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HCRS 230 Pharmacology for the Health Professional
This course presents the components of pharmacology including techniques of
administration, dosage calculations, foundations of pharmacology, patient education, health
promotion, and a detailed overview of each drug class and commonly used drugs by body
system. Pharmacology is an integral part of every aspect of health careers and this course is
recommended for any individual with a Health Career objective. (Advisory: Writing Level 2,
Reading Level 1, Math Level 4.) Prerequisite:
1. Basic Pharmacology for Nurses by Bruce D. Clayton, Yvonne N. Stock, & Sandra E.
2. Basic Pharmacology for Nurses Study Guide for the above (15th Ed).
o Computer, either a Macintosh or IBM compatible o Modem, minimum 28.8, preferably 56K or faster
o A web browser software, preferably Netscape 6.0, or Internet Explorer 5.0 o An e-mail program o A word processing program
• Students are expected to accept responsibility for activities assigned by the instructor.
Students are expected to observe the attendance requirements of the College.
• Students are to participate (log in) at least twice weekly, master each course
objective, successfully complete all study guide assignments, and achieve at least 75% on the final exam including 90% mastery of calculations.
o Makeup for the final exam will be allowed with prior approval of the
o Under no circumstance is a student allowed to retake an assignment or final
exam in which they obtained an unsatisfactory grade.
Letter grades will be assigned for overall course average percentage as follows:
A = 90% - 100% B = 80% - 89% C = 70% - 79% D = 60% - 69% F = Below 60%
Overall course average percentages are weighted as follows:
• Study Guide Assignments 75%: • Final Exam 25%:
The objectives of the course will be met through text and study guide assignments,
companion CD ROM resources, and online presentations, discussions, and assignments via the
internet and email. Unit Descriptions
Unit 1 – Foundations of Pharmacology: Ch 1 – 5. Unit 2 – Illustrated Atlas of Medication Administration and Math Review: Ch 6 – 12. Unit 3 – Drugs Affecting the Autonomic and Central Nervous Systems: Ch 13 – 20. Unit 4 – Drugs Affecting the Cardiovascular System: Ch 21 – 29. Unit 5 – Drugs Used to Treat Disorders of the Respiratory System: Ch 30 – 31. Unit 6 – Drugs Affecting the Digestive System: Ch 32 – 35. Unit 7 – Drugs Affecting the Endocrine System: Ch 36 – 39. Unit 8 – Drugs Affecting the Reproductive System: Ch 40 – 41. Unit 9 – Drugs Affecting Other Body Systems: Ch 42 – 50.
Chapter 1 – Definitions, Names, Standards, and Information Sources
1. State the origin and definition of pharmacology. 2. Explain the meaning of therapeutic methods. 3. Describe the process used to name drugs. 4. Differentiate among the chemical, generic, official, and brand names of medicines. 5. Differentiate between the official drug and the proper name of a medicine. 6. List official sources of American drug standards. 7. List and describe literature resources for researching prescription and nonprescription
8. List and describe literature resources for researching drug interactions and drug
9. Cite a literature resource for reviewing information to be given to the patient
10. List legislative acts controlling drug use and abuse. 11. Differentiate among Schedule I, II, III, IV, and V medications, and describe nursing
responsibilities associated with the administration of each type.
12. Describe the procedure outlined by the FDA to develop and market new medicines.
Chapter 2 – Principles of Drug Action and Drug Interactions
1. Identify five basic principles of drug action. 2. Explain nursing assessments necessary to evaluate potential problems associated with
3. Describe nursing interventions that can enhance drug absorption. 4. List three categories of drug administration and state the routes of administration for
5. Differentiate between general and selective types of drug distribution mechanisms. 6. Name the process that inactivates drugs. 7. Identify the meaning and significance to the nurse of the term half-life when used in
8. Compare and contrast the following terms used in relationship to medications: desired
action, side effects, adverse effects, allergic reactions, and idiosyncratic reactions.
9. List factors that cause variations in the absorption, distribution, metabolism, and
10. State the mechanisms by which drug interactions may occur. 11. Differentiate among the following terms used in relationship to medications: additive
effect, synergistic effect, antagonistic effect, displacement, interference, and incompatibility.
Chapter 3 – Drug Action Across the Life Span
1. Discuss the effects of patient age on drug action. 2. Cite major factors associated with drug absorption, distribution, metabolism, and
excretion in the pediatric and geriatric populations.
3. Cite major factors associated with drug absorption, distribution, metabolism, and
Chapter 4 – The Nursing Process and Pharmacology
1. Explain the purpose of the nursing process and methodology used to apply to the
2. State the 5 steps in the nursing process and describe them in terms of a problem-
solving method used in nursing practice.
3. Describe the components of the assessment process. 4. Compare current methods used to collect, organize, and analyze information about
the health care needs of patients and their significant others.
5. Define the term nursing diagnosis and discuss the wording used in formulating
6. Define the term collaborative problem. 7. Differentiate between a nursing diagnosis and a medical diagnosis. 8. Differentiate between problems that require formulation of a nursing diagnosis and
those categorized as collaborative problems, which may not require nursing diagnosis statements.
