NUR 112 EXAM 1
The nurse is caring for a newborn with bluish nails and lips, rapid respirations, sweating, and having difficulty feeding. Which considerations should the nurse use when assessing the blood pressure to screen for potential cardiac problems? Select all that apply.
Assess blood pressure in upper extremities. Assess blood pressure in lower extremities. If the diastolic blood pressure continues to "0," document as the reading/P for "pulse."
The nurse is attempting to assess a client's radial pulse. The pulse is weak, irregular and unable to be counted. What action would the nurse take next?
Assess the apical pulse.
The nurse takes a client's vital signs and notes a blood pressure of 88/56 mm Hg with a pulse rate of 60 beats/min. Which action should the nurse take first?
Assess the client for dizziness.
Drug excretion, which is the removal of the drug from the body, occurs primarily via the _______________________.
Kidneys - But it can occur via skin, lungs, bile, or feces
The nurse is preparing to assess the peripheral pulse of an adult client. Which action is correct?
Lightly compress the client's radial artery using the first, second, and third fingers.
The nurse is assessing the apical pulse of a client using auscultation. What action would the nurse perform after placing the diaphragm over the apex of the heart?
Listen for heart sounds.
what are the sources of heat loss
Skin (primary source) Evaporation of sweat Warming and humidifying inspired air Eliminating urine and feces
The nurse is checking the client's temperature. The client feels warm to touch. However, the client's temperature is 98.8°F (37.1°C). Which statement could explain this?
The client is covered with a couple of thick blankets.
When administering beta blocker medications, the physician adds an order to hold medication when the client is bradycardic. Which statement explains this order?
The client's pulse rate is below 60 beats per minute.
The nurse is assessing a client's blood pressure and is having difficulty hearing Korotkoff sounds. What is the most appropriate nursing action?
ask the client to make a fist after cuff inflation
An ultrasonic Doppler is used for:
auscultating a pulse that is difficult to palpate.
The pulse is regulated by the _____________ nervous system through the sinoatrial (SA) node, the pacemaker of the heart.
autonomic
define therapeutic classification
broad categories based on therapeutic ex- antianginals, sedatives and analgesics ----(a drug that will lower bp)----
bradypnea
less than 10 breaths a min
The ___________ is the most important site for drug metabolism.
liver
The nurse is taking the apical pulse of a 6-month-old infant. Upon completion, the nurse tells the parent the baby's pulse is 140 beats per minute. The parent is concerned, stating, "That seems kind of high!" The nurse responds:
"I know it seems fast, but normal infant heart rates are 100-160 beats per minute."
What is included in FDA approval of a drug for OTC availability?
evaluation of evidence that the consumer can use the drug safely, using information on the product label explanation: FDA approval of a drug for OTC availability involves evaluation of evidence that the consumer can use the drug safely, using information on the product label, and shifts primary responsibility for safe and effective drug therapy from health care professionals to consumers. With prescription drugs, a health care professional diagnoses the condition, often with the help of laboratory and other diagnostic tests, and determines a need for the drug.
The removal of the drug from the body is referred to as ________________.
excretion- removal of a drug from the body
Which condition will lead to an increase in cardiac output?
exercise
T or F Phase II Korotkoff sounds are characterized by distinct, abrupt, and muffling sounds with a soft, blowing quality.
false
T or F The axillary site is considered to be one of the most accurate routes for assessing temperature.
false
T or False The generic name of a drug is the name given to the drug by the manufacturer.
false
T or F Phase I clinical studies study the effect of a drug on patients with the disease.
false- phase ll
T or F The liver plays a key role in the excretion of drugs from the body.
false- this it mostly the kidneys
T or F The ability of a drug to move into the body's tissue is referred to as absorption.
false-it's distribution
The _____________ effect refers to the process that occurs when an oral medication is processed through the liver before entering general circulation.
first-pass
what are the sources and production of drugs?
natural: meds that have a plant or animal based semisynthetic: a natural drug with chemicals added to it synthetic: chemically bond meds that have been made in the lab (MOST DRUGS ARE) biotechnologic: hormone replacement
what are the normal temps for a healthy adult
oral 98.6 rectum 99.5 axillary 97.7 tympanic 99.5 (ear) forehead 94.0
administration of oral medication
oral route- having pt swallowing drugs enteral route- administering drugs through an enteral tube sublingual administration- placing drugs under the tongue buccal administration- placing drugs between tongue and cheek
A nurse is filling out an incident report after an older adult client fell while attempting to transfer from her bed to a commode. Which health problem should the nurse consider when client falls occur?
orthostatic hypotension
chyene stokes Respiration
periods of apnea followed by periods of rapid breathing = regular
What is the branch of pharmacology that uses drugs to treat, prevent, and diagnose disease?
