Quizlet - pharmacology PDF

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Pharmacology and the Nursing Process Exam 1 Study online at quizlet.com/_6vz29t 1.

1. You have an order to give Avelox 400mg IVPB over 2 hours. You remove the med from the Pyxis and you see Avelox 400mg diluted in 250mL of NS. At what rate do you set the pump for correct infusion of this medication?

_𝟐𝟓𝟎𝒎𝑳/𝟐 𝐡𝐨 𝐮𝐫)_ = 125mL/hr

2.

3 basic areas of pharmacology

Pharmaceutics Pharmacokinetics Pharmacodynamics

3.

3. One and a half liters of Normal Saline is required to be given over 4 hours. Using a set which delivers 10 drops/ml how many drops per minute will need to be infused?

_𝟏𝟓𝟎𝟎𝒎𝑳 𝒙 𝟏𝟎 𝒈𝒕𝒕/𝒎𝒍 /𝟒 𝐱 𝟔𝟎 𝐦𝐢𝐧_ = 62.5 gtt/min = 63 gtt/min

4.

3 ways drug exert actions

receptors, enzymes, non selctive interactions

5.

4. Calculate the drip rate for 2 liters of IV fluids to be given over 5 hours via _𝟐𝟎𝟎𝟎𝒎𝑳 𝒙 𝟏𝟎𝒈𝒕𝒕/𝒎𝒍 /𝟓 𝐱 𝟔𝟎 𝐦𝐢𝐧_ = 66.6gtt/min = a set which delivers 10 drops/mL. 67 gtt/min

6.

4. The physician has ordered erythromycin 200mg in 250ml of D5W to infuse in 75 minutes. Calculate the rate on the pump.

_𝟐𝟓𝟎𝒎𝑳_𝟏.𝟐𝟓 𝐡𝐨 𝐮𝐫)_ = 200mL/hr Or _𝟐𝟓𝟎𝒎𝑳 𝒙 𝟔𝟎𝒎𝒊𝒏/𝟕𝟓𝒎𝒊𝒏_ = 200mL/hr

7.

6 major initiatives of QSEN

Patient-centered care Teamwork and collaboration Evidence-based practice (EBP) Quality improvement (QI) Safety Informatics

8.

7. You have an order for Cipro 400mg BID over 30 minutes. The medication is supplies as 400mg in 200mL from the pharmacy. . What will you set your rate on the pump?

_𝟐𝟎𝟎𝒎𝑳_𝟎.𝟓 𝐡𝐨 𝐮𝐫)_ = 400mL/hr Or _𝟐𝟎𝟎𝒎𝑳 𝒙 𝟔𝟎𝒎𝒊𝒏_𝟑𝟎𝒎𝒊𝒏_ = 400mL/hr

9.

A 77-year old man who has been diagnosed with an upper respiratory tract What type of reaction did you have when you took penicillin infection tells the nurse he is allergic to penicillin what is the appropriate response by the nurse

10.

An 86-year-old patient is being discharged to home on 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.

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. 11.

active transport

the movement of materials through a cell membrane using energy

12.

Acute therapy

Involves intensive drug treatment and is implemented in the acutely ill (those with rapid onset of illness) or even the critically ill to sustain life or treat disease.

13.

Adverse drug event

any undesirable occurrence related to administering meds

14.

adverse drug reaction

any unexpected, unintended, undesired, or excessive response to a medication given at therapeutic dosages (as opposed to overdose)

15.

Adverse effects

Predictable reactions

16.

Affective Domain

The most intangible domain of the learning process. It involves affective behavior, which is conduct that expresses feelings, needs, beliefs, values, and opinions; the feeling domain.

17.

Albumin

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

18.

alternative medicine

Herbal medicine, chiropractic, acupuncture, massage, reflexology, and any other therapies traditionally not emphasized in Western medical schools

19.

analgesic

pain reliever

20.

Any change in the mothers ________ can change the amount of drug in which the fetus can get exposed to

phyiology

21.

Areas of rapid distribution

heart, liver, kidneys, brain

22.

Biosimilar

a copy version of an already authorized biological product

23.

Calculate the drip rate for 100 mls of IV fluid to be given over a half hour via aset which delivers 10 drops/ml.

_𝟏𝟎𝟎𝒎𝑳 𝒙 𝟏𝟎 𝒈𝒕𝒕/𝒎𝒍 /𝟎.𝟓 𝐡𝐨 𝐮𝐫 𝐱 𝟔𝟎 𝐦𝐢𝐧_ = 33 gtt/min

24.

Case study on Page 7

Use of home or folk remedies 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

1) What questions does the nurse need to ask during the assessment phase 25.

