Exam 2 prep Flashcards


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1

what is pharmacology?

study of drugs and their actions on living organisms

2

what are drugs used for?

  • prevent, treat, or cure disease or disorders (vaccines)
  • restore or maintain body system function (insulin)
  • relieving symptoms (ibuprofen)
  • aid in diagnosing disease (dye)
3

what is the nurse responsible for when administering a medication?

  • understanding how medication works
  • correct administration (safe dose, route, pt, time)
  • therapeutic effects, side effects, contraindications
  • questioning an order that is unclear or may contain an error
  • following the 6 rights of administration
  • pt and family education
  • correct documentation
  • evaluation of effectiveness
4

what meds can chronic lung patients not have?

beta blockers; can be detrimental

5

how are OTC & prescription drugs similar?

  • can be as effective as the other one
  • can have as many side effects as the other
  • can be as safe as the other
6

what are the drug categories?

  • curative
  • prophylactic
  • diagnostic
  • palliative
  • replacement
  • destructive
7

when asking a pt about their medications, what do we need to know?

ALL their meds: OTC, prescription, & any herbals

routine & PRN

8

what are the different names of drugs?

  • generic
  • trade
9

the official and nonproprietary name approved by the USAN Council; there is only ONE for each drug; always lowercase

generic name

10

registered name; are always capitalized; may be more than one

trade/brand name

11

why is it important to get information from patients about all of their medications?

because of the risk for drug-drug interaction

12

who regulates drugs?

United States Pharmacopeia (USP)

13

assures that drugs have met high standards for therapeutic use, pt safety standards, quality, purity, strength, packaging safety, and dosage form by the U.S. Pharmacopeia National Formulary

United States Pharmacopeia (USP)

14

the USP designation does not indicate

FDA approval

15

ensures drugs are labeled correctly

Food and Drug Administration (FDA)

16

all drug administration laws are initiated, implemented, and enforced by

FDA

17

requires drug companies to study their products in children for safety and efficacy to be marketed for pediatric use

Pediatric Research Quality Act

18

when pediatric studies are required, they must be conducted with

the same drug and for the same use for which they were approved in adults

19

identifies and regulates the manufacture and sale of narcotics and dangerous drugs

Controlled Substance Act (1970)

20

which drugs have the highest abuse potential?

I and II

21

which drugs have the lowest abuse potential?

IV and V

22

examples of schedule I drugs?

  • heroin
  • LSD
  • peyote
  • ecstasy
23

examples of schedule II drugs?

  • morphine
  • hydromorphone
  • methadone
  • meperidine
  • oxycodone
  • fentanyl
  • adderall
  • ritalin
  • cocaine
24

examples of schedule III drugs?

  • tylenol w/ codeine
  • steroids
  • ketamine (requires new prescription after 6 months or 5 refills)
25

examples of schedule IV drugs?

  • tramadol
  • talwin
  • benzos
  • zolpidem
  • phentermine
26

examples of schedule V drugs?

  • lyrica
  • lomotil
  • robitussin AC
27

what can cocaine be used to treat?

nose bleeds

28

where can we, as nurses, find reliable and up-to-date drug information?

  • Micromedex
  • Hospital Formulary
  • Facts and Comparisons
  • Physicians Desk Reference (PDR)
  • Package Inserts
  • FDA
  • Drug Books
29

the study of how drugs are processed in the body (how medications travel through the body)

pharmacokinetics

30

the process of pharmacokinetics begins and ends when?

from administration to elimination

31

What is the process of pharmacokinetics?

ADME

  • Absorption
  • Distribution
  • Metabolism
  • Excretion
32

the first step in which a drug enters the body

absorption

33

what are the ways to introduce and administer drugs into the body?

  • enteral
  • topical
  • inhalation
  • parenteral
34

enteral

oral, SL, buccal

35

topical

transdermal, eye, ear, nose, rectal, vaginal

36

inhalation

MDI

37

parenteral

IV, IM, ID, SQ, IO, epidural

38

certain medications have to be given by certain means because

of the way drugs are absorbed

39

why must insulin be given SQ as opposed to PO?

if it was taken PO, by the time it would reach the small intestine, digestive enzymes from the GI tract would destroy the insulin, and it would no longer function

40

what is the primary site for GI absorption of a drug?

small intestine

41

what are some factors that could affect the absorption of drugs in the small intestine?

Crohn's, small intestine surgery

42

the process of a drug going from the bloodstream to tissues from circulating body fluids (bloodstream) to receptor sites

distribution

43

what affects distribution of drugs?

  • blood flow (too little): PVD, CVD, hypovolemia, hypotension
  • plasma protein binding (albumin-taxi cab)
  • blood-brain barrier
  • body weight/distrubution (muscle mass and fat composition)
44

what does albumin do?

carries molecules to the sites they need to go to

45

if albumin level is low, what can happen?

problems related to distribution

46

is the process of changing medications into less active or inactive forms by the action of enzymes

metabolism

47

where are most drugs metabolized?

liver

48

what can inhibit enzyme action (metabolism) resulting in excess drug accumulation in the body?