pharmacotherapeutics
state how a drug is develop
phase 0- chemicals tested on lab animals phase l - chemicals tested on humans volunteers (males) phase ll- drug tried on informed pt who has the disease phase lll- drug used in vast clinical market phase lv-continued evaluation of the drug
Plants and plant parts have been used as medicines since prehistoric times. Morphine (roxanol) is derived from which plant?
poppy
Agonist receptor
substances or drugs that activate receptors acts like something natural that occurs in the body like a hormone (hormone replacement therapy) (insulin)
Antagonist receptor
substances or drugs that attach to receptors and prevent them from being activated blocks the receptor site so it does not blind blocks the meds\hormone\enzymes
what is the normal vital signs for an aged adult 65 or older
temp- 96.4-98.3 pulse- 40-100 respiration- 16-24 bp- 120/80
what are the normal vital signs for adults
temp- 96.4-99.5 pulse- 60-100 respiration- 12-20 bp- 120/80
what are the normal vital signs for preteens
temp- 96.4-99.5 pulse- 65-100 respiration- 19-26 bp- 102/61
what are the normal vital signs for a new born
temp- 96.7-98.5 pulse- 70-190 respiration- 30-40 bp- 73/55
what are the normal vital signs for a child
temp- 98.2-100 pulse- 70-115 respiration- 20-26 bp-95/57
what are the normal vital sings for toddlers
temp- 98.7-100.5 pulse- 80-130 respiration- 25-32 bp- 89/46
what are the normal vital signs for infants
temp- 98.7-100.5 pulse- 80-160 respiration- 20-40 bp- 83/37
what are the locations of peripheral pulses
temporal carotid brachial radial popliteal posterior tibial dorsalis pedis
A nurse is assessing the blood pressure of a team of healthy athletes at the heath care facility. Which observation can be made by the nurse and athletes by measuring the blood pressure?
the ability of the arteries to stretch
A pulse deficit is the difference between:
the apical pulse and the radial pulse rates.
Pharmacokinetics
the drugs stages after administration what the body does with the drug "ADME"
Define pharmacology
the study of the biological effect of chemicals related to the words charm poison and remedy
what are the 2 drug classification
therapeutic and pharmacologic
During measurement of a rectal temperature, the thermometer probe should be inserted about 1.5 inches (3.8 cm) in an adult and 0.5 inches (1.3 cm) in an infant.
true
T or F Pregnancy categories indicate a drug's potential or actual teratogenic effects.
true
T or F Critical concentration is the amount of a drug that is needed to create a therapeutic effect.
true
T or F Pharmacotherapeutics is the branch of pharmacology that uses drugs to treat, prevent, and diagnose disease.
true
T or F Tachycardia occurs in an adult when the pulse rate is 100 to 180 beats/minute.
true
T or F The Food and Drug Administration (FDA) is the agency that regulates the development and sale of drugs in the United States.
true
T or F The blood-brain barrier is designed to keep foreign substances away from the central nervous system (CNS).
true
T or F The core body temperature is maintained within a fairly constant range by the thermoregulatory center in the hypothalamus.
true
T or F The nurse should know that a systolic blood pressure reading greater than 100 mm Hg is abnormal in a toddler.
true
true or false changes in the rate and depth of inhalation and exhalation are brought about by the inhibition or stimulation of the respiration muscle by respiration centers of the medulla and pons
true
true or false the normal pulse rate for adolescent and adults ranges from 60-100 beats/min
true
T or F Pharmacodynamics is the term used to describe how a drug affects the body.
true- "what drugs do to the body"
Bilot's Respiration
varying depths and rates of breathing followed by periods of apnea = irregular
Define Pharmcodynamics
what the drugs does to the body
A nurse records a pulse rate of 170 beats/min on a client's electronic health record. For which client would this be considered a normal assessment finding?
a healthy newborn infant
Clients demonstrating apnea have what?
a temporary cessation of breathing
A nurse is assessing an apical pulse on a cardiac client. The client is taking digoxin, which is a cardiac medication. The nurse can anticipate that the digoxin will:
decrease the apical pulse
A difference between the apical and radial pulse rates, called the pulse _______, indicates that all of the heartbeats are not reaching the peripheral arteries or are too weak to be palpated.
deficit
Define pulse deficit
difference between the apical and radial pulse rates
The nurse has just measured an adult client's oral temperature and obtained a result of 102.4ºF (39.1ºC). The client states, "I just finished my coffee right before you came in. Can I have another cup?" Which response by the nurse is most appropriate?
