Observe, record, and report falls, seizures, and unsafe practices to ensure implementation of appropriate interventions. Overdose of certain medications (such as phenothiazines) can cause such neurologic problems as seizures.
Instruct patient or family member in the drug regimen, including the reasons for taking drugs, safety precautions, and how to monitor the effectiveness of drugs, to increase compliance.- Regularly review and document patient's medication regimen to monitor medication use, assess whether certain medications should be discontinued, and monitor for drug interactions.
- Instruct patient or family member to store drugs in a secure area away from the bedside to prevent accidental ingestion. Many older patients keep medications at their bedside to decrease the need to arise during the night.
- If color-coding medications, use only bright, contrasting colors. Older patients can't distinguish pastel colors well.
- Help patient or family member identify behaviors that contribute to the risk of toxicity, such as obtaining prescriptions from various health care providers or using different pharmacies, to raise awareness of potential hazards.
Encourage patient or family member to retain a primary physician who coordinates care. Older patients with multiple health problems may receive care from various providers who are unaware of each other's treatment plans and medication regimens.- Provide instructions for the use of medications, including quantity, frequency, and number of doses, to enhance understanding of the medication regimen and increase compliance. Make sure the instructions are clearly written in black or blue ink. Older patients can read black or blue ink more easily.
- Make sure all medication labels are inscribed in large print and include dosage instructions to avoid medication errors.
- Help patient maintain an accurate and effective system for following the medication regimen, such as a check-off calendar system or separate pill boxes labeled for each day of the week, to reduce errors. Encourage the patient to work with a pharmacist when developing this system.
- Monitor and record patient's respiratory status because certain poisons can cause respiratory depression.
- Monitor and record neurologic status because excessive toxic exposure can cause coma. Patient may have pinpoint or dilated pupils, depending on the type of drug or poison ingested and the length of time patient has been hypoxic.
- Monitor vital signs, intake and output, and LOC. Record and report any changes. Severe hypotension may develop following overdose. It may be related to central nervous system defect, direct myocardial depression, or vasodilation. Marked hyperthermia can occur with salicylate overdose, which affects the metabolic rate. Dehydration may develop in some patients from an increased respiratory rate, sweating, vomiting, and urine losses.
- Remove dangerous or potentially dangerous products from the environment to avoid injury.
- Observe, record, and report falls, seizures, and unsafe practices to ensure implementation of appropriate interventions. Overdose of certain medications can cause such neurologic problems as seizures.
- Check the settings on oxygen flow meters every hour on patients known to retain carbon dioxide (e.g., some patients with chronic obstructive pulmonary disease). This avoids carbon dioxide narcosis from excessive oxygen therapy in poorly ventilated patients; if unchecked, patient may stop breathing.
- Monitor patient's urine and serum toxicity levels, when indicated, to reduce the risk of toxicity. Age-related changes in body function may lead to decreased renal, liver, and GI clearance of drugs, increasing the patient's risk of toxicity. Also, various drugs commonly used by the older patient increase the risk of toxicity from drug interactions.
- Teach patient about the harmful and potentially lethal effects of abusing drugs, alcohol, or other dangerous substances to enhance knowledge and foster better informed decisions. Provide appropriate written materials. Written materials reinforce teaching and allow review after discharge.
- Teach parents and caregivers to be alert for stomach aches, irritability, and headaches. These may be early signs of poisoning.
- Provide patient and family members with information about such specific products as medications, oxygen, and total parenteral nutrition. Tailor instructions to a specific product and patient's ability to learn self-care. This enables patient and family members to identify and alter environmental or lifestyle factors to achieve optimum health level.
Identify available community resources to help prevent or treat substance abuse. Support services and groups can provide the patient with safe settings in which to explore problems and feelings and develop adaptive methods of coping.
Suggested NIC Interventions
Environmental Management: Safety; Environmental Risk Protection; Health Education; Home Maintenance Assistance; Surveillance: Safety; Vital Signs Monitoring; Medication Management; Risk Identification |