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Pharm Nurs 8
Pharmacology for Nurses Ch 8
| Question | Answer |
|---|---|
| d. holistic approach | Each person must be viewed as an integrated biological, psychosocial, cultural, communicating whole, existing and functioning within the communal environment |
| 6 risk factors which influence pharmacotherapeutic outcomes which are better understood by the holistic approach | 1- Age 2- Genetics 3- Biologic characteristics 4- Environment 5- Personal Habits 6- Lifestyle |
| How do the risk factors to pharmacotherapeutics of Personal habits and Lifestyle differ? | Lifestyle refers to trends such as eating habits, exercise, and risk taking. Personal habits are specific events such as storage of medication. |
| d. human integration pyramid | A conceptual framework for dealing with patients in a holistic manner |
| Levels of the human integration pyramid are ( 2 ) | interconnected and interrelated |
| By considering the levels of the human integration pyramid, the nurse can help ensure that the pharmacotherapy is ( ) | not only treating the symptoms, but addressing issues related to the total patient. |
| Western medicine (in the US) and the holistic approach. | Western medicine (in the US) and the holistic approach are seemingly at odds. Western medicine tends to break down the disease into individual parts. The holistic approach looks at the whole patient. |
| 6 elements of the human integration pyramid starting from the bottom. | 1- psychological-social-spiritual dimension 2- Cultural and ethnic perspectives 3- Community-Environmental factors 4- Genetic Predisposition 5- Gender determinants 6- Age corollaries |
| d. psychosocial | One's psychological development in the context of one's social environment |
| 5 aspects of spirituality | 1- The capacity to love 2- To convey compassion and empathy 3- To give and forgive 4- To enjoy life 5- To find peace of mind and fulfillment in living |
| Health impairments related to an individual's psychosocial situation often require a blending of (3) | 1- individualized nursing care 2- therapeutic drugs 3- psychotherapeutic counciling |
| When patients have strong spiritual and religious beliefs, these may greatly influence their (2) | 1- their perception of illness 2- affect the outcome of pharacotherapy |
| When patients with stong spiritual belilefs suffer from (3) they look to (2) | Ill health, suffering, loneliness.... hope and meaning |
| The psychosocial history of a patient is and essential component of ( ) | the initial interview and assessment |
| Patients who are convinced that their treatment is important will demonstrate ( ) | better compliance with drug therapy |
| 5 psychological and psychosocial factors which influence outcomes of pharmacotherapy | 1- past experiences with medication 2- the acceptability of taking medicine in a social environment 3- Social stigma of taking cerain medicines 4- Clients attitude toward personal health 5- clients expectation of pharmacotherapy |
| If a nurse trivializes the limitations of pharmacotherapy the result may be ( ) | the patient will have unrealistic expectations regarding treatment |
| Patients have an ( ) to receive accurate information regarding drug therapy | an ethical and legal right |
| d ethnicity | people have biologic and genetic similarities |
| d culture | a set of beliefs values and norms that provide meaning for an individual or group |
| ethnicity, culture and pharmacotherapy | ethnicity and culture have a great impact on medication outcomes |
| ethnicity and clinical trials | most clinical trials in the US have been done on Caucasians |
| future trends in ethnicity and medication | as technology advances, nurses will see variations in perscribed amounts and form of medication based on ethnicity |
| Illness and culture | How illness is defined can be affected by cultural beliefs |
| d cultural competence | The ability to provide care to people with diverse values, beliefs, and behaviors, including the ability to adapt delivery of care to meet the needs of these patients |
| 3 variables to consider when treating a patient from a different culture. these factor can affect pharmacotherapy | 1- Alternative therapies 2-Beliefs about health and illness 3- Dietary considerations |
| 1 ethnic factor that can inpact pharmacotherapy | Genetic differences |
| ( ) of the 2 billion perscriptions filled every year in the US are taken incorrectly | 50% |
| How many patients take all of their medicine? How many take some of it? How many take none of it? | 1/3 in each category |
| 2 cultural dietary factors that can affect pharmacotherapy | Spices and herbs |
| Cultural groups may use alternative therapies and substances in 2 ways | 1-Along with modern medicine 2- In place of modern medicine |
| Risk of alternative substances | may cause a drug interaction |
| 3 important environmental influences on pharmacotherapy | 1- population growth 2- complex technological advances 3- evolving globalization patterns |
| The most obvious community related influence on pharmacotherapy | access to health care |
| 5 community factor that affect pharmacotherapy | 1- population density 2- age distribution 3- socioeconomic levels 4- ocupational patterns 5- induatrial growth |
| 2 important poor world community related influences on pharmacotherapy | adequate sanitation and potable water supplies |
| 3 obstacles to access to health care | 1- inadequate health insurance 2- cost of treatment and drugs 3- limited medical care in rural areas |
| What % of the English-speaking population is functionally illiterate? | 48% |
| d functional illiteracy at related to health care | The ability to read, understand and act on health information |
| Functional illiteracy prevents clients from being able to read (3) | Drug labels, written treatment instructions, brocheres regarding medication or disease |
| Functional illiteracy prevents ( ) can lead to ( ) | It prevents the understanding of the importance of pharmacotherapy and can lead to poor drug compliance |
| Patient education and functional illiteracy | Nurses may need to make and extra effort to educate patients with illiteracy or that speak a foreign language |
| one strategy for educating clients with functional illiteracy | use of graphic rich material |
| What % of human genetic information is different? What may this result in? | .2% It may result in significant differences in the patient's ability to handle some medications |
| d genetic polymorphism | 2 or more versions of the same enzyme |
| What is genetic polymorphism cause by? (3 steps) | 1-a single base mutation in DNA 2- may result in an amino acid change in the enzyme 3- which alters enzyme function |
| d pharmacogenetics | The study of genetic variations that give rise to differences in the way patients handle medications |
| Structural variants in metabolic enzymes and ethnicity; impacts | Genetic polymorphism appears more frequently in certain ethnic groups; impacts pharmacotherapy |
| Enzyme change and drug metablolism (2) | 1- increased drug metabolism for certain drugs 2- decreased drug metabolism for certain drugs |
| Why is genetic polymorphism identified with specific ethnic groups (2) | 1- people in an ethnic group have been located in the same area 2- people in an ethnic group have married within the ethnic group for many generations |
| Three types of enzyme polymorphism | 1- Acetyltransferase 2- Debrisoquin hydroxylase 3- mephenytoin hydroxylase |
| Ethnic groups of acetyltransferase 3 | Caucasian, North african, Jews |
| Ethnic groups of debrisoquin and mephenytoin hydorylase 2 | Asians and African Americans |
| Gender behavior differences can affect ( ) Why? | Success of medication treatment, because women seek health care more readily than males |
| Side affects of medication and gender. What is an affect of this? | Side affects of medication can be gender specific. Can cause non-compliance. |
| Local and systemic responses of medication differ between the genders (3) | 1- Body composition 2- Cerebral blood flow 3- rate of elimination of drugs |
| Gender and drug testing. policy requires. When passed? | FDA requires inclusion of subjects of both genders in drug tests, FDA policy changed in 1993 |
| 3 specific gender related requirements of drug research since 1993 | 1- Analysis of clinical data by gender 2-assessment of pharmacokinetic and pharmacodynamic differences between genders 3- additional studies specific to women's health when appropriate |
| Gender inequality and prescription drug coverage. What was excluded? What has changed? | In the past some health insurance excluded women's contraceptives. This was ruled sex descrimination by courts in 2001. |
Created by:
twininger1
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