"I will bring you another cup when I return in 30 minutes to reassess your temperature. Please do not drink any other beverages until I return."
sympathetic stimulation
"fight of flight" increases heart rate
Parasympathetic stimulation
"rest and digest" decreases heart rate
Essential Order Components
* Client name * Date / time * Medication name * Dose * Route * Time and frequency * Signature
2.2 lb = ___ kg
1 kg
1 cc = ___ mL
1 mL
2 T = _____ oz
1 oz
3 tsp = ___ tbsp
1 tbsp
1 qt = ___ mL
1,000 mL
what are the 4 ways that body heat goes into external environment
1. RADIATION: the diffusion of heat through electromagnetic waves ex- the body gives of waves of heat from uncovered surfaces like your head 2. CONVECTION: the moving of heat by motion from areas of unequal density ex- a fan blowing cool air on a warm body 3. EVAPORATION: the conversion of a liquid to a vapor ex- body fluids in the form of perspiration and insensible loss is vaporized from the skin (SWEATING) 4. CONDUCTION- the transfer of heat to another object during direct contact ex- the body transfer heat to an ice pack causing the ice to melt
what are the 3 different names of drugs?
1. chemical name- the name given based on the chemical makeup 2. generic name- the original name given when it has been approved by the FDA (ONLY 1) 3. brand\trade name- name given by the companies that mass markets the drug (MANY NAMES) based on the company that makes it
categories of antihyoertensives meds
1. diuretics- to decrease fluid volume 2. beta-adrenergic blockers- to block sympathetic stimulation and decrease cardiac output END IN "LOL" 3. vasodilators and calcium channel blockers- to relax smooth muscle of arterioles and decrease peripheral vascular resistance 4. ACE inhibitors- to prevent vasoconstriction and reducing aldosterone production
what are the types of fevers?
1. intermittent: temp returns to normal at least once every 24 hr 2. remittent: temp does not return to normal and fluctuates a few degrees up and down 3. sustained or continuous: temp remains above normal and minimal variation 4. relapsing or recurrent: temp returns to normal for one or more days with one or more episodes of fever each as long as several days
what are the responses to drugs
1. the desired effect- what the drug is supposed to do 2. side effect- secondary actions unavoidable 3. adverse effect- undesirable effects didn't happen in the trail of the drug it is unexpected & can happen when the drug isn't taken correctly 4. idiosyncratic effect- unexpected often tied to genetic makeup sometimes completely different effect 5. allergic effect- has to have a histome release to action -need to know what happen when you take it- 6.teratogen- affects the fetus 7. carcinogen- can cause cancer
what are the three factors of respiration
1. ventilation: movement of air in and out of the lungs (breathing) 2. diffusion: exchange of oxygen and carbon dioxide between the alveoli of the lungs and circulating blood 3. perfusion: exchange of oxygen and carbon dioxide between circulating blood and tissue cells.
1 cm = ___ mm
10 mm
1 kg = ___ g
1000 g
1 L = ___ mL
1000 mL
1 mg = ___ mcg
1000 mcg
1 g = ___ mg
1000 mg
what temperature is considered a medical emergency
106.0 F high fever can cause damage to vital organs and causes dehydration pt would need to be cooled down asap and have oral med and iv fluids
what is the normal respiration rate
12-20 breaths per minute
A diagnosis of hypertension is made when the systolic pressure is _______ mm Hg or higher or the diastolic pressure is 90 mm Hg or higher.
140
1 t = ___ mL
15 mL
1 tbsp = ___ mL
15 mL
I lb (pound) = _____ oz (ounces)
16 oz
Based upon circadian rhythms, when would the nurse note the highest temperature during a 24-hour period?
1700
When assessing an infant's axillary temperature, it will be:
1°F (0.5°C) lower than an oral temperature.
1 in = ___ cm
2.5 cm
1 oz = ____ mL
30 mL
The nurse has completed an assessment and notes that the client's blood pressure is 132/92 mmHg. What is this client's pulse pressure?
40 mmHg
1 tsp = _____ mL
5 mL
A nurse is calculating the cardiac output of an adult with a stroke volume of 75 mL (75 × 109/L) and a pulse of 78 beats/min. What number would the nurse document for this assessment?
5,850 mL (5,850 × 10^9/L)
1 pt = ___ mL
500 mL
1 gr = ___ mg
60 mg
1 cup = ___ oz = ___ mL
8 oz, 240 mL
A client is being started on a laxative regimen. Before beginning the regimen the nurse performs which of the following assessments? SELECT ALL THAT APPLY A. Liver function test B. Abdominal examination C. Skin color and lesion evaluation D. Lung auscultation E. 24-hour urine analysis F. Cardiac assessment
A. Liver function test B. Abdominal examination C. Skin color and lesion evaluation
what is ADME
A- absorption: how the drug enters the body until it enters the bloodstream (depends on the route of administration) D- distribution: the transport of a drug molecules within the body (depends on the circulation to be transported throughout the body) M- metabolism: how the body breaks down the drug (depends on the enzyme system) E- excretion: how the drug is removed from the body (urine, bile, feces or exhalation)
After teaching a patient about digoxin (generic)—a drug used to increase the effectiveness of the heart's contractions—which statement indicates that the teaching was effective? A. "I need to take my pulse every morning before I take my pill." B. "If I forget my pills, I usually make up the missed dose once I remember." C. "This pill might help my hay fever when it becomes a problem." D. "I don't remember the name of it, but it is the white one."
