Pharmacology Notes for Exam Preparation

Pharmacology can be a source of stress for many students and healthcare professionals due to the vast number of drug classifications and the complexities involved in their applications. Understanding dosage calculations, potential side effects, interactions, and patient-specific factors are crucial.

Important drug classifications include:

• Urine Stimulant: Oxytocin, which stimulates contractions during labor and is critical in managing postpartum hemorrhage.

• Tocolytic: This drug stops contractions, relaxing the myometrium, and is essential in controlling preterm labor, but can have side effects such as hypotension or nausea.

Cushing's Syndrome Symptoms

Key symptoms to identify include:

• Heritourism: Unusual or unexpected growth patterns.

• Truncal obesity: Accumulation of fat in the trunk area often leads to a round face, which can be an important indicator for diagnosis.

• Increased testicular size and decrease in pubic hair: Hormonal imbalances affect sexual development and can vary by individual.
  Focus on recognizing physical cues related to Cushing's syndrome to ensure timely intervention and management.

Vancomycin Flushing Syndrome

Commonly mislabelled as an allergic reaction but is actually a side effect of vancomycin. Key considerations include:

• Recommendations to avoid perpetuating misconceptions in education:

  • Stop using the term “vancomycin flushing syndrome” to clarify the nature of the reaction.

  • Educate future healthcare staff accurately regarding this condition to improve patient education and care.

Burn Fluid Replacement Protocol

The importance of calculating fluid replacement after burns cannot be overstated.

• Total fluid calculation: Given within the first eight hours post-burn, which is crucial for survival.

• If fluids are given pre-hospitalization, those amounts should be deducted from the total volume for the first eight hours.

• Example calculation for an 85 kg patient:

  1. Calculate total fluid for 24 hours: 12,240 mL.

  2. Administer 6,120 mL in the first eight hours.

  3. Manage fluid replacement for subsequent hours based on previous loss, taking care to monitor vital signs and urine output.

End-of-Life Considerations

Essential to address pain management and patient wishes:

• Respect living wills and documented patient wishes, actively involving them in decision-making and respecting their dignity.

• Offer anticipatory grief information to families to aid emotional health during mourning as they navigate this challenging time.

Postmortem care involves:

• Bathe and dress the deceased, apply gentle handling to preserve dignity, replace dentures for appearances, and manage hair to present the deceased respectfully.

Chronic Conditions and Dietary Management

• Pancreatitis: Patients may need an NPO diet (nothing by mouth), with a gradual progression from clear liquids to a high fiber diet based on their condition's severity and recovery stage.

• Diverticulitis: Requires a low-fat diet and increased fluid intake to manage symptoms effectively.

• Cholecystitis: Symptoms may include nausea, vomiting, and a need to avoid certain foods high in fat, which can trigger attacks.

• Duffy's syndrome management: Recommend small, frequent meals to prevent discomfort and stabilize digestion.

NCLEX Preparation Tips

Focus on identifying key terms in questions to aid decision-making; practicing with sample questions helps reinforce this skill.
Familiarize with priority interventions related to respiratory and other systems based on symptoms, ensuring a thorough understanding of patient safety.
Understanding CBC (Complete Blood Count) overviews is critical for accurate patient assessments to identify potential abnormalities.

Medications and Interventions

• Bisphosphonates for osteoporosis: Important nursing points include:

  • Administer with a full glass of water and avoid other beverages to promote absorption.

  • Direct patients to remain upright for at least 30 minutes post-administration to prevent esophagitis.

• Antidepressants (e.g., Trazodone): May be less effective as sole treatment; usually prescribed for insomnia in smaller doses, thus requiring monitoring for side effects.

• Know signs of opioid-related issues, such as constipation, and educate patients accordingly to manage side effects effectively.

Drug Interactions and Side Effects

• Educate patients about avoiding alcohol with certain medications, as it can lead to severe reactions, including increased sedation or enhanced toxicity.

• Monitor electrolytes and therapeutic levels for medications like digoxin and others that have serious side effects to prevent toxicity or therapeutic failure.

• Warfarin management: Consistency in dietary Vitamin K intake is essential to minimize complications; patients should be instructed not to completely avoid Vitamin K-containing foods but rather maintain a consistent intake.

Mental Health Insights

Recognize the importance of therapeutic communication in nursing:

• Using silence and clear, concise statements can aid patients with anxiety or schizophrenia in expressing their needs and feelings more comfortably.

• Understand defense mechanisms and how they impact patient responses and interactions, enhancing the therapeutic relationship.

• Be versed in symptoms and assessment strategies for conditions like ADHD and impulsive disorders, ensuring appropriate referrals and educational support.

Child and Adolescent Disorders

• Early intervention and involving families in planning for children’s educational needs is crucial for their development.

• Understanding differences in learning disabilities versus intellectual disabilities helps tailor educational approaches and support, promoting the best outcomes for children and adolescents.

Conclusion

Pay attention to the complexities of pharmacology and the emotional aspects of caregiving, especially for end-of-life care.
Stay vigilant during interactions with patients about medication management and mental health to ensure effective, empathetic care.