9. Identify the steps in the planning of nursing care.
10. Explain the process of prioritizing individual patient needs using Maslow’s hierarchy
11. Formulate measurable goal statements for assigned patients in the clinical practice
12. State the behavioral responses around which goal statements revolve when the
13. Identify the purposes and uses of a patient care plan. 14. Integrate outcome/classification system(s) and critical pathways into care plans. 15. Differentiate between nursing interventions and therapeutic outcomes. 16. Compare the types of nursing functions classified as dependent, interdependent, and
17. Describe the evaluation process used to establish whether patient behaviors are
consistent with the identified short-term or long-term goals.
18. State the information that should be obtained as a part of a medication history. 19. Identify primary, secondary, and tertiary sources of information used to build a
20. Define the problem. 21. Describe the process that is used to identify factors that could result in patient
problems when medications are prescribed.
22. Review the content of several drug monographs to identify information that may
result in patient problems from the medication therapy.
23. Identify steps used to plan nursing care in relation to a medication regimen prescribed
24. Describe an acceptable method of organizing, implementing, and evaluating the
25. Practice developing short- and long-term patient education objectives and have them
26. Differentiate among dependent, interdependent, and independent nursing actions and
27. Describe the procedure for evaluating the therapeutic outcomes obtained from
Chapter 5 – Patient Education and Health Promotion
1. Differentiate among cognitive, affective, and psychomotor learning domains. 2. Identify the main principles of learning applied when teaching a patient, family, or
3. Apply the principles of learning to the content taught in pharmacology. 4. Describe essential elements of patient education in relation to the prescribed
5. Describe the nurse’s role in fostering patient responsibility for maintaining well-being
and adhering to the therapeutic regimen.
6. Identify the types of information that should be discussed with the patient or
significant others to establish reasonable expectations for the prescribed therapy.
7. Discuss specific techniques used in the practice setting to document the patient
education performed and degree of achievement attained.
1. Read and write selected numerical values using Roman numerals. 2. Demonstrate proficiency in mathematic problems using addition, subtraction,
multiplication, and division of fractions.
3. Demonstrate proficiency in calculating mathematic problems using addition,
subtraction, multiplication, and division of decimals.
4. Convert decimals to fractions and fractions to decimals. 5. Demonstrate proficiency in calculating mathematic problems using percentages. 6. Convert percents to fractions, percents to decimals, decimal fractions to percents, and
7. Demonstrate proficiency in converting ratios to percentages and percentages to ratios,
in simplifying ratios, and in use of the proportion method for solving problems.
8. Memorize the basic equivalents of the household and metric systems. 9. Demonstrate proficiency in performing conversion of medication problems using the
10. Use formulas to calculate intravenous fluid and medicine administration rates. 11. Demonstrate proficiency in performing conversions between the centigrade and
Fahrenheit systems of temperature measurement.
Chapter 7 – Principles of Medication Administration
1. Identify the limitations relating to medication administration placed on licensed
practical nurses, vocational nurses, registered nurses, and nurse clinicians by the nurse practice act in the state where you will be practicing.
2. Study the policies and procedures of the practice setting to identify specific
regulations concerning medication administration by licensed practical nurses, vocational nurses, registered nurses, and nurse clinicians.
3. Identify the basic categories of information available in a patient’s chart. 4. Study patient charts at different practice settings to identify the various formats used
5. Cite the information contained in a Kardex and describe the purpose of this file. 6. Cite the advantages and disadvantages of the ward stock system, computer-controlled
ordering and dispensing system, the individual prescription order system, and the unit dose system.
7. Study the narcotic control system used at your assigned clinical practice setting and
compare it with the requirements of the Controlled Substances Act of 1970.
8. Define the four categories of medication orders used. 9. Describe the procedure used in the assigned clinical setting for taking, recording,
transcribing, and verifying verbal medication orders.
10. Identify common types of drug errors and actions for their prevention. 11. Identify specific precautions needed to ensure that the right drug is prepared for is
12. Memorize and recite standard abbreviations associated with the scheduling of
13. Identify data found in the patient’s chart used to determine if the patient has abnormal
14. Describe specific safety precautions the nurse should follow to ensure that correct
15. Review the policies and procedures of the practice setting to identify drugs for which
16. Describe the methods that should be used to ensure that the correct patient receives
the correct medication, by the correct route, in the correct amount, at the correct time.
17. Compare each safety measure described to ensure safe preparation and administration
of medications with those procedures used at the clinical practice setting.
18. Identify appropriate nursing actions to document the administration and therapeutic
effectiveness of each medication administered.
Chapter 8 – Percutaneous Administration
1. Describe the topical forms of medications used on the skin. 2. Cite the equipment needed and techniques used to apply each of the topical forms of
3. Describe the procedure used and purpose of performing patch testing. 4. Describe specific charting methods used with allergy testing. 5. Identify the equipment needed, sites and techniques used, and patient education
required when nitroglycerin ointment is prescribed.
6. Describe specific documentation methods used to record the therapeutic effectiveness
7. Identify the equipment needed, sites used, techniques employed, and patient
education required when transdermal medication systems are prescribed.
8. Describe specific documentation methods used to record the therapeutic effectiveness
of medications administered using a transdermal delivery system.
9. Describe the dose form, sites used, and techniques employed to administer
10. Describe the dose forms, sites, equipment used, and techniques for administration of
11. Identify the dose forms safe for administration to the eye. 12. Describe patient education necessary for patients requiring ophthalmic medications. 13. Compare the techniques used to administer ear drops in patients younger than age 3
14. Describe the purpose, precautions necessary, and patient education required for
people requiring medications by inhalation.
15. Describe the dose forms available for vaginal administration of medications. 16. Identify the equipment needed, site, and specific techniques required to administer
17. State the rationale and procedure used for cleansing vaginal applicators or douche tips
18. Develop a plan for patient education of people taking medications via percutaneous
1. Correctly define and identify oral dose forms of medications. 2. Identify common receptacles used to administer oral medications.
3. Describe general principles of administering solid forms of medications and the
different techniques used with a medication card, and a computer-controlled and unit dose distribution system.
4. Compare techniques used to administer liquid forms of oral medication using
medication card and unit dose systems of distribution.
5. Cite the equipment needed, techniques used, and precautions necessary when
administering medications via a nasogastric tube.
6. Meet the person’s basic metabolic requirements and provide adequate nutritional
intake through the use of enteral nutrition support.
7. Cite the equipment needed and technique required to administer rectal suppositories. 8. Cite the equipment needed and technique used to administer a disposable enema.
Chapter 10 – Parenteral Administration: Safe Preparation of Parenteral Medications
1. Name the three parts of a syringe. 2. Read the calibrations of the minim and cubic centimeter or milliliter scale on different
3. Identify the sites where the volume of medication is read on a glass syringe and a
4. Give examples of volumes of medications that can be measured in a tuberculin
syringe, rather than a larger volume syringe.
5. State the advantages and disadvantages of using prefilled syringes. 6. Explain the system of measurement used to define the inside diameter of a syringe. 7. Identify the parts of a needle. 8. Explain how the gauge of a needle is determined. 9. Compare the usual volume of medication that can be administered at one site when
giving a medication by intradermal, subcutaneous, or IM routes.
10. State the criteria used for the selection of the correct needle gauge and length. 11. Identify examples of the safety-type syringes and needles. 12. Differentiate among ampules, vials, and Mix-O Vials. 13. List the equipment needed for the preparation of parenteral medications. 14. Describe, practice, and perfect the preparation of medications using the various dose
15. Describe, practice, and perfect the technique of preparing two different drugs in one
syringe, such as insulin or preoperative medications.
Chapter 11 – Parenteral Administration: Intradermal, Subcutaneous, and Intramuscular Routes
1. Describe the technique used to administer a medication via the intradermal route. 2. Identify the equipment needed and describe the technique used to administer a
3. Describe the technique used to administer medications in the vastus lateralis muscle,
rectus femoris muscle, ventrogluteal area, dorsogluteal area, or the deltoid muscle.
4. For each anatomic site studied, describe the landmarks used to identify the site before
5. Identify suitable sites for intramuscular administration of medication in an infant, a
Chapter 12 – Parenteral Administration: Intravenous Route
1. Define intravenous (IV) therapy. 2. Describe the processes used to establish guidelines for nurses to perform infusion
3. Describe equipment used to perform IV therapy. 4. Differentiate among peripheral, midline, central venous, and implantable access
5. Differentiate among isotonic, hypotonic, and hypertonic intravenous solutions. 6. Explain the usual circumstances for administering isotonic, hypotonic, and hypertonic
7. Describe the three intravascular compartments and the distribution of body water
8. Describe the different types of large-volume solution containers. 9. Identify the dose forms available, the types of sites of administration, and general
principles of administering medications via the IV route.
10. List criteria used for the selection of an IV access site. 11. Describe the correct techniques for administering medications by means of an
established peripheral or central IV line, a heparin lock, an IV bag, a bottle or volume-control device, or through a secondary piggyback set.
12. Describe the recommended guidelines and procedures for IV catheter care, IV line
dressing changes, and for peripheral and central venous IV needle or catheter changes.
13. Discuss the proper baseline patient assessments needed to evaluate the IV therapy. 14. Explain the signs, symptoms, and treatment of complications associated with IV
Chapter 13 – Drugs Affecting the Autonomic Nervous System
1. Differentiate between afferent and efferent nerve conduction within the central
2. Explain the role of neurotransmitters at synaptic junctions. 3. Name the most common neurotransmitters known to affect central nervous system
4. Identify the two major neurotransmitters of the autonomic nervous system. 5. Cite the names of nerve endings that liberate acetylcholine and those that liberate
6. Explain the action of drugs that inhibit the actions of the cholinergic and adrenergic
7. Identify two broad classes of drugs used to stimulate the adrenergic nervous system. 8. Name the neurotransmitters that are called catecholamines. 9. Review the actions of adrenergic agents to identify conditions that would be affected
favorably and unfavorably by these medications.
10. Explain the rationale for use of adrenergic blocking agents for conditions that have
vasoconstriction as part of the disease pathophysiology.
11. Describe the benefits of using beta-adrenergic blocking agents for hypertension,
angina pectoris, cardiac arrhythmias, and hyperthyroidism.