A. "I need to take my pulse every morning before I take my pill."
A patient asks what generic drugs are and if he should be using them to treat his infection. Which of the following statements should be included in the nurse's explanation? select all that applies A. A generic drug is a drug that is sold by the name of the ingredient, not the brand name. B. Generic drugs are always the best drugs to use because they are never any different from the familiar brand names. C. Generic drugs are not available until the patent expires on a specific drug. D. Generic drugs are usually cheaper than the well-known brand names, and some insurance companies require that you receive the generic drug if one is available. E. Generic drugs are forms of a drug that are available over the counter and do not require a prescription. F. Your physician may want you to have the brand name of a drug, not the generic form, and DAW will be on your prescription form. G. Generic drugs are less likely to cause adverse effects than brand name drugs.
A. A generic drug is a drug that is sold by the name of the ingredient, not the brand name. C. Generic drugs are not available until the patent expires on a specific drug. D. Generic drugs are usually cheaper than the well-known brand names, and some insurance companies require that you receive the generic drug if one is available. F. Your physician may want you to have the brand name of a drug, not the generic form, and DAW will be on your prescription form. Generic drugs are less likely to cause adverse effects than brand name drugs.
Pregnant women should be advised of the potential risk to the fetus any time they take a drug during pregnancy. What fetal problems can be related to drug exposure in utero? A. Fetal death B. Nervous system disruption C. Skeletal and limb abnormalities D. Cardiac defects E. Low-set ears F. Deafness
A. Fetal death B. Nervous system disruption C. Skeletal and limb abnormalities D. Cardiac defects E. Low-set ears F. Deafness
A patient is taking a drug that is known to be toxic to the liver. The patient is being discharged to home. What teaching points related to liver toxicity and the drug should the nurse teach the patient to report to the physician? A. Fever; changes in the color of urine B. Changes in the color of stool; malaise C. Rapid, deep respirations; increased sweating D. Dizziness; drowsiness; dry mouth E. Rash, black or hairy tongue; white spots in the mouth or throat F. Yellowing of the skin or the whites of the eyes
A. Fever; changes in the color of urine B. Changes in the color of stool; malaise F. Yellowing of the skin or the whites of the eyes
When considering the pharmacokinetics of a drug, what points would the nurse need to consider? A. How the drug will be absorbed B. The way the drug affects the body C. Receptor site activation and suppression D. How the drug will be excreted E. How the drug will be metabolized F. The half-life of the drug
A. How the drug will be absorbed D. How the drug will be excreted E. How the drug will be metabolized F. The half-life of the drug
A nurse is preparing to administer a drug to a client for the first time. What questions should the nurse consider before actually administering the drug? A. Is this the right patient? B. Is this the right drug? C. Is there a generic drug available? D. Is this the right route for this patient? E. Is this the right dose, as ordered? F. Did I record this properly?
A. Is this the right patient? B. Is this the right drug? D. Is this the right route for this patient? E. Is this the right dose, as ordered? F. Did I record this properly?
The nurse obtains a medical history from a patient before beginning drug therapy based on an understanding of which of the following? A. Medical conditions can alter a drug's pharmacokinetics and pharmacodynamics. B. A medical history is a key component of any nursing protocol. C. A baseline of information is necessary to evaluate a drug's effects. D. The medical history is the first step in the nursing process.
A. Medical conditions can alter a drug's pharmacokinetics and pharmacodynamics.
A client is experiencing a reaction to the penicillin injection that the nurse administered approximately ½ hour ago. The nurse is concerned that it might be an anaphylactic reaction. What signs and symptoms would validate her suspicion? A. Rapid heart rate B. Diaphoresis C. Constricted pupils D. Hypotension E. Rash F. Client report of a panicky feeling
A. Rapid heart rate B. Diaphoresis (SWEATING) E. Rash F. Client report of a panicky feeling
The FDA pregnancy categories A. indicate a drug's potential or actual teratogenic effects. B. are used for research purposes only. C. list drugs that are more likely to have addicting properties. D. are tightly regulated by the DEA.
A. indicate a drug's potential or actual teratogenic effects.
The half-life of a drug A. is determined by a balance of all pharmacokinetic processes. B. is a constant factor for all drugs taken by a patient. C. is influenced by the fat distribution of the patient. D. can be calculated with the use of a body surface nomogram.
A. is determined by a balance of all pharmacokinetic processes
A patient receiving an antihistamine complains of dry mouth and nose. An appropriate comfort measure for this patient would be to A. suggest that the patient use a humidifier. B. encourage voiding before taking the drug. C. have the patient avoid sun exposure. D. give the patient a back rub.
