Pharmacology and the Nursing Process Exam 1 Flashcards Quizlet PDF

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Pharmacology and the Nursing Process Exam 1 Terms in this set (196)

compliance

Implementation or fulfillment of a prescribers treatment plan or therapeutic plan by patient.

Any preventable adverse drug event involving medication error

inappropriate medication use by a patient or health care professional; it may or may not cause the patient harm.

An informed decision on the part of the patient not Noncompliance

to adhere to or follow a therapeutic plan or suggestion.

Assessment Diagnosis Nursing Process

Planning Implementation Evaluation

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Descriptions of specific patient behaviors or responses that demonstrate meeting of or Outcomes

achievement of behaviors related to each nursing diagnosis. These statements are specific while framed in behavioral terms and are measurable.

Any health care professional licensed by the Prescriber

appropriate regulatory board to prescribe medications.

QSEN

Quality and Safety Education for Nurses

knowledge, skills, attitudes needed to to continually KSA

improve the quality and safety of a patient within a healthcare system

Patient-centered care Teamwork and collaboration 6 major initiatives of QSEN

Evidence-based practice (EBP) Quality improvement (QI) Safety Informatics

1) Right drug 2) Right dose 3) Right time Nine Rights of Medication Administration

4) Right route/form 5) Right patient 6) Right documentation 7) Right reason 8) Right response 9) Right of patient to refuse

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Right drug

Must be checked against the medication label or profile 3x b4 giving

always check the dose and confirm that is appropriate for patient's age and size Right Dose

check prescribed dose against available drug stock and against normal drug range recheck all math calculations

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0.2 is allowed, but NEVER 2.0

ZERO's

Include in your 3 check the frequency of the ordered medication, the time administered and the last time the med was given. Right Time ***For routine med orders the standard of care is within the half hour it was prescribed.

PNR

analgesic

as needed

pain reliever

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Never use abbreviations

Right Route and Form

Right Patient

It is crucial to patient safety to never use any abbreviations for any component of the drug order

Never assume the route of admission

requires confirmation of a patient's identity with two forms of identification before drug administration

requires the nurse to record immediately the appropriate information about the drug Right Documentation

administered ** DOCUMENT ONLY AFTER med was given

Right Reason

Is it appropriate to give the med

refers to the drug and it's desired response Right response

continually assess and evaluate the achievement of the desired response as well as any undesired response

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right to refuse

When can you NEVER return a

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clients have right but need to clarify reason and notify prescriber

When it has been unwrapped, or opened.

med

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any preventable event or activity that can cause Medication errors

inappropriate medication use or patient harm

Use of home or folk remedies Case study on Page 7 1) What questions does the nurse need to ask during the assessment phase

Intake of caffeine Use of over-the-counter medications Past and present health history, in addition to her anemia Pertinent family history Cultural differences/issues Responses to medications taken in the past

Case Study on Page 7

Deficient knowledge about therapy with iron

What nursing diagnosis is

supplements

appropriate at the time?

Self-health management, readiness for enhanced

Think about the "Nine Rights"! Assuming the prescription has her name on it (right patient), and the licensed prescriber's signature (right documentation), the prescription has the drug name (right drug), 325 mg (right dose), PO (right route), Case study on page 7

and right reason (for anemia), but something is

3) What is missing, what should

missing! The right TIME. How often does this

be done?

medication need to be taken? Should it be taken with meals or on an empty stomach? The pharmacist will need to contact the licensed prescriber to clarify the prescription. The frequency of the medication will certainly affect the dosage she ultimately receives each day.

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Dollie has the right to refuse to take the medication. However, the nurse needs to identify Dollie's reasons for refusing the medication. If the "cause" of refusal is known, then the nursing care plan may be revised and further actions implemented, such as Case study page 7

education about the purpose of the drug and how

How should the nurse Handle

to manage side effects, as well as other concerns

this?

raised by the patient. In addition, the licensed prescriber should be notified of Dollie's concerns, and the data should be documented, including information about the nurse's response to Dollie's concerns.

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• The nursing process is an ongoing, constantly changing, and evolving organizational framework for the practice of nursing, encompassing all steps taken by the nurse in caring for a patient. • The phases of the nursing process include assessment; development of nursing diagnoses; planning, with establishment of goals and outcome criteria; implementation, including Overview of the Nursing

patient education; and evaluation.

Process

• Safe, therapeutic, and effective medication administration is a major responsibility of professional nurses as they apply the nursing process to the care of their patients. • Critical thinking is a major part of the nursing process and involves the use of the mind and thought processes to gather information and then develop conclusions, make decisions, draw inferences, and reflect on all aspects of patient care.

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. Whenever a patient questions a particular medication or mentions something about the medication that is not in accordance with what the nurse thinks, the nurse must always be careful—stop, recheck the prescriber's order against the medication administration record or profile, and When medications were administered during the night shift. a patient refused to take his 0200 dose of an antibiotoc claiming he had just taken it what is the best action by the nuste.

check the dispensing system or medication record/profile to determine whether a dose was given and signed off by another nurse. Never ignore a patient's concerns! Never assume that the patient is unaware of his or her medication; always doublecheck to be safe. If all records and orders have been checked, and the nurse is certain that the drug has not been given, then the nurse proceeds with medication administration. A simple explanation could then be given to the patient. If the patient continues to refuse the medication, document this in the nurses' notes and report it to the charge nurse or nurse supervisor and to the prescriber.

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Because this is a newly admitted patient, it would be best to perform an assessment before giving any medications. However, because the order is stat, meaning to give immediately, the assessment has to be brief and focused. Assess the patient's vital signs (blood pressure, pulse, respirations, temperature) and level of consciousness. Check for signs of fluid During a busy shift, the nurse

retention (pedal edema), ask about urine output and

notes that the chart of a newly

function, and listen to breath and heart sounds. Do

admitted patient has a few

not forget to assess for drug allergies and other

orders for various medications

drug reactions. However, the stat order is missing

and diagnostic test that were

something—a route. Never assume that a medication

taken by telephone by another

is to be given by mouth. Even though this patient

nurse. The nurse is on the way

was just admitted and may or may not have an

to the patient room to do an

intravenous line, the best action is to clarify the

assessment when the unit

route by which this drug should be given. The order

secretary tells the nurse one of

was taken by telephone by another nurse, so you

the orders read: Lasiz, 20 mg

can ask the nurse whether a route was specified

stat. What is the priority action

when the nurse spoke to the prescriber. If not, the

by the nurse>

prescriber must be contacted right away for clarification. To streamline things, the order can be checked by another nurse or, in some facilities, the pharmacist, while you are performing the assessment. Lastly, even though the medication is stat, be sure to check the patient's identification with two patient identifiers per the health care institution protocol.

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An 86-year-old patient is being

a) The patient and patient's daughter will state the

discharged to home on

proper way to take the drug.

digitalis therapy and has very little information regarding the medication. Which statement best reflects a realistic outcome of patient teaching activities? a) The patient and patient's daughter will state the proper way to take the drug. b) The nurse will provide teaching about the drug's adverse effects. c) The patient will state all the symptoms of digitalis toxicity. d) The patient will call the prescriber if adverse effects occur.

A patient has a new

Risk for injury

prescription for a blood pressure medication that may cause him to feel dizzy during the first few days of therapy. Which is the best nursing diagnosis for this situation?

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A patient's chart includes an

d) The nurse contacts the prescriber to clarify the

order that reads as follows:

dosage route.

"Atenolol 25mg once daily at 0900." Which action by the nurse is correct? a) The nurse gives the drug via the transdermal route. b) The nurse gives the drug orally. c) The nurse gives the drug intravenously. d) The nurse contacts the prescriber to clarify the dosage route.

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The nurse is compiling a drug

c) "When you have pain, what do you do to relieve

history for a patient. Which

it?"

question from the nurse will obtain the most information from the patient? a) "Do you depend on sleeping pills to get to sleep?" b) "Do you have a family history of heart disease?" c) "When you have pain, what do you do to relieve it?" d) "What childhood diseases did you have?"

A 77-year old man who has

What type of reaction did you have when you took

been diagnosed with an upper

penicillin

respiratory tract infection tells the nurse he is allergic to penicillin what is the appropriate response by the nurse

The nurse is preparing a care

ADPIE

plan for a patient sho has been newly diagnosed with type 2 diabetes mellutis. Which of these relect the correct order of the nursing process?

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The nurse is reviewing new

Sitagliptin (50 mg daily)

medication orders that have

Docusate as needed for constipation

been written for a newly admitted patient. Which orders should the nurse clarify.

drug

any chemical that affects the physiologic processes of a person

the study or science of a drug Pharmacology

pharm enable the nurse to better understand how drugs effect humans.

chemical name

The name that describes the chemical composition and molecular structure of a drug.

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is a much shorter and simpler than the chemical generic name

name. This us used most official drug compendiums to drug list.

trade name

The drugs registered trademark

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The length of time from patent to approval until patent expires. This is normally 17 years.

patent life

The research for a new drug is usually 10 years Manufactures generally have the remaining 7 years to make profit before it expires

Biosimilar

Drug classification

a copy version of an already authorized biological product

Can be classified by structure or therapeutic use.

Pharmaceutics 3 basic areas of pharmacology

Pharmacokinetics Pharmacodynamics

Pharmaceutics

Pharmakinetics

Pharmadynamics

Off-label prescribing

The study of how various drug forms influence the way in which the drug affects the body

what the body does to the drug Absorption, distribution, metabolism, excretion

what the drug does to the body

A drug is prescribed to treat conditions other than those approved by the FDA.

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What oral drugs usually absorb more quickly?

Enteric coated tablets have

Oral drugs that are liquid are already disolved and are usually absorbed more quickly than solid doage forms

Stomach, intestine.

coating that prevents them from breaking down in the __________, instead they break down in the ____________.

What type of drug must never

extended release.

be crushed

first pass effect

Drugs taken orally have a

reduces the bioavailability of the drug to less than 100%

less than 100, 100%

bioavailibily of ____________, whereas IV routes have an ___________ biovailabilty.

Areas of rapid distribution

Albumin

unbound proteins

drug-drug interactions

Hydrophilic

heart, liver, kidneys, brain

the most common blood protein and carries the majority of protein-bound drug molecules

Considered a Free drug

When the presence of one drug decreases or increases the action of another

water soluble

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lipophilic

Metabolism

The organ the drug is most

fat soluble

biotransformation

liver

responsible for is the

Organs responsible for drug

kidneys, liver and bowel.

elimination

time required for 50% of the drug to be removed half-life

from the body Is a measure of the rate the drug is eliminated

How many half lives until the

5

drug is considered removed from the body

The physiologic state in which the amount of drug steady state

removed via elimination is equal to the amount of drug absorbed with each dose.

Onset of action

Peak effect

duration of action

peak level

The time required for a drug to elicit a therapeutic response after dosing.

the time required for a drug to reach its maximum therapeutic response in the body

The length of time the concentration of a drug in the blood or tissues is sufficient to elicit a response.

highest blood level

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trough level

3 ways drug exert actions

Adverse effects

lowest blood level

receptors, enzymes, non selctive interactions

Predictable ...