Lehne’s Pharmacology for Nursing Care 10th Edition
Genres: Medical
Book Preface
Pharmacology pervades all phases of nursing practice and relates directly to patient care and education. Yet despite its importance, many students—and even some teachers—are often uncomfortable with the subject. Why? Because traditional texts have stressed memorizing rather than understanding. In this text, the guiding principle is to establish a basic understanding of drugs, after which secondary details can be learned as needed. This text has two major objectives: (1) to help you, the nursing student, establish a knowledge base in the basic science of drugs, and (2) to show you how that knowledge can be applied in clinical practice. The methods by which these goals are achieved are described in the following sections.
LAYING FOUNDATIONS IN BASIC PRINCIPLES
To understand drugs, you need a solid foundation in basic pharmacologic principles. To help you establish that foundation, this text has major chapters on the following topics: basic principles that apply to all drugs (Chapters 4 through 8), basic principles of drug therapy across the life span (Chapters 9 through 11), basic principles of neuropharmacology (Chapter 12), basic principles of antimicrobial therapy (Chapter 83), and basic principles of cancer chemotherapy (Chapter 101).
REVIEWING PHYSIOLOGY AND PATHOPHYSIOLOGY
To understand the actions of a drug, it is useful to understand the biologic systems influenced by the drug. Accordingly, for all major drug families, relevant physiology and pathophysiology are reviewed. In almost all cases, these reviews are presented at the beginning of each chapter rather than in a systems review at the beginning of a unit. This juxtaposition of pharmacology, physiology, and pathophysiology is designed to help you understand how these topics interrelate.
TEACHING THROUGH PROTOTYPES
Within each drug family we can usually identify a prototype—a drug that embodies the characteristics shared by all members of the group. Because other family members are similar to the prototype, to know the prototype is to know the basic properties of all family members. The benefits of teaching through prototypes can be appreciated with an example. Let’s consider the nonsteroidal antiinflammatory drugs (NSAIDs), a family that includes aspirin, ibuprofen [Motrin], naproxen [Aleve], celecoxib [Celebrex], and more than 20 other drugs.
Traditionally, information on these drugs is presented in a series of paragraphs describing each drug in turn. When attempting to study from such a list, you are likely to learn many drug names and little else; the important concept of similarity among family members is easily lost. In this text, the family prototype—aspirin—is discussed first and in depth. After this, the small ways in which individual NSAIDs differ from aspirin are pointed out. Not only is this approach more efficient than the traditional approach, it is also more effective in that similarities among family members are emphasized.
LARGE PRINT AND SMALL PRINT: A WAY TO FOCUS ON ESSENTIALS
Pharmacology is exceptionally rich in detail. There are many drug families, each with multiple members and each member with its own catalog of indications, contraindications, adverse effects, and drug interactions. This abundance of detail confronts teachers with the difficult question of what to teach and confronts students with the equally difficult question of what to study. Attempting to answer these questions can frustrate teachers and students alike. Even worse, basic concepts can be obscured in the presence of myriad details. To help you focus on essentials, two sizes of type are used in this text. Large type is intended to say, “On your first exposure to this topic, this is the core of information you should learn.” Small type is intended to say, “Here is additional information that you may want to learn after mastering the material in large type.” As a rule, we reserve large print for prototypes, basic principles of pharmacology, and reviews of physiology and pathophysiology.
We use small print for secondary information about the prototypes and for the discussion of drugs that are not prototypes.
This technique allows the book to contain a large body of detail without having that detail cloud the big picture. Furthermore, because the technique highlights essentials, it minimizes questions about what to teach and what to study. The use of large and small print is especially valuable for discussing adverse effects and drug interactions.
Most drugs are associated with many adverse effects and interactions. As a rule, however, only a few of these are noteworthy. In traditional texts, practically all adverse effects and interactions are presented, creating long and tedious lists. In this text, we use large print to highlight the few adverse effects and interactions that are especially characteristic; the rest are noted briefly in small print. Rather than overwhelming you with long and forbidding lists, this text delineates a moderate body of information that is truly important, thereby facilitating comprehension.