A. suggest that the patient use a humidifier.
acute vs chronic pain
Acute- less than 6 months (just happened a recent injury) Chronic- more than 6 months from a disease cancer or non cancerous
A nurse attempts to count the respiratory rate of a client via inspection and finds that the client is breathing at such a shallow rate that it cannot be counted. What is an alternative method of determining the respiratory rate for this client?
Auscultate lung sounds, count respirations for 30 seconds, and multiply by 2.
The nurse has palpated the client's radial artery and identified a heart rate of 88 beats per minute with an irregular rate. What is the nurse's most appropriate action?
Auscultate the client's apical heart rate.
A nurse is assessing the respirations of a 60-year-old female client and finds that the client's breaths are so shallow that the respirations cannot be counted. What would be the appropriate initial nursing intervention in this situation?
Auscultate the lung sounds and count respirations.
The nurse writes a nursing diagnosis for which reason? A. Direct medical care B. Help to increase patient compliance C. Identify actual or potential alteration in patient function D. Determine insurance reimbursement in most cases
C. Identify actual or potential alteration in patient function
The nursing care of a patient receiving drug therapy should include measures to decrease the anticipated adverse effects of the drug. Which of the following measures would a nurse consider? A. A positive approach B. Environmental temperature control C. Safety measures D. Skin care E. Refrigeration of the drug F. Involvement of the family
B. Environmental temperature control C.Safety measures D. Skin care
Receptor sites are: A. are a normal part of enzyme substrates. B. are protein areas on cell membranes that react with specific chemicals. C. can usually be stimulated by many different chemicals. D. are responsible for all drug effects in the body.
B. are protein areas on cell membranes that react with specific chemicals
Clinical pharmacology is the study of A. the biological effects of chemicals. B. drugs used to treat, prevent, or diagnose disease. C. plant components that can be used as medicines. D. binders and other vehicles for delivering medication.
B. drugs used to treat, prevent, or diagnose disease.
Healthy young women are sometimes not able to be involved in phase I studies of drugs because A. male bodies are more predictable and responsive to chemicals. B. females are more apt to suffer problems with ova, which are formed only before birth. C. males can tolerate the unknown adverse effects of many drugs better than females. D. there are no standards to use to evaluate the female response.
B. females are more apt to suffer problems with ova, which are formed only before birth.
When trying to determine why the desired therapeutic effect is not being seen with an oral drug the nurse should consider A. the blood flow to muscle beds. B. food altering the makeup of gastric juices. C. the weight of the patient. D. the temperature of the peripheral environment.
B. food altering the makeup of gastric juices.
A patient with a severe infection is given gentamicin, the only antibiotic shown to be effective in culture and sensitivity tests. A few hours after the drug is started intravenously the patient becomes very restless and develops edema. Blood tests reveal abnormal electrolytes and elevated blood urea nitrogen. This reaction was most likely caused by A. an anaphylactic reaction. B. renal toxicity associated with gentamicin. C. superinfection related to the antibiotic. D. hypoglycemia.
B. renal toxicity associated with gentamicin.
A woman has had repeated bouts of bronchitis throughout the fall and has been taking antibiotics. She calls the clinic with complaints of vaginal pain and itching. When she is seen, it is discovered that she has developed a yeast infection. You understand that A. her bronchitis has moved to the vaginal area. B. she has developed a superinfection, because the antibiotics kill bacteria that normally provide protection. C. she probably has developed a sexually transmitted disease related to her lifestyle. D. she will need to take even more antibiotics to treat this new infection.
B. she has developed a superinfection, because the antibiotics kill bacteria that normally provide protection.
A patient reports that she has a drug allergy. In exploring the allergic reaction with the patient, which of the following might indicate an allergic response? A. Increased urination B. Dry mouth C. Rash D. Drowsiness
C. Rash
When teaching a patient about OTC drugs, which points should the nurse include? A. These drugs are very safe and can be used freely to relieve your complaints. B. These compounds are called drugs, but they aren't really drugs. C. Some of these drugs were once prescription drugs, but are now thought to be safe when used as directed. D. Reading the label of these drugs is very important; the name of the active ingredient is prominent; you should always check the ingredient name. E. It is important to read the label and to see what the recommended dose of the drug is; some of these drugs can cause serious problems if too much of the drug is taken. F It is important to report the use of any OTC drug to your health care provider because many of them can interact with drugs that might be prescribed for you.
C. Some of these drugs were once prescription drugs, but are now thought to be safe when used as directed. D. Reading the label of these drugs is very important; the name of the active ingredient is prominent; you should always check the ingredient name. E. It is important to read the label and to see what the recommended dose of the drug is; some of these drugs can cause serious problems if too much of the drug is taken. F It is important to report the use of any OTC drug to your health care provider because many of them can interact with drugs that might be prescribed for you.