12. Identify disease conditions that preclude the use of beta-adrenergic blocking agents. 13. List the neurotransmitters responsible for cholinergic activity. 14. List the predictable side effects of cholinergic agents. 15. List the predictable side effects of anticholinergic agents. 16. Describe the clinical uses of anticholinergic agents.
1. Differentiate among the terms sedative and hypnotic; initial, intermittent, and
terminal insomnia; and rebound sleep and paradoxical excitement.
2. Identify alterations found in the sleep pattern when hypnotics are discontinued. 3. Cite nursing interventions that can be implemented as an alternative to administering
4. Compare the effects of barbiturates and benzodiazepines on the central nervous
5. Explain the major benefits of administering benzodiazepines rather than barbiturates. 6. Identify laboratory tests that should be monitored when benzodiazepines or
barbiturates are administered over an extended period.
7. Develop a plan for patient education for a patient receiving a hypnotic.
Chapter 15 – Drugs Used for Parkinson’s Disease
1. Prepare a list of signs and symptoms of Parkinson’s disease and accurately define the
vocabulary used for the pharmacologic agents prescribed and the disease state.
2. Name the neurotransmitter that is found in excess and the neurotransmitter that is
3. Describe reasonable expectations of medications prescribed for treatment of
4. Identify the period necessary for a therapeutic response to be observable when drugs
used to treat Parkinsonism are initiated.
5. Name the action of bromocriptine, carbidopa, levodopa, entacapone, and
apomorphine on neurotransmitters involved in Parkinson’s disease.
6. List symptoms that can be attributed to the cholinergic activity of pharmacologic
7. Cite the specific symptoms that should show improvement when anticholinergic
agents are administered to the patient with Parkinson’s disease.
8. Develop a health teaching plan for an individual being treated with levodopa.
Chapter 16 – Drugs Used for Anxiety Disorders
1. Define key words associated with anxiety states. 2. Describe the essential components of a baseline assessment of a patient’s mental
3. Cite the side effects of hydroxyzine therapy and identify those effects requiring close
4. Develop a teaching plan for patient education of people taking antianxiety
5. Describe signs and symptoms the patient will display when a positive therapeutic
outcome is being seen for the treatment of a high-anxiety state.
6. Discuss psychologic and physiologic drug dependence.
Chapter 17 – Drugs Used for Mood Disorders
1. Describe the essential components of a baseline assessment of a patient with
2. Discuss the mood swings associated with bipolar disorder. 3. Compare drug therapy used during the treatment of the manic phase and depressive
4. Cite monitoring parameters used for patients taking monoamine oxidase inhibitors
(MAOIs), selective serotonin reuptake inhibitors (SSRIs), or tricyclic antidepressants.
5. Prepare a teaching plan for an individual receiving tricyclic antidepressants. 6. Differentiate between the physiologic and psychologic therapeutic responses seen
7. Identify the premedication assessments necessary before administration of MAOIs,
SSRIs, tricyclic antidepressants, and antimanic agents.
8. Compare the mechanism of action of SSRIs to that of other antidepressant agents. 9. Cite the advantages of SSRIs over other antidepressant agents. 10. Examine the drug monograph for SSRIs to identify significant drug interactions.
Chapter 18 – Drugs Used for Psychoses
1. Identify signs and symptoms of psychotic behavior. 2. Describe major indications for the use of antipsychotic agents. 3. Identify common adverse effects observed with antipsychotic medications. 4. Develop a teaching plan for a patient taking haloperidol and one receiving clozapine.
Chapter 19 – Drugs Used for Seizure Disorders
1. Prepare a chart to be used as a study guide that includes the following information:
Name of seizure type; Description of seizure; Medications used to treat each type of seizure; Nursing interventions and monitoring parameters for seizures.
2. Describe the effects of the hydantoins on patients with diabetes and on people
receiving oral contraceptives, theophylline, folic acid, or antacids.
3. Cite precautions needed when administering phenytoin or diazepam intravenously. 4. Explain the rationale for proper dental care for people receiving hydantoin therapy. 5. Develop a teaching plan for patient education for people diagnosed with a seizure
6. Cite the desired therapeutic outcomes for seizure disorders. 7. Identify the mechanisms of action thought to control seizure activity when
8. Discuss the basic classification systems used for epilepsy.
Chapter 20 – Drugs Used for Pain Management
1. Differentiate among opiate agonists, opiate partial agonists, and opiate antagonists. 2. Describe monitoring parameters necessary for patients receiving opiate agonists. 3. Cite the side effects to expect when opiate agonists are administered. 4. Compare the analgesic effectiveness of opiate partial agonists when administered
5. Explain when naloxone can be used effectively to treat respiratory depression. 6. State the three pharmacologic effects of salicylates. 7. Prepare a list of side effects to expect, side effects to report, and drug interactions that
8. Explain why synthetic nonopiate analgesics are not used for inflammatory disorders. 9. Prepare a patient education plan for a person being discharged with a continuing
10. Examine Table 20-5 and identify the active ingredients in commonly prescribed
analgesic combination products. Identify products containing aspirin and compare the analgesic properties of agents available in different strengths.
Chapter 21 – Introduction to Cardiovascular Disease and Metabolic Syndrome
1. Define metabolic syndrome. 2. List the major risk factors of metabolic syndrome. 3. List the diagnostic criteria for metabolic syndrome for men and women using the
National Cholesterol Education Program guidelines.
