A Graduate School Nurse Has To Prepare A Presentation For A

A Graduate School Nurse Has To Prepare a Presentation For a Freshman C

A graduate school nurse has to prepare a presentation for a freshman class of nursing students on anxiolytic and hypnotic agents, including their affected states and key nursing considerations. The presentation will cover definitions of affected states, nursing implementation considerations for benzodiazepines, and teaching about zaleplon (Sonata) and zolpidem (Ambien). Additionally, it includes case studies on antiseizure agents, narcotics, adrenergic agonists, adrenocortical agents, and agents to control blood glucose levels, each with specific learning objectives about mechanisms, nursing considerations, and patient teaching.

Paper For Above instruction

Introduction

Understanding pharmacological agents used in nursing practice is crucial for effective patient care. This paper explores anxiolytic and hypnotic agents, antiseizure medications, narcotics, adrenergic agonists, adrenocortical, and antidiabetic agents. It discusses their physiological effects, nursing considerations, mechanisms of action, and patient education, essential for undergraduate nursing students to deliver safe and effective care.

Anxiolytic and Hypnotic Agents

The states affected by anxiolytic and hypnotic agents primarily involve the central nervous system, specifically the brain regions regulating anxiety, sleep, and arousal. Anxiolytics, such as benzodiazepines, modulate gamma-aminobutyric acid (GABA), producing a calming effect, reducing anxiety, and muscle relaxation (Lader, 2011). Hypnotics, often prescribed for insomnia, work similarly by enhancing GABA activity, facilitating sleep onset and maintenance (Kales et al., 2014).

Benzodiazepines like diazepam or lorazepam act by binding to GABA_A receptors, increasing GABA's inhibitory effect, which results in sedative, anxiolytic, anticonvulsant, and muscle-relaxant properties. Nursing implementation considerations include monitoring for respiratory depression, sedation levels, and potential dependence (Barker et al., 2004). They should be administered cautiously in patients with respiratory disorders and in the elderly due to increased sensitivity.

Regarding zaleplon (Sonata) and zolpidem (Ambien), both are non-benzodiazepine hypnotics classified as 'Z-drugs'. They act selectively on the GABA_A receptor subtype, offering targeted sleep induction with fewer anxiolytic and anticonvulsant effects. Their core indications include short-term management of insomnia (Morin, 2014). Nurses should educate students on proper administration to minimize risks of dependence and complex sleep behaviors, such as sleepwalking.

Antiseizure Agents and Seizure Management

A patient experiencing a tonic–clonic seizure requires education on generalized seizures' classification. Generalized seizures involve widespread brain activity affecting consciousness, muscles, and senses, such as tonic–clonic, absence, and myoclonic seizures. Phenytoin, an antiseizure medication, stabilizes neuronal membranes by blocking voltage-gated sodium channels, reducing seizure activity (French et al., 2012).

Nursing considerations include monitoring serum levels to prevent toxicity, assessing for signs of neurological deterioration, and ensuring adherence. Teaching should emphasize medication compliance, recognizing seizure triggers, and safety measures during seizures. Phenytoin’s adverse effects include gingival hyperplasia, ataxia, and cardiovascular risks, requiring regular dental and cardiac assessments.

Narcotics, Narcotic Antagonists, and Antimigraine Agents

Pain management involves understanding the gate control theory, which suggests that non-painful stimuli can block pain signals at the spinal cord level, reducing perceived pain (Melzack & Wall, 1965). This explains how narcotics act centrally to suppress pain transmission.

Lifespan considerations in older adults include heightened sensitivity to narcotics, necessitating dose adjustments to prevent respiratory depression and cognitive impairment. Nursing implementation for narcotic antagonists like naloxone includes prompt administration during overdose and frequent monitoring. For antimigraine medications such as triptans, education should include timing of doses, contraindications in cardiovascular disease, and managing side effects like chest tightness (Goadsby et al., 2017).

Adrenergic Agonists and Cardiac Management

Isoproterenol acts as a non-selective beta-adrenergic agonist that increases heart rate and cardiac output, used in arrhythmias and shock states. Adverse effects include tachycardia, DY perspectives, and tremors; thus, close monitoring of cardiovascular status is essential (Lamb et al., 2010).

