Pharmacology Chapters 4-6
The exact dose of a medication for a pediatric client is based on what parameter?
Weight
The 68-year-old client states, "I have been taking aspirin on occasion for my arthritis for many years but notice that it takes longer for it to start working now." What is the best response by the nurse?
"As you get older, absorption is prolonged and medications may take a little longer to act than normal."
The nurse tells a 9-year-old child that the child will be receiving an injection today. What statement by the child is most indicative of the fear that children of this age group feels?
"I hate getting shots. The last time I got one it hurt so bad."
A client is pregnant and is at 7 weeks' gestation. She has type 1 diabetes and has been taking insulin since she was 13 years old. She asks the nurse if the insulin will be harmful to her baby. The best response to the client by the nurse would be:
"Insulin is usually the drug of choice for controlling blood glucose levels during pregnancy because it does not cross into the placenta."
The pediatric nurse is precepting a new graduate on the unit. When administering medications, the new graduate draws up an oral medication in a syringe used for injections. What is the best response by the preceptor?
"It is very important to use an oral syringe when giving oral medications so that it is not given by the incorrect route."
Megan is a 20-year-old college student who has presented to the campus medical clinic with an unplanned pregnancy. Despite being under significant stress from this event, she has focused herself on doing all she can to maximize her own health and the health of the fetus. What teaching point should the nurse prioritize during patient education with Megan?
"Quitting smoking will have great benefits both for you and your unborn child."
A patient arrives at the clinic and states that she is going to be traveling outside of the United States and requires a smallpox vaccine. What laboratory study should the patient have prior to receiving the vaccine?
A pregnancy test
An older adult is concerned because his clothes feel tight though he hasn't gained any weight. The nurse knows that this is because of what physiologic change related to aging?
Aging results in an increase in body fat and a decrease in lean body mass.
To reduce older adults' risk of experiencing adverse drug effects or interactions, what action should the nurse prioritize?
Assess clients' use of herbal remedies and over-the-counter (OTC) medications
What schedule of medication dosing assists older adults in adhering to a medication regimen?
Begin with a low dose to minimize adverse effects
When appraising an older adult's ability to excrete medications, what laboratory or diagnostic finding should the nurse prioritize?
Blood urea nitrogen and creatinine levels
What type of pediatric drug calculation is expressed in square meters?
Body surface area
The nurse is preparing to administer an oral medication to a toddler. To elicit cooperation from the child, what should the nurse do before administering the medication?
Communicate with the child at the appropriate developmental level
How is the renal system affected by the aging process? (Select all that apply.)
Decrease in blood flow to the kidneys Decrease in the number of functioning nephrons Decrease in tubular secretion
What phenomenon is primarily responsible for the changes in pharmacokinetics that accompany the aging process?
Decreased function of vital organs
What are the most common medical problems seen in older adults? (Select all that apply.)
Diabetes mellitus Arthritis Heart disease
A nurse is aware that older adults tend to have a significantly decreased rate of hepatic blood flow compared with younger adults. What effect is this likely to have on pharmacokinetics and pharmacodynamics in an older adult?
Drug clearance is likely to be slower
A nurse is performing a teratogenic risk assessment relating to maternal drug taking on a new client. The nurse knows that the time of greatest developmental risk to the fetus is:
First trimester
To prevent neural tube defects, a health care provider may prescribe what drug during pregnancy?
Folic acid
A pregnant woman is experiencing nausea and vomiting in her first trimester of pregnancy. Which herbal agent that has traditionally been used as an antiemetic could the nurse discuss with the client?
Ginger
The nurse is assessing a young pregnant woman at her first prenatal visit. When the nurse inquires if the client is using OTC or herbal preparations, the client names some herbs she uses. Which of the following should the nurse recognize as one to avoid?
Ginseng
The nurse is instructing a mother in applying a topical medication to her infant's diaper area. The nurse instructs the mother to place the cream only on the affected area and use it sparingly. These instructions are necessary because of what physiologic characteristic of neonates?
Highly permeable skin tissue
Which condition contributes to nonadherence to the medication regimen due to its lack of identifiable symptoms?
Hypertension
A nurse is working with a 16-year-old pregnant teen and assessing for behavior that may put the baby at risk. What is the most important assessment the nurse can make?
Illegal substances
What interventions will the nurse use to improve adherence to a medication regimen for the older adult? (Select all that apply.)
Keep the cost of the medications as low as possible Provide easy-to-follow directions Educate client and family to the medication regimen
What intervention can the nurse provide to improve adherence for elderly clients who are taking multiple drugs?
Make drug regimens easy to follow and uncomplicated
The nurse is aware that almost a third of all hospital admissions in older adults are as a result of what problem?
Medication reactions
Ethnicity is a variable that is known to affect what aspect of pharmacokinetics in older adults?
Metabolism
During a prenatal visit, the client mentions she has been drinking peppermint and ginger tea. The nurse should inquire if the client is having problems with which of the following?
Nausea
A client mentions at her prenatal visit that she has been using an OTC cough syrup with alcohol. The nurse is concerned and suggests an alternative therapy for which of the following reasons?
No amount of alcohol is considered safe during pregnancy
The nursing instructor is teaching the student about drugs given to induce uterine contractions and promote labor. These drugs are classified as which of the following?
Oxytocic
A nurse is teaching an older adult about polypharmacy. Which statement best describe this term?
Taking several drugs simultaneously
A 24-year-old client at 23 weeks' gestation is concerned that her asthma medication is not as effective as it normally is. What might be the cause of the change?
Temporary pharmacokinetic changes
Before a pregnant client is given any medication, consideration must be given to its effects on the fetus. The main concern is for medications that potentially have which effects?
Teratogenic
A nurse is teaching a newly pregnant woman about the care team's strategy for helping her manage her medications during pregnancy. What overriding principle should the nurse should stress to the client?
The benefits of a drug to the mother must outweigh the potential risks to the fetus.
Which statement regarding infant pharmacokinetics is most accurate?
The immature liver of infants makes drug metabolism less effcient
An infant who recently experienced seizures is being treated in the neonatal intensive care unit with phenytoin. The infant's low plasma protein levels during the first year of life have what consequence?
The infant may have an increased risk of toxicity
A child who has been hospitalized with pneumonia is being discharged with two new medications. What information does the nurse need to educate the family about? (Select all that apply.)
The name of the drug What the medication is being taken for How the drug works Adverse effects
The client is showing signs of pre-clampsia. The nurse realizes the client is at increased risk for preterm labor. The nurse discusses the potential use of which drug class with the client?
Tocolytics
What is the relation between the activity level of older adults and the response to medication?
The older adult who is more physically active is less likely to have an adverse drug effect