Case study on page 7 3) What is missing, what should be done?

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), and right reason (for anemia), but something is missing! The right TIME. How often does this 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.

26.

Case Study on Page 7 What nursing diagnosis is appropriate at the time?

Deficient knowledge about therapy with iron supplements Self-health management, readiness for enhanced

27.

Case study page 7 How should the nurse Handle this?

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 education about the purpose of the drug and how to manage side effects, as well as other concerns 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.

28.

chemical name

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

29.

Cognitive Domain

Storage of basic knowlwdge

30.

Complementary and alternative medicine categories

1) alternative medicine systems, 2) mind body interventions, 3)biologically based therapies, 4) manipulative and body based method and energy therapies.

31.

complementary medicine

Alternative medicine when used simultaneously with, rather than instead of, standard Western medicine.

32.

compliance

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

33.

conventional medicine

The practice of medicine as taught in Western medical schools

34.

Dietary Medicine

A product that contains an ingredient intended to supplement the diet, including vitamins, herbs , minerals or other botanical stuff

35.

Diffusion

passive movement of a substance between diffrent tissues from areas of higher concentration

36.

Dosage Calculation: Weight-based Calculations

Enoxaparin and Heparin are weight-based Heavier the person higher dose Lighter the patient smaller dose ALL weight based medications are based on kilograms (kg)!!!! 1kg = 2.2 pounds You will have to convert pounds to kilograms!

37.

DRIP (gtt ) RATE FACTOR

You literally stand there and count the drops in the drip chamber for 1 minute. Example: You want 25 gtt/min....you need 25 drops to fall in one minute.

38.

Drop Factor Formula

(time in hours) _total volume(ml) x gtt/ml (tubing) /hours to administer x 60 minutes = GTT/ min Or _total volume(ml) x gtt/ml (tubing)/_Minutes to administer

39.

drug

any chemical that affects the physiologic processes of a person

40.

Drug classification

Can be classified by structure or therapeutic use.

41.

drug-drug interactions

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

42.

A drug given by which route is altered by the first-pass effect?

Oral Medications absorbed in the stomach and small intestine travel through the portal system and are metabolized by the liver before they reach the general circulation.

43.

Drug half-life is defined as the amount of time required for 50% of a drug to:

be eliminated by the body. In pharmacokinetics, the time required for half of an administered dose of drug to be eliminated by the body, or the time it takes for the blood level of a drug to be reduced by 50%, is the drug's half-life (also called elimination half-life).

44.

Drug polymorphism

refers to the effect of a patient's age, gender, size, body composition, and other characteristics on the pharmacokinetics of specific drugs

45.

Drug properties that impact drug transfer to the fetus include:

Drug'c chemistry, dosage, and concurrently administered drugs.

46.

Drugs taken orally have a bioavailibily of ____________, whereas IV routes have an ___________ biovailabilty.

less than 100, 100%

47.

duration of action

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

48.

During a busy shift, the nurse notes that the chart of a newly admitted patient has a few orders for various medications and diagnostic test that were taken by telephone by another nurse. The nurse is on the way to the patient room to do an assessment when the unit secretary tells the nurse one of the orders read: Lasiz, 20 mg stat. What is the priority action by the nurse>

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 retention (pedal edema), ask about urine output and function, and listen to breath and heart sounds. Do not forget to assess for drug allergies and other drug reactions. However, the stat order is missing something— a route. Never assume that a medication is to be given by mouth. Even though this patient was just admitted and may or may not have an intravenous line, the best action is to clarify the route by which this drug should be given. The order was taken by telephone by another nurse, so you can ask the nurse whether a route was specified when the nurse spoke to the prescriber. If not, the 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.

49.

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

Stomach, intestine.

50.

exposure to the fetus to drugs is most detrimental in the ________ trimester, it is more likely during the _________

first, last

51.

Factors contributing to drug polymorphism

environmental factors, cultural factors, genetic factors

52.

first pass effect

reduces the bioavailability of the drug to less than 100%

53.

generic name

is a much shorter and simpler than the chemical name. This us used most official drug compendiums to drug list.

54.

Gestation age is important in pharmacology because

it determines when the drug can most easily cross the placenta and into the fetus.

55.

Greatest danger of drug induced developmental defects

First trimester of pregnancy

56.

The greatest percentage of maternally absorbed drugs is during

the last trimester

57.

half-life

time required for 50% of the drug to be removed from the body Is a measure of the rate the drug is eliminated

58.

health literacy

the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions

59.

herbal medicine

the practice of using herbs to heal

60.

herbs

Plant components including bark, roots, leaves, seeds, flowers, fruit of trees, and extracts of these plants that are valued for their savory, aromatic, or medicinal qualities.

