It is also important for nurses to understand and apply knowledge or pharmacology in nursing practice. Nurses are frequently responsible for instructing the client and family regarding the safe administration of medications. National Council Licensure Exam (NCLEX) devoted 13% - 19 % of the physiological integrity section to pharmacology.

There are three major areas of pharmacology as followed here:

1. Pharmacokinetics: How drugs are absorbed, distributed, metabolized and excreted by the body.
2. Pharmacodynamics: How drugs are used by the body.
3. Pharmacotherapeutics: How the client response to the drugs.

Nurses are expected to use their knowledge of pharmacology to:

• Recognize common uses, side effects, and adverse effects.
• Challenge medication errors
• Meet the client's learning need.

Administering of medication depend on the area of practice and the assigned patient. Here are medication classifications that commonly prescribed for adult patient:

• Anti-infectives: for the treatment of infections have common side effects - GI upset
• Antihypertensive: to lower blood pressure and increase blood flow to the myocardium, have common side effects such as orthostatic hypotention,
• Antidiarrheals: to decrease gastric motility and reduce water content in the intestinal tract, have side effects include bloating and gas.
• Diuretics: to decrease water and sodium absorption from the loof of Henle or inhibit antidiuretic hormone (potassium-sparing diuretics). Side effects include hypokalemia.
• Antacids: to reduce hydrochloric acid in the stomach. The calcium and aluminum based antacids have side effect of constipation whereas the magnesium based antacids have side effects of diarrhea.
• Antipyretics: to reduce fever
• Bronchodilators: to dilate large air passages (for asthma patient), have common side effect of tachycardia.
• Laxatives: to promote the passage of stool (such as stool softeners, cathartics, fiber, lubricants and stimulants).
• Anticoagulants: to prevent clot formation by decreasing vitamin K levels and blocking the clotting chain or by preventing platelet aggregation.
• Antianemics: to increase factors necessary for red blood cell production such as B12, iron, and Epogen.
• Narcotics / analgesics: to relieve moderate to severe pain, include opioids (morphine and codeine), synthetic opioids (meperidine), and NSAIDs (ketoralac).
• Anticonvulsants: to treat seizure disorder and bipolar disorder, such as phenobarbital, phenytoin and lorazepam.
• Anticholinergics: to dry mucous membranes such as atropine.
• Mydriatics: to dilate the pupils, such as for cataract patients.
• Miotics: to constric the pupil, such as pilocarpin HCl for treatment of glaucoma.

Time-released Drugs:
Here are abbreviations of time-released drugs:

• Dur = Duration
• SR = Sustained release
• CR = Continuous release
• SA = Sustained action
• Contin = Continuous action
• LA = Long acting

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When preparing to administer medication, the physicians order must be reviewed by the nurse such as the rout of the medicines. Many medication are supplied in various preparation and need specific right route. Of course the choice of medication administration is depend on several factor including the client's blood level, ability to swallow and disease or disorder being treated.

However there is the seven rights when administering medication to the patient. They include five rights of drug administration and two of patient's bill of rights.

These seven rights of medication administration are:

1. Right client / patient: should be done by asking the client to state his name and checking the identification band.
2. Right route: medications should be given as physician's prescribed route of administration.
3. Right drug: the name of the drug as well as the generic name ordered by physician should be checked promptly. The nurse should investigate when the patient's diagnosis does not match the drug category.
4. Right amount: The nurse is expected to know common dosages for both adults and children.
5. Right time: the nurse can administer the medication either 30 minutes before or after the assigned time.
6. Right documentation (as the Patient's Bill of Rights and legality issues in nursing): it mus be done to prevent duplicating drug administration,
7. Right to refuse treatment (as the Patient's Bill of Rights): the patient / client has the right to refuse medication or treatment physician ordered.

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Magnetic Resonance Imaging

• Magnetic resonance imaging provides cross-sectional images of brain tissue. It is more detailed than a CT scan
• The procedure is contraindicated to pregnant women, obesity (more than 300 lbs), claustrophobic patients, patients with metal implants (pacemaker, hip replacements and jewelries)

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Mantoux Test

• Mantoux test is done to determine the exposure to mycobacterium tuberculosis
• Positive reaction means there is an exposure to the TB bacilli
• Positive test: induration of 10 mm or more for foreign-born patient and children under 4 years old, and induration of 5 mm or more if the patient is HIV (+), with healed TB and if patient has had contact with a patient with active TB
• BCG vaccine may cause false positive reaction
• Assess the patient for previous history of TB and report it to the physician

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Mammography

• Mammography procedure detects the presence of breast tumor
• Instruct patient not to use deodorant, talcum powder, lotion, perfume and any ointment on the day of the exam since they contain calcium oxalate which may crystallize and may give a false positive result
• Inform the patient that the breast will be placed between two x-ray plates
• The procedure is best done a week after menstruation
• During the procedure, the patient will be positioned on lying down with pillow under the shoulder of the breast being examined

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Lung Scan

• Lung scan determines lung perfusion when pulmonary emboli and infarction are suspected
• It needs consent
• Assess patient for allergy to dye, iodine and sea-foods
• Remove jewelry from the chest area if any
• Sedative is given as prescribed
• The procedure involves injection of radioactive isotope into the body
• Nurse should wear gloves within 24 hour after the procedure when urine is being discarded

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Lumbar Puncture

• Lumbar puncture is a procedure to withdraw CSF and it is used to determine the abnormalities of CSF
• Empty bladder and bowel before the procedure
• Place patient on C-position
• During the procedure, the needle is inserted between L3-L4 or L4-L5
• After the procedure, increase fluid intake and place the patient on flat position to prevent spinal headache

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