NR 526 Week 4 Graded Discussion: Teaching Medications
Examining the case of Alicia Lujan, provide two questions about one of Alicia’s medications that
... [Show More] you will ask your students doing their clinical experiences in Urgent Care. Relate your questions to the 3Ps.
Would you prefer they use (1) medication cards or (2) concept maps or (3) another method of your choice to demonstrate that they are ready to pass medications and why?
ANSWER
Dr. and Class,
After examining the case of Alicia Lujan, I had many questions that came to mind regarding her medications. I will discuss two that I found the most relevant given her current situation and the possibility of her cancer metastasizing. Alicia Lujan is taking Tamoxifen Citrate, Sertraline HCl, and OTC St. John’s Wort as needed. My first question to the student would be to explain the indications, therapeutic effects, and pharmacokinetics of Tamoxifen. Vallerand, Sanoski, and Quiring (2019) explain that Tamoxifen is given to delay recurrence of breast cancer and suppresses tumor growth. The evaluation and desired outcomes of this medication are to decrease the spread of breast cancer Vallerand, Sanoski, & Quiring, 2019) This question would help me as a faculty member make sure the students understood why the patient was taking the medication and what effect the medication was expected to have. The students need to understand the pathophysiology, pharmacology, and physical assessment needed of a patient taking Tamoxifen. My second question would be broad to allow the student to critical think about the medication. The next question would be to ask the student what the nursing implications are for a patient taking Tamoxifen.
This question would have the student think about 3 P’s. Nursing implications include assessment, interventions, and evaluations of the medication. I would expect the student to know that they would need to assess for pain at the tumor site, pain or swelling of the legs, hypertension, shortness of breath, blurred vision, monitor CBC and calcium levels, monitor hepatic function, assess for metastasis, and that severe risks of taking this medication are uterine cancer, stroke and blood clots (Vallerand, Sanoski, & Quiring, 2019). I would have to ask a third question to any level of student that would also relate to the 3 P’s of nursing. My third question is how does; Sertraline HCl and St. John’s Wort effects the therapeutic levels of Tamoxifen Citrate. Lewis (2016) gives nurses and students the information to realize that St. John’s Wort and Sertraline, a SSRI, can both reduce the effects of Tamoxifen. St. John’s Wort is contraindicated with multiple medications including SSRIs and antineoplastic medications such as Tamoxifen. This is education that should have been provided to the Alicia Lujan as soon as she was prescribed the medication. I believe all three questions I would ask the student to relate to the 3 P’s of nursing.
Previously, I have used both drug cards and concept maps. However, I have a medication form that was presented to me at an ATI conference that I routinely use with my students to prepare them to pass medications. This form is similar to a concept map. Through trial and error, I have decided this medication form is my favorite. The form requires the student to identify the pathophysiology of the disease being treated, how the medication works, assessments and diagnostics needed, contraindications, and patient/family teaching. I believe it also helps because the student must write the information in rather than read it off a printed card or book. If a student cannot answer my questions, especially regarding how to safely administer the medication and what assessments need to be done during the medication therapy, I will not allow the to give that medication. The reason I prefer the form is the information it is asking the student helps them put all the information together rather easily. I make them write the information on the form in hopes that it will help them remember the medications.
Thank you,
Jamie Mears, BSN, RN References
Lewis, S. L. (2016). Medical-Surgical Nursing Assessment and Management of Clinical Problems, (10th ed.). St. Louis M.: Elsevier.
Vallerand, A. H., Sanoski, C. A., & Quiring, C. (2019). Tamoxifen Citrate. Davis's drug guide for nurses (15th ed.). pg. 1163-1164. Philadelphia, PA: F.A. Davis Company. [Show Less]