Pharmacology for Nurses: A Pathophysiological Approach, Second Canadian Edition

Book Preface

When students are asked which subject in their nursing program is the most challenging, pharmacology always appears near the top of the list. The study of pharmacology demands that students apply knowledge from a wide variety of the natural and applied sciences. The successful prediction of drug action requires a thor-ough knowledge of anatomy, physiology, chemistry, and pathol-ogy, as well as knowledge of the social sciences of psychology and sociology. Current knowledge of drug actions, mechanisms, interactions, and legislation is mandatory for nurses to provide safe and effective care to their clients in all healthcare settings. Lack of proper application of pharmacology can result in immediate and direct harm to the client; therefore, the stakes in learning the subject are high.

Pharmacology can be made more understandable if the proper connections are made to knowledge learned in other disciplines. The vast majority of drugs in clinical practice are prescribed for specific diseases, yet many pharmacology texts fail to recognize the complex interrelationships between phar-macology and pathophysiology. When drugs are learned in iso-lation from their associated diseases or conditions, students have difficulty connecting pharmacotherapy to therapeutic goals and client wellness. The pathophysiology approach of this text gives the student a clearer picture of the importance of pharmacology to disease, and ultimately to client care. The approach and rationale of this text focus on a holistic per-spective to client care, which clearly shows the benefits and limitations of pharmacotherapy in curing or preventing illness. Although challenging, the study of pharmacology is truly a fascinating, lifelong journey.

The new edition provides a unique Canadian perspective on pharmacotherapeutics, geared towards the education of Canadian undergraduate nursing students and their curriculum. During the editorial process, the text content was thoroughly reviewed and scrutinized by Canadian nurse educators and sea-soned Canadian clinical pharmacists. The editors adapted the content accordingly to fit the Canadian nursing context. The technical review process helped ensure accurate information on Canadian drug names, and their respective doses and routes of administration, including common Canadian Trade names for drugs, and highlighting drugs that are exclusively available in Canada. Pregnancy categorization of drugs were updated based on Canadian standards. Finally tables and illustrations to help students better assimilate pharmacotherapeutic concepts were also added to the respective chapters.

Organization: A Body System  and Disease Approach

Pharmacology for Nurses: A Pathophysiological Approach, 2nd Canadian Edition, is organized according to body systems (units) and dis-eases (chapters). This edition of the text has been expanded with new information. We have added many new chapters and included NCLEX Success Tips within each chapter to assist the student with making connections to the new NCLEX exam requirement for Canadian registered nurses. The first chapter in each unit (except in Units 1, 2, and 3) provides a brief discussion of the physiology of the corresponding body system. Each chapter pro-vides complete information on the drug classifications used to treat the diseases discussed in that chapter. Specially designed headings cue students to each classification discussion.

The pathophysiology approach clearly places the drugs in con-text in terms of how they are used therapeutically. The student is able to easily locate all relevant anatomy, physiology, pathology, and pharmacology in the same chapter in which the drugs are discussed. This approach provides the student with a clear view of the connections between pharmacology, pathophysiology, and the nursing care learned in other clinical courses.

NCLEX Success Tips

The second Canadian edition of Pharmacology for Nurses: A Patho-physiological Approach includes more chapters to address the rapidly growing needs of students practising in the Canadian healthcare system. Before we started writing the text, we collected feedback from university professors, asking specifically about their experi-ence using other pharmacology texts and their perceptions of an ideal text. These professors shared some of the challenges their students face while taking a pharmacology course. An emerging but immediate need that echoed at a national level was the need to prepare Canadian nursing students to pass the NCLEX exam. Although students can take NCLEX courses after graduation or just before taking the exam, we believe that early introduction of NCLEX format and concepts will give the students ample time to understand and assimilate these concepts. Our textbook, is the first nursing pharmacology text to incorporate NCLEX Success Tips.

We experienced challenges while trying to address all stake-holder concerns, as well as student needs, and at the same time keeping the text to a reasonable length. As a result, we reviewed several NCLEX texts and designed tips based on the NCLEX exam blueprints. We have presented the new content in a concise and succinct format and have used tables, figures, and illustrations to explain concepts.

Prototype Approach to Learning Drugs

The number of drugs available in clinical practice is staggering. To facilitate learning, we use prototype drugs and provide detailed introductions to the one or two most representative drugs in each classification. Students are less intimidated when they can focus their learning on one representative drug in each class. Prototype Drug boxes clearly describe these important medications. Within these boxes, the actions and uses of the drug are succinctly pre-sented, including administration alerts, which highlight vital in-formation related to the administration of that drug and treatment of overdose and antidotes when known. Pharmacokinetics in-formation regarding the absorption, distribution, metabolism, ex-cretion, and half-life of drugs is included when known. Adverse effects and interactions are also included when necessary.

Focused Coverage of the Nursing Process

This text features a focused approach to the nursing process, which allows students to quickly find the content that is essen-tial for safe and effective drug therapy. Nursing Considerations sections appear within the discussion of each drug class. These sections discuss the major needs of the client, including general assessments, interventions, and client teaching for the classi-fication. Client education discussions provide students with the essential information that they need to convey to their clients. Integrated rationales for nursing actions help students to learn the reasoning that is key to the development of critical thinking skills.

Nursing Process Focus charts provide a succinct, easy-to-read view of the most commonly prescribed drug classes for the disease. Need-to-know nursing actions are presented in a format that reflects the “flow” of the nursing process: nursing assessment, pattern identification and potential nursing diagnoses, planning, interventions, client education and discharge planning, and evalua-tion. Rationales for interventions are included in parentheses. The Nursing Process Focus charts identify clearly the nursing actions that are most important. Some prototype drugs have important nursing actions that are specific to that drug; in these instances, we provide a Nursing Process Focus chart in the text devoted solely to the prototype drug.

Holistic Pharmacology

Our new edition, examines pharmacology from a holistic perspec-tive. The Special Considerations and Lifespan Considerations features present pharmacology and nursing issues related to cul-tural, ethnic, age, gender, and psychosocial aspects. These features remind students that a drug’s efficacy is affected as much by its pharmacokinetics as by the uniqueness of the client. In addition, pediatric and geriatric considerations are integrated throughout the text.
Natural Therapies features present a popular herbal or dietary supplement that may be considered along with conven-tional drugs. Although the authors do not recommend the use of these alternative treatments in lieu of conventional medicines, many clients use complementary and alternative therapies and the nurse must become familiar with how they affect client health. Herb-drug interactions are also included within the Prototype Drug boxes when relevant. Non-pharmacological methods for controlling many diseases are also integrated into the chapters and include lifestyle and dietary modifications.