Chapter 1: Nursing Practice in Canada & Drug Therapy

The first chapter establishes the systematic, research-supported framework known as the Nursing Process (assessment, nursing diagnoses, planning, implementation, and evaluation) as the foundational organizational structure for professional nursing practice, particularly concerning the increasingly complex landscape of drug therapy in Canada. The initial phase, Assessment, demands the nurse holistically collect, review, and analyze both subjective data (patient complaints, needs) and objective data (physical exam results, laboratory findings, and a comprehensive medication profile encompassing prescription, OTC, and natural health products) to ensure safe pharmacotherapy. This critical analysis leads to the formulation of Nursing Diagnoses, which are clinical judgments detailing the patient's human response to health conditions or drug therapy, structured with an identified response, related factors, and supporting evidence. Following this, the Planning phase involves prioritizing needs and setting patient-oriented, measurable, and time-specific Goals and concrete Expected Patient Outcomes. Implementation is the action phase, requiring the nurse to carry out specific interventions (including patient education) guided by the principles of informed consent and patient advocacy. Paramount to safety in implementation are the Ten Rights of Medication Administration (including the Right Drug, Dose, Time, Route, Patient, Reason, Documentation, Evaluation, Patient Education, and Right to Refuse), which supersede the traditional five rights and function as core standards of care to prevent medication errors. The final phase, Evaluation, is the ongoing monitoring of goal achievement, therapeutic effects, and signs of adverse reactions or toxicity, necessitating accurate, real-time documentation and constant clinical judgment. Throughout these steps, nurses integrate Critical Thinking and Evidence-Informed Practice (EIP) to provide ethical, high-quality, individualized care.