Study Guide N 180 Quiz 1 April 13 2021 PDF

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STUDY GUIDE N180 QUIZ 1, April 13, 2020 1. Drugs may elicit different responses depending on individual client factors. List these factors?  Age, Sex, Body mass, Health status, genetics 2. Physician has prescribed a brand name drug for the client. The client tells the nurse that the medication is too expensive. What is the best plan by the nurse?  Ask the physician if a generic drug may be substituted. (Taken from Quizlet) 3. The nurse is teaching a class for clients about over-the-counter (OTC) medications. How does the nurse determine that education has been effective?  we must read all the directions on the label and call the doctor’s office if they are not clear. (Taken from Quizlet)

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Determine effectiveness:  Observe return demonstrations to see whether the patient has learned the necessary psychomotor skills for a task.  Ask the patient to restate instructions in his or her own words.  Ask the patient questions to see whether there are areas of instruction that need reinforcing or re-teaching. Define pharmacotherapeutics?  Branch of Pharmacology defined by the study of the therapeutic uses and effects of drugs - Pharmacotherapeutics is the application of drugs for the purpose of treating disease and the treatment of suffering (PPT) List examples of complement therapy?  Natural plant extracts, herbs, vitamins, minerals, dietary supplements  Acupuncture, hypnosis, biofeedback, massage, therapeutic touch - Complementary therapy is outside mainstream health care, consider health care of whole person, emphasize integration of mind and body, promote disease prevention, self-care, self-healing, and recognize role of spirituality; combine traditional beliefs and main stream health practices - Manual healing: Massage, pressure-point therapies, hand-medicated biofield therapies - Mind-body interventions: Yoga, meditation, hypnotherapy - Guided imagery, biofeedback - Movement-oriented therapies (music and dance) - Herbs- Technically a botanical without any woody tissue such as stems or bark - Ginger: Used for nausea, motion sickness, diarrhea, relieves pain, swelling, arthritic stiffness. - Side effects may include gas, bloating, heartburn, nausea. - Ginkgo biloba: Used for asthma, bronchitis, fatigue, tinnitus. - Used to improve memory, decrease intermittent claudication. Treats sexual dysfunction, multiple sclerosis. - Side effects include headache, dizziness, nausea, GI upset, increase bleeding, allergic reactions. - Astragalus - Boosts immune system + limits cold and flu symptoms - Chamomile - Relief of anxiety, sleeplessness, digestive complaints, skin conditions, and oral ulcers - May have sedative effects Describe the term therapeutic?  Desirable response of medication or drug Describe the prototype drug approach?  well understood; Has known action and adverse effects  used to compare other drugs in the same pharmacologic class  May not be the most widely used drug in its class

 Disagreements may exist over which drug should serve as prototype drug. 8. Describe mechanism of action?  Like key to lock May trigger second messenger events  activation of specific G proteins and associated enzymes  Initiates drug action; Can stimulate or inhibit normal activity - Mechanism of Action -> how a drug produces an effect within the body 9. List examples of medication trade names?  Advil, Motrin, and Nuprin - Brand (trade) name (proprietary name) – chosen by drug company and usually registered trademark owned by a specific company; always in capital letter. ex. furosemide (Lasix) - Drug developer has exclusive rights to name and market new drug for 17 years in USA 10. How does a laboratory become a FDA laboratory? - Any pharmaceutical laboratory must obtain approval from the Food and Drug Administration (FDA) before marketing a drug. - Four stages: 1. Preclinical investigation 2. Clinical investigation 3. Review of new drug application (NDA) 4. Post marketing surveillance - Amount of time for approval varies.

11. Describe clinical investigation?  Takes place in three different stages termed clinical phase trials  Longest part of approval process  Evaluates human benefits  Tests on healthy humans first, then on those with the target ailment 12. Define controlled substances?  Definition: Drugs that have a high potential for addiction  Are frequently abused  Have a high potential for addiction or dependence   -

Have restricted use placed into one of five schedules Described in 5 schedules or categories Schedule I: not approved for medical use Schedule II-V have accepted medical use Abuse potential and extent of physical and psychological dependence are greatest with schedule I drugs Dependency decreases as one moves through the schedule Schedule V – have limited abuse potential

