Exam 1 Review for 318 - study guide for exam blueprint cheat sheet PDF

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Exam 1 Review for 318 Topic 1: Introduction to Nursing Pharmacology, Terminology, and Medication Calculation Ch 1,2,5,10,11 1.1 Describe basic concepts of medication safety Follow the same process every time you administer medications: ● Obtain patient’s vitals and recent lab work, consider pt’s current physical condition before administering drug ● Perform the 6 rights of medications; perform a focused assessment on the body system based on the patient’s chief complaint ● Verify orders, question order if it turns to be harmful for the pt ● Clarify orders- if any information is missing from the drug order (such as dosage or route), the nurse needs to contact HCP first 1.2 What is the basic terminology and concepts of pharmacology? Define ● ● ●

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Pharmacology - The study of medication/drugs. Drugs are any chemicals that affect the physiologic process of a living organism. Pharmacology definition ○ The study of the manner in which the function of living systems is affected by chemical substances Drug definition ○ Any chemical substance other than those required for normal sustenance which produces a biological effect Contraindication ○ A condition that makes a particular treatment or procedure inadvisable; may be absolute or relative First pass effect ○ A drug may be completely metabolized by the liver on the first pass through the GI tract ○ Only applies to oral drugs ○ The reason why oral drugs have higher doses than IV Plateau ○ When the amount of drug eliminated between doses equals the dose administered; average drug levels will remain constant and plateau will have been reached Potency ○ Refers to the amount of drug we must give to elicit an effect---says nothing about maximal efficacy Agonists ○ Activate receptors; have a high affinity and high intrinsic activity; make things in body work better, faster, stronger Antagonists ○ Prevent receptor activation, must be agonist present in order for the antagonist to have any effect; stop processes in the body from working/diminish them Partial agonist ○ Only has moderate intrinsic activity Half-Life - Is the time it takes for the amount of drugs in the body to be reduced by half *Look at terms at the end of this document*

1.3. Identify the various routes of medication administration I.

Oral (tablets, capsules, liquids, suspensions, and elixirs). a. Liquid forms include elixirs, emulsions, and suspensions. >elixirs are sweetened, hydro-alcoholic liquids used in the preparation of oral liquid medications

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Exam 1 Review for 318 >emulsions are a mixture of two liquids that are not mutually soluble >suspensions are liquids in which particles are mixed BUT NOT dissolved **you must read labels to know if diluting or shaking is needed b. Sublingual- under the tongue (must remain there until absorbed) c. Buccal- between the cheek and gum (must remain there until absorbed) ● Transdermal- medication is stored in patch and placed on the skin to be absorbed. Never cut the patch in half ● Topical medications are often applied to the skin by painting or spreading the medication over an area and applying a moist dressing OR leaving the area exposed to air. Always wear gloves when applying topical medications ● Instillation- liquid medications typically administered as drops, ointments, or sprays in the following forms (review pg. 88): ➔ Eyedrops ➔ Eye ointments ➔ Eardrops ➔ Nose drops and sprays ● Inhalation- Metered-dose inhalers are handheld devices used to deliver a number of asthma and bronchitis medications MDIS drugs act faster than oral drugs and have less side effects since the drug goes directly to the lungs Spacers are devices used to enhance medication delivery from MDI. Nebulizer is a device that changes a liquid to fine mist or aerosol and has the ability to reach the lower, smaller airways Ensure the patient is in semi-Fowler or high Fowler position when giving these MDI or nebulizer ● Nasogastric and gastrostomy tubes ● Suppositories ● Parenteral forms- Methods of parenteral administration include intradermal, subcutaneous, intramuscular, Ζtrack technique, and intravenous administration. A description of each follows with special considerations noted for the pediatric patient. 1.4 Apply principles of dimensional analysis to calculate medication dosages ●

