8 Important Questions Every Nursing Student Should Ask (Nursing)

by Rhonda Lawes, PhD, RN

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    00:01 Hi.

    00:01 Welcome to the video that's going to teach you 8 important questions that every nursing student should ask in pharmacology.

    00:08 Now, how we came up with these 8 important questions is that we've talked to nursing students as they're studying pharmacology, and it can be so overwhelming.

    00:16 So we're going to give you some tips and some strategies in these 8 simple questions that you can ask about each and every drug as you're preparing for your tests.

    00:24 Okay.

    00:25 So, here are the 8 eight questions.

    00:28 Now, we're going to walk through each one of these in the video, but what I recommend that you do is pause the video for just a moment and read these eight questions to yourself.

    00:45 Okay.

    00:45 Let's start with question number 1.

    00:47 First of all, why would a patient need this drug? That's the most important question to start with.

    00:53 So why would the health care provider order this specific drug for this specific patient? Lots of drugs have multiple uses, and it's really important that you know why this patient is taking this particular drug.

    01:05 Even if a physician has ordered an antibiotic, you want to know where the infection is, and what they're using the antibiotic to treat.

    01:14 Next, what are we… going to be the benefits of this drug for your patient? If they have an infection and they're taking an antibiotic, we want the infection to resolve if they have high blood pressure and they're taking an antihypertensive, we want their blood pressure to go down.

    01:28 So you want to know why a patient would need this drug, what's the specific reason, and what are going to be the benefits for this patient.

    01:36 Next, how would I know if this drug was doing what it was intended to do? Well, let's use those examples we just talked about.

    01:42 Where if evaluate if the medication is effective, that's really important in NCLEX questions and as you're studying, think about what the medication was intended to do.

    01:52 If I know the antibiotic is supposed to treat a lung infection or a pneumonia, I'm going to look at lab work and see if they're CBC is going back to normal.

    02:02 If their white blood cell count is back to normal, if they're breathing easier, if their pulse oxs are more normal.

    02:08 So it's really important that you know the first question, why they're receiving the medication, and how you're going to evaluate if that was effective.

    02:16 Now, this is really important on NCLEX level questions, because a lot of the questions dealing with pharmacology are assessing your ability to evaluate the effectiveness of a medication.

    02:27 You want to start, again, with the individual reason that this drug was ordered for this patient and know the important ways to assess it.

    02:35 Like we talked about, an antibiotic for pneumonia, you're gonna look at their lab values and see if their CBC, their complete blood count, or their white blood cell count, is back to normal.

    02:44 If they say they're not as short as breath, and their pulse ox is back to normal.

    02:50 Now, the next question is all about safety.

    02:52 How would I know if the patient was experiencing adverse effects because of this drug? So there's three must-knows.

    02:59 You need to know if the message causes any organ damage, like kidneys, liver, or ears.

    03:05 You want to know the impact of this drug on vital signs.

    03:08 What will it do to the blood pressure, to the respiratory rate, to their heart rate? And then any signs of anaphylaxis.

    03:15 I know that in NCLEX world or in real life, if a patient is showing you any signs of anaphylaxis or an allergic reaction, stop the medication immediately, hold the next dose, and notify the health care provider.

    03:28 So, those are the must-knows: organ damage, impact on vital signs, and signs of anaphylaxis or an allergic reaction.

    03:37 But oftentimes, nursing students get completely overwhelmed by the pages and pages they see of side effects of medications.

    03:45 So let me give you some tips and some pointers, how to group those and prioritize those.

    03:50 These are some important ways that you can do it.

    03:53 So group the family category of medication adverse effects together.

    03:57 It's kind of like chunking groups of items together.

    04:01 So don't look at all the individual ACE inhibitors, look at the adverse effects of ACE inhibitors as a whole.

    04:08 Look at beta blockers as a whole.

    04:10 Look at cephalosporins as a whole.

    04:13 So by grouping these families of drugs together, it will help your brain be able to remember those key adverse side effects.

    04:20 Also, things that are across the board, GI distress with most oral meds, it always would happen.

    04:27 So don't even waste your time memorizing GI distress as a negative effect.

    04:33 It just is with any oral medications.

    04:37 Now, next.

    04:38 We're going to look at why a patient should not take this drug or only take it with caution.

    04:43 Now, in real life, the health care provider will weigh out all the variables and may decide to go ahead and give a patient that medication.

    04:50 But in NCLEX world and in testing world, you want to be ultra, ultra-conservative.

    04:56 So you want to look at the impact of the drug on organ failure.

    04:59 If I have an organ that's already failing or struggling… say the patient's having some renal problems.

    05:05 I don't want to give them a medication that we know is nephrotoxic or could damage the kidneys.

    05:10 If…medications that have similar side effects.

    05:12 I mean, like negative side effects.

    05:14 If one drug is a CNS depressant, it will depress our central nervous system and we could end up with respiratory issues, I don't want to give another drug that's also a CNS depressant.

    05:25 So that would be an example of why I'd only want the patient to take it with extreme caution, but really, in NCLEX world, you wouldn't do that.