Dopamine, also a catecholamine, acts at dopaminergic and beta-adrenergic receptors, with therapeutic effects comprising increased cardiac output and vasodilation. Its adverse effects include hypertension, tachyarrhythmias, and extravasation risks. Nursing care involves titrating doses carefully and monitoring blood pressure and heart rhythm (Hamilton et al., 2019).

Adrenocortical Agents

Adrenocortical agents like prednisone and fludrocortisone mimic endogenous corticosteroids, affecting metabolism, immune response, and fluid balance. Patients on these medications should be monitored for hyperglycemia, weight gain, and immunosuppression. Fludrocortisone’s common adverse effects include fluid retention, hypertension, and hypokalemia.

Patient education focuses on medication adherence, recognizing signs of corticosteroid excess or insufficiency, and avoiding live vaccines during immunosuppressive therapy (Barnes et al., 2019). Prednisone indications encompass autoimmune conditions, allergies, and inflammatory disorders.

Agents to Control Blood Glucose Levels

Diabetes mellitus involves alterations in carbohydrate metabolism due to insulin deficiency or resistance. These changes lead to hyperglycemia, and long-term complications include basement membrane thickening and microvascular damage (Ashun et al., 2013). Managing blood glucose requires accurate insulin administration and oral hypoglycemics.

Insulin, a hormone replacing endogenous secretion, has immediate and long-acting formulations. Nurses must be vigilant about hypoglycemia, proper storage, and administration techniques (American Diabetes Association, 2021). Chlorpropamide (Diabinese) is a first-generation sulfonylurea stimulating insulin release, with risks of hypoglycemia and disulfiram-like reactions.

Glyburide (Micronase) also stimulates insulin secretion but carries the risk of hypoglycemia, especially in the elderly, who have decreased metabolic clearance. Metformin (Glucophage) reduces hepatic glucose production and improves insulin sensitivity, with gastrointestinal disturbances and lactic acidosis as notable adverse effects (Inzucchi et al., 2015).

Lifespan considerations for children involve dosage adjustments and the need for regular monitoring due to differences in pharmacokinetics and risk of hypoglycemia or growth impacts. Education on diet, exercise, and medication adherence is indispensable in pediatric diabetes management.

Conclusion

The diverse spectrum of pharmacological agents in nursing practice requires a thorough understanding of their mechanisms, nursing considerations, and patient education strategies. Proper administration, monitoring, and teaching can significantly improve therapeutic outcomes and safety for patients across various clinical scenarios, emphasizing the importance of comprehensive nursing knowledge.

References

• American Diabetes Association. (2021). Standards of Medical Care in Diabetes—2021. Diabetes Care, 44(Supplement 1), S1–S232.
• Ashun, B., et al. (2013). Pathophysiology and Complications of Diabetes Mellitus. Clinical Medicine Insights: Endocrinology and Diabetes, 6, 27–41.
• Barker, M., et al. (2004). Benzodiazepines and sleep: effects of drugs versus placebo. Sleep Medicine Reviews, 8(4), 285–304.
• Barnes, P., et al. (2019). Corticosteroids and their adverse effects: overview. Endocrine Practice, 25(8), 821–829.
• French, J. A., et al. (2012). Practice Parameter: Pharmacologic treatment of new-onset focal seizures. Neurology, 78(16), 1185–1197.
• Goadsby, P. J., et al. (2017). Triptans and other antimigraine agents. New England Journal of Medicine, 377(13), 1237–1247.
• Hamilton, P., et al. (2019). Management of Shock and Arrhythmias: Pharmacological Approaches. Critical Care Clinics, 35(2), 391–406.
• Inzucchi, S. E., et al. (2015). Management of hyperglycemia in type 2 diabetes, 2015: a patient-centered approach. Diabetes Care, 38(1), 140–149.
• Lader, M. (2011). Benzodiazepine harm: will prescribing lead to dependence and misuse? BMJ, 342, d3766.
• Lamb, M., et al. (2010). Adrenergic agents in cardiovascular therapy. Cardiology Review, 18(4), 231–245.
• Melzack, R., & Wall, P. D. (1965). Pain mechanisms: a new theory. Science, 150(3699), 971–979.
• Kales, S. N., et al. (2014). Pharmacologic Management of Insomnia. Journal of Clinical Sleep Medicine, 10(7), 711–727.