When reviewing a drug to be given the nurse notes that the drug is excreted in the urine. What points should be included in the nurse's assessment of the patient? A. The patient's liver function tests B. The patient's bladder tone C. The patient's renal function tests D. The patient's fluid intake E. Other drugs being taken that could affect the kidney F. The patient's intake and output for the day
C. The patient's renal function tests D. The patient's fluid intake E. Other drugs being taken that could affect the kidney
An example of a drug allergy is A. dry mouth occurring with use of an antihistamine. B. increased urination occurring with use of a thiazide diuretic. C. breathing difficulty after an injection of penicillin. D. urinary retention associated with atropine use.
C. breathing difficulty after an injection of penicillin.
An orphan drug is a drug that A. has failed to go through the approval process. B. is available in a foreign country but not in this country. C. has been tested but is not considered to be financially viable. D. is available without a prescription.
C. has been tested but is not considered to be financially viable.
Phase I drug studies involve A. the use of laboratory animals to test chemicals. B. patients with the disease the drug is designed to treat. D. mass marketing surveys of drug effects in large numbers of people. C. healthy human volunteers who are often paid for their participation.
C. healthy human volunteers who are often paid for their participation.
chemotherapeutic agents are drugs that A. are used only to treat cancers. B. replace normal body chemicals that are missing because of disease. C. interfere with foreign cell functioning causing cell death, such as invading microorganisms or neoplasms. D. stimulate the normal functioning of a cell.
C. interfere with foreign cell functioning causing cell death, such as invading microorganisms or neoplasms.
The evaluation step of the nursing process A. is often used as a last resort. B. is important primarily in the acute setting. C. is a continuous process. D. includes making nursing diagnoses.
C. is a continuous process.
A patient has been taking fluoxetine (Prozac) for several years, but when picking up the prescription this month found that the tablets looked different and became concerned. The nurse, checking with the pharmacist, found that fluoxetine had just become available in the generic form and the prescription had been filled with the generic product. The nurse should tell the patient A. that the new tablet may have similar effects or may not so the patient should carefully monitor response. B. that generic drugs are available without a prescription and they are just as safe as the brand name medication. C. that the law requires that prescriptions be filled with the generic form if available to cut down the cost of medications. D. that the pharmacist filled the prescription with the wrong drug and it should be returned to the pharmacy for a refund.
C. that the law requires that prescriptions be filled with the generic form if available to cut down the cost of medications.
Much of the biotransformation that occurs when a drug is taken occurs as part of A. the protein-binding effect of the drug. B. the functioning of the renal system. C. the first-pass effect through the liver. D. the distribution of the drug to the reactive tissues.
C. the first-pass effect through the liver.
The generic name of a drug is A. the name assigned to the drug by the pharmaceutical company developing it. B. the chemical name of the drug based on its chemical structure. C. the original name assigned to the drug at the beginning of the evaluation process. D. the name that is often used in advertising campaigns.
C. the original name assigned to the drug at the beginning of the evaluation process.
Knowing that a patient is taking a loop diuretic and is at risk for developing hypokalemia the nurse would assess the patient for A. hypertension, headache, and cold and clammy skin. B. decreased urinary output and yellowing of the sclera. C. weak pulse, low blood pressure, and muscle cramping. C. diarrhea and flatulence.
C. weak pulse, low blood pressure, and muscle cramping.
the formula to convert F to C
C= (F-32) ________ 1.8
The nurse is assessing the client's blood pressure (BP) and heart rate (HR) for orthostatic hypotension. In which step should this nurse intervene because of potential danger?
Client stands at bedside, becomes pale, diaphoretic.
The nurse is preparing to give medications to a client with high blood pressure. The prescription indicates that the client is to have the combination drug dextroamphetamine saccharate-amphetamine aspartate monohydrate-dextroamphetamine sulfate-amphetamine sulfate 40 mg by mouth twice daily. What is the appropriate nursing action?
Contact the health care provider for clarification of the prescription. explanation: Before administering the medication, the nurse should immediately contact the health care provider to verify the prescription; no one else can verify the prescription. The combination drug dextroamphetamine saccharate-amphetamine aspartate monohydrate-dextroamphetamine sulfate-amphetamine sulfate and the drug propranolol are medications that have look-alike and sound-alike properties, but are very different in indication and dosage.
What is the manufacturer's responsibility during phase IV of a drug trial?
Continue to monitor the drug's effects while the drug is in general use.
the formula to convert C to F
F= C (1.8) +32
When establishing the nursing interventions appropriate for a given patient A. the patient should not be actively involved. B. the patient support systems should be included only at discharge. C. teaching should be done when the patient states he or she is ready to learn. D. an evaluation of all of the data accumulated should be incorporated to achieve an effective care plan.
