Welcome to the video that's going
to teach you 8 important questions
that every nursing student
should ask in pharmacology.
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.
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.
So, here are the 8 eight questions.
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.
Let's start with question number 1.
First of all, why would a patient need this drug?
That's the most important question to start with.
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.
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.
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.
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.
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.
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.
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.
If their white blood cell count is back to normal,
if they're breathing easier, if
their pulse oxs are more normal.
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.
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.
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.
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.
If they say they're not as short as breath,
and their pulse ox is back to normal.
Now, the next question is all about safety.
How would I know if the patient was experiencing
adverse effects because of this drug?
So there's three must-knows.
You need to know if the message causes any
organ damage, like kidneys, liver, or ears.
You want to know the impact
of this drug on vital signs.
What will it do to the blood pressure, to
the respiratory rate, to their heart rate?
And then any signs of anaphylaxis.
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.
So, those are the must-knows: organ damage,
impact on vital signs, and signs of
anaphylaxis or an allergic reaction.
But oftentimes, nursing students get
completely overwhelmed by the pages
and pages they see of side
effects of medications.
So let me give you some tips and some pointers,
how to group those and prioritize those.
These are some important ways that you can do it.
So group the family category of
medication adverse effects together.
It's kind of like chunking
groups of items together.
So don't look at all the
individual ACE inhibitors,
look at the adverse effects
of ACE inhibitors as a whole.
Look at beta blockers as a whole.
Look at cephalosporins as a whole.
So by grouping these families of drugs together,
it will help your brain be able to
remember those key adverse side effects.
Also, things that are across the board,
GI distress with most oral meds,
it always would happen.
So don't even waste your time memorizing
GI distress as a negative effect.
It just is with any oral medications.
We're going to look at why a patient should not
take this drug or only take it with caution.
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.
But in NCLEX world and in testing world,
you want to be ultra, ultra-conservative.
So you want to look at the impact
of the drug on organ failure.
If I have an organ that's
already failing or struggling…
say the patient's having
some renal problems.
I don't want to give them a medication that we
know is nephrotoxic or could damage the kidneys.
If…medications that have similar side effects.
I mean, like negative side effects.
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.
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.
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.
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.
Some medications, like digoxin, theophylline
or phenytoin have serum drug levels.
They have their own special lab test.
Now, don't worry about
memorizing all these examples.
These are just to help you understand
why these questions are important.
But you don't have to memorize
these drug names right now.
We'll come back to them when we study each
of these drugs in the following videos.
Impact on organs.
Remember, that you don't want to
give nephrotoxic drugs to people
who have declining renal function.
So you should be looking at a
patient's BUN in creatinine lab work.
That gives us an idea of
what the kidney function is.
And last, look at the electrolytes.
Diuretics classically impact electrolytes.
So you want to make sure that
your patient's electrolytes
are within a normal and safe range
before you would give a diuretic.
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.
So let's talk about corticosteroids.
They will raise your blood sugar,
so if the patient is diabetic,
that means their blood sugars can
become even more difficult to manage.
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.
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.
Another example is you
want to know the antidote.
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.
And again, you don't need to
memorize these exact examples.
I just want you to understand how
we would apply these questions
as we're walking through the other medications.
And the 8th and final question is really
important to both you and your patient.
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.
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.
So it'd be very important
that you teach the patient
what are the types of foods they
should not eat with this medication.
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.
Anyone who's taking digoxin or a beta
blocker needs to watch their pulse closely,
because both digoxin and beta
blockers decrease your pulse.
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.
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.
Now, if I have someone on an
it makes sense to you that we would want
them to monitor their blood pressure.
Sometimes, our blood pressure can become too low
while they're taking the anti-hypertensive
medication and they should not take it.
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.
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.
Thank you for listening.