Med Card Help

CT Pixie, BSN, RN · Jan 17, 2008

doesn't your drug book have a section w/each med for evaluations? here's what my pda davis drug book has for eval for demerol

[color=#007000]evaluation• decrease in severity of pain without a significant alteration in level of consciousness or respiratory status

is that a copy of what you personally made for a drug card? if so, you're on track i can make out your evaluations and they look good..says something like evaluation therapeutic effect occurs, pain relieved, pt can demonstrate understanding of med regimen weight ???? and diet adequate.

you're doing it correctly.

allnurses Guide · Jan 17, 2008

ok so im doing my med cards for catapres, demerol, lasix, digoxin and k-dur. i think im making this WAY more difficult than it really is but i cant figure out what to write as my nusring implication section... we need to write something for assessment, teaching and evaluation...
heres my demerol card
i know its hard to read i just wanted you guys to see the layout...
so for instance, demerol is a pain reliever... so my evaluation would be that the pt does not have any notable pain right?? is it that easy?? im stressing but i have a feeling im being silly:bugeyes:

Evaluation for Demerol (things I think of off the top of my head):

1. pain relief

2. mental status/hallucinations r/t metabolites from Demerol

3. Temperature r/t decreased ability to maintain temp d/t inhibition of shivering

4. Resp status (rate, depth etc) d/t potential for decreased respiratory drive

5.Nausea/vomiting r/t demerol (often given w/ phenergan d/t high incidence of N/V)

6.BP r/t potential hypotension

When you are looking for things to place under evaluation I suggest looking under uses and side effects profile. Those two things should give the majority of things you need.

Good Luck it gets easier as you go along!

Daytonite, BSN, RN · Jan 17, 2008

An implication is (and this is straight out of a dictionary) something that is implied, or from which an inference (conclusion through reasoning) may be drawn. In other words, as a result of giving xyz drug you can infer (conclude through reasoning) that the following is most likely to happen or going to occur. How will you know if it happens? By assessing for it. By teaching the patient to look and assess for it.

Evaluation is determining if goals and outcomes have been met. What was the medication designed to be used for? Why is it given to the patient? [use] Evaluation is a determination of whether the drug achieved its use. How do you go about determining this? Again, assess. Assess to see that the symptoms were relieved.

In the case of Demerol, it is used for pain relief. For evaluation you want to determine if it has relieved pain and, also, if it has caused any major side effects. The major side effects of demerol (meperidine) are increased intracranial pressure and respiratory depression. So, we put on our critical thinking caps and ask ourselves what are the symptoms of these two conditions (increased intracranial pressure and respiratory depression) and what are we going to be on the alert for in the patient. You may have to look up the symptoms of these two conditions if you don't know them. Then, what are we going to do about it if they occur? That will form the basis for our nursing implications. We can imply that the patient is going to have relief of their pain. We can also imply that they might have some side effects, so when you do assess the patient as part of your evaluation activity you are not only going to assess that the drug is doing what it is being used for, but also for any adverse side effects, the worst of which would be symptoms of increased intracranial pressure or respiratory depression. Of course, there are other side effects as well: drowsiness, dizziness, confusion, headache, sedation, and euphoria. You don't want to forget those either. You also won't want to forget about some of the minor side effects either. So, for your nursing implications you are going to have things that are going to keep the patient safe from those side effects. Many will be nursing interventions. Nursing interventions come in four varieties: assessment, actual hands-on care, teaching and care management.