1 Start Here——Path to Academic Success: Pathophysiology and Pharmacology Basics in Nursing
Navigating the Montgomery College Nursing Program’s Pathophysiology and Pharmacology Course
Learning Objectives
- Describe the course description and course objectives of NURS 129 in the Montgomery College Nursing Program
- Create a plan of academic success for NURS 129 and beyond
- Apply conceptual approach to learning Pathophysiology and Pharmacology
- Navigate Open Education Resource (OER)-Pathophysiology and Pharmacology Basics
I. Pathophysiology and Pharmacology as Foundations of Nursing Practice
Pathophysiology and pharmacology are foundations of nursing practice, forming the base of clinical decision-making, patient care, and therapeutic interventions. Nurses must have a solid knowledge base in these disciplines to provide safe, effective, and evidence-based care. This resource is created as a learning resource and guide for the Montgomery College NURS 129 course-Pathophysiology and Pharmacology in Nursing. The details of this course are provided in the course syllabus found in the course’s Learning Management System-Blackboard. The course description and objectives are provided below to help learners understand the remaining information in this chapter.
NURS 129: Pathophysiology and Pharmacology in Nursing
Course Description: Pathophysiology and Pharmacology in Nursing introduces pharmacodynamics, pharmacokinetics, and pharmacotherapeutics of various classifications of medications as they relate to basic pathophysiology seen in each body system. Emphasis is on the nursing implications and patient education requirements for the safe administration of each class of medications. Students explore the role and responsibility of the registered nurse in administering and evaluating medications. Some content in the course will be covered in an online format.
Course Outcomes
Upon completion of this course, students will be able to:
1. Apply knowledge of evidence-based practices to enhance understanding of disease processes and other health-related conditions.
2. Recognize legal and ethical issues pertaining to the medication delivery process in healthcare practice.
3. Utilize the nursing practice for decision-making in caring for patients with altered health states.
4. Demonstrates knowledge of healthcare technological resources to support understanding disease processes, pharmacokinetics, and pharmacodynamics.
5. Discuss pharmacokinetics, pharmacodynamics, and the pharmacotherapeutics of medications within each pharmacological category.
Evaluation of Learning Outcomes: Cognitive written assessments and application of concepts through active learning exercises and projects.
Pathophysiology: The Foundation of Understanding Disease
Pathophysiology is the study of the functional changes that occur in the body due to a disease or injury. This knowledge allows nurses to understand the underlying mechanisms of diseases, which is crucial for several reasons:
1. Accurate Assessment: Knowledge of pathophysiology enables nurses to perform thorough and precise assessments. Pathophysiological knowledge is rooted in recognizing a disease’s signs and symptoms, understanding its progression, and predicting potential complications. For example, understanding the pathophysiology of diabetes mellitus allows nurses to monitor blood glucose levels, recognize signs of hyperglycemia or hypoglycemia, and implement appropriate interventions (McCance & Huether, 2019).
2. Informed Decision-Making: Nurses often make critical decisions regarding patient care. Understanding the pathophysiology of diseases aids in interpreting diagnostic tests, recognizing abnormalities, and prioritizing care. It supports the development of nursing care plans tailored to patients’ individual needs (Lewis et al., 2020).
3. Patient Education: Nurses play a vital role in educating patients about their conditions. A solid understanding of pathophysiology allows nurses to explain complex medical concepts in an accessible way, helping patients to understand their illnesses, treatment plans, and the importance of adherence to therapeutic regimens (Gulanick & Myers, 2021).
Pharmacology: The Science of Medication Management
Pharmacology is the study of drugs and their effects on the body. In nursing practice, pharmacological knowledge is indispensable for several reasons:
1. Safe Medication Administration: Nurses are responsible for administering medications and monitoring their effects. Understanding pharmacokinetics (how drugs move through the body) and pharmacodynamics (how drugs affect the body) is crucial for administering the correct dosages, recognizing potential side effects, and preventing adverse drug interactions (Adams & Urban, 2021).
2. Therapeutic Effectiveness: Pharmacology knowledge enables nurses to evaluate the effectiveness of medications. Nurses can assess whether a medication achieves its intended therapeutic effect and identify signs of drug toxicity or inefficacy. This is particularly important in managing chronic conditions where medication regimens may need to be adjusted regularly (Burchum & Rosenthal, 2021).
3. Patient Advocacy: Nurses are often the primary advocates for their patients. Understanding pharmacology empowers nurses to advocate for appropriate medication management, including suggesting alternative therapies when necessary and ensuring that patients receive the most effective treatments with the least risk (Kee et al., 2018).
4. Patient Education: Educating patients about their medications is a key nursing role. Nurses must be able to explain the purpose of each medication, how to take them correctly, potential side effects, and interactions with other drugs or foods. This education helps to ensure adherence and optimize therapeutic outcomes (Holland et al., 2019).
Integration in Nursing Practice
The integration of pathophysiology and pharmacology in nursing practice ensures that nurses are well-equipped to provide holistic and patient-centered care. This integration supports the nursing process, from assessment and diagnosis to planning, implementation, and evaluation, providing a solid basis for clinical decisions. By understanding the science behind diseases and their treatments, nurses can enhance the quality of care they deliver, improve patient outcomes, and contribute to the advancement of the nursing profession (Craven & Hirnle, 2017).
Pathophysiology and pharmacology are indispensable to nursing practice. They provide the necessary framework for understanding diseases and their treatments, ensuring that nurses can deliver comprehensive, safe, and effective care. The continuous study and application of these disciplines are crucial for the ongoing development of nursing knowledge and practice.
This book will present clinical cases and scenarios that exemplify the integration of Pathophysiology and Pharmacology. It is important to note that you will also draw knowledge from anatomy and physiology, physical assessment, and the basic sciences to fully understand these concepts and their applications.
Illustration of a Case Study: Integrating Pathophysiology and Pharmacology in Nursing Practice
Background
Maria, a 58-year-old female, presented to the emergency department with severe chest pain, sweating, and a sensation of heaviness in her chest that had started suddenly while she was gardening. Maria has a history of hypertension and type 2 diabetes. She is currently on Metformin and Lisinopril.
Knowledge check:
Assessment and Initial Findings:
- Upon arrival, Maria’s vital signs were recorded: blood pressure 170/100 mmHg, heart rate 110 beats per minute, respiratory rate 22 breaths per minute, and oxygen saturation 94% on room air. An electrocardiogram (ECG) showed elevated ST segments in the anterior leads, suggestive of an acute anterior myocardial infarction (MI) (Smith et al., 2020). Blood tests were ordered, including cardiac enzymes, which confirmed the diagnosis.
You will be learning pathophysiology in the course of the semester. It is essential that you pay attention to the assessment findings. As a nurse caring for Maria, the question below should be at the forefront:
“What are the Pathophysiological Considerations for Maria’s diagnosis ( Myocardial Infection)?”
- The pathophysiology behind Maria’s acute MI primarily involves the disruption of an atherosclerotic plaque in her coronary artery, leading to thrombus formation and subsequent occlusion of the artery. This occlusion results in ischemia and necrosis of the myocardium supplied by the affected artery. Maria’s existing conditions, hypertension and diabetes, contribute to her heightened risk for atherosclerosis and coronary artery disease, complicating her cardiovascular status (Johnson & Lee, 2021).
A huge component of patient care is pharmacological management. In Maria’s case, she is prescribed:
1. Aspirin: Administered immediately to inhibit platelet aggregation and reduce the growth of the thrombus (Williams, 2019).
2. Nitroglycerin: Given to relieve chest pain by dilating coronary arteries and improving blood flow to the myocardium (Taylor, 2018).
3. Beta-blockers (e.g., Metoprolol): Introduced to decrease heart rate, reduce myocardial oxygen demand, and limit the size of the infarction (Davis, 2020).
4. ACE inhibitors (e.g., continuation of Lisinopril): Beneficial post-MI to prevent adverse cardiac remodeling and improve survival rates (Khan & Patel, 2021).
5. Statins: Initiated to lower cholesterol levels and stabilize atherosclerotic plaques, preventing further cardiovascular events (Rossini et al., 2022).
Nursing Care and Considerations: Supported by knowledge of pathophysiology and pharmacology, the nurse will include in Maria’s plan of care:
– Monitoring cardiac and vital signs closely to assess for stability or any signs of deterioration.
– Administering medications as prescribed and monitoring for effects and potential side effects.
– Educating the patient about her condition, the importance of medication adherence, and lifestyle modifications to manage her risk factors.
– Coordinating care with a multidisciplinary team to plan for ongoing treatment, rehabilitation, and management of her diabetes and hypertension.
Key Takeaways
This case study underscores the importance of integrating pathophysiological knowledge and pharmacological principles in nursing practice. Understanding the underlying pathophysiology of diseases and the mechanisms of drugs enables nurses to provide effective and comprehensive care, ensuring better patient outcomes and education on disease management and prevention.
II. Conceptual Approach to Learning Pathophysiology and Pharmacology
Students preparing to become professional nurses must learn complex clinical conditions and the pharmacological interventions required in diverse healthcare settings. Traditional approaches often emphasize rote memorization, which may not fully equip future nurses with the critical thinking skills necessary for effective practice. Conceptual learning offers a more integrative and practical approach to nursing education, particularly pathophysiology and pharmacology (Johnson & Lee, 2021).
Conceptual learning in nursing focuses on understanding broad underlying principles that can be applied across various conditions and treatments. This educational strategy encourages students to see connections between concepts, fostering a deeper understanding and better retention of knowledge (Davis, 2019).
Application in Pathophysiology
In pathophysiology, conceptual learning helps nursing students understand the why behind disease processes. For instance, by grasping the concept of the inflammatory response, students can predict potential complications in conditions like autoimmune disorders or infections and understand the rationale behind specific nursing interventions (Wilson, 2020). This also provides the rationale behind pharmacologic management.
Application in Pharmacology
Pharmacology education benefits similarly from conceptual learning. It enables students to comprehend how drugs modify physiological processes. Understanding drug-receptor interactions, for example, helps nurses anticipate therapeutic outcomes and potential side effects, enhancing their ability to manage patient care effectively (Taylor, 2018).
Benefits of Conceptual Learning
- Enhanced Critical Thinking: By connecting concepts, students develop the ability to think critically and make informed decisions in clinical settings (Khan & Patel, 2017).
- Improved Problem-Solving Skills: Conceptual knowledge equips students with the skills to address novel and complex patient scenarios (Lopez, 2019).
- Interdisciplinary Learning: This approach facilitates an integrated understanding of nursing with other healthcare disciplines, promoting collaborative and holistic care (Martin, 2022).
Key Takeaway
- Adopting a conceptual learning approach in nursing education transforms how nurses are trained in pathophysiology and pharmacology. It prepares nurses to perform tasks and understand the reasons behind those tasks, which is crucial for patient safety and effective care (Smith & Jones, 2020).
III. Metacognition for Academic Success in Pathophysiology and Pharmacology
Pathophysiology and pharmacology are challenging subjects that require students to understand complex biological processes and the effects of medications on the human body. Metacognition, or self-awareness about one’s own learning processes, can significantly enhance understanding and retention in these disciplines. By applying metacognitive strategies, students can optimize their study habits, improve comprehension, and achieve academic success in these critical areas of healthcare education.
Metacognition involves two main components: knowledge about cognition and regulation of cognition. The former pertains to understanding one’s own learning processes, while the latter involves planning, monitoring, and evaluating one’s learning activities. Effective metacognitive strategies enable students to assess their knowledge, recognize their learning needs, and adjust their study tactics accordingly (Flavell, 1979).
Metacognitive Strategies for Pathophysiology and Pharmacology
1. Self-Explanation: Students can enhance their comprehension by explaining complex concepts aloud or in writing. This practice can clarify understanding of the mechanisms of diseases and drug actions, solidifying learning and revealing areas that require further study (Chi, de Leeuw, Chiu, & LaVancher, 1994).
Students can also join study groups and practice explaining concepts, pathophysiology, and pharmacology to teach others. Note-taking templates, such as medication drug cards, are helpful methods for imprinting information in memory.
The following are links to sample note-taking templates:
2. Elaborative Interrogation: Students can deepen their understanding and retention of course material by asking why certain processes occur in pathophysiology or how a drug exerts its effect. This strategy helps integrate new knowledge with existing knowledge, making learning more meaningful (Woloshyn, Willoughby, & Wood, 1994).
Teachers and learners practice Socratic Questioning in classrooms, clinical rotations, and simulations. Learners can also do this during group discussions. Eventually, through repeated practice, learners will perform their own elaborative interrogations independently.
3. Error Analysis: Regularly testing themselves and analyzing errors can help students identify misconceptions or gaps in their understanding. This reflection is crucial for mastering complex pharmacological interactions and pathophysiological processes (Schraw, Crippen, & Hartley, 2006).
- Take practice quizzes on pharmacology provided by your nursing programs, such as ATI quizzes and/or practice tests. You can also practice taking tests using free resources such as Real Life Pharmacology and Pharmafactz.
- Analyzing errors is more important than memorizing test items so that the learner can address knowledge gaps.
4. Concept Mapping: Creating visual representations of the relationships between symptoms, diseases, and drugs can help students organize and integrate knowledge. Concept maps are especially useful in understanding the connections and applications in pathophysiology and pharmacology (Novak & Gowin, 1984).
