NUR 2407 Ethical dilemmas in medication administration

NUR 2407 Ethical dilemmas in medication administration
NUR 2407 Ethical dilemmas in medication administration
Choose a medication type from the following list, note why the medication is used, and consider adverse effects. Invent a scenario where giving this medication could result in an ethical or legally charged situation. Try not to choose a category that has been well addressed by your peers.
NUR 2407 Ethical dilemmas in medication administration

Bethanaechol / cholinergics: Consider risks of inducing urgency or bradycardia in a clients with dementia issues
Benztropine /anticholinergics: Consider harms that can occur with comorbidities like glaucoma or BPH
Albuterol /adrenergics: Consider harms that can occur is asthmatic children are in charge of their own inhalers
Atenolol/ beta blockers: Consider harms that could occur if heart rate was low or patient was asthmatic
Lorazepam /benzodiazepines: Consider vulnerability issues related to sedation and induction of memory loss
Oxycodone / opiates: Consider addiction, drug seeking and patient vulnerability in impaired nurses
Amitriptylline /tricyclics: Consider vulnerability issues with risk of suicidal overdose given anticholinergic effects
Phenelzine /MAOIs: Consider consequences of nonadherence to dietary restrictions on these medications
Haloperidol / neuroleptics: Consider risks of chemical sedation, especially long term risks
Lithium: Consider risks of mismanagement by clients whose behaviors are unpredictable
Phenytoin / antiepileptics: Consider risks of Class D in young women vs risks of going without anti-epileptics
Secobarbital / barbituates: Consider risks related to availability of barbituates to teens via the internet
Kava or Valerian: Consider risks of availability of compounding poorly controlled over the counter sedatives
Sumatriptan / triptans: Consider risks of cerebral ischemia when giving vasoconstrictors for migraine control
Cyclobenzaprine for back spasms: Consider risks of impaired function when nurses take muscle relaxants
Prednisone / steroids: Consider long term effects, when other immune suppressors are too expensive to access.
Aspirin / NSAIDs: Consider vulnerability of elders due to over the counter, affordable nature of this analgesic

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Atenolol belongs to a group of medicines called beta blockers.
It’s used to treat high blood pressure and irregular heartbeats (arrhythmia).
It can also be used to prevent chest pain caused by angina.
If you have high blood pressure, taking atenolol helps prevent future heart disease, heart attacks and strokes.
Atenolol is sometimes prescribed to prevent migraines and help with anxiety. But it’s not officially approved to treat these conditions.
This medicine is only available on prescription.
It comes as tablets or as a liquid that you swallow. It can also be given as an injection, but this is usually done in hospital.

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2. Key facts

Atenolol slows down your heart rate and makes it easier for your heart to pump blood around your body.
It can make you feel dizzy, sick or tired, or give you constipation or diarrhoea. These side effects are usually mild and short-lived.
Your very first dose of atenolol may make you feel dizzy, so take it at bedtime. After that, if you do not feel dizzy, you can take it in the morning.
Do not stop taking atenolol suddenly, especially if you have heart disease. This can make your condition worse.
Atenolol is known by the brand name Tenormin. Other brand names include Tenif (for atenolol mixed with nifedipine) and Co-tenidone (atenolol mixed with chlortalidone).

3. Who can and cannot take atenolol

Atenolol can be taken by adults. It’s sometimes also prescribed for babies and children.
It’s not suitable for everyone. To make sure it’s safe for you, tell your doctor before starting atenolol if you have:

had an allergic reaction to atenolol or any other medicine in the past
low blood pressure or a slow heart rate
serious blood circulation problems in your limbs (such as Raynaud’s phenomenon), which may make your fingers and toes tingle or turn pale or blue
metabolic acidosis – when there’s too much acid in your blood
lung disease or asthma

Tell your doctor if you’re trying to get pregnant, are already pregnant or breastfeeding.

4. How and when to take it

You’ll usually take atenolol once or twice a day.
When you start taking atenolol, your doctor may advise you to take your first dose before bedtime because it can make you feel dizzy.
After the first dose, if you do not feel dizzy, you can take your medicine in the morning.
If you’re taking atenolol twice a day, you’ll usually have 1 dose in the morning and 1 dose in the evening.
It’s a good idea to leave 10 to 12 hours between doses if you can.
Do not stop taking atenolol suddenly, especially if you have heart disease. This can make your condition worse.
If you want to stop taking your medicine, speak to your doctor. They may recommended reducing your dose gradually over a few weeks.
How much you take depends on why you need atenolol.
For high blood pressure – the usual dose is 25mg to 50mg taken once a day.
For angina (chest pain) – the usual dose is 100mg taken once a day, or split into 2 50mg doses.
For irregular heartbeats (arrhythmia) – the usual dose is 50mg to 100mg taken once a day.
For migraine – the usual dose is 25mg to 100mg taken twice a day. Doctors sometimes prescribe atenolol for migraine, but it’s not officially approved for preventing it.
For children taking atenolol, your child’s doctor will work out the right dose by using their weight and age.

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