The nurse learns that a patient cannot afford a prescribed medication and enlists the assistance of the social worker and an outside agency to provide medications at a lower cost. Which QSEN competency do the nurse’s actions best demonstrate?

a) Decreased drug effects are unlikely in liver disease because impaired liver function reduces drug metabolism, leading to higher drug concentrations in the bloodstream.

b) Increased drug effects occur because the liver is responsible for metabolizing many drugs. In liver disease, drug metabolism is slowed, leading to prolonged drug action and potential toxicity.

c) Decreased therapeutic range is not the primary concern. The therapeutic range refers to the safe and effective drug concentration, but liver disease mainly affects drug metabolism and clearance.

d) Increased therapeutic range is incorrect because liver disease does not widen the range of safe drug levels; instead, it increases the risk of drug accumulation and toxicity.

a) Herbs are not classified as medications under the Dietary Supplement Health and Education Act of 1994. The law classifies them as dietary supplements, which are not subject to the same rigorous safety and efficacy standards as medications.

b) Discussing herbal remedies with the patient's provider is essential. Herbs can interact with prescribed medications, and their safety and effectiveness can vary. It is important for providers to be aware of any herbal remedies the patient is using to avoid potential harmful interactions.

c) Herbs are not regulated by the government in the same way as pharmaceuticals. The FDA does not determine their safety before marketing, and manufacturers are not required to prove safety or efficacy before selling them.

d) Herbs are not harmless. Some herbs may be ineffective, but others can cause adverse effects, especially when taken alongside other medications. Therefore, it's important to consider their safety in the context of the patient’s overall treatment plan.