Here is an example:
There are benefits of metacognitive practices. Applying metacognitive strategies in pathophysiology and pharmacology offers several advantages including:
1. Improved Critical Thinking: Students develop better critical thinking skills, enabling them to tackle complex clinical scenarios effectively.
2. Enhanced Long-Term Retention: These strategies aid in the long-term retention of complex information, which is essential for future clinical practice.
3. Increased Academic Performance: Students who actively engage in metacognitive practices often achieve higher academic performance and better test scores.
Key Takeaways
Metacognition is a powerful tool for students in the fields of pathophysiology and pharmacology. By actively engaging in metacognitive strategies, students improve their academic performance and prepare for successful careers in healthcare. Educators should encourage the use of these strategies to help students become more effective and autonomous learners.
IV. Guide to Using this Pressbooks Open Educational Resource- Pathophysiology and Pharmacology Basics for Nurses
This open and free educational resource will be used as your reference and guide. By following this guide, subscribers and learners can effectively navigate and utilize Pressbooks OER to enhance their learning experience. Engage actively with the content, use the interactive features, and take advantage of collaborative opportunities to maximize your educational outcomes. The following are important information to review to successfully use this resource:
How to Use Open Educational Resources (OERS) using the Pressbooks Platform
1. Receiving Access: You have been given access by Montgomery College and have received the link to this resource: https://pressbooks.montgomerycollege.edu/pathophysiologyandpharmacology/
2. Creating an Account: You do not have to create an account. This book is also available as a free, open resource to everyone. You may continue to use this after this course or your nursing program and serve as a guide for your clinical practice.
3. Navigating the Book
a. Table of Contents:
– Access the Table of Contents from the left sidebar or the main navigation menu.
– Click on chapter titles to navigate directly to specific sections.
b. Reading Mode:
– Use the navigation arrows or the Table of Contents to move between chapters.
– Adjust font size and screen brightness for comfortable reading.
4. Using Interactive Features
a. Embedded Media:
– Click on images, videos, and audio files embedded within chapters to view or play them.
– Use provided links to access external resources.
b. Quizzes and Activities:
– Complete interactive quizzes, activities, and exercises directly within the book.
– Your progress may be saved automatically, or you may need to submit your responses as instructed.
5. Downloading and Offline Access
a. Exporting Content:
If allowed, you can download the book in various formats (PDF, EPUB, MOBI) by clicking on the “Export” option, which is usually found in the book’s settings or toolbar.
– Save the file to your device for offline reading.
6. Offline Reading Apps:
– Use compatible reading apps (e.g., Adobe Acrobat for PDFs, iBooks for EPUBs) to read downloaded content on your preferred device.
7. Troubleshooting and Support
a. Technical Issues:**
– If you encounter any technical problems, check the Pressbooks Help Center: [Pressbooks Help Center](https://pressbooks.com/help/)
– Contact your instructor or the person who provided you access for specific issues related to your course material.
b. Feedback and Suggestions:**
– Provide feedback or suggestions using any provided contact forms or feedback tools within the book or with course evaluations
8. Effective Reading Strategies
a. Active Reading:
– Take notes, highlight important sections, and jot down questions as you read.
– Engage with the material by summarizing key points in your own words.
b. Using Bookmarks:
– Use the bookmarking feature to mark important pages or sections for quick reference later.
– Create a list of bookmarks for easy navigation during study sessions.
9. Engaging with Interactive Content
a. Multimedia:
– View videos, listen to audio files, and explore interactive elements to reinforce learning.
– Pause and take notes during multimedia presentations to capture important information.
b. Quizzes and Self-Assessments:
– Complete quizzes and self-assessments to test your understanding of the material.
– Review incorrect answers and revisit related sections to improve comprehension.
c. Collaborating and Sharing
1. Discussion Forums: ( The thread may also be available in Blackboard)
– Participate in discussion forums or comment sections if available to engage with peers and instructors.
– Share insights, ask questions, and contribute to collaborative learning.
2. Group Projects:
– Use the book’s interactive features to collaborate on group projects or assignments.
– Share media, links, and notes with group members directly within the book or in face to face classes with your faculty.
10. Maximizing Learning Outcomes
a. Setting Goals:
– Set specific learning goals for each study session and track your progress.
– Use the book’s features to stay organized and focused on your objectives.
b. Reviewing and Revising:
– Regularly review bookmarked sections, notes, and completed activities.
– Use quizzes and self-assessments to gauge your understanding and identify areas needing revision.
