*NURSING > EXAM REVIEW > Pharmacology-Final-Exam-Review ALL ANSWERS 100% CORRECT SPRING FALL-2022 LATEST SOLUTION GUARANTEED (All)
Nursing Process & Drug Therapy • In a prescription what must you have: o name of the med o route- (no route call the Dr. and verify it) o date/time o dose o time/frequency of med o Dr. sign... ature • If you don’t understand the prescription: o hold med & call the Dr. • Types of meds that cannot be crushed: o Enteric coated (EC) o Long acting (extended release) o Sustained action (SA) o Sustained Release (SR) ▪ If crushed it loses the effect, it will also dissolve sooner than it is supposed to increasing toxicity. DO NOT CRUSH!! • Do a pre assessment: o What medications is the patient taking o Baseline of medication o Allergies o OTC meds currently taking o If taking Digoxin- check the Apical HR (60-100); if HR less than 60 CANNOT give Digoxin; also check Digoxin level & K+ (if K+ level is high, it decreases the effect of Digoxin; if the potassium level is low, increases the effect of Digoxin) o For Beta Blockers- check if pulse is less than 60 (If less than 60 do not give beta blocker), after the med is given you always Assess o Diuretics- always give in the A.M (check K+ level, electrolyte levels, vital signs *mostly BP, weight the pt, intake/output of pt) • Purpose of 9 rights of drug administration: o to avoid medication error of OD (Safety of drug administration) o right med, right time, right patient, right dose, right to refuse, right route, right documentation, right reason, & right response to med o use 2 identifiers to check pt o read medication level 3 times! o newborn-check the mother’s identifier/older children-check the parent’s identifiers o elderly- 2 identifiers; if confused (do not ask pt for the name) o give med 30 min before or 30 min after the due time (right time) o TID: 3 times/day; BID: 2 times/day; QID: 4 times/day; DO NOT use QD (write the word Daily) • Pharmacokinetics: o What the body does to the drug o Four Principles of Pharmacokinetics: ▪ Absorption (Route) depends on the site: • Parenteral goes 1st because- it bypasses 1st pass effect, so it has a bioavailability of 100%, IV has more effect than oral • Oral: has the 1st pass effect, the bioavailability is 80% • Sublingual: under the tongue because of increase in vascularity bypasses the 1st pass effect 100% bioavailability • Buccal: between the cheeks & the upper/lower molar & rotate, with vascularity you also will bypass the 1st pass effect 100% bioavailability ▪ Distribution- also depends on the site (high/more vascularity = more distribution of the med) • Plasma protein affects distribution of meds (Albumin) • Albumin meds are highly protein bound so it attaches to the receptor & once attached they remain in the bloodstream & the rest of meds are free to go • 2 meds together compete & can cause toxicity ▪ Metabolism AKA (Biotransformation)- the main organ is the Liver • Is the process by which the body inactivates drugs • If you have liver problems- higher chances of toxicity because medication cannot be broken down • Elderly & Newborns are at higher risk due to immature liver ▪ Excretion- the main organ is the Kidney • If patient has renal failure cannot excrete the drugs so higher chances of toxicity to occur; also newborns have immature kidneys so they as well are at higher risk of toxicity o Half-Life of a Drug: ▪ Is the time required for 1 half of the medication to be removed from the body • EX: 800mg, half-life is every 8 hrs. Within 24 hrs. how much of the drug will be left/remain? 1st half life is 400; 2nd is 200; 3rd is 100 so the half-life is 100 o Pharmacodynamics: • Is what the drug does to the body • Can have receptor on receptor binding • It can have enzymes- it can break down or enhance the effect (agonist action- mimics receptor actions, so it binds to it) • Antagonist actions- blocks the reaction • Partial agonist- blocks & enhances at the same time (partial reaction) o Synergistic Effects: • When TWO drugs are given- 1 of the drug enhances the effