Help With Pharmacology

LadyCRNA · Jan 16, 2009

Start with looking up the drug (you don't state the drug so I'm naturally thinking Xanax since that is the most commonly prescribed). Xanax is primarily eliminated via kidneys & diabetics w/ Hypertension commonly develop renal problems. Given that information, you should be able to figure out the rest (ie., labs that best indicate renal function/GFR). Another concept for you to understand is volume of distribution & you can look that up in any pharm book. Good Luck !

Daytonite, BSN, RN · Jan 16, 2009

you are being asked questions about a treatment that has been prescribed for a patient even though this is for your pharmacology. drugs are treatments prescribed by doctors and as nurses we are collaboratively helping the doctors carry out those treatments. you didn't mention where you are in your nursing education, but if you have been doing any actual nursing classes at all, somewhere in the cells of your brain, a light bulb and the words "nursing process" should be trying to get your attention right about now. here is why.

before any problem can be examined, the facts of the situation must be investigated (step 1 of the nursing process--assessment). a policeman is going to do some questioning and investigation before doing anything or throwing any handcuffs on any suspect. in every case, a nurse investigating a patient's complaint or a policeman investigating a citizen's complaint, each brings their education along with them to the table when they intercede in the situation.

so, let me start again. . .you have a fellow who you are told has diabetes, hypertension and who is obese coming to a doctor with complaints of anxiety and not being able to sleep well [i deliberately rearranged the sequence of those conditions as a hint for you]. you need to do a little investigation about the diseases of diabetes and hypertension: causes, signs, symptoms, pathophysiology and complications. i'll give you another hint here and tell you that the obesity, diabetes, hypertension, not being able to sleep well and the anxiety are related but you are not going to find these links unless you do some reading about these conditions and how they come about.

that is going to help you understand why the doc ordered this drug for this guy. now you need to get into the pharmacology of it.

a) what assessment supports the fact that the drug distribution, could be a problem for this patient?

this will be probably be found in the information you discovered about diabetes. what do you think?

b)how will the nurse evaluate the effectiveness of the drugs used to treat anxiety?

what are the signs and symptoms of anxiety in the first place? better look those up and be prepared to rattle them off during your presentation. you can find a list of the symptoms of anxiety in the taxonomy information of the nursing diagnosis of

anxiety

listed on this web page (see the defining characteristics):

anxiety

. wouldn't the patient's symptoms have been present when the doctor saw and examined him if he prescribed an antianxiety drug? [keep in mind that symptoms can be both objective and subjective.] so, to know the drug is working, the expected result of this drug would be that the symptoms of anxiety would start to decrease or go away, wouldn't you say? another assessment or re-evaluation would be called for, wouldn't you say? how long after starting the drug would this be done, or will this be drug specific for each different medication? this is starting to sound like step 5 (evaluation) of the nursing process.

c)what organ function tests should be assessed to ensure the metabolism and excretion of the drug is normal and what other nursing data can be collected to evaluate the proper functioning of the organ of excretion?

this is the tie in to your pharmacology class. what are the different classifications of antianxiety agents that could have been prescribed for this patient? what side effects have to be watched and monitored for with each of them? how? what body organs are involved in the metabolism and excretion? as i recall, there are only 2 major organs involved in metabolism and excretion: the liver and the kidneys. something i learned is that when a patient has kidney disease, medications have to be found that specifically cannot be excreted by the kidneys and that is often a bit of a problem since the majority of drugs are excreted through the kidneys. the liver often takes a real beating when it comes to drug metabolism. your question is specifically asking how to evaluate the proper functioning of those organs. maybe i've been a nurse too long, but all i'm thinking about is the lab tests that would be ordered to monitor their function. but, it is also asking for

nursing data

. how do we assess normal function during a physical exam of these organ systems? you may need to go back to a physical exam resource like

http://meded.ucsd.edu/clinicalmed/introduction.htm

just going through these questions, i realized this is a huge project. best organize the work and split it up among you. do not wait to get started on this. good luck!

shadowluva · Jan 26, 2009

Thanks ALOT for the help. I think my group managed to snag atleast a B+.Very grateful for the info.

Daytonite, BSN, RN · Jan 26, 2009

Good for you! Can you tell us briefly how all of you decided to organize and present this project?