V. Summary
This chapter provided an overview of why and how pathophysiology and pharmacology are foundational knowledge to nursing practice. It showed a brief overview of the Montgomery College Nursing Program’s Pathophysiology and Pharmacology for Nursing ( NURS 129), walked the learner through conceptual learning and metacognitive strategies to achieve academic success in pathophysiology and pharmacology, and steps to navigating this open educational resource.
Enjoy learning!- The Montgomery College Nursing Program NURS OER Team
References
Adams, M. P., & Urban, C. Q. (2021). *Pharmacology: Connections to nursing practice* (5th ed.). Pearson.
Burchum, J. R., & Rosenthal, L. D. (2021). *Lehne’s pharmacology for nursing care* (11th ed.). Saunders.
Craven, R. F., & Hirnle, C. J. (2017). *Fundamentals of nursing: Human health and function* (8th ed.). Wolters Kluwer Health.
Chi, M. T. H., de Leeuw, N., Chiu, M. H., & LaVancher, C. (1994). “Eliciting self-explanations improves understanding.” Cognitive Science, 18(3), 439-477.
Davis, S. (2020). “Cardiovascular Pharmacology: Principles and Practice.” Journal of Cardiac Nursing, 35(1), 24-29.
Davis, S. (2019). “Integrative Approaches in Nursing Education: The Role of Conceptual Learning.” Journal of Nursing Education, 38(2), 104-110.
Divakaran, S., & Loscalzo, J. (2017). The Role of Nitroglycerin and Other Nitrogen Oxides in Cardiovascular Therapeutics. Journal of the American College of Cardiology, 70(19), 2393–2410. https://doi.org/10.1016/j.jacc.2017.09.1064
Flavell, J. H. (1979). “Metacognition and cognitive monitoring: A new area of cognitive-developmental inquiry.” American Psychologist, 34(10), 906-911.
Gulanick, M., & Myers, J. L. (2021). *Nursing care plans: Diagnoses, interventions, and outcomes* (9th ed.). Elsevier.
Gunaseelan, R., Sasikumar, M., Nithya, B., Aswin, K., Ezhilkugan, G., Anuusha, S. S., Balamurugan, N., & Vivekanandan, M. (2022). Early/Subtle Electrocardiography Features of Acute Coronary Syndrome and ST-Segment Elevation Myocardial Infarction. Journal of emergencies, trauma, and shock, 15(1), 66–69. https://doi.org/10.4103/JETS.JETS_186_20
Jourdi, G., Lordkipanidzé, M., Philippe, A., Bachelot-Loza, C., & Gaussem, P. (2021). Current and Novel Antiplatelet Therapies for the Treatment of Cardiovascular Diseases. International journal of molecular sciences, 22(23), 13079. https://doi.org/10.3390/ijms222313079
Holland, L. N., Adams, M., & Brice, J. (2019). *Core concepts in pharmacology* (5th ed.). Pearson.
Khan, H., & Patel, S. (2021). “The Role of ACE Inhibitors in Post-MI Recovery.” Pharmacology Today, 31(3), 142-150.
Khrais, H. and Saleh, A. (2017) The Outcomes of Integrating Concept Mapping in Nursing Education: An Integrative Review. Open Journal of Nursing, 7, 1335-1347. doi: 10.4236/ojn.2017.711096.
Kee, J. L., Hayes, E. R., & McCuistion, L. E. (2018). *Pharmacology: A nursing process approach* (9th ed.). Saunders.
Lewis, S. L., Bucher, L., Heitkemper, M. M., Harding, M. M., Kwong, J., & Roberts, D. (2020). *Medical-surgical nursing: Assessment and management of clinical problems* (11th ed.). Elsevier.
McCance, K. L., & Huether, S. E. (2019). *Pathophysiology: The biologic basis for disease in adults and children* (8th ed.). Elsevier.
Novak, J. D., & Gowin, D. B. (1984). “Learning How to Learn.” Cambridge University Press.
Rossini, E., Biscetti, F., Rando, M. M., Nardella, E., Cecchini, A. L., Nicolazzi, M. A., Covino, M., Gasbarrini, A., Massetti, M., & Flex, A. (2022). Statins in High Cardiovascular Risk Patients: Do Comorbidities and Characteristics Matter?. International journal of molecular sciences, 23(16), 9326. https://doi.org/10.3390/ijms23169326
Schraw, G., Crippen, K. J., & Hartley, K. (2006). “Promoting self-regulation in science education: Metacognition as part of a broader perspective on learning.” Research in Science Education, 36(1-2), 111-139
Media Attributions
- post MI
- read notes out loud
- drug template
- Socratic Questions
- xr:d:DAFMCb1e7lA:22,j:35141790726,t:22091218