  • liver disease (hepatitis, cirrhosis)
  • liver failure

** this would increase the drugs effect and can lead to toxicity

49

if a pt has high liver enzymes, how might we alter the medication dose?

decrease it

50

process by which a drug is removed or eliminated by the body

excretion

51

drugs are eliminated either

unchanged or as metabolites in the urine

52

what is the primary organ involved in excretion?

kidneys

53

what labs would you follow to ensure safe medication administration and excretion?

BUN & Creatinine

54

if above labs are elevated, what should you do as a nurse?

call MD & suggest decreasing dose or changing to a medication that is not excreted by the kidneys

55

what can impair excretion causing drugs to accumulate?

  • kidney disease
  • kidney failure
  • decreased blood flow to the kidneys (hypotension)
56

what are some factors affecting pharmacokinetics? "ADME"

  • age-elderly changes (GI system, GU system, decreased body weight)
  • body composition
  • liver and kidney conditions
  • polypharmacy
  • inadequate blood flow (hypotension, PVD, CAD)
  • nutritional status
57

what are some issues seen in the elderly?

  • delayed emptying
  • decreased blood flow to liver and kidneys
  • decreased lean body weight & increased SQ fat
58

The registered nurse is providing care for a pt with a brain tumor. Which nursing action helps to prevent cerebral edema?

Administering glucocorticoids to the pt

59

a pt is started on low molecular wt heparin (LMWH). what complications should the nurse monitor for?

thrombocytopenia

60

what is an example of an ototoxic medication that can cause damage to the sensitive structures of the ear, with prolonged or overuse?

furosemide

61

what medication may cause patients to develop a dry, nonproductive cough

angiotensin-converting enzyme inhibitor

62

a pt reporting chest tightness arrives at the hospital. on assessment, the nurse noted wheezing, cough, elevated BP, and pulse rate. the primary healthcare provider prescribes corticosteroids, which is the most likely outcome of the prescribed therapy?

decreases the inflammation of the airway

63

what is true regarding herbal remedies' impact during surgery?

they can decrease the effectiveness of anesthesia

64

what is it called when a pt takes six or more medications?

polypharmacy

65

the pt with systemic lupus erythematosus (SLE) is experiencing pancytopenia. what would be the cause of this?

immunosuppression

66

which test measures the amount of glucose that binds to RBC's in a nonpregnant adult patient?

Hemoglobin A1c

67

what is true regarding long acting insulin?

it is a dose of basal insulin used in combination with rapid acting or short acting

68

which is true of the action of proton pump inhibitors (PPIs) in treating gastroesophageal reflux disease?

they block gastric acid production

69

The nurse is assessing a patient with a history of angina. The patient states that "I usually experience chest pain while climbing the stairs or after walking for 5 minutes." What question should the nurse ask next?

"If you rest, does the pain subside?"

Rationale: This question will help to determine if the angina is stable or unstable.

70

The nurse is admitting a patient in the emergency department with new onset of confusion. The laboratory report shows Na 120 mEq/L; K 5 mEq/L; urine specific gravity 1.038. Which intervention is the highest priority?

Pad the siderails of the bed.

Rationale: The sodium level is very low and the risk for seizures is very high. Implementing seizure precautions is the priority.

71

While caring for a patient who underwent surgical repair of a fracture, the nurse finds edema in the area where the surgery occurred. Which should the nurse assess next based on these findings?

Distal pulses

Rationale: Edema in the area of the surgery may be the cause of impaired perfusion.

72

involves the interactions between medications and target cells-the drugs actions and effects "lock and key"

pharmacodynamics

73

primary effect of pharmacodynamics is called

therapeutic effect

74

what are receptror sites?

proteins on the surface of cells that are capable of recognizing a specific molecule

75

drugs that combine with a specific receptor site to cause a pharmacologic response; the drug action will begin once it attaches to receptor sites

agonists

76

drugs that prevent a receptor response or block a normal cellular response

antagonist

77

act both as agonists and antagonists with limited affinity to receptor sites; act differently depending on the receptor site that is used

partial agonists

78

time it takes for drug to reach an effective blood level and to initiate a response (depends on the route of administration)

onset

79

when drug achieves its highest blood concentration

peak

80

length of time the drug has a pharmacologic effect

duration

81

amount of time needed for elimination process to decrease original blood concentration by 50%

half-life

82

how the drug works

mechanism of action

83

the patient's response to drug action

therapeutic effect

84

ability of a drug to produce maximal effects

efficacy

85

amount of drug required to produce 50% of maximal response possible for that drug

potency

86

affects the time that a drug stays in the body and can also have an effect upon the drug's efficiency

plasma protein binding (PPB); it affects both pharmacodynamics and pharmacokinetics

87

the most common plasma protein that drugs are bound to is

albumin

88

the part of the medication that is bound to the protein is

inactive

89

what are some things that increase the risk of having interactions:

  • drug-drug
  • food-drug
  • chronically ill (polypharmacy)
  • seeing several specialists
  • multiple pharmacies
  • taking OTC, prescription, & herbals
90

highest concentration of a drug in the patient's bloodstream

peak

91

lowest concentration of a drug in the pt's bloodstream

trough

92

the difference between average toxic and therapeutic doses

therapeutic index

93

rapidly achieving a higher level of a drug into the patients system to quickly achieve a therapeutic effect

loading dose

94

maintaining the drug level within a therapeutic range

maintenance dose

95

examples of medications that may require a loading dose

  • azithromycin
  • digoxin
  • diltiazem
  • amiodarone
96

how a drug produces its response

pharmacodynamics

97

what affects pharmacodynamics?

