Pharmacology and Pharmacotherapeutics in Advanced Nursing Practice NGR6172 TEST BANK

Pharmacology and Pharmacotherapeutics in Advanced Nursing Practice NGR6172 Chapter 1: Prescriptive Authority and Role Implementation: Tradition vs Change o Primary Care is provided by clinicians who address "personal health care needs, developing a sustained partnership with patient, and practicing in the context of family and community."  Prevention, Diagnosis, Prescription, Treatment  Assess health status.  Promote healthy lifestyles.  Identifying/diagnosing normal/abnormal conditions.  Determining the causes of abnormal conditions, providing referral to health care specialists.  Selecting appropriate therapeutic measures.  Implementing treatment.  Supervising/monitoring the patient on an ongoing basis.  Traditional Primary Care--physicians as the only providers with diagnostic and treatment authority--an intention to protect the public.  Prescriptive practices should not be compared to those of physicians--all providers should be held to a standard of approved therapeutic practice.  Most Prescribed by PCP--antidepressants, NSAIDs, antihistamines/bronchodilators, antihypertensives, antilipidemic.  Rate of Adoption by Prescribers--innovators, early adopters, early majority, late majority, and laggards. o Problems in the Prescribing Practice of Physicians  Prescriptions are not the most up to date--"new research findings diffuse slowly into practice."  Pharmaceutical company influence--FDA intervention and PhRMA guidelines.  Lack of time--short consultation, incorrect H&P, problem is left undefined, over-reliance on drug therapy.  Consumers' pressure for prescribed medications--"Do something!"--lifetime of medications, overused antibiotics, and direct-to-consumer advertising.  Ineligible prescriptions -- Medication errors. Current federal mandate for e-prescribing. TJC Do Not Use Abbreviations.  Undetected/anticipating drug interactions--liver cytochrome P450 enzymes = drug-to-drug interactions may render medication ineffective--prescription warning system alerts. Rising use of OTC and herbal products.