NURS 1108 2nd Exam Prep (mainly Pharmacology )
The nurse is caring for a client who has problems coordinating his breathing with the inhaler use. Therefore, the client is unable to receive the full dose. Which would help maximize drug absorption in this client?
Spacer
Minimum effective concentration
amount of drug needed to give therapeutic effect
Category X
animal and human studies have shown fetal abnormalities
"This is your furosemide; it helps your body to eliminate extra fluid." The patient states, "I don't usually take that. My family doctor has me on a water pill called Lasix." What is the nurse's best response?
are two different names for the same drug.
11 rights of Drug administration 2 dR. trap-red rm
Right Route
11 rights of Drug administration 3 dr. Trap-red rm
Right Time
basic principles of pharmacology, including drug nomenclature and types of drug preparations.
Therapeutics and Pharmacology , Produce biological responses in the body
Category D
There is confirmed effect on the fetus
The nurse is working the night shift in the ER when an ambulance arrives carrying a man s/p motor vehicle accident (MVA). His initial BP is 100/56 and the nurse notes that he is bleeding heavily from a laceration on the forehead. Fifteen minutes later, the nurse reassesses the client and finds that his BP is 95/58. What IV fluid would the nurse expect to be ordered?
0.9% NS
Subcutaneous
45-90 degrees; commonly in abdomen or upper arm
Intradermal
5-15 degrees; commonly on inner forearm
Intramuscular
90 degrees; commonly in deltoid
Pharmacokintic Movements
Absorption Distribution Metabolism Excretion (AD ME)
Efficacy
Amount of maximal response that can be produced from a drug ( more important when refering to theraputic drugs -cap off effect)
Plasma Half-Life
Amount of time needed to decrease drug concentration by half
Category B
Animal studies fail to show fetal risk or adverse affects
A nurse at the health care facility needs to administer an otic application for a client with an earache. What should the nurse do after instilling the prescribed eardrops in the client's ear?
Ask the client to maintain the position for some time.
Generic Name
Assigned by the U.S. Adopted Name Council Less complicated and easier to remember
Pharmacological Classification of a drug
At molecular, tissue, or body-system level
Which is a recommended guideline for the nurse who is administering a piggyback intermittent intravenous infusion of medication?
Attach infusion tubing to the medication container by inserting the tubing spike into the port with a firm push and twisting motion.
Hormones, Antibodies, Natural blood products and components, Interferon and Vaccines are all examples of
Biologics
Animal cells
Biologics are agents naturally produced in _____________, by microorganisms, or by the body itself
Calcium channel blocker
Blocks heart calcium channels
Angiotensin - converting enzyme inhibitor
Blocks hormonal Activity
adrenergic antagonist
Blocks physiological reactions to stress
Oral
Capsule, pill, tablet, extended release, elixir, suspension, syrup
Medication error
Check pt condition immediately, Notify nurse manage and PCP, Document are immediate responses too
identifies drug's atomic and molecular structure
Chemical name
Vasodilator
Dilates peripheral blood vessels
Who regulates Controlled substances
Drug Enforcement Administration (DEA)
Potency
Drug with higher concentration produces a therapeutic effect at a lower dose
Drug classifications are determined by
Effect on body system Chemical composition Clinical indication or therapeutic action
____________ route drugs are broken down by stomach acids and enzymes.
Enteral
Route, Drug formulation,Dosage, Digestive motility,Digestive tract enzymes and Blood flow at administration site are all
Factors effecting drug absorption
_______________ protects fetus; no pregnant woman should be given medication without strong consideration of condition
Fetal-placenta barrier
A, B, C, D, and X
Five categories of risk that a drug poses to a fetus in the case of a pregnant woman taking the drug
assigned by the manufacturer that first develops the drug
Generic name
11 rights of Drug administration 4 dr. tRap-red rm
Right Reason
Advantages to RX drugs
Health care provider examines pt and orders proper drug Amount and frequency is controlled Instructions on use and side effects are discussed
The telehealth nurse receives a call from a client who is using a topical nasal decongestant and states, "I feel like my nose is stuffier than ever." What is the appropriate response by the telehealth nurse?
How often are you administering?
A code is called and Nurse A hands several drugs to Nurse B, stating while rushing off, "Give these to my client while I help with the code." What is Nurse B's appropriate response?
I cannot give medications for other nurses.
