Special population considerations Flashcards
Ethnopharmacology
study of drug responses that may be unique to an individual owing to social, cultural and biological phenomena
Transcultural nursing
- traditional health practices include use of teas, herbs, spices, special foods, homeopathic remedies and ointments
- complementary health practices
- alternative health practices
- mainstream health practices
Transcultural assessment model
- culturally unique individual
- communication
- space
- social organization
- time
- environmental control
- biological variations
Communication
- verbal and nonverbal
- when language is not understood
- use translators whenever possible
- do not assume understanding when patient is being polite and nodding
Space
-ask patient preferences
-Americans desire much personal space.
Challenges include:
-use of touch
-protection of modesty
Social organization
- groups organized according to social order
- include family whenever appropriate
Time
perception of time is shaped by culture
- present-oriented
- past-oriented
- future-oriented
environmental control
- Otherworldly begins (spirits)
- traditional healers
- spiritual advisors
Biological variations
- pharmacogenomics
- human genome project
- the genographic project
Nursing process
- assessment
- planning
- nursing interventions
- patient teaching
- evaluation
Common indications for use of medications during pregnancy
- nutritional supplements with iron, vitamins and minerals
- herbal preparations are not generally recommended during pregnancy
Pregnancy category A
no risk to the fetus
Pregnancy category B
no risk in animal studies
-well controlled studies in pregnant women not available
Pregnancy category C
animal studies indicate a risk to the fetus
-risk vs benefit must be determined.
Pregnancy categories D
a risk to the human fetus has been proven
- risk vs benefit must be determined
- it could be used in life threatening situations
Pregnancy category X
a risk to the fetus has been proved
-risk outweighs the benefit
Nausea and vomiting (Pregnancy)
the FDA has approved one drug for morning sickness
- doxylamine succinate and pyridoxine hydrochloride (diclegis)
- ginger can be used
pain (pregnancy)
-acetaminophen (most commonly ingested nonprescription drug during pregnancy)
Heartburn. (Pregnancy)
-sucralfate
Constipation (pregnancy)
- Metamucil
- docusate sodium
Pediatric population
- nurse must make adaptions in care
- both in administration of medications and the evaluation to children and the evaluation of the therapeutic and adverse effects of medication
Pediatric population. Variables that affect drug dosing
- age
- weight
- height
- anatomical and physiological characteristics (organ maturity)
- health status
Pharmacokinetics (pediatric)
- absorption
- distribution
- metabolism
- excretion
Pharmacodynamics (pediatric)
- onset
- peak
- duration
Pediatric medication dosing and monitoring
- monitoring for therapeutic effects and adverse reActions
- calculations
Pediatric medication administration
- patient identification
- consider developmental and cognitive differences
Pediatric medication administration
- family-centered care
- maintaining safety with minimal restraint
- atraumatic care
- distraction and other nonpharmacologic methods of pain and anxiety control
Geriatric population
physiological changes associated with aging effect the pharmacokinetic and pharmacodynamic phases of drug action
Variables that impact geriatric drug dosage
- weight
- body composition
- lab values
- health status: hepatic, renal and cardiac
- in general drug doses need to be decreased
Drug teaching for older population
- reason for medication therapy
- therapeutic effects, side effects and adverse reactions
- self administration
- diet
- when to notify health care provider. Or pharmacist
- scheduling of meds
Med teaching checklist for older adults
- take as prescribed
- med schedule/log, maintain list
- storage of meds
- keep out of reach of children
- polypharmacy
