1. An 18-year old patient decided to discontinue taking oral contraceptives because of bloating and other uncomfortable feelings and has been having unprotected sex. She asks the nurse about continuing to take medications for her acne treatment if she becomes pregnant? The patient is currently taking benzoyl peroxide and tetracycline. She asks the nurse “In what trimester do drugs pose the greatest risk to my baby?”

a. What will the nurse tell the patient?

b. The patient asks about continuing to take tetracycline. How will the nurse respond?

c. In which pregnancy category is tetracycline included?

2. A 5-year old patient is admitted with a diagnosis of acute lymphoblastic leukemia (ALL). The patient and family are unsure about the many treatment options and have questions about the first phase of treatment.

a. The family wants to know if the chemotherapy is the same medication given to adults.
How should the nurse respond to this?
b. The family asks if these medications have been research on children before being used
on them. What is the best response by the nurse?
c. How soon would the nurse expect for the child’s system to clear the medications?
3. A 70-year old patient is discharged from the hospital after having an acute myocardial infarction
and has diabetes mellitus, hypertension, rheumatoid arthritis, and coronary artery disease. The
home health nurse is making the first visit after speaking with the patient’s son who is
concerned about her ability to be compliant with her treatment.

a. What is the best way for the nurse to build a rapport with the patient?
b. What should be included in the plan of care for this patient?
c. What risk factors might interfere with the patient’s plan of care?

ANSWER

 Medication Concerns in Different Patient Scenarios

Introduction

Medication management is a crucial aspect of healthcare, and nurses play a pivotal role in educating patients about their medications and addressing their concerns. In this article, we will explore three patient scenarios involving medication-related questions and discuss how a nurse should respond in each situation.

1. Scenario 1: Birth Control and Acne Medication During Pregnancy

a. The nurse will inform the patient that drugs pose the greatest risk to the baby during the first trimester of pregnancy. This is because the baby’s organs and systems are rapidly developing during this period, making them more vulnerable to potential adverse effects from medications.

b. In response to the patient’s question about continuing tetracycline, the nurse will advise against it. Tetracycline is known to be harmful during pregnancy as it can affect the baby’s bone and tooth development, potentially causing permanent discoloration and deformities. The nurse will recommend discussing alternative acne treatment options with a healthcare provider.

c. Tetracycline is classified in pregnancy category D, indicating that it has been shown to be harmful to the fetus. It should be avoided during pregnancy whenever possible.

2. Scenario 2: Childhood Leukemia Treatment

a. The nurse will explain that chemotherapy medications for children with acute lymphoblastic leukemia (ALL) are tailored to their specific needs. While some medications may be similar to those used in adults, the dosages and combinations are adjusted to ensure safety and effectiveness in pediatric patients.

b. The nurse will reassure the family that medications used in pediatric cancer treatment have undergone extensive research and clinical trials specifically in children. These medications are selected based on their proven efficacy and safety profiles in pediatric populations.

c. The nurse will explain that the clearance time for chemotherapy medications varies depending on the specific drugs used and the child’s individual response. Some medications may be eliminated from the system relatively quickly, while others may take longer. The medical team will closely monitor the child’s progress and adjust the treatment plan as needed.

3. Scenario 3: Complex Medication Regimen for Elderly Patient

a. To build rapport with the elderly patient, the nurse should take a patient-centered approach. This involves actively listening to the patient’s concerns, showing empathy, and involving the patient in decision-making regarding their treatment plan. Establishing trust and open communication is essential.

b. The plan of care for the elderly patient should include a comprehensive assessment of their medical conditions, medications, and lifestyle factors. It should also outline medication management strategies, including a medication schedule, education on proper administration, and monitoring for potential side effects or interactions.

c. Several risk factors may interfere with the patient’s plan of care, including cognitive impairment, polypharmacy (the use of multiple medications), and limited mobility. These factors can impact medication adherence and safety. The nurse should collaborate with the healthcare team to address these challenges and implement strategies to enhance compliance and patient well-being.

Conclusion

Medication-related questions and concerns from patients are common in healthcare settings. Nurses play a vital role in addressing these concerns by providing accurate information, ensuring patient safety, and promoting adherence to treatment plans. Effective communication and patient-centered care are key in managing medication-related issues across different patient scenarios.