USING CLINICAL REALITY TO PRIORITIZE CONTENT
This book contains two broad categories of information: pharmacology (the basic science about drugs) and therapeutics (the clinical use of drugs). To ensure that content is clinically relevant, we use evidence-based treatment guidelines as a basis for deciding what to stress and what to play down. Unfortunately, clinical practice is a moving target. Guidelines change when effective new drugs are introduced and when clinical trials reveal new benefits or new risks of older drugs, and so we need to work hard to keep this book current. Despite our Pharmacology best efforts, the book and clinical reality may not always agree: Some treatments discussed here will be considered inappropriate before the 11th edition is published. Furthermore, in areas where controversy exists, the treatments discussed here may be considered inappropriate by some clinicians right now.
NURSING IMPLICATIONS: DEMONSTRATING THE APPLICATION OF PHARMACOLOGY IN NURSING PRACTICE
The principal reason for asking you to learn pharmacology is to enhance your ability to provide patient care and education. To show you how pharmacologic knowledge can be applied to nursing practice, nursing implications are integrated into the body of each chapter. That is, as specific drugs and drug families are discussed, the nursing implications inherent in the pharmacologic information are noted side-by-side with the basic science. To facilitate access to nursing content, nursing implications are also summarized at the end of most chapters. These summaries serve to reinforce the information presented in the chapter body. These summaries have been omitted in chapters that are especially brief or that address drugs that are infrequently used. However, even in these chapters, nursing implications are incorporated into the main chapter text.
WHAT’S NEW IN THE BOOK?
Lehne’s Pharmacology for Nursing Care has been revised cover to cover to ensure that the latest and most accurate information is presented. Three new features have been added to help promote our focus on the most useful and most critical information for nursing students:
• Prototype Drugs: This content, which appeared in an end-of-book appendix in previous editions, has been moved into the book’s chapters as a new, easy-to-find feature.
• Safety Alerts: This eye-catching new feature draws the reader’s attention to important safety concerns related to contraindications, adverse effects, pregnancy categories, and more.
• Patient-Centered Care Across the Life Span: New tables in many chapters highlight care concerns for patients throughout their lives, from infancy to older adulthood. In addition, the popular Special Interest Topics of past editions have been thoroughly revised to allow for the most current research. Canadian trade names have been updated and continue to be identified by a maple-leaf icon.
LEARNING SUPPLEMENTS FOR STUDENTS
• Online Evolve Resources accompany this edition and include Downloadable Key Points, Review Questions for the NCLEX® Examination, Unfolding Case Studies, and more. These resources are available at http://evolve .elsevier.com/Lehne.
• Pharmacology Online for Lehne’s Pharmacology for Nursing Care, tenth edition, is a dynamic online course resource that includes interactive self-study modules, a collection of interactive learning resources, and a media-rich library of supplemental resources.
• The Study Guide, which is keyed to the book, includes study questions; critical thinking, prioritization, and delegation questions; and case studies.
TEACHING SUPPLEMENTS FOR INSTRUCTORS
• The Instructor Resources for the tenth edition are available online and include TEACH® for Nurses Lesson Plans, a Test Bank, a PowerPoint Collection, and an Image Collection.
WAYS TO USE THIS TEXTBOOK
Thanks to its focus on essentials, this text is especially well suited to serve as the primary text for a course dedicated specifically to pharmacology. In addition, the focused approach makes it a valuable resource for pharmacologic instruction within an integrated curriculum and for self-directed learning by students, teachers, and practitioners. How is this focus achieved? Four primary techniques are employed: (1) teaching through prototypes, (2) using standard print for essential information and small print for secondary information, (3) limiting discussion of adverse effects and drug interactions to information that matters most, and (4) using evidence-based clinical guidelines to determine what content to stress. To reinforce the relationship between pharmacologic knowledge and nursing practice, nursing implications are integrated into each chapter. To provide rapid access to nursing content, nursing implications are summarized at the end of most chapters using a nursing process format. In addition, key points are listed at the end of each chapter. As in previous editions, the tenth edition emphasizes conceptual material— reducing rote memorization, promoting comprehension, and increasing reader friendliness. Pharmacology can be an unpopular subject due to the vast and rapidly changing area of content. Often, nursing students feel that pharmacology is one of the most difficult classes to master. We hope that this book makes the subject of pharmacology easier and more enjoyable for you to understand by allowing you to focus on the most important umbrella concepts of pharmacology as they relate to nursing care and the safety of patients.
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