1-3 pharmacy
ethyl 1 methyl-4-phenyl isonipecotate hydrochloride is and example of what drug name?
chemical name
in order to avoid confusion over the various names given to drugs, many hospitals are now using which drug names, which is the most common name and is recognized all over the world?
generic name
who indicated the right dose of the drug you are given?
healthcare provide/doctor
in the acronym PINCH, P is for potassium, I is for insulin, N is for narcotics (opioids), C is for cancer chemotherapy drugs, and H is for heparin or any drug type that interferes with blood clotting this acronym is helpful for identifying which category of drugs?
high alert drugs
why is it important to note whether your patient is dehydrated or over hydrated when adjusting the dosage of a new prescription?
hydration impacts the blood flow which determines how well the drug is distribution throughout the body
information used to reliably prove an individual is the person for whom the drug treatment was intended. example persons full name, medical record, ID #, birthdate, or even telephone number
identifiers
the nurse who is taking the pain drug is violating the American Nurse Association (ANA) Code og Ethics and is unable to fulfill his duties in a safe and effective manner. what is this called?
impaired nurse
the act of carrying out the planned interventions
implementation
standing drug order
indicates that the drug is to be given until discontinued or for a certain number of doses
as needed drug order/PRN
is an order for a drug to be given as needed based on a nurses judgement of safety and patient need
why might you not be able to crush a particular drug and give it to one of your patients who has difficulty swallowing the drug?
crushing the drug will speed up the delivery to the patients system which maybe create adverse reactions
a name (or label) for the patient's disease or condition
diagnosis
a patient has an allergic reaction to a new drug that has just been just given for the first time. what type of drug order is this?
emergency or STAT drug order
before giving your patient a prescribed drug, it is important that you are familiar with possible reactions, the patients current history, and whether the patient is responding correctly. what is this process called?
nursing process
before you crush his pills, however, you refer to the Institude of State Medicine website to ensure the pill can be used this way. what is this called?
do not crush list
dosages of controlled substances are dispensed by the pharmacy with an accompanying ? sheet on which the nurse must record the administration of the drug
inventory
emergency or STAT drug order
is a one time order to be given immediately
how do you ensure you are giving the right drug?
read order/label at least 3 times
what practice can cause the most potential harm when caring for a patient with communicable disease?
recapping a needle that you just used to inject the patient
for a drug to work inside the body, it needs to attach to which of the following areas in order to activate the chemical reaction between the drug and the body?
receptor sites
what doing a patient history you will gather objective and subjective data. why is it important information to gather on the patient?
it can be used as a baseline for comparison of the patients condition as care progresses
why does the right reason matter when giving the drug?
know the symptoms, does it make sense
why would you know the reason you are giving the patient the drug
learn what the drug is supposed to do for the patient
biotransformation is the process by which the body transforms the drug into usable or inactive components and happens primarily in the ?
liver
drugs to be used to patients are kept either in a ? cabinet or an automated dispensing system
locked
how do you manage a patients right to refuse a drug?
make sure ask reason for refusal, provide good patient teaching, and document
LPN/VN practice has shifted over the past decade. although current most graduates practice in long-term and community-based settings, previously where did they most frequently practice?
mostly in acute care settings (hospital/based case)
what information a legal prescription order must contain?
name of drug route of administration dose duration
chemical name
names that include all the different substances used to make the drug
a system to guide the nurses work in a logical way. 5 steps. assessment, diagnosis, planning, implementation, and evaluation
nursing process
what is the preferred route of drug administration?
oral
five methods that can be used to give drugs to a patient
oral (by mouth) sublingual (under the tongue) feeding tube rectally injection
federal laws define three categories of drugs, including controlled substances and prescription drugs. what is the third category?
over the counter drugs
Buspirone isn't given to a patient who is already taking Prozac to help boost the effects of the antidepressant. what drug action is that?
partial agonist
a patient who has been taking controlled substances for pain decided she no longer needs them. after a few days she begins shaking and becomes confused. what is this condition?
physical dependence resulting in drug withdrawal
access to these drugs is never given to ? or any unauthorized healthcare workers
physicians
you cannot give a drug unless there is a prescription ordered by a healthcare provider who has prescription authority. who of the following individuals would most likely NOT have authority to sign a prescription?
psychologist
psychological dependence
"I need it" desire they have to have it
evaluation
-after giving the drugs you assess the patient for any possible adverse reactions or side effects -assess patient after giving the drugs in order to determine whether the patients condition is improving
planning
-as part of the medical plan. you analyze goal and write nursing care plans (RN writes care plan, LPN's do vitals among assessment)
trade/brand name
-drug name following by the symbol, which indicates that the name is registered to a specific drug maker -the proprietary name of a drug
characteristics associated with the Older adults
-drug side effects more severe -dehydrated more easily -hypotension
at the end of the shift, the controlled substance drug inventory does not account for all the dosages received for the shift, list at least three steps to try and account for the differences
-during drug preparations -bringing drug to patient -giving drug to patient
characteristics associated with adolescents
-growth spurts increase metabolism
diagnosis
-healthcare team labels patients condition -the identification of the patients condition helps you identify how to teach the patient self-care
characteristics associated with newborns/infants
-highest metabolism of all age groups -oral drugs poorly absorbed -higher percentage of total body water -poor intramuscular absorption
if you believe there has been an error in the administration of any drug, list at least three steps you should take to ensure the patients safety
-immediately check patient -notify healthcare provider promptly -follow any orders the provider gives to reduce the effect of drug error
why do you need to learn specific information about the drug you are giving?