D. an evaluation of all of the data accumulated should be incorporated to achieve an effective care plan.
Patients receiving antineoplastic drugs that disrupt cell function often have adverse effects involving cells that turn over rapidly in the body. These cells include A. ovarian cells. B. liver cells. C. cardiac cells. D. bone marrow cells.
D. bone marrow cells.
A patient taking glyburide (an antidiabetic drug) has his morning dose and then does not have a chance to eat for several hours. An adverse effect that might be expected from this would be A. a teratogenic effect. B. a skin rash. C. an anticholinergic effect. D. hypoglycemia.
D. hypoglycemia.
The storing, prescribing, and distributing of controlled substances—drugs that are more apt to be addictive—are monitored by A. the FDA. B. the Department of Commerce. C. the Federal Bureau of Investigation. D. the DEA.
D. the DEA.
Selective toxicity is A. the ability of a drug to seek out a specific bacterial species or microorganism. B. the ability of a drug to cause only specific adverse effects. C. the ability of a drug to cause fetal damage. D. the ability of a drug to attack only those systems found in foreign or abnormal cells.
D. the ability of a drug to attack only those systems found in foreign or abnormal cells.
receptor theory of drug action
Drugs exert their effects by chemically binding with receptor cells through Activation, inactivation, or alteration of intracellular enzymes 1. agonist drugs- acts like something natural that occurs in the body like a hormone (hormone replacement therapy) (insulin) 2. antagonist- blocks the receptor site so it does not blind blocks the meds\hormone\enzymes
Which statement describes diastolic blood pressure?
During ventricular relaxation, blood pressure is due to elastic recoil of the vessels.
The amount of time that a drug level takes to decrease to one half of its peak level in the blood is called the __________________.
Half Life
A nurse needs to measure the blood pressure of a client who has just undergone a bilateral mastectomy. How should the nurse measure the blood pressure?
Over the client's thigh
A patient, scheduled to be involved in a drug trial, asks about the involvement of animals in the process. What information should the nurse provide to the patient? During which stage of drug development is the drug tested on laboratory animals?
Phase 0 involves testing the medication's effect on animals explanation: During Phase 0, drugs are tested on laboratory animals. A phase I study uses human volunteers for testing. A phase II study allows investigators to try out the drug in clients who have the disease that the drug is designed to treat. A phase III study involves the use of the drug in a vast clinical market.
The nurse is preparing to assess a rectal temperature on an adult client. What is the appropriate nursing intervention?
Provide privacy for the client.
A nurse is assessing the pulse volume of a client with influenza. The nurse notes that the client has a thready pulse. Which of the following is a description of a thready pulse?
Pulse is felt with difficulty and disappears with slight pressure.
A client with a long-standing dermatologic health problem has been advised to use a drug with a local effect. The nurse should recognize what characteristic of this drug?
The drug acts primarily at the site where it is applied. explanation: Drugs with local effects, such as sunscreen lotions and local anesthetics, act mainly at the site of application. Those with systemic effects are taken into the body, circulated through the bloodstream to their sites of action in various body tissues, and eventually eliminated from the body. A drug with local effect does not necessarily have to be applied at multiple sites, and its action may affect tissues long after contact.
The nurse treating a client for the past week notes no improvement in the client's condition. Another nurse mentions a new drug that might help the client. The first nurse has never heard of this newly introduced drug. What is the most likely reason that Sally has not heard about this new drug?
The nurse was not aware of or did not have access to reliable resources for new drug information. explanation:It is most likely that Sally has not had access to reliable and up-to-date drug reference information. Awareness of reliable resources and the specific type of information provided in those resources ensures that a nurse is efficiently and completely informed about safe drug administration and new therapeutic developments. It is unlikely that the cause could be Sally's lack of initiative or level of interest in the ailment.
The nurse is teaching the parents of an infant with an irregular heartbeat how to check the pulse rate. The infant's pulse is very high and irregular. What will the nurse have to do in order to teach these parents how to monitor their infant's pulse rate?
The parents will have to be taught how to use a stethoscope so that they can listen to and count the infant's apical pulse.
Which client's blood pressure best describes the condition called hypotension?
The systolic reading is below 100 and diastolic reading is below 60.
define a drugs half life
The time it takes a drug in the body to decrease one-half of the original peal level half life is affected by ADME
A nurse is assessing the blood pressure of a client using the Korotkoff sound technique. The nurse notes that the phase I sound disappears for 2 seconds. What should the nurse document on the progress record?
There is an auscultatory gap.
A 62-year-old female client being treated for hypertension did not take her daily BP medication over the weekend because she was out of medication and the pharmacy was closed. Her average home blood pressure monitoring (HBPM) reading has been 130/82. Today her BP has been 138/90, 135/85, and 142/86. She calls the on-call nurse for her health care provider. What is the most appropriate thing for this nurse to advise this client?