4. State the importance of lifestyle modification in the treatment of metabolic syndrome. 5. List the treatment goals for type 2 diabetes management, lipid management, and
6. State why long-term control and adherence to medications are important in managing
Chapter 22 – Drugs Used to Treat Dyslipidemias
1. Identify the four major types of lipoproteins. 2. Describe the primary treatment modalities for lipid disorders. 3. State the oral administration instructions for antilipemic agents.
Chapter 23 – Drugs Used to Treat Hypertension
1. Summarize nursing assessments and interventions used for the treatment of
2. State recommended lifestyle modifications for a diagnosis of hypertension. 3. Identify 10 classes of drugs used to treat hypertension. 4. Review Figure 23-2 to identify options and progression of treatment for hypertension. 5. Identify specific factors the hypertensive patient can use to assist in managing the
6. Develop patient education objectives for individuals with hypertension. 7. Summarize the action of each drug class used to treat hypertension.
Chapter 24 – Drugs Used to Treat Dysrhythmias
1. Describe the therapeutic response that should be observable when an antidysrhythmic
2. Identify baseline nursing assessments that should be implemented during the
3. List the dosage forms and precautions needed when preparing IV lidocaine for the
4. Cite common side effects that may be observed with the administration of
amiodarone, bretylium tosylate, disopyramide, lidocaine, flecainide, mexiletine, procainamide, and quinidine.
5. Identify the potential effects of muscle relaxants used during surgical intervention
when combined with antidysrhythmic drugs.
Chapter 25 – Drugs Used to Treat Angina Pectoris
1. Describe the actions of nitrates, beta adrenergic blockers, calcium channel blockers,
and angiotensin-converting enzyme inhibitors on the myocardial tissue of the heart.
2. Explain the rationale for the use of HMG-CoA reductase inhibitors (statins) to treat
3. Identify assessment data needed to evaluate an anginal attack. 4. Implement medication therapy health teaching for an anginal patient in the clinical
Chapter 26 – Drugs Used to Treat Peripheral Vascular Disease
1. List the baseline assessments needed to evaluate a patient with peripheral vascular
2. Identify specific measures the patient can use to improve peripheral circulation and
prevent complications from peripheral vascular disease.
3. Identify the systemic effects to expect when peripheral vasodilating agents are
4. Explain why hypotension and tachycardia occur frequently with the use of peripheral
5. Develop measurable objectives for patient education for patients with peripheral
6. State both pharmacologic and nonpharmacologic goals of treatment for peripheral
Chapter 27 – Drugs Used to Treat Thromboembolic Disorders
1. State the primary purposes of anticoagulant therapy. 2. Analyze Figure 27-1 to identify the site of action of warfarin, heparin, and fibrinolytic
3. Identify the effects of anticoagulant therapy on existing blood clots. 4. Describe conditions that place an individual at risk for developing blood clots. 5. Identify specific nursing interventions that can prevent clot formation. 6. Explain laboratory data used to establish dosing of anticoagulant medications. 7. Describe specific monitoring procedures to detect hemorrhage in the patient taking
8. Describe procedures used to ensure that the correct dose of an anticoagulant is
9. Explain the specific procedures and techniques used to administer heparin
subcutaneously, via intermittent administration through a heparin lock, and via intravenous infusion.
10. Identify the purpose, dosing determination, and scheduling factors associated with the
11. State the nursing assessments needed to monitor therapeutic response and the
development of side effects to expect or report from anticoagulant therapy.
12. Develop objectives for patient education for patients receiving anticoagulant therapy.
Chapter 28 – Drugs Used to Treat Heart Failure
1. Summarize the pathophysiology of heart failure, including the body’s compensatory
2. Identify the goals of treatment of heart failure. 3. Explain the process of digitalizing a patient, including the initial dosage, preparation,
and administration of the medication, as well as the nursing assessments needed to monitor therapeutic response and digoxin toxicity.
4. Describe safety precautions associated with the preparation and administration of
5. State the primary actions on cardiac output of digoxin, angiotensin-converting
enzyme inhibitors, nitrates, and calcium channel blockers.
6. Identify essential assessment data, nursing interventions, and health teaching needed
1. Cite nursing assessments used to evaluate a patient’s state of hydration. 2. Review possible underlying pathologic conditions that may contribute to the
development of excess fluid volume in the body.
3. State which electrolytes may be altered by diuretic therapy. 4. Cite nursing assessments used to evaluate renal function. 5. Identify the effects of diuretics on blood pressure, electrolytes, and diabetic or
6. Review the signs and symptoms of electrolyte imbalance and normal laboratory
values of potassium, sodium, and chloride.
7. Identify the action of diuretics. 8. Explain the rationale for administering diuretics cautiously to older adults and
individuals with impaired renal function, cirrhosis of the liver, or diabetes mellitus.
9. Describe the goal of administering diuretics to treat hypertension, heart failure, or
increased intraocular pressure or before vascular surgery in the brain.
10. List side effects that can be anticipated whenever a diuretic is administered. 11. Cite alterations in diet that may be prescribed concurrently with loop, thiazide, or
12. State the nursing assessments needed to monitor therapeutic response or the
development of side effects to expect or report from diuretic therapy.
