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2 Minute EBP Challenge

Monday, March 08, 2010
Restoring Hemoglobin
One of the goals for a patient who has a large blood loss is the restoration of normal hemoglobin levels.  This is partially done by blood transfusions, usually to a hemoglobin level of about 10g/dL.  A hemoglobin level that low will leave the patient feeling fatigued, but should be high enough to protect the heart from anemic ischemia.

Sunday, February 28, 2010
Renal Dysfunction
Mrs. Mersa is admitted with sepsis and hypotension.  Her labs indicate:
BUN 58 mg/dl
Serum creatinine 2.1 mg/dl
Urine sodium 70 mEq/L
Urine specific gravity 1.010, with cellular casts and RBCs in the urine.
Based on these findings you would consider:

Friday, February 12, 2010
Which action first?
Which information about a patient who has just been admitted to the hospital with nausea and vomiting will require the most rapid intervention by the nurse?

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Home > 2 Minute EBP Challenge > Compliance with Antihypertensives

Compliance with Antihypertensives

Monday, November 23, 2009

Stay up-to-date the easy way!

How would you answer this question?

Nurses are aware of the importance of patient adherence with antihypertensive medication therapy.  What many nurses often don't know is that adherence is decreased in which patient population?

a. Obese patients
b. Diabetic patients
c. The patient on multiple drugs
d. Patients with cancer

The correct answer is "c," patients with cancer.

In an interesting study by Mazzaglia and associates, the authors found that patients with cancer were more likely to be noncompliant with antihypertensive medication therapy.  Interestingly, obese patients, diabetic patients, and patients taking multiple medications were more complaint with antihypertensive therapy than were other patients.  But overall drug therapy discontinuation was about 5%-10% per year, and may even be as high as 50% after six months.

The high discontinuation rate may be due to the financial cost of the medications or the perceived lack of benefit in a patient who may subjectively feel healthy.  The low adherence in cancer patients may be due to a variety of reasons, but this is a patient population who should be carefully assessed for adherence to prescribed antihypertensive therapy.

Those patients with high adherence to antihypertensive drug therapy had significant reductions in cardiovascular mortality and morbidity.  Therefore it is important to assess why some patients are not compliant and plan appropriate interventions to help them acquire their medications and take them appropriately.

From: Mazzaglia, G. et al. (2009).  Adherence to antihypertensive medications and cardiovascular morbidity among newly diagnosed hypertensive patients.  Circulation, 120:1598.

Congratulations to Cheryl Trice who won an autographed copy of my 101 Tips to Improve Your Nursing Care book for answering this week's question correctly.  Congratulations Cheryl!    

Best wishes,
David W. Woodruff, MSN, RN-BC, CNS, CEN
President, Ed4Nurses, Inc.

Take 10% off any program at Ed4Nurses.com using the 2-Minute EBP code (SaveEBP).

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