To take the recommended daily dose of medication and call the health care provider if the average of her HBPM readings increase/decrease by 10, or if she has any other concerns.
The student nurse is having difficulty feeling the pedal pulse of the client with a fractured leg. What should the nurse do next?
Use the Doppler ultrasound device.
The nurse is caring for a client with pneumonia who requires administration of medications. When does the nurse document administration in the medication administration record (MAR)?
after completion of administration of each drug explanation: The nurse documents administration after giving medications each time. The nurse never documents administration of medications ahead of delivery, nor does the nurse document during the actual delivery time. Nurses do not wait until the end of the shift to document medication administration.
what are factors that should be considered when deciding how to take a pt temp?
age pain treatment levels of conscious
what are the factors affecting bp
age, gender, race, circadian, food intake, exercise, weight, emotional state, body position, drugs, and meds
what affects drug action?
age, weight, pregnancy, gender-hormonal effects, pathologic conditions, & placebo response
what are things that effect pulse rate
age- infants, kids, teens have high pulse while older people tend to have lower pules exercise fever stress pain anxiety meds diseases
Which peripheral pulse site is generally used in emergency situations?
carotid
what are the factors affecting body temp ?
circadian rhythms- 24 hr period of temps changing age and gender physical activity state of health environment temp
Pharmacotherapeutics
clinical pharmacology—the branch of pharmacology that deals with drugs; chemicals that are used in medicine for the treatment, prevention, and diagnosis of disease in humans two key concerns: the drug's effects on the body and the body's response to the drug.
The mechanics of heat transfer, known as _____________, refers to the transfer of heat to another object during direct contact.
conduction
Define drug action.
how well the drug can do what it supposed to do 1. on set of action- when the drug starts to work 2. peak action- when the drug reaches its highest concentration 3. duration of action- how long the drug has the effects 4. drug level- determines how much of the drug is present
Shivering, a response that increases the production of heat, is initiated by the _____________ and results in muscle tremors, resulting in the production of heat.
hypothalamus
Tachypnea
increased respiratory rate greater than 24
what is the site for heat production in the body
primary source is metabolism hormones, muscle movements, and exercise increase metabolism epinephrine and norepinephrine are released when additional heat is required and alter metabolism thyroid hormone and shivering creates heat energy production decreases and heat production increases
factors that affect frequency of vital signs
pt medical diagnosis comorbidity (presence of two chronic diseases or conditions in a patient) types of treatments pt received pt level of acuity (how much care\attention the pt needs)
the _________ is regulated by the autonomic nervous system through cardiac sinoatrial node (SA)
pulse
Define bradycardia
pulse below 60
Define tachycardia
pulse of 100-180
Which term indicates a potentially serious client condition?
pyrexia (a spike in temperature; fever)
what is the term for the heat that is lost when a person goes in the cold without a hat?
radiation
What are the characteristics of peripheral pulse
rate- either normal, tachycardia, or bradycardia amplitude and quality- strong or weak 0-pulse is absent unable to palpate 1-weak pulse 2-normal pulse 3-bounding pulse rhythm volume of blood ejected with each heartbeat (stroke volume)!!!!!!
A nurse is caring for an adult with fever. The nurse determines that which site is most ideal for obtaining the client's core body temperature?
rectum
A nurse needs to assess the temperature of a client with high fever. Which site will most closely reflect core body temperature of the client?
rectum
rights of medications administration
right medication right patient right dosage right route right time right document right to refuse
A nurse is preparing to administer morphine and recognizes morphine as belonging to what classification of controlled substance?
schedule II (C-II) explanation: Morphine is a schedule II (C-II) controlled substance with a severe risk of abuse and dependence. Schedule III drugs have a lower abuse potential and generally contain nonbarbiturate sedatives, nonamphetamine stimulants, and limited amounts of certain narcotics. Schedule IV drugs are those with less abuse potential than schedule III and limited dependence liability, including some sedatives, antianxiety agents, and nonnarcotic analgesics. Schedule V medications have limited abuse potential and are often found in small amounts in antitussives or antidiarrheals. Federal law allows purchase without a prescription directly from a pharmacist if the purchaser is over age 18 and furnishes suitable identification.
state the controlled substance schedules
schedule l: high potential for abuse, NO medical use, ex- heroin, marijuana, & LSD schedule ll: high potential for abuse, ACCEPTED for medical use, morphine, demerol, & hydrocodone schedule lll: lower potential for abuse, ACCEPTED for medical use, tylenol with codeine & testosterone schedule lv: lower potential for abuse, ACCEPTED for medical use, librium & valium schedule v: lower potential for abuse, ACCEPTED for medical use, lomotil, robitussin a-c
