Nice job, but …
1
preparations. "Decaffeinated" teas and coffees should also be considered because they may contain caffeine in smaller amounts. Nurses need to obtain information about caffeine and nicotine intake, including any recent changes in habits, as part of their medication assessment. Nicotine interferes with drug metabolism and effec- tiveness through a variety of physiological effects, in- cluding its actions as a vasoconstrictor and central nervous system stimulant. Box 2 lists examples of com- mon nicotine-drug interactions. Many of these interac- tions necessitate a higher dose of medication in smokers to achieve the same therapeutic effectiveness as in a non- smoker. This is an important consideration when smoking patterns are influenced by the place of care. For example, patients may be forced to quit or reduce their smoking in an institutional setting but be able to resume or increase smoking when they are in a community setting. Nursing implications with regard to caffeine-drug and nicotine-drug interactions are threefold. First, nurses need to obtain information about caffeine and nicotine in- take, including any recent changes in habits, as part of their medication assessment. Second, nurses must con- sider caffeine and nicotine as potential sources of drug interactions and as factors that may increase the risk of adverse medication effects. Third, nurses should incorpo- rate this information in their health teaching about med- ications when working with people who consume caffeine or use nicotine products. LETTER Nice job, but... The September/October issue GERIATRIC NURSINGwas THE BEST ISSUE YET! The photos of scabies were es- pecially helpful, as was the really useful drug issue. The mentor's assessment of skill mastery provides a workable model. As the RN on a 60-bed skilled care unit, teaching the team is my major role. Every article in this issue will be used. I must comment about the nursing student's clinical placement as reported in the NGNA section of the Journal (GERIATR NUNS 1995;16:246-8). It was well written and enjoyable, but I don't believe this placement should be in the Introduction to Nursing. Geriatric patient/residents are complex and should not be used as entry level expe- riences teaching "how-to-do." Historically, CNAs and LVNs are "started out" in the LTC setting; now the AD RNs are also doing so. Many are confronting their feel- ings about aging on the basis of a small segment of the population that are institutionalized and have numerous obvious and subtle problems. Why do we use the aged in this way? Because these elders can't or don't complain about those less skilled or emotionally immature staff and students they are exposed to. Where are our values? SAMANTHA KING, RN Virginia Beach, Virginia GERIATRIC NURSING Volume 17, Number 1 Miller 47
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Transcript of Nice job, but …
preparations. "Decaffeinated" teas and coffees should also be considered because they may contain caffeine in smaller amounts.
Nurses need to obtain information
about caffeine and nicotine intake,
including any recent changes
in habits, as part of their
medication assessment.
Nicotine interferes with drug metabolism and effec-
tiveness through a variety of physiological effects, in- cluding its actions as a vasoconstrictor and central nervous system stimulant. Box 2 lists examples of com- mon nicotine-drug interactions. Many of these interac-
tions necessitate a higher dose of medication in smokers
to achieve the same therapeutic effectiveness as in a non-
smoker. This is an important consideration when smoking
patterns are influenced by the place of care. For example,
patients may be forced to quit or reduce their smoking in
an institutional setting but be able to resume or increase
smoking when they are in a community setting.
Nursing implications with regard to caffeine-drug and
nicotine-drug interactions are threefold. First, nurses
need to obtain information about caffeine and nicotine in-
take, including any recent changes in habits, as part of
their medication assessment. Second, nurses must con-
sider caffeine and nicotine as potential sources of drug
interactions and as factors that may increase the risk of
adverse medication effects. Third, nurses should incorpo-
rate this information in their health teaching about med-
ications when working with people who consume
caffeine or use nicotine products. �9
L E T T E R
Nice job, b u t . . .
The September/October issue GERIATRIC NURSING was THE BEST ISSUE YET! The photos of scabies were es- pecially helpful, as was the really useful drug issue. The
mentor's assessment of skill mastery provides a workable model.
As the RN on a 60-bed skilled care unit, teaching the team is my major role. Every article in this issue will be used.
I must comment about the nursing student's clinical placement as reported in the NGNA section of the Journal
(GERIATR NUNS 1995;16:246-8). It was well written and enjoyable, but I don't believe this placement should be in the Introduction to Nursing. Geriatric patient/residents
are complex and should not be used as entry level expe-
riences teaching "how-to-do." Historically, CNAs and
LVNs are "started out" in the LTC setting; now the AD
RNs are also doing so. Many are confronting their feel-
ings about aging on the basis of a small segment of the
population that are institutionalized and have numerous
obvious and subtle problems. Why do we use the aged in
this way? Because these elders can't or don't complain
about those less skilled or emotionally immature staff and
students they are exposed to. Where are our values?
SAMANTHA KING, RN
Virginia Beach, Virginia
GERIATRIC NURSING Volume 17, Number 1 Miller 47
