Based on physiological changes in the kidney during pregnancy, ...

[Kikoku]

Based on physiological changes in the kidney during pregnancy, which adjustment would a nurse anticipate for a patient in her third trimester who has been taking a drug excreted only by the kidneys?
 
  a. Decreased dosage to protect the fetus
  b. Increased dosage because of accelerated clearance
  c. Rescheduling of drug administration times
  d. No changes would be expected

Question 2

A nurse is providing patient education to the community regarding medication compliance. The nurse is correct to state that the most important factors affecting adherence to a drug regimen is(are) (Select all that apply.)
 
  a. genetics.
  b. placebo effect.
  c. patient education.
  d. ability to pay for the medication.
  e. manual dexterity.
  f. visual acuity.

[ndhahbi]

Answer to Question 1

ANS: B
By the third trimester, renal blood flow is doubled, causing a large increase in the glomerular filtration rate. As a result, there is accelerated clearance of drugs eliminated by glomerular filtration. To compensate for accelerated excretion, the dosage must be increased.
A decreased dosage is not indicated in this instance.
Rescheduling of the drug is not indicated in this instance.
With an increase in the glomerular filtration rate, the dosage must be increased, not left the same.

Answer to Question 2

ANS: C, D, E, F
Patient education, ability to pay for the medication, manual dexterity, and visual acuity
Patient education is essential in medication compliance, because the patient should understand how to take the drug and the reason or reasons for taking it. The ability to pay for the medication is a factor, because a patient who can't afford the drug won't buy it and won't get the benefits of the prescribed medication. Manual dexterity is another factor related to compliance. If the bottle is difficult to open, the patient will not take the medication. Visual acuity may also be an issue. A patient who cannot see the label well may not know what the prescribed drug is, the dosage, or the timing.
Genetics and the placebo effect are not related to medication compliance.

[Kikoku]

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[ndhahbi]

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