-know the major action of the drug -learn the main drug interactions -learn the usual dosage, route, and frequency
why would you plan for special storage or procedures, techniques, or equipment needed?
-learn whether the drug should be refrigerated -learn whether the drug should be kept room temperature
generic name
-most common name used for drug -name used for a drug that is the same throughout the world
why would you develop a teaching plan for the patient?
-what does the patient know to take the drug correctly? -what does the patient. red to know about the potential side effects?
assessment
-you gather complete information about the patients history of illnesses and surgeries, including any drugs the patient is currently taking -you gather initial information that can be used as a baseline for comparison as care progresses
how do you identify the right patient?
2 identifiers; full name, medical records, ID#, birthdate, or phone number
? that include the name of the drug and the type of reaction the patient experienced (in other words, was it mild of severe effect?)
allergies
what percentage of a work week does an LPN/VN usually spend giving drugs to patients and monitoring their reactions?
40% of the work week
adverse reactions responses
anaphylactic shock seizures bleeding kidney damage
the nursing process guides your work when giving drugs. what are the 5 steps in the process?
assessment,diagnosis,planning, implementation, and evaluation
in the case of an opiate overdose, Naloxone is given to a patient to reverse the effects of the opiate, which is bound to the opioid receptor sites. what drug action is that?
antagonist
a patient is given tylenol #3 whenever she complains of intermittent pain. what kind of drug order is this?
as needed drug order/PRN
mr. y reports having only one kidney due to a bad infection during childhood. why is this important to know when monitoring his reaction to a new drug?
Mr. Y decreased kidney function may indicate that the drug is not being excreted effectively and he may experience an overdose of the drug
after moving halfway across the country to another state, you are ready to start work again but have a few questions about what the state allows you as an LPN/LVP to do regarding the administration of drugs. You want to find out the Nurse Practice Act for your new home. Where would you find this information?
National Council of State Boards of Nursing website
mrs. x takes a Valium every nigbt before sleeping. however she has a difficult time asking in the morning. when you report this to her healtcare provider, why does she replace the Valium with ativan?
Valium stays longer in the body because it builds up in fat cells
first pass
a lot of the drug is inactivated on the first pass through the liver before it can be distributed to other parts of the body
single drug order
a one time order to be given at specified time
the ? process identifies how the drug enters the body and reaches the area it needs to affect.
absorption
four basic processes are involved in drug utilization in the body
absorption, distribution, metabolism, and excretion
a drug effect that is more severe than expected and has potential to damage tissue or cause serious health problems. may be called adverse effect, toxic effect, or toxicity, and usually requires an intervention by a prescriber
adverse effect
a patient is in severe pain and is given morphine, which then activated the opioid receptors and produces pain relief. what drug action is that?
agonist
a health related reason for not giving a specific drug to a patient or a group of patients
contraindictation
by utilizing these drugs for himself, this nurse has violated specific laws and may face fines or imprisonment. what was he using?
controlled substance
scheduled drugs must be ? at the end of every shift by the nurse whom the agency has given the responsibility for controlled substances
counted
your patient refuses to take his drug so you decide to crush his pills and mix them in his oatmeal. however you must inform him or his family of your method of getting him to take his pills. what is this called?
covert drug administration
a collection of information typically stored in a computer or electronic medical record
database
you have been instructed to give an intramuscular injection to a 5 year old child. to ensure rapid absorption what muscle is the best place to give the injection?
deltoid
? that may prohibit or limit use of some drugs (such as sickle cell disease, glucose-6-phosphate dehydrogenase defiance, history of drug addiction, or immune deficiencies?)
diseases
upon entering the body, the drug must reach the area needing treatment. the method of movement can occur by way of the blood or lymph system and is known as ? of the drug
distribution
how do you make sure you provide the right documentation?
document right after given; time, sight, route, initial
partial agonists
drug attach to the receptor site but produce only a partial effect
antagonist
drug attaches at a drug receptor site but does NOT activate or unlock it, there is no increase in cell activity.
you suspect that one of your colleagues is actually not providing his patient all the drugs ordered for her pain. instead the nurse is using a portion of the drugs for his own personal use. what is this called?
drug diversion
how do you know the right route to give a drug?
drug order must state how drug is given
how do you ensure you are giving the drug at the right time?
drug order should say when and how the drug is given
what factor can impact the safety and effectiveness of a drug, what is most commonly attributed to life threatening adverse reactions?