13. Develop objectives for patient education for patients taking loop, thiazide, and
Chapter 30 – Drugs Used to Treat Upper Respiratory Disease
1. State the causes of allergic rhinitis and nasal congestion. 2. Explain the major actions (effects) of sympathomimetic, antihistaminic, and
corticosteroid decongestants and cromolyn.
3. Define rhinitis medicamentosa, and describe the patient education needed to prevent
4. Review the procedure for administration of medications by nose drops, sprays, and
5. Explain why all decongestant products should be used cautiously in people with
hypertension, hyperthyroidism, diabetes mellitus, cardiac disease, increased intraocular pressure, or prostatic disease.
6. State the premedication assessments and nursing assessments needed during therapy
to monitor therapeutic response and side effects to expect or report from using decongestant drug therapy.
7. Identify essential components involved in planning patient education that will
enhance adherence with the treatment regimen.
Chapter 31 – Drugs Used to Treat Lower Respiratory Disease
1. Compare the physiologic responses of the respiratory system to emphysema, chronic
2. Describe the physiology of respirations. 3. Identify components of blood gases. 4. Cite nursing assessments used to evaluate the respiratory status of a patient. 5. Implement patient education for patients receiving drug therapy for lower respiratory
6. Distinguish the mechanisms of action of expectorants, antitussives, and mucolytic
7. Review the procedures for administration of medication by inhalation. 8. State the nursing assessments needed to monitor therapeutic response and the
development of side effects to expect or report from expectorant, antitussive, and mucolytic therapy.
9. State the nursing assessments needed to monitor therapeutic response and the
development of side effects to expect or report from sympathomimetic bronchodilator therapy.
10. State the nursing assessments needed to monitor therapeutic response and the
development of side effects to expect or report from anticholinergic bronchodilator therapy.
11. State the nursing assessments needed to monitor therapeutic response and the
development of side effects to expect from xanthine derivative therapy.
12. State the nursing assessments needed to monitor therapeutic response and the
development of side effects to expect or report from corticosteroid inhalant therapy.
Chapter 32 – Drugs Used to Treat Oral Disorders
1. Cite the treatment alternatives and associated nursing assessments to monitor
response to drug therapy for common mouth disorders.
2. Identify baseline data the nurse should collect on a continuous basis for comparing
3. Identify important nursing assessments and interventions associated with the drug
therapy and treatment of diseases of the mouth.
Chapter 33 – Drugs Used to Treat Gastroesophageal Reflux and Peptic Ulcer Diseases
1. Cite common stomach disorders that require drug therapy. 2. Identify factors that prevent breakdown of the body’s normal defense barriers
3. State the drug classifications and actions used to treat stomach disorders. 4. Develop health teaching for an individual with stomach disorders that incorporates
pharmacologic and nonpharmacologic treatment.
Chapter 34 – Drugs Used to Treat Nausea and Vomiting
1. Compare the purposes of using antiemetic products. 2. State the therapeutic classes of antiemetics. 3. Discuss scheduling of antiemetics for maximum benefit.
Chapter 35 – Drugs Used to Treat Constipation and Diarrhea
1. State the underlying causes of constipation. 2. Explain the meaning of “normal” bowel habits. 3. Identify the indications for use, method of action, and onset of action for stimulant
laxatives, saline laxatives, lubricant or emollient laxatives, bulk-forming laxatives, and fecal softeners.
4. Describe medical conditions in which laxatives should not be used. 5. Cite nine causes of diarrhea. 6. State the differences between locally acting and systemically acting antidiarrheal
7. Identify electrolytes that should be monitored whenever prolonged or severe diarrhea
8. Describe nursing assessments needed to evaluate the patient’s state of hydration when
suffering from either constipation or dehydration.
9. Cite conditions that generally respond favorably to antidiarrheal agents. 10. Review medications studied to date and prepare a list of those that may cause
Chapter 36 – Drugs Used to Treat Diabetes Mellitus
1. State the current definition of diabetes mellitus. 2. Identify the extent of the disease within the United States. 3. Describe the current classification system for diabetes mellitus. 4. Identify normal fasting glucose levels. 5. Differentiate between the symptoms of type 1 and type 2 diabetes mellitus. 6. Identify the objectives of dietary control of diabetes mellitus. 7. Discuss the action and use of insulin as opposed to oral hypoglycemic and
antihyperglycemic agents to control diabetes mellitus.
8. Identify the mechanism of action of the different oral antidiabetic agents. 9. Identify the major nursing considerations associated with the management of the
10. Differentiate among the signs, symptoms, and management of hypoglycemia and
11. Discuss the difference between microvascular and macrovascular complications.
12. Define “intensive therapy.” 13. Identify the symptoms of the major complications of diabetes. 14. Discuss the contributing factors, nursing assessments, and nursing interventions
needed for patients exhibiting complications associated with diabetes mellitus.
