Pharmacology Basics - Chapter 3

infant

1 month to 1 year

child

1-12 years

When giving medications to older adults, the nurse will keep in mind the changes that occur as a result of aging. Which statements regarding changes in the older patient are true? (Select all that apply.) a. The ratio of fat to water is increased. b. Gastric pH is less acidic because of reduced hydrochloric acid production. c. Protein albumin binding sites are reduced because of decreased serum protein. d. Total body water content increases as body composition changes. e. The absorptive surface area of the gastrointestinal tract is increased because of flattening and blunting of the villi.

a. The ratio of fat to water is increased. b. Gastric pH is less acidic because of reduced hydrochloric acid production.

Which explanation underpins the nurse's understanding that the greatest risk to the fetus to the exposure of maternal drugs occurs in the first trimester? a. This is the period of organogenesis. b. This is the period of greatest placental blood flow. c. This is the period of nutritional interruption because of pregnancy-induced emesis. D. This is the period of greatest resistance to insulin receptors throughout the maternal body.

a. This is the period of organogenesis.

The nurse recognizes that drug dosages in older adults are based on which factor? a. Age b. Weight c. Total body water d. Serum albumin

b. Weight

An 82-year-old patient is admitted to the hospital after an episode of confusion at home. The nurse is assessing the current medication s he is taking home. Which method is the best way to assess his home medications? a. Ask the patient what medications he takes at home. b. Ask the patient's wife what medications he takes at home. c. Ask the patient's wife to bring his medications to the hospital in their original containers. d. Contact the patient's pharmacy for a list of the patient's current medications.

c. Ask the patient's wife to bring his medications to the hospital in their original containers.

Understanding the role of the kidney in the elimination of drugs from the body, which laboratory test assessment is priority in evaluating kidney function? a. Albumin level b. Red blood cell count c. Creatinine d. Bicarbonate

c. Creatinine

While teaching a 76-year-old patient about the adverse effects of his medications, the nurse encourages him to keep a journal of the adverse effects he experiences. This intervention is important for the older adult patient because of which alteration in pharmacokinetics? a. Increased renal excretion of protein-bound drugs b. More alkaline gastric pH, resulting in more adverse effects c. Decreased blood flow to the liver, resulting in altered metabolism d. Less adipose tissue to store fat-soluble drugs

c. Decreased blood flow to the liver, resulting in altered metabolism

pediatric

pertaining to a person who is 12 years of age or younger

older adult

pertaining to a person who is 65 years of age or older

neonate

pertaining to a person younger than 1 month of age; newborn infant

Neonate or newborn infant

younger than 1 month

Premature or preterm infant

younger than 38 weeks gestation

A toddler is to receive a daily dose of digoxin 2 mcg/kg/day IV. The toddler weighs 23 lbs. Calculate the amount of medication in milligrams that the toddler will receive.

0.02 mg

The medication in Question 16 is available in a vial of 0.1 mg/mL. Calculate how much solution the nurse will draw up into the syringe and then mark the syringe with your answer.

0.2mg

Match each pregnancy safety category with its corresponding description: 1. Category A 2. Category B 3. Category C 4. Category D 5. Category X a. Possible fetal risk in humans is reported; however, consideration of potential benefit versus risk may, in selected cases, warrant use of these drugs in pregnant women. b. Studies indicate no risk to animal fetuses; information for humans is not available. c. Fetal abnormalities are reported, and positive evidence of fetal risk in humans is available from animal or human studies. d. Studies indicate no risk to human fetuses. e. Adverse effects are reported in animal fetuses; information for humans is not available.

1. d 2. b 3. a 4. e 5. c

The nurse is preparing to give an oral dose of acetaminophen (Tylenol) to a child who weighs 12 kg. The dose is 15 mg/kg. How many milligrams will the nurse administer for this dose.

180 mg

A child is to receive a medication that is dosed as 8 mg/kg. The child weighs 40 kg. What is the dose of medication that the nurse will administer to this child?

320 mg

active transport

The active (energy-requiring) movement of a substance between different tissues via pumping mechanisms contained within cell membranes.

Diffusion

The passive movement of molecules or particles along a concentration gradient, or from regions of higher to regions of lower concentration.

Polypharmacy

The use of many different drugs concurrently in treating a patient, who often has several health problems.

Which factor would have the greatest effect on medication response in the newborn? a. Immaturity of the organs b. Increased muscle mass c. Increased protein binding d. Less drugs enter the brain

a. Immaturity of the organs

The nurse is preparing to administer an injection to a preschool-age child. Which approaches are appropriate for this age group? (Select all that apply.) a. Explain to the child in advance about the injection. b. Provide a brief, concrete explanation about the injection. c. Encourage participation in the procedure. d. Make use of magical thinking. e. Provide comfort measures after the injection.

b. Provide a brief, concrete explanation about the injection. d. Make use of magical thinking. e. Provide comfort measures after the injection.

The nurse is reviewing factors that influence pharmacokinetics in the neonatal patient. Which factors puts the neonatal patient at risk with regard to drug therapy? (Select all that apply.) a. Higher gastric pH b. Increased peristalsis in the GI tract c. Immature renal function d. Reduced first-pass elimination in the liver e. Decreased protein-binding medications

c. Immature renal function d. Reduced first-pass elimination in the liver e. Decreased protein-binding medications

Which physiologic factor is most responsible for the differences in the pharmacokinetic and pharmacodynamic behavior of drugs in neonates and adults? a. Infant's stature b. Infant's smaller weight c. Immaturity of neonatal organs d. Adult's longer exposure to toxins

c. Immaturity of neonatal organs

The pregnant patient who is at 32 weeks' gestation has a cold and calls the office to ask about taking an over-the-counter medication that is rated as pregnancy category A. Which answer by the nurse is correct? a. "This drug causes problems in the human fetus, so you should not take this medication." b. "This drug may cause problems in the human fetus, but nothing has been proven in clinical trials. It is best not to take this medication." c. "This drug has not caused problems in animals, but no testing has been done in humans. It is probably safe to take." d. "Studies indicate that there is no risk to the human fetus, so it is okay to take this medication as directed if you need it.

d. "Studies indicate that there is no risk to the human fetus, so it is okay to take this medication as directed if you need it.

When the nurse is reviewing a list of medications taken by an 88-year-old patient, the patient says, "I get dizzy when I stand up." She also states that she has nearly fainted "a time or two" in the afternoons. Her systolic blood pressure drops 15 points when she stands up. Which type of medication may be responsible for these effects? a. Non-steroidal anti-inflammatory drugs (NSAIDs) b. Cardiac glycosides c. Anticoagulants d. Anti-hypertensives

d. Anti-hypertensives

Most drug references provide recommended pediatric dosages based on which of the following? a. Total body water content b. Fat-to-lean mass ratio c. Renal function studies d. Body weight in kilograms

d. Body weight in kilograms

The physiologic differences in the pediatric patient compared with the adult patient affect. The nurse is aware that one of the main differences is that infants have which of these factors? a. Increased protein in circulation b. Fat composition lower than 0.001% c. More muscular body composition d. Water composition of approximately 75%

d. Water composition of approximately 75%