Method 3: Dimensional Analysis - Dimensional analysis (DA) is a calculation method known as units and conversions. The D, H, and V are still used in DA. The advantage of DA is that all the steps for calculating drug dosages are conducted in one equation without having to remember various formulas. However, conversion factors (CF) still need to be memorized. ○ Steps for Dimensional Analysis ■ 1. Identify the unit/form (tablet, capsule, mL) of the drug to be calculated. Place this unit/form to one side of the equal sign (=). This is your desired unit/form. ■ 2. Determine the known dose and unit/form from the drug label. Place this on the other side of the equal sign. ■ 3. Continue with additional fractions using a multiplication operation between each fraction until all but that one unit/format you want is eliminated. ■ 4. Multiply the numerators and multiply the denominators. ■ 5. Solve for x (the unknown unit/form). ○ EXAMPLE: ■ Order: Amoxicillin 500 mg PO q8h ■ Available: 250 mg per capsule

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EXAMPLE:

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Exam 1 Review for 318 ■ ■

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Available: 250 mg per capsule How many capsules will the nurse administer?

= EXAMPLE: ■ Order: Acetaminophen 1 g PO q6h PRN for headache ■ Available: Acetaminophen 325 mg per tablet ■ Conversion factor: 1000 mg = 1 g ■ How many tablet(s) should be given?

Dimensional Analysis ● a. Determine BSA (we will use the calculated BSA from earlier, 0.71 m2). ● b. Solve for the desired unit of measure.

= Dimensional Analysis (Notice that the CFs are included in this one equation.)

= (Because you can administer tenths of liquid medications, round to the nearest tenth.) EXAMPLE: ● Order: Cefaclor oral suspension 20 mg per kg per day in three divided doses for a pediatric patient who weighs 66 lb ● Available: Cefaclor oral suspension 125 mg per 5 mL ○ Dimensional Analysis

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1.5 Discuss the measures followed by the nurse to ensure medications are administered safely ● ● ● ● ●

Verify any medication order and make sure it’s complete. The order should include the drug name, dosage, frequency and route of administration. If any element is missing, check with the practitioner. Check the patient's medical record for an allergy or contraindication to the prescribed medication. If an allergy or contraindications exist, don't administer the medication and notify the practitioner. Prepare medications for one patient at a time. Educate patients about their medications. Encourage them to speak up if something seems amiss. Follow the 6 rights of medication administration.

1.6 List the components of a drug label Pharmaceutical companies include the brand name/trade name and generic name on their drug labels. Generic drugs only have the generic name on the label. All drugs need the following information on the labels:

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Exam 1 Review for 318 ➢ ➢ ➢ ➢ ➢

The formulation or the drug amount per tablet, capsule, or unit of liquid (for oral and parenteral doses) Lot # Expiration date Proper storage of the drug Whether it is controlled drug (Schedule I-V) ➔ Schedule I drugs are not approved for medical use and have high abuse potential ➔ Schedule II-V have acceptable medical use and decreasing potential for abuse leading to psychological and/or physiologic dependence

➢ All OTC drugs must have the following information on their labels: • The product’s active ingredients, including the amount in each dosage unit • The purpose of the product • The uses (indications) for the product • Specific warnings, including when the product should not be used under any circumstances, substances or activities to avoid, side effects that could occur, and when it is appropriate to consult with a doctor or pharmacist • Dosage instructions that include when, how, and how often to take the product • The product’s inactive ingredients and important information to help consumers avoid ingredients that may cause an allergic reaction

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Exam 1 Review for 318 Topic 2: Drugs and the Body: Pharmacodynamics, Pharmacokinetics, and Pharmacogenetics Ch 3,4,11 2.1 Differentiate among pharmacokinetics, pharmacodynamics, and pharmacogenetics ● ●

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Pharmacokinetics - the movement of drugs in the body ○ Pharmacokinetic Phase - absorption, distribution, metabolism, excretion Pharmacodynamics - effects of drugs in the body ○ Pharmacodynamic Phase ■ Receptor binding ■ Postreceptor effects ■ Chemical reaction Pharmacogenetics - study of medication as it relates to the human genome ○ looks at the difference in each individual's response to medications based on genetic variations ○ goal of pharmacogenetics ■ create an individualized drug treatment program that involves the best choice and dose of drugs for a particular patient

2.2 Discuss diagnostic labs and values related to pharmacokinetics associated with the liver and kidneys, such as aspartate transaminase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), creatinine (CR), and blood urea nitrogen (BUN) ●

Kidneys ○ BUN: 10-20 mg/dL ○ Serum Creatinine: 0.5-1.3 mg/dL...