61.

How does the nurse best evaluate the patient's understanding of teaching about a new medication?

Ask specific questions to assess the patient's understanding. The nurse should ask the patient very specific questions to determine if the patient has a true understanding of the medication.

62.

How many half lives until the drug is considered removed from the body

5

63.

Hydrophilic

water soluble

64.

iatrogenic effects

unintentional adverse effects that are caused by the actions of a prescriber, other health care professional, or by a specific treatment

65.

idosyncratic reaction

An abnormal and unexpected response to a medication, other than an allergic reaction, that is peculiar to an individual patient.

66.

integrative medicine

simultaneous use of both traditional and alternative medicine

67.

Knowing that the albumin in neonates Decrease the amount of drug given. A lower binding capacity leaves more drug available for action; thus, a lower dose and infants has a lower binding capacity for medications, the nurse anticipates the would be required to prevent toxicity. health care provider will perform which action to minimize the risk of toxicity?

68.

KSA

knowledge, skills, attitudes needed to to continually improve the quality and safety of a patient within a healthcare system

69.

LASA

look alike sound alike

70.

Learning

the acquisition of new knowledge, skills, or responses from experience that results in a relatively permanent change in the state of the learner

71.

Legend drugs

Medications that are not legally available without a prescription from a prescriber; also called prescription drugs

72.

lipophilic

fat soluble

73.

look at chart

74.

maintenance therapy

Does not eradicate pre-existing problems the patient may have, but will prevent progression of a disease or condition.

75.

A male patient who abuses alcohol tells the nurse that he is treating himself with kava. Which instruction should the nurse include in patient teaching?

Stop taking the kava now. The nurse should instruct the patient to stop taking kava now because kava can enhance the effects of alcohol, a depressant, possibly resulting in respiratory arrest. This is a nursing priority because it involves an immediate, potentially life-threatening issue. The nurse would avoid suggesting the use of a substance that the patient abuses and so in this case would avoid a recommendation to use the kava or the alcohol.

76.

The MD orders NS 1000ml to infuse over 4 hours. What rate do you set the pump for?

Rate=250 ml/hr

Rate=Volume (ml)/ time(hrs) Rate=1000ml/ 4 hours

77.

medication error

Any preventable adverse drug event involving inappropriate medication use by a patient or health care professional; it may or may not cause the patient harm.

78.

Medication error can occur at any point in the med proccess:

procuring, prescribing, transcribing, dispensing, administering, and monitering Half of all med errors begin in the prescribing stage any preventable event or activity that can cause inappropriate medication use or patient harm

79.

Medication errors

80.

1.5 million 117,00 4 million Medication errors harm about ________ people per year, including __________ hospitilizations and a cost of over ________ million

81.

Metabolism

biotransformation

82.

A mother of a 1-month-old infant calls the clinic and asks the nurse if the medication she is taking can be passed to her infant during breastfeeding. What is the nurse's best response to the mother's question?

"Drugs can cross from mother to infant in breast milk, so it will depend on the drug you are taking." The nurse is aware that medications can pass in breast milk, but each medication is different. Women who take medication while breastfeeding must be assessed on a case-by-case basis, including assessment of the medication the patient is taking.

83.

mutagenic effects

permanent changes in genetic composition of DNA or chromosomes

84.

neonate

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

85.

Never use abbreviations

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

86.

The new order on your patient is to infuse 1 Liter of 0.9% NS to infuse over 100ml/hr. How long until the liter of IVF is complete?

_𝟏𝟎𝟎𝟎𝒎𝑳_𝒙 𝐡𝐨 𝐮𝐫_ = 100mL/hr → X (_𝟏𝟎𝟎𝟎𝒎𝑳/𝒙 𝐡𝐨 𝐮𝐫_) = 100 x X → 1000mL=100 X → X = 1000mL/100 → X = 10

87.

Nine Rights of Medication Administration

1) Right drug 2) Right dose 3) Right time 4) Right route/form 5) Right patient 6) Right documentation 7) Right reason 8) Right response 9) Right of patient to refuse

88.

Noncompliance

An informed decision on the part of the patient not to adhere to or follow a therapeutic plan or suggestion.

89.

The nurse administers a medication to the wrong patient. Which is the appropriate nursing action following this error?

Notify the health care provider and document the error on an incident report. All medication errors that involve a patient need to be called to the health care provider's attention and documented on an incident report.

90.

The nurse is compiling a drug history for a patient. Which question from the nurse will obtain the most information from the patient?

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

a) "Do you depend on sleeping pills to get to sleep?" b) "Do y...