Anticoagulant
Influencing blood clotting
11 rights of Drug administration 7 dr. trap-Red rm
Right Response
Injectable
Intravenous, Intramuscular, Subcutaneous, Intradermal
Maintenance dose
Keeps plasma-drug concentration in therapeutic range
Topical
Liniment, lotion, ointment, suppository, transdermal patch
Schedule I drugs
Little or no therapeutic value, Heroin LSD Methaqualone
Antihypertensive
Lower blood pressure
Antihyperlipidemic
Lowering blood cholesterol
Diuretic
Lowers plasma volume
Schedule II-V Drugs
May be dispersed only in cases where therapeutic value has been determined Some drugs may be dispersed without a prescription.
bioavailability
Measuring how long a drug takes to exert its effect gives a crude measure of
Advantages to OTC drugs
No HCP appointment needed Often less expensive than prescription drugs
Tobacco, alcohol, and caffeine
Non regulated abuse prone drugs
The nurse is preparing to administer the second dose of ordered antibiotics to a client and notes that the first dose of medication is still in the automated medication-dispensing system. The medication administration record (MAR) does not show that the initial dose was given. What is the appropriate nursing action?
Notify the healthcare provider.
If the dosage is inappropriate for a client, who is responsible?
Nurse
How drugs are administered, Where drugs travel in the body, Responses that drugs produce
Pharmacology
Absorption
Primary factor determining length of time for effect of drug to occur
Disadvantages to OTC drugs
Pt may choose wrong drug Pt may not know reactions or interactions Ineffective treatment may result in disease progression
Disadvantages to RX drugs
Require a prescription Need HCP appointment
Antidysrhythmic
Restore normal cardiac rhyhem
11 rights of Drug administration 5 dr. trAp-red rm
Right Assessment
11 rights of Drug administration 9 dr. trap-reD rm
Right Documentation
11 rights of Drug administration 1 Dr. trap-red rm
Right Dosage
11 rights of Drug administration 11 dr. trap-red rM
Right Medication
11 rights of Drug administration 6 dr. traP-red rm
Right Patient
11 rights of Drug administration 8 dr. trap-rEd rm
Right to Education
11 rights of Drug administration 10 dr. trap-red Rm
Right to Refuse
Category A
Studies in women fail to show risk from mother to fetus
Therapeutic Index
The higher the value, the safer the drug
brand name copyrighted by the company that sells the drug
Trade name
Antianginal
Treat angina
A nurse needs to administer a prescribed injection to a toddler. Which injection site is most suitable for the client?
Vastus lateralis site
Generic names
Written in lower case letters Example: diazepam
If undesirable response occurs it is
adverse
Adverse Drug effects
allergic, drug tolerance, toxic, idiosyncratic, drug interactions
Category C
either studies in animals have shown adverse effects and/or human studies were not recorded
Which component of a syringe's needle does the nurse recognize that refers to width?
gauge
Loading dose
higher amount of drug given to quickly give a therapeutic response
Therapeutic range
level between minimum and toxic (where you want to be)
Toxic concentration
level of drug that will result in serious adverse effects
PRN
medication given as needed by patient condition
STAT
medication given immediately, and only once
ASAP
medication given within 30 minutes of written order
After administering medication to a client subcutaneously, the nurse removes the needle at the same angle at which it was inserted. Which explains the nurse's action?
minimizes tissue trauma to the client
Which medications are dropped into the ear to treat ear infections or to soften and remove ear wax?
otic
The nurse is caring for a client who has normal saline infusing through a peripheral intravenous catheter with a prescription for an antibiotic secondary infusion. Which technique would be most appropriate for the nurse to administer the secondary infusion by gravity?
placing the secondary infusion higher than the primary solution
Liver is the
primary site
What is meant by the unit dose supply method?
self-contained packets that hold one tablet or capsule for individual clients
Simplest factor determining distribution is
the amount of blood flow to body tissues.
A client with a central venous catheter develops a catheter-related bloodstream infection (CRBSI). The nurse understands that which route is the most common for causing this type of infection?
the catheter tip contamination due to skin organisms encountered during insertion
bioavailability
the physiologic ability of the drug to reach its target cells and produce its effect.
Pharmacokinetics
the study of drug movement throughout the body how the body handles medication, the actions and side effects of drugs, the obstacles that a drug faces to reach target cells
If desirable response occurs it is
therapeutic
A nurse flushes an intravenous lock before and after administering a medication. What is the rationale for this step?
to clear medication and prevent clot formation
The primary reason for the Controlled Substances Act is
to prevent drug abuse.
A client is taking numerous eye drops to prepare for cataract surgery. Which teaching about ophthalmic application will the nurse provide?
wait 5 minutes between instillations
The nurse is teaching a client about using two inhalers. Which client statement reflects that nursing teaching has been effective?
wait at least 1 full minute use
