Page 1 of 12
NUR 607 FINAL EXAM STUDY GUIDE (MODS 1,2,8 ONLY)
What factors affect medication compliance? - ANSWER-complex medication
regimens, cost of the drug, side effects of the drug, ease of administration
and/or drug form (e.g., large tablets or capsules), education and communication
between provider and patient, perceived side effects not truly related to the
medication, functional and/or mental deficits (eg. vision changes, dementia,
arthritis of hands), provider approachability, perception of patient respect,
belief that the therapy is beneficial and outweighs the risks or side effects, the
degree to which the patient participates in the development of the treatment
regimen, degree to which patient believes that expectations and concerns are
being met, degree to which the practitioner motivates the patient to adhere to
the regimen, degree to which the regimen is compatible with the patient's busy
lifestyle, medication taste.
What are important aspects of patient teaching to consider? - ANSWER-Clear
verbal instructions with readable written instructions to take home if indicated.
Educating regarding side effects in advance and instructing patient to report to
clinic with symptoms in order to prevent early discontinuation of drug. Instill the
belief in the patient that the drug will work for them in order to maintain
adherence, advise patient to use only one pharmacy in order to reduce drug to
drug interactions.
Causes of poly-pharmacy in the elderly. - ANSWER-Varied symptoms and
complaints associated with chronic illnesses; when a drug doesn't work, another
is prescribed (known as the prescribing cascade); stockpiling discontinued
medications due (primarily due to the cost); placing prescriptions in different
bottles; sharing of medications between family members; seeing
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"polyproviders": seeing multiple specialists for various chronic diseases; failure
of providers to fully review the patient's other medications before prescribing;
lack of primary care provider;
Risks associated with polypharmacy in the elderly: - ANSWER-Drug overuse
and complications; ADRs; creation of avoidable side effects and related
complications
How do you address medication compliance issues? - ANSWER-Consider the
cost of the drug; give a written list and instructions to the patient after each
office visit of the medications to be taken; give written instructions in large, easy
to understand instructions to the elderly; explain and document both the brand
and generic names of the drug with the patient to avoid confusion and explain
the important reason for taking the medication; review medication changes with
family/caregivers (especially for those with cognitive impairments); recommend
or provide medication planners or weekly/daily dosage containers to improve
compliance and promote safe administration; schedule timely follow-ups and
check for adherence at each visit.
What data collection is included in a patient's health history encounter? -
ANSWER-Biographic data, reason for seeking care, history of present illness
(if in pain, remember old cart); past health history; family history; ROS;
functional health patterns (including activities of daily living); allergies; surgical
history; health habits; social history; current medications, vaccination history;
travel history. The physical exam and diagnostic tests then serve to develop
differential diagnoses.
NUR 607 FINAL EXAM STUDY GUIDE (MODS 1,2,8 ONLY)
What factors affect medication compliance? - ANSWER-complex medication
regimens, cost of the drug, side effects of the drug, ease of administration
and/or drug form (e.g., large tablets or capsules), education and communication
between provider and patient, perceived side effects not truly related to the
medication, functional and/or mental deficits (eg. vision changes, dementia,
arthritis of hands), provider approachability, perception of patient respect,
belief that the therapy is beneficial and outweighs the risks or side effects, the
degree to which the patient participates in the development of the treatment
regimen, degree to which patient believes that expectations and concerns are
being met, degree to which the practitioner motivates the patient to adhere to
the regimen, degree to which the regimen is compatible with the patient's busy
lifestyle, medication taste.
What are important aspects of patient teaching to consider? - ANSWER-Clear
verbal instructions with readable written instructions to take home if indicated.
Educating regarding side effects in advance and instructing patient to report to
clinic with symptoms in order to prevent early discontinuation of drug. Instill the
belief in the patient that the drug will work for them in order to maintain
adherence, advise patient to use only one pharmacy in order to reduce drug to
drug interactions.
Causes of poly-pharmacy in the elderly. - ANSWER-Varied symptoms and
complaints associated with chronic illnesses; when a drug doesn't work, another
is prescribed (known as the prescribing cascade); stockpiling discontinued
medications due (primarily due to the cost); placing prescriptions in different
bottles; sharing of medications between family members; seeing
, Page 2 of 12
"polyproviders": seeing multiple specialists for various chronic diseases; failure
of providers to fully review the patient's other medications before prescribing;
lack of primary care provider;
Risks associated with polypharmacy in the elderly: - ANSWER-Drug overuse
and complications; ADRs; creation of avoidable side effects and related
complications
How do you address medication compliance issues? - ANSWER-Consider the
cost of the drug; give a written list and instructions to the patient after each
office visit of the medications to be taken; give written instructions in large, easy
to understand instructions to the elderly; explain and document both the brand
and generic names of the drug with the patient to avoid confusion and explain
the important reason for taking the medication; review medication changes with
family/caregivers (especially for those with cognitive impairments); recommend
or provide medication planners or weekly/daily dosage containers to improve
compliance and promote safe administration; schedule timely follow-ups and
check for adherence at each visit.
What data collection is included in a patient's health history encounter? -
ANSWER-Biographic data, reason for seeking care, history of present illness
(if in pain, remember old cart); past health history; family history; ROS;
functional health patterns (including activities of daily living); allergies; surgical
history; health habits; social history; current medications, vaccination history;
travel history. The physical exam and diagnostic tests then serve to develop
differential diagnoses.