15. Develop a health teaching plan for people taking any type of insulin or oral
Chapter 37 – Drugs Used to Treat Thyroid Disease
1. Describe the signs, symptoms, treatment, and nursing interventions associated with
2. Identify the two classes of drugs used to treat thyroid disease. 3. State the drug of choice for hypothyroidism. 4. Explain the effects of hyperthyroidism on doses of warfarin and digoxin and on
5. Cite the actions of antithyroid medications on the formation and release of the
6. State the three types of treatment for hyperthyroidism. 7. Explain the nutritional requirements and activity restrictions needed for an individual
8. Identify the types of conditions that respond favorably to the use of radioactive
9. Cite the action of propylthiouracil on the synthesis of T3 and T4.
1. Review the functions of the adrenal gland. 2. State the normal actions of mineralocorticoids and glucocorticoids in the body. 3. Cite the disease states caused by hypersecretion or hyposecretion of the adrenal
4. Identify the baseline assessments needed for a patient receiving corticosteroids. 5. Prepare a list of the clinical uses of mineralocorticoids and glucocorticoids. 6. Discuss the potential side effects associated with the use of corticosteroids, and give
examples of specific patient education needed for the patient who will be taking these agents.
7. Develop measurable objectives for patient education for people taking corticosteroids.
1. Describe the body changes that can be anticipated with the administration of
2. State the uses of estrogens and progestins. 3. Compare the side effects seen with the use of estrogen hormones with those seen with
a combination of estrogen and progesterone.
4. Differentiate between the side effects to expect and those requiring consultation with
the physician that occur with the administration of estrogen or progesterone.
5. Identify the rationale for administering androgens to women who have certain types
1. Describe nursing assessments and nursing interventions needed for the pregnant
patient during the first, second, and third trimesters of pregnancy.
2. Identify appropriate nursing assessments, nursing interventions, and treatment options
used for the following obstetric complications: infection, hyperemesis gravidarum, miscarriage, abortion, preterm labor, premature rupture of membranes, gestational diabetes, and pregnancy-induced hypertension.
3. State the methods and time parameters of each approach to the termination of a
4. Summarize the care needs of the pregnant woman during labor and delivery and the
immediate postpartum period including the patient education needed before discharge to promote safe self-care and care of the newborn.
5. State the purpose of administering glucocorticoids to certain women in preterm labor. 6. State the actions, primary uses, nursing assessments, and monitoring parameters for
uterine stimulants, uterine relaxants, clomiphene citrate, magnesium sulfate, and Rho(D) immune globulin.
7. Compare the effects of uterine stimulants and uterine relaxants on a pregnant
8. Describe specific nursing concerns and appropriate nursing actions when uterine
stimulants are administered for induction of labor, augmentation of labor, and postpartum atony and hemorrhage.
9. Cite the effects of adrenergic agents on beta-1 and beta-2 receptors, then identify the
relationship of these actions to the side effects to report when adrenergic agents are used to inhibit preterm labor.
10. Describe specific assessments needed before and during the use of terbutaline or
11. Identify emergency supplies that should be available during magnesium sulfate
12. Identify the action, specific dosage, administration precautions, and proper timing of
the administration of Rho(D) immune globulin and rubella vaccine.
13. Summarize the immediate nursing care needs of the newborn following delivery.
Chapter 41 – Drugs Used in Men’s and Women’s Health
1. Identify common organisms known to cause leukorrhea. 2. Cite the generic and brand names of products used to treat Candida albicans,
Trichomonas vaginalis, and Gardnerella vaginalis.
3. Review specific techniques for administering vaginal medications. 4. Develop a plan for teaching self-care to women and men with sexually transmitted
diseases and include personal hygiene measures, medication administration, methods of pain relief, and prevention of spread of infection or reinfection.
5. Discuss specific interviewing techniques that can be used to obtain a history of sexual
6. Compare the active ingredients in the two types of oral contraceptive agents. 7. Differentiate between the actions and the benefits of the combination pill and the
8. Describe the major adverse effects and contraindications to the use of oral
9. Develop specificpatient education plans to be used to teach a patient to initiate oral
contraceptive therapy with the combination pill and the minipill.
10. Identify the patient teaching necessary with the administration of the transdermal
contraceptive and the intravaginal hormonal contraceptive.
11. Describe pharmacologic treatments of benign prostatic hyperplasia. 12. Describe the pharmacologic treatment of erectile dysfunction.
Chapter 42 – Drugs Used to Treat Disorders of the Urinary System
1. Explain the major action and effects of drugs used to treat disorders of the urinary
2. Identify baseline data the nurse should collect on a continuous basis for comparison
3. Identify important nursing assessments and interventions associated with the drug
therapy and treatment of diseases of the urinary system.
4. Identify essential components involved in planning patient education that will
enhance compliance with the treatment regimen.
5. Analyze Table 42-1 and identify specific portions of a urinalysis report that would
indicate proteinuria, dehydration, infection, or renal disease.
6. Prepare a chart of antimicrobial agents used to treat urinary tract infections. Give the
drug names, the organisms treated, and special considerations.
7. Identify the symptoms, treatment, and medication used for overactive bladder
8. Develop a health teaching plan for an individual who has repeated urinary tract
Chapter 43 – Drugs Used to Treat Glaucoma and Other Eye Disorders
1. Describe the normal flow of aqueous humor in the eye. 2. Identify the changes in normal flow of aqueous humor caused by open-angle and
3. Explain baseline data that should be gathered when an eye disorder exists. 4. Review the correct procedure for instilling eye drops or eye ointments. 5. Develop teaching plans for a person with an eye infection and a person receiving
Chapter 44 – Drugs Affecting Neoplasms
1. Cite the goals of chemotherapy. 2. Explain the normal cycle for cell replication and describe the effects of cell cycle-
specific and cell cycle-nonspecific drugs within this process.
