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Discussion

Medication Question

I am trying to figure out why my pt. is taking Neuroutin. They have a hx of DM, HTN, and CVA. No hx of seizures though. In the med book it didnt mention any of the dx as an indaction to take this med. Any help please?!?

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    • Featured Replies

    Many pts take it for nerve pain.. What is a huge issue re to complications of DM.. that's your connect. If you med book doesn't have much information, might be time for an upgrade.. A quick google search will give you lots of information.

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    I have the 2013 drug book and it didnt mention neuropathic pain but I did find a lot of info on Google. Thanks!

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    • Experts

    Here is the example of lateral thinking process of nursing....your critical thinking skills. A patient tells you they have no medical history but give you a list of meds. (yes this happens all the time) You need to determine what medical history they have? Some patients will tell you that they don't have HTN anymore...the pill they take got rid of it.....their B/P is normal now.

    Look at your patient. What are their medical diagnosis's? What complications can arise from these diagnosis's? Neurontin for peripheral neuropathy is an "off label" use of the drug. Like diabetes causes peripheral neuropathy, so doe HTN, do they have so nerve involvement in an extremity from the CVA?

    This is what they mean but critical thinking.....does this make sense? ;)

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    Neurontin is actally a pretty bad antiepileptic. Neuropathic pain has become one of its primary uses. That, and other types of pain like headaches. I worked in neurology for years and saw it used rarely as an antiepileptic.

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    That's Neurontin (gabapentin). If your patient has DM, did your nursing assessment pick up any neuropathic pain? Once again, you're in nursing school, not CNA school, and so you have to look at your nursing diagnosis. If you didn't assess your DM patient for neuropathic pain you didn't do an adequate assessment. That includes reading the physician admission note, which would also have noted neuropathic pain. That would have given you some idea about the gabapentin after you looked that up. Hmmm. The thought process ought to go like this: Gabapentin is often given for neuropathic pain ... my patient is diabetic and has diabetic neuropathy ... bingo!

    My friend Esme is right-- this is a great example of critical thinking, the ability to remember what you learned before and apply it to a novel situation. Everything you learn in nursing school has an application somewhere down the road-- you can't just pass the test and put it out of your mind, because patient care is a test every single day. If you can't do that, you didn't really learn it ... and you will really need to learn it not only to pass the exam, and to pass NCLEX, but to care for real patients, each and every day. We all do.

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    OH yeah, and you can always ASK YOUR PATIENT: "Why do you take this medication? And this one? And this one?" He might not be correct, but you'll want to know whether he knows anyway, and it may help you out. All part of your intake nursing evaluation.

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