them to perform a comprehensive assessment analysis, diagnosis, and intervention implementation to address all the concerns of each patient (Alfaro LeFevre, 2012).

ADPIE stands as assessment, diagnosis planning, implementation, evaluation and evaluation in a care setting.

Because this assignment is mainly about medication management, we will only use three sections of ADPIE’s frame work: implementation, assessment and evaluation.

Phase of Assessment

The first step in the process is the assessment. Here, the medical professional attempts discover the patient’s problem and creates a list of care cues by interviewing family members or the patient.

In this section of care delivery, registered nurses will have two core nursing responsibilities.

Inzucchi et. al. (2012). The nurse’s first responsibility will be to review the patient’s drug history. This includes prescriptions and over-the counter drugs as well as hypersensitivity to drugs.

While the patient was on metformin 500mg for diabetes, she didn’t remember to take it. She had also been admitted with metformin, metformin, metformin, and atorvastatin.

The second responsibility of the nurse professional is to assess the patient’s medical history including biographical data, lifestyle and beliefs as well as sensory and cognitive status.

To meet cultural requirements, the nurse must ensure they follow a traditional and culturally sensitive approach to patient care and provide cultural safety for the patient.

Phase of Implementation

In this instance, the registered nurse’s primary responsibility is to maintain constant communication with the healthcare team and adhere to the “eight right” of medication administration. This includes the right patient and the right medication, right dosage, right route and time, right documentation, right reasons and the right response.

The second core responsibility of the registered nurse will be to analyze and explain the medication’s pharmacologic profile to the patient.

Metformin is an antihyperglycemic biguanide that is used primarily for the treatment of non-insulin dependent Diabetes mellitus.

Metformin, also known as Fortamet, Glucophage and GlucophageXR, Riomet, Glumetza and Riomet is the generic name.

This drug is classified as a Schedule II drug. The mechanism of action for metformin is to lower blood glucose levels through reducing hepatic sugar production (Bailey, et al. 2010).

Side effects may include nausea, vomiting, diarrhea, low blood sugar, shortness of breath, fever, or stomach pain. Mavis will need contact the hospital if this happens.

Glibenclamide’s generic name is glibenclamide. Other brand names include Glucovance and Glucobene. Semi-dionil is another name.

Mavis needs to be informed about how the medication binds on the ATP sensitive potassium channels of the pancreatic cell. This causes membrane polarization and stimulates calcium ion influx, inducing insulin secretion and exocytosis (Seino et.al., 2010).

Mavis needs to be informed about side effects such as nausea, vomiting, constipation and diarrhea.

For atorvastatin, the generic name is Lipitor and the brand is atorvastatin.

Mavis needs to be informed about how the statin drug group selectively and competitively inhibits HMGCoA reductase. In turn, this increases hepatic LDL cholesterol and decreases serum LDL-C levels.

Education will cover side effects like memory loss, confusion, rhabdomyolysis or autoimmune myopathy, muscle pain and fever, unusual tiredness, changes of urine, and other issues.

Concerning cultural appropriateness, the registered nurse will need the ability to deliver the education in a way that is culturally appropriate and in a language she understands. She may use the assistance of a language interpreter or cultural liaison officer (Kirmayer (2012)).

Phase Evaluation

The third step of the process is the evaluation. Here, the nursing professional will need to assess the success of the planning or implementation.

This is the final step prior to discharge. Here, the nurse will need to make sure that the patient is fully informed about the safe and effective administration of medication.

Safe medication administration guidance will be part of the nursing responsibilities.

The nurse must instruct the patient on how to properly take her medication. If she has missed a dose, the nurse should ensure Mavis receives the appropriate dosage. Mavis is not allowed to take twice the recommended dosage to make up for the missed dose.

Mavis will also be instructed by the nurse to keep metformin in a sealed container at room temperature.

Mavis will also be taught by the nurse that metformin should not be taken with alcohol.

Glybenclamide: The nurse will remind Mavis that the medication should be taken in the morning, immediately after breakfast, and that double doses of metformin should not be taken if the dose is missed.

Mavis should be trained to seek medical assistance if there is nauseam, vomiting or constipation.

Mavis must also be instructed by the nurse to store the medicine in cool, dry places, away from heat and sunlight.

Mavis should know how to store atorvastatin in a room that is between 68-77°F (20-25°C), away from moisture, light and the bathroom (Jin, et al. 2012).

Mavis will be advised to take her prescribed doses every day. If she forgets, Mavis must move on to the next dose. She should also not overdose in order to make up the missed dose.

Mavis will be instructed by the nurse to keep her medication locked in a cabinet that is secure so she can’t access them (Roth et. al. 2012).

The nurse will need to include Mavis in the discharge planning session and implementation session in order to ensure Mavis understands everything and can fully participate.

The RN will have to ensure that all patient education details are presented in a written format, using aboriginal language symbols and culturally appropriate formats.

The RN will also have to respect the dignity and autonomy of the patient and ensure they are approached culturally safe.

Let’s conclude by mentioning that self medication administration can prove to be dangerous for those with limited English proficiency and culturally diverse backgrounds. It can cause the patient to miss doses or misinterpret dosages, and can also lead to improper storage.

The role of a nurse professional in teaching and guiding patients is crucial to ensure safe and effective medication administration.

This essay has used the ADPIE clinical decisions framework in order to administer medication and safely administer drug therapy. We also considered cultural safety guidelines for an Aboriginal patient.

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