https://padlet.com/sarahd59/aier44ksy4z3bv3l Management of patients experiencing GIT and cellular dysfunction en-us 2023-04-23 11:01:33 UTC 2023-04-24 07:24:25 UTC hello@padlet.com sarahd59 https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564554164 What were your significant risks Tamoxifen? Are you able to group these risks? Why are they significant?
Do you understand the MoA of how the patient might develop the risks?
Did you need to go and look them up again? ]]> 2023-04-23 11:01:33 UTC https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564554164 sarahd59 https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564554165 How / why does it occur?
What are they and what signs and symptoms would we see?
What do we as nurses do;
- prevent and/ or manage these?]]> 2023-04-23 11:01:33 UTC https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564554165 sarahd59 https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564554166 2023-04-23 11:01:33 UTC https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564554166 sarahd59 https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564554167 2023-04-23 11:01:33 UTC https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564554167 sarahd59 https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564554168 2023-04-23 11:01:33 UTC https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564554168 sarahd59 https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564554169 2023-04-23 11:01:33 UTC https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564554169 sarahd59 https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564554170 2023-04-23 11:01:33 UTC https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564554170 sarahd59 https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564554171 Note: Always consider:
Is there anything in the patient's condition/ past history that may increase the risks?]]> 2023-04-23 11:01:33 UTC https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564554171 sarahd59 https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564554172 What factors may result in impaired medication effects in these patients?]]> 2023-04-23 11:01:33 UTC https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564554172 sarahd59 https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564554173 2023-04-23 11:01:33 UTC https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564554173 sarahd59 https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564554174 2023-04-23 11:01:33 UTC https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564554174 sarahd59 https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564554175 2023-04-23 11:01:33 UTC https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564554175 sarahd59 https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564554176 2023-04-23 11:01:33 UTC https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564554176 sarahd59 https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564554177 Morphine

MOA: act on the receptors in the CNS and GIT producing analgesia. Acting mainly at mu-opioid receptors in the CNS to reduce the pain impulse. 

Indications for use: 
- Used for severe pain management. 
- Opioids that are used for general anaesthesia

Nursing considerations:
- Reassess the patient's pain frequently using the numerical pain assessment and adjust morphine dose accordingly
- peak analgesic effects occur within 60mins after oral dose, 50-90mins after SC injection and 20mins after IV injection
- Advise laxatives as opioids can cause constipation
- Education for dental hygiene

Drug - drug interactions
- Pregabalin = may lead to additive CNS or respiratory depression 
- Tramadol = additive serotonergic effects therefore increasing the risk of serotonin syndrome
- Naloxone = ]]> 2023-04-23 11:01:33 UTC https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564554177 sarahd59 https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564554178 Esomeprazole

MOA: Bind to the hydrogen/potassium ATPase enzyme system (proton pump), inhibit and both stimulated and basal acid secretion

Indications for use: GORD, Zollinger/Ellison syndrome, H.pylori eradication, treatment prevention for NASID peptic ulcers, prevention of peptic ulcer re-bleeding

Nursing considerations: asses ongoing PPI use regularly. consider stop treatment, intermittent use when symptoms develop, step down to lowest effective dose. watch for enteric infection. watch for possible association of decrease vitamin B12, pneumonia, fracture, iron deficiency and chronic kidney disease with PPI therapy

Drug - drug interactions: anticoagulants ]]> 2023-04-23 11:01:33 UTC https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564554178 sarahd59 https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564554179 Ondansetron (5HT3 antagonist) 
Anti emetic

MOA: Seretonin -HT3 receptor agonist. Works by blocking the action of seretonin, a natural substance that may cause nausea and vomiting

Indications for use: Nausea and vomiting
Cancer chemotherapy
post operative
pregnancy
radiotherapy induced

Nursing considerations:
More effective for acute than delayed symptoms
Can be given orally or intravenously

Drug - drug interactions:
Ondansetron + Rifamipicin
- may increase metabolism of ondansetron, decreasing its efficacy. Monitor clinical effect]]> 2023-04-23 11:01:33 UTC https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564554179 sarahd59 https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564554180 Naproxen Nsaid

MOA: it works by blocking natural substance that causes inflamation

Indications for use: pain due to inflamation and swelling such as headache, pain and arthritis 

Nursing considerations: check for kidney problems and allegys to NSAIDS 
Drink plenty of fluids to prevent dehaydration
Stop smoking and alcohol because it cause stomach bleeding avoid driving cause it has sedation effect

Drug - drug interactions: 
Anti-platelet increased bleeding
Other pain reliever- it may increased kidney damage.]]> 2023-04-23 11:01:33 UTC https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564554180 sarahd59 https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564554182 2023-04-23 11:01:33 UTC https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564554182 sarahd59 https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564554183 Mrs Marple now has constipation. What medication/s will you give her to relieve this?
Deakin Hospital Protocol needs to be considered for this decision]]> 2023-04-23 11:01:33 UTC https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564554183 sarahd59 https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564554184 2023-04-23 11:01:33 UTC https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564554184 sarahd59 https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564554185 - Increased body fat
- Decreased body water
- Decreased muscle mass
- Changes in renal and liver function
- Brings on menopause

]]> 2023-04-23 11:01:33 UTC https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564554185 sarahd59 https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564554186 2023-04-23 11:01:33 UTC https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564554186 sarahd59 https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564554187 2023-04-23 11:01:33 UTC https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564554187 sarahd59 https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564555125 TAMOXIFEN
Risks associated:
Menopausal syndrome 
Signs and symptoms of hot flush, night sweat, and regular menstration
It can increased blood clot formation which could potentially led to thrombo-embolic episod such as pulmonary embolism and stroke. It can also increased risk of uterine cancer because it acts like estogen.


Why are they significant?
Decreased the risk of having breast cancer


]]> 2023-04-23 11:04:47 UTC https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564555125 sarahd59 https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564555174 TAMOXIFEN
Risks associated:
- stevens johnson syndrome
- leg cramps
- alopecia
- menopause like symptoms
- leg swelling
- nausea
- skin rash
- vaginal discharge
- weight gain
- fluid retention
- headache

Why are the risks significant?
- Tamoxifen works by blocking the actions of oestrogen which is a natural female sex hormone.]]> 2023-04-23 11:04:57 UTC https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564555174 sarahd59 https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564555226 TAMOXIFEN
Risks associated:
- Leg cramps 
- alopecia 

Why are the risks signficant?
- leg cramps may mean not enough blood flow 
- alopecia means that your immune system mistakenly attacks a part of your body]]> 2023-04-23 11:05:06 UTC https://padlet.com/sarahd59/aier44ksy4z3bv3l/wish/2564555226