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2 Minute EBP Challenge

Monday, July 26, 2010
Ms. Shepard and DIC
This morning rapid response is called for Ms. Shepard who was admitted with a urinary tract infection and sepsis. Her blood pressure dropped during the evening hours and she is now hypotensive and is having difficulty breathing. Her IV sites are oozing and there is blood in the urinary catheter. Her physician suspects disseminated intravascular coagulation (DIC). The primary mechanism in the development of DIC is:

Monday, July 19, 2010
Thyrotoxicosis

Which of the following laboratory findings is indicative of thyrotoxicosis?

Monday, July 12, 2010
Urban CPR Patterns
In a recent study of inner-city neighborhoods, the authors found that out of hospital cardiac arrest was 2-3 times higher in some neighborhoods compared to others. In these high incidence neighborhoods what was the rate of bystander CPR?

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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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