drug-alcohol interactions
drug errors are most commonly occur at which of the following points in drug administration?
during drug preparation when bringing the drug to the patient when giving the drug to patient
your patient is experiencing pain, and it is not yet time for her next dose of pain reliever, what can you do to help her decrease the pain without the use of drugs?
encourage her to do deep breathing to release the body's own endorphins
your patients has just been prescribed a new drug that you are instructed to give. this patient has had a number of bad reactions to drugs so as part of your due diligence, what will you do to reduce the risk of an adverse reaction to the new drug?
ensure that the drug will not react poorly with any other drugs she is already taking.
process determining the right response by looking at what happened to the patient when nursing care plan is put into action
evaluation
what must you do after the drug administration to ensure that the patient has right response?
evaluation
excretion is the process of removing the inactive chemicals, by products, and waste from the body. what chemicals are excreted?
fecal matter saliva urine sweating crying
as a nurse, you must learn about and follow three levels of rules in giving drugs. what entity is the first level that takes precedence over the remaining entities?
federal rules
absorption of a drug is enabled through the processes of diffusion, ? , and osmosis
filtration
when entering the room of a patient under your care at an assisted living facility, you discover he is swallowing several doses of tylenol. what should be your response?
remove the tylenol and explain to the patient that he cannot take any drugs including over the counter drugs, without his healthcare providers written permission
a patient appears to be overdosed but insists she only took the amount of long acting drug as prescribed and following all other instructions. upon further questioning you discover which of the following as the likely reason for her reaction?
she experienced difficult swallowing and therefore crushed the tablet and ate it with her morning bowl of oatmeal
what behavior would lead you to suspect a coworker may be diverting controlled substances for her own personal use?
she frequently reports dropping or spilling controlled substances
a patient is given nitroglycerin just before going under a cardiac CT scan. what type of drug order is this?
single drug order
side effects responses
sleepiness nausea diarrhea constipation
before a drug can enter the body's tissue, it must be discolor in body fluid. how effectively a drug can dissolve is called ?
solubility
a patient requires a daily dose of losartan for her blood pressure. what drug order is this?
standing drug order
as an LPN/VN you can dispense controlled substances only if permitted by you ? board of nursing?
state
idiosyncratic response
strange, unique, peculiar, or unpredictable responses to drugs
reports of what the patient says he/she is feeling or thinking
subjective data
what following task will you do as part of your continuing assessment of the patient to evaluate the effectiveness of the drug you are giving?
take the patients blood pressure
almost everyone makes an error at some point in their career. what situation could make a nurse more reluctant to report the error?
the agency is unusually harsh and judgemental about drug errors among nurses
what does the black box warning on the inset of the drug packaging indicate?
the drug has a higher than normal risk for causing serious and even life threatening problems
a patient in your car is being treated for high blood pressure. you note, however that the drug is not as effective as expected, so you discuss it with your patient. discovery of which of the following would indicate a need for increased dosage?
the patient did not report having liver disease, therefor the drug is not effectively delivered throughout the body
paradoxical response
the patients reaction may be just the opposite of what would be the expected
when documenting the administration of the drug. what must you record in the patients chart?
the time the drug was given
after giving the drug you notice the patients condition has improve. what is the effect called?
therapeutic effect
the intended action of the drug, known as beneficial outcomes
therapeutic effect
what is one factor that has increased the demand for LPNs/VNs?
there are an increased number of people living with chronic illnesses
half life
time it takes the body to remove 50% of the drug from the body, helps explain the dose, the frequency, and the duration
why is it important to ask what kind of over the counter drugs a patient is taking?
to identify potential drug interactions with any drugs the healthcare provider may prescribe
hypersensity (allergy)
unexpected reaction is an increased reaction to a drug
agonist
wen drugs activate or unlock receptors and have the same actions as the body's own chemicals
although is it not your role to develop a medical or nursing diagnosis of the patient, what will you be responsible for?
yoi will decide how carefull the patient need monitoring
implementation
you give the drugs to the patient, following the plan
one of your patients has just been given a new prescription. however she explains to you that she is currently nursing her newborn. what is one way to help her reduce adversely impacting her baby with the drug?
you recommend she take the drug immediately after nursing so that it has a chance to be excreated before nursing time again
Mr. B a 78 year old patient. is given a capsule to swallow, and you encourage him to drink a full cup of water with the pill. why is this important?
you suspect he is dehydrated and the water will help the drug dissolve and begin working in the body more quickly
why does an electronic health record that has the capabikitg of scanning a patients wristband provide more accuracy when identifying a patient?
you will avoid having to decipher illegible hand writing
what is one reason that it is important for you to know as much as possible about a drug before giving it to your patient?
you will need to know the most common side effects and observe for adverse reactions in each of your patients, particularly when giving a drug for the first time
what is it important to do a patients history when he/she enters the healthcare setting?
you will provide the healthcare provider with information they need to identify physical signs of illness