  • age
  • body composition/weight
  • genetics
  • ethnicity
  • disease conditions
  • psychosocial conditions
  • nutritional status
98

relationship between a person's genetic make-up and response to medication

pharmacogenetics

99

effects that occur when the actions of one drug are affected by another drug; example: antacid and abx

drug-drug interactions

100

when 2 drugs with similar actions are taken together and the additive effect increases the sum of the effects; example: ASA and codeine

additive effect

101

when 2 drugs together cause a greater response than each drug given individually; example: lisinopril and furosemide (BP responds much better)

synergism

102

the action of one drug increases the effect of the second drug; example: warfarin and ASA (causes increase in bleeding potential)

potentiation

103

drug not a suitable composition to be combined or mixed with another agent or substance, results in an undesirable reaction including chemical alteration or destruction

drug incompatibility

104

what puts a client at risk for drug interactions?

  • chronic health conditions
  • polypharmacy
  • more than one provider
  • supplement use
  • OTC use
  • use of more than one pharmacy
105

anticipated effects, usually mild (opioids-nausea, constipation_

side effects

106

pt becoming sensitized to drug, producing antibodies against drug creating antigen-antibody reaction (rash, hives, itching)

allergy

107

severe allergic rxn (bronchospasm, angioedema, etc.)

anaphylaxis

108

unusual or unexpected response; opposite the desired effect (diphenhydramine should induce sleepiness, however, if it causes hyperactivity, restlessness-that would be this rxn)

idiosyncratic effect

109

harmful, undesired effects of the possibility of organ damage

toxic effect

110

...

hepatotoxicity

111

...

nephrotoxicity

112

...

ototoxicity

113

drugs that cause birth defects

teratogenic effect

114

sociological factors affecting medication administration

socioeconomic status, housing, marital status/children, season, religious beliefs, finances, transportation

115

psychological factors affecting medication administration

ethics/cultural beliefs, cognitive functioning, food preferences

116

physiological factors affecting medication administration

health, senses, chronic disease processes, medication use, dental health

117

what are the rights of medication administration

  1. patient
  2. drug
  3. time
  4. route
  5. dose
  6. documentation
  7. some consider technique
118

what is the most common medication error?

incorrect dosage of drug

119

_________________ people are injured annually by medication errors in the U.S. according to the CDC. Medication errors cause at least one death every day.

1,300,000

120

through absorption from GI tract

enteral

121

parenteral

by injection: ID, SQ, IM, IV

122

percutaneous administration routes?

  • transdermal
  • ophthalmic
  • otic
  • nasal
  • vaginal
  • rectal
123

what organs must be carefully considered in pediatric medication administration?

liver and brain b/c they are not fully developed in pediatric patients

124

elderly population-specific information R/T pharmacology

  • body processes slow down
  • decrease blood flow to liver and kidney therefore decreasing the effectiveness (which are responsible for metabolizing and eliminating excess medication from body)
  • decreased albumin levels
  • doses may need to be decreased
125

females of childbearing age-specific information R/T pharmacology

  • could be pregnant, medication could be potentially harmful to fetus (teratogenic)
126

1 c is ____ mL

240

127

1 tbsp is ____ tsp

3

128

1 unit is __________ milliU

1,000

129

requires lifelong learning and ability to acquire relevant experiences

critical thinking

130

what are the levels of critical thinking?

  • basic
  • complex
  • commitment
131

an inner sensing that facts do not currently support something; should spark the nurse to search the data to confirm or disprove the feeling

intuition

132

a nurse trusts the experts and thinks concretely based on the rules

basic critical thinking

133

the nurse begins to express autonomy by analyzing and examining data to determine the best alternative

complex critical thinking

134

the nurse expects to make choices without help from others and fully assumes the responsibility for those choices

commitment

135

what are the components of critical thinking?

  • knowledge
  • experience
  • competence
  • attitude
  • standards
136

information that's specific to nursing and comes from:

-basic nursing education

-use of evidence-based practice

-continuing education courses

-advanced degrees and certification

knowledge

137

decision-making ability derived from opportunities to observe, sense, and interact with clients followed by active reflection

experience

138

cognitive processes a nurse uses to make nursing judgments

competence

139

mindsets that affect how a nurse approaches a problem

attitudes

140

model for comparing care to determine acceptability, excellence, and appropriateness

standards