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Pharmacology case study
Running head: Pharmacology case study
Pharmacology Case Study
Elizabeth Maimo
Nursing 3191 professional Clinical Nursing RN 1
Fall, 2014
School of Nursing
Columbus State University
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Pharmacology case study
Assuming the patient is a type @ diabetic, diet and exercise can be employed to manage
diabetes. Alternative therapy for management of diabetes includes both diet therapy and physical
activity. Diet therapy involves modifying the diet so that carbohydrates that are consumed would
be of low glycemic value. Whole grain carbohydrates and low glycemic index carbohydrates
cause a gradual and sustained release of glucose into the blood stream, as opposed to simple and
processed carbohydrates which cause a ‘dumping’ of glucose into the bloodstream, resulting in
hyperglycemia. ‘Diets based on carbohydrate foods that are more slowly digested, absorbed, and
metabolized (i.e., low glycemic index [GI] diets) have been associated with a reduced risk
of type 2diabetes and cardiovascular disease’ Marsh et al. (2011). Traditionally exercise is
believed to improve the cells uptake of glucose improved sensitivity to insulin. According to
Zanuso et al (2010), exercise has been shown to decrease HgA1c, when followed consistently.
Given that the patient has limited resources, dietary modification and exercise would be
affordable methods to improve her outcomes. The exercise that would need to be performed
could be as simple as walking for up to 30 minutes a day, 4-5 days a week. In the same study by
Zanuso et al (2010) it was found that cholesterol (LDL) levels and blood pressures were
decreased in patients who consistently exercise. The patient has problems with her cholesterol
levels and elevated blood pressure. Moderate fat, low sodium diet and exercise aid in lowering
both cholesterol levels and blood pressure. As far as diet goes, emphasis will be placed on
consuming non-starchy vegetables in the meals as well as complex carbohydrates, all of which
do not cause an abrupt spike in blood glucose levels. The patient has problems with finances,
since this is the case; it is obviously not a good idea for her to check her blood pressure while out
shopping. Blood pressures are bound to be increased in instances of stress (emotional or
physical).
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Pharmacology case study
Patient empowerment is a big factor in determining positive outcomes for patients.
Patient empowerment enables informed decision-making by patients on matters concerning their
own care. When patients are educated on their disease processes, they’re better able to participate
in their care and offer relevant feedback on matters regarding their treatments. Patient safety is
enhanced when patients participate in the decision-making concerning their health through the
following ways: patients who actively involve themselves in their treatments will communicate
better with their healthcare providers and thus reduce the likelihood of some health information
being overlooked if they change healthcare providers. Medication safety is improved when
patients are knowledgeable about their medications. It is not uncommon for patients to halt
medication errors by alerting the nurse that the said medication has never been taken or in
instances where the dosage is incorrect. Patients can also enhance safety by inquiring about the
medications they’re being given and what the effects are. Conscientious nurses will pause when
patients ask about their, potential errors might even be discovered when the nurse pauses to
explain the medications to the patient. One of the factors that drive healthcare cost is diagnostic
procedures that employ innovative medical equipment. Some Diagnostic procedures might be
bypassed if the patient is able to provide a comprehensive history of their health condition. For
patients who do not possess health insurance or primary care providers or who have problems
affording medications, social workers often work with patients to get them situated.
Active patient participation in healthcare could often be impaired by certain barriers on
the part of the patients. Literacy levels play a role in how much patients are able to contribute to
their healthcare. The more educated a patient is, the more likely they would understand
instructions and directions about their health management. In addition to education, fear and awe
of healthcare providers is a factor in how much patients participate in their healthcare. Hispanic
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Pharmacology case study
and African cultures often ‘look up’ to healthcare providers and believe that healthcare providers
know best in matters of healthcare. This acquiescence on the part of some culture limits active
participation in healthcare decision making. Ignorance on healthcare practices/processes limits
patient contribution. Another barrier to active patient involvement is the healthcare professionals
themselves; according to Boivin et al (2014), critics of patient involvement in healthcare ‘doubt
that patients can actually influence professionals’ decisions and have an impact on collective
healthcare’. Such thinking, and stereotyping of patients by some healthcare providers will limit
patient participation in their healthcare.
Knowledge plays a major part of patient empowerment. As the old phrase goes
‘knowledge is power’, patients who have been educated on the various aspects of their healthcare
are better placed to make informed decisions. Given that nurses spend more time in physical
proximity to patients, the duty of patient education should be integrated in nursing care. Most
patients will ask questions when in doubt of treatments or procedures. As much as possible,
nurses should strive to provide answers to patients’ questions, or channel the questions to the
appropriate quarters. Healthcare providers need not assume a paternalistic stance when treating
patients, patients should have autonomy and matters should be explained to them in terms that
would be understood.
McAllister et al (2012, p. 2) propose that patient empowerment promotes adherence
instead of mere compliance. They define adherence as ‘the patient voluntarily agreeing with a
healthcare plan developed through share decision-making’. For patients with chronic conditions
like diabetes, hypertension, etc, adherence to the treatment plan will promote positive outcomes
for the patient. Patients and families should be provided the necessary tools that would enable
them be participants in their own care, instead of as passive consumers.
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Pharmacology case study
Reference:
Boivin, A., Lehoux, P., Lacombe, R., Burgers, J., & Grol, R. (2014). Involving patients in setting
priorities for healthcare improvement: a cluster randomized trial. Implementation
Science, 9(1), 1-20. doi:10.1186/1748-5908-9-24
Marsh, K., Barclay, A., Colagiuri, S., & Brand-Miller, J. (2011). Glycemic index and glycemic
load of carbohydrates in the diabetes diet. Current Diabetes Reports, 11(2), 120-127.
doi:10.1007/s11892-010-0173-8
McAllister, M., Dunn, G., Payne, K., Davies, L., & Todd, C. (2012). Patient empowerment: the
need to consider it as a measurable patient-reported outcome for chronic conditions.
BMC Health Services Research, 12157.
Zanuso, S., Jimenez, A., Pugliese, G., Corigliano, G., & Balducci, S. (2010). Exercise for the
management of type 2 diabetes: a review of the evidence. Acta Diabetologica, 47(1), 1522. doi:10.1007/s00592-009-0126-3