    05:33 And last, if it has a really narrow therapeutic window, you want to be careful that you need to do regular and consistent lab work to make sure that that drug is in the right range.

    05:45 So, what about lab tests? Not all drugs require lab tests, but some of them do, so it'll be important as you're setting to make note if there's a medication that has a lab test that should be monitored before or during because of the medication that they're taking.

    06:00 Some medications, like digoxin, theophylline or phenytoin have serum drug levels.

    06:05 They have their own special lab test.

    06:08 Now, don't worry about memorizing all these examples.

    06:12 These are just to help you understand why these questions are important.

    06:15 But you don't have to memorize these drug names right now.

    06:18 We'll come back to them when we study each of these drugs in the following videos.

    06:22 Impact on organs.

    06:23 Remember, that you don't want to give nephrotoxic drugs to people who have declining renal function.

    06:28 So you should be looking at a patient's BUN in creatinine lab work.

    06:32 That gives us an idea of what the kidney function is.

    06:35 And last, look at the electrolytes.

    06:38 Diuretics classically impact electrolytes.

    06:41 So you want to make sure that your patient's electrolytes are within a normal and safe range before you would give a diuretic.

    06:49 So how does this drug impact other disease processes? Now, this may or may not be a pivotal question as you're walking through the test, but you always want to make sure that you consider it.

    06:59 So let's talk about corticosteroids.

    07:01 They will raise your blood sugar, so if the patient is diabetic, that means their blood sugars can become even more difficult to manage.

    07:10 What would happen if a patient received too much of this drug? That's just another way of asking, what are the signs of toxicity if the patient was taking this medication? So, you need to know, for like dig toxicity, if a patient tells you they have nausea or vomiting, diarrhea, or some visual disturbances, that's a signal for dig toxicity.

    07:30 Now, I know we just said any oral medications can cause GI distress, but for this particular drug, that's why we use it as an example, want you to be very aware that if a patient tells you they're having some GI distress and they're taking digoxin, that is cause for alarm.

    07:49 Another example is you want to know the antidote.

    07:51 So I want to know what happens if they get too much of this drug, I want to know those clinical signs and symptoms, but I also want to know what do we do about it? And in the case of digoxin, we give a drug called digibind, which is so cleverly named, that's easy to remember.

    08:06 And again, you don't need to memorize these exact examples.

    08:09 I just want you to understand how we would apply these questions as we're walking through the other medications.

    08:16 Okay.

    08:16 And the 8th and final question is really important to both you and your patient.

    08:20 It's what do I need to teach the patient about this drug to keep them safe and increase the effectiveness of this drug? So, maybe there's a special diet that this medication requires.

    08:30 Things like MAOI inhibitors that we use as a psych medication, the patient would be at risk for a hypertensive crisis if they eat aged foods while they're taking MAOIs.

    08:41 So it'd be very important that you teach the patient what are the types of foods they should not eat with this medication.

    08:48 What about their vital signs? What vital signs should the patient check before, during, and after they take the medication? Some examples would be anyone taking insulin needs to monitor their blood sugar closely.

    09:01 Anyone who's taking digoxin or a beta blocker needs to watch their pulse closely, because both digoxin and beta blockers decrease your pulse.

    09:11 So, usually, the rule of thumb is if the pulse is 60…< 60, you want to hold the medication and notify the health care provider.

    09:19 Now if I was teaching the patient this, you would ask them to check their pulse, and if it was < 60, they would hold the medication and notify the health care provider.

    09:29 Now, if I have someone on an antihypertensive medication, it makes sense to you that we would want them to monitor their blood pressure.

    09:35 Sometimes, our blood pressure can become too low while they're taking the anti-hypertensive medication and they should not take it.

    09:42 But oftentimes, the antihypertensive medication is no longer effective, and the physician needs that information to know that the treatment plan isn't working so they can make an adjustment.

    09:52 So, you want to talk to them about special diet, about vital signs they should check before, during, and after administration of the drug, and then anything else from questions 1 through 7 that you think will help that patient safely and effectively be involved in their medication plan.

    10:09 Thank you for listening.

    About the Lecture

    The lecture 8 Important Questions Every Nursing Student Should Ask (Nursing) by Rhonda Lawes, PhD, RN is from the course Pharmacology and Implications for Nursing.

    Included Quiz Questions

    1. Presence of new organ damage
    2. Unexpected alteration in baseline vital signs
    3. Signs and symptoms of anaphylactic reaction
    4. Traumatic nerve injury that may impair vision or hearing
    5. Ineffectiveness of the medication
    1. Nausea and vomiting
    2. Diarrhea
    3. Visual disturbances
    4. Hyperactivity
    5. Constipation
    1. White blood count
    2. Hemoglobin
    3. Creatinine
    4. Platelet count
    1. Serum levels
    2. Daily vital signs
    3. Complete blood count
    4. Nutritional intake

    Author of lecture 8 Important Questions Every Nursing Student Should Ask (Nursing)

     Rhonda Lawes, PhD, RN

    Rhonda Lawes, PhD, RN

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