3. Cite the rationale for giving chemotherapeutic drugs on a precise time schedule. 4. State which types of chemotherapeutic agents are cell cycle-specificand those that are
5. Describe the role of targeted anticancer agents in treating cancer. 6. Describe the role of chemoprotective agents in treating cancer. 7. Describe the role of bone marrow stimulants in treating cancer.
8. Describe the nursing assessments and interventions needed for people experiencing
9. Develop patient education objectives for a patient receiving chemotherapy.
Chapter 45 – Drugs Used to Treat the Muscular System
1. Prepare a list of assessment data needed to evaluate a patient with a skeletal muscle
2. State the nursing assessments needed to monitor therapeutic response and the
development of side effects to expect and report from skeletal muscle relaxant therapy.
3. Develop a health teaching plan for patients with skeletal muscle relaxant therapy. 4. Describe the effect of centrally acting skeletal muscle relaxants on the central nervous
system and the safety precautions required during use.
5. Describe essential components of patient assessment used for patients receiving
6. State where information on the use of these agents is found in the patient’s chart. 7. List the equipment that should be available in the immediate patient care area when
neuromuscular blocking agents are to be administered.
8. Describe the physiologic effects of neuromuscular blocking agents. 9. Cite four uses of neuromuscular blocking agents. 10. Identify the effect of neuromuscular blocking agents on consciousness, memory, and
11. Describe disease conditions that may affect the patient’s ability to tolerate the use of
12. List steps required to treat respiratory depression.
1. Identify significant data in a patient history that could alert the medical team that a
patient is more likely to experience an allergic reaction.
2. Identify baseline data the nurse should collect on a continual basis for comparison
and evaluation of antimicrobial drug effectiveness.
3. Describe basic principles of patient care that can be implemented to enhance an
individual’s therapeutic response during an infection.
4. Identify criteria used to select an effective antimicrobial agent. 5. Differentiate between gram-negative and grampositive microorganisms and between
anaerobic and aerobic properties of microorganisms.
6. Explain the major action and effects of drugs used to treat infectious diseases. 7. Describe the nursing assessments and interventions for the common side effects
associated with antimicrobial agents: allergic reaction; direct tissue damage; secondary infection; and other considerations such as photosensitivity, peripheral neuropathy, and neuromuscular blockage.
8. Review parenteral administration techniques and the procedure for vaginal insertion
9. Develop a plan for implementing patient education for patients receiving
aminoglycosides, carbapenems, cephalosporins, glycyclines, ketolides, penicillins,
quinolones, streptogramins, sulfonamides, tetracyclines, antifungal agents, and antiviral agents.
1. Differentiate between information found in the dietary reference intake tables and the
2. Identify the function of macronutrients in the body. 3. Compare and contrast the Estimated Energy Requirement for a healthy male and
female of similar height, weight, and level of activity.
4. Research good dietary sources of fiber. 5. Identify the exercise guidelines currently recommended for people with different
6. Differentiate between fat-soluble and water-soluble vitamins. 7. List five functions of minerals in the body. 8. Describe nutritional assessments essential before administration of tube feedings and
9. Describe physical changes associated with a malnourished state. 10. Cite common laboratory and diagnostic tests used to monitor a patient’s nutritional
11. Discuss nursing assessments and interventions required during the administration of
12. Discuss home care needs of a patient being discharged on any form of enteral or
Chapter 48 – Herbal and Dietary Supplement Therapy
1. Summarize the primary actions, uses, and interactions of the herbal and dietary
2. Describe the possible impact of the use of herbal and dietary supplement products on
1. Differentiate among key terms associated with substance abuse. 2. Explore biologic, psychological, and sociocultural models that influence the
assessment and treatment of substance abuse.
3. Describe the different types of screening tools used to assess alcohol and substance
4. Cite the responsibilities of professionals who suspect substance abuse by a colleague. 5. Explain the primary long-term goals in the treatment of substance abuse. 6. Study the withdrawal symptoms and approaches to treatment and relapse prevention
for major substances that are commonly abused.
1. Review actions, uses, and therapeutic outcomes for agents used in alcohol
rehabilitation, Alzheimer’s treatment, hepatic encephalopathy, and gout.
2. Discussion of side effects to expect and report as well as any known drug interactions
Journal of Paediatric Respirology and Critical CareEvidence based management of acute bronchiolitis Sou-Chi SIT Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong Bronchiolitis is a common acute lower respiratory tractroutine use of salbutamol is not recommended judgingdisease affecting infants. It is associated with viralinfection and respiratory sync
PANADOL AND PANADEINE FORTE FOR CANCER PAIN How to use Panadol (Tylenol, paracetamol, acetaminophen etc) and Panadeine Forte (which contains codeine as well as paracetamol/acetaminophen) to relieve chronic pain due to cancer DISCLAIMERS This article, written by a senior medical practitioner with considerable experience in palliative medicine and hospice care, is offered purely fo