13. What are scheduled 2 medications?  Dilaudid, methadone, meperidine, morphine, fentanyl (cocaine also schedule II), Ritalin... - Have high potential for drug abuse. Accepted medical use. Can lead to strong physical and psychological dependency. Labeled C-II. 14. What is the preclinical investigation for medication testing?  Involves laboratory research  Tests done on cells and animals  Determines drug-dose range  Examines adverse effects, Results considered inconclusive - Preclinical testing -> consists of in vitro and in vivo systems. - In vitro experimentation -> generally conducted in a test tube/other lab equipment - In vivo testing -> conducted w/ living organisms. - Testing is followed by toxicity screening to identify 1. Abnormal changes in animal organs related to drug administration 2. Parameters of the safe therapeutic dose - Control and experimental groups of animals are compared 15. List the names of drugs that have the highest potential for addiction?  Heroin, LSD, Marijuana, Ecstasy - Schedule I drugs have the highest abuse potential - Restricted to situations of medical necessity if allowed at all - Little or no therapeutic value; mostly used for research/highest potency for abuse 16. Describe physical dependence to medication?  Drugs, substances, or chemicals defined as drugs with a high potential for abuse, with use potentially leading to severe psychological or physical dependence.  presence of physical withdrawal symptoms (muscle tremors) is seen when a person is physically dependent on a drug and the drug is removed. - Physical dependence - reliance on a substance that has reached the level that its absence will cause impairment in function; cessation causes severe emotional, mental, and/or physiologic reactions - Dilaudid, methadone, meperidine, morphine, fentanyl (cocaine also schedule II), Ritalin -> drugs with high potential for abuse 17. List the 5 rights of medication administration?  Right patient, Right medication, Right dose, Right route of administration, Right time of delivery 18. What are the important points to medication administration that ensure patient safety?  Know classifications, actions, and side effects of drug  Know patient details and why drug was prescribed  Know how drug is acquired and pharmacy procedures  Know how to prepare and administer drug safely  Before drug is administered, the nurse must know all variables of the patient's condition.  Be prepared to recognize and react to adverse effects - Right patient -> 2 forms of identification - Right Drug -> date and time ordered, drug name, drug dosage, route, and frequency - Right time -> time prescribed dose is ordered to be administered - Right assessment -> collection of appropriate data before administration of drug - Right documentation -> nurse must immediately record appropriate information about drug administered 19. What does the nurse do if the wrong medication is ordered for N/G tube administration? - Medication error is a common cause of morbidity and preventable death in hospitals - If a medication error does occur the nurse must first assess the patient, then report error to the physician and lastly document the error in an incident report. 20. How many mls are in 2 tsps.?  2 Teaspoons = 9.85784 mLs; 1mL = 0.202884 - 1 teaspoon = 5 mL so 2 tsps = 10 mL

21. What are the effects of medication on patents that are malnourished? P.5 - Patients with liver or kidney disease or those who are malnourished may have an abnormally low serum albumin level. - This results in fewer protein-binding sites, which leads to excess free drug and eventually to drug toxicity. 22. 1 tsp = how many mls?  1 Teaspoon = 4.92892 mLs - 1 teaspoon = 5 mL 23. Why are medications with the highest therapeutic index the safest medications?  a patient would have to take a much higher dose of such a drug to reach the toxic threshold than the dose taken to elicit the therapeutic effect.  In addition, there is less chance of drug abuse - Drug with a high therapeutic index have a wide margin of safety and less danger of producing toxic effects - The closer the ratio is to 1, the greater the danger of toxicity 24. What labs are important to assess for medication administration to older patients?  Before administering a new drug to an older patient, the nurse should consider the patient’s kidney and liver function - BUN, serum creatinine, creatinine clearance levels, and liver enzymes 25. What action does the nurse take when administering a medication in the morning that should be administered at night? - If missed medication is essential -> call the doctor to order 1x dose of that medication and confirm with the pharmacy - If not, don’t administer it. Document if medication was missed 26. Phase 1 clinical trial indicates?  Test drug for safety in 20-80 healthy people - Phase 1 trials -> primarily designed to assess safety - Objectives are to determine the human dosage range based on response in healthy human beings and to identify the pharmacokinetics (ie. Absorption, distribution, metabolism/biotransformation, and excretion/elimination) of the drug. - Progression to the next phase occurs if no serious adverse effects are demonstrated, the drug is eliminated in a reasonable amount of time, and the dose range is below that known to induce pathology in animals 27. What organ is responsible for biotransformation of a drug?  Liver—primary site 28. What action occurs with the initial transformation of a drug? P.6 - Metabolism or biotransformation is the process by which the body inactivates or biotransforms drugs. Drugs can be metabolized in several organs; however; liver is primary site of metabolism. -

Most drugs are inactivated by liver enzymes and are then converted or transformed by hepatic enzymes to inactive metabolites/water-soluble substances for excretion.

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Liver metabolizes lipid-soluble drug substance to water-soluble substance for renal excretion.

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When drug is transformed into active metabolites -> increased pharmacologic response

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When drug metabolism is decreased -> excess drug accumulation would lead to drug toxicity

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Half-life -> time it takes for one half of the drug concentration to be eliminated

29. Describe the pharmacological classification of a drug?  Based on the drug's mechanism of action, or how the drug produces its effect  At molecular, tissue, or body-system level

 More specific than therapeutic classification: Diuretic, Vasodilator Study your pharmacology text book A few questions from your Mc

30. Cuistion book, look at the end of the chapter and I will select a few from there. 31.

Study questions from your ATI and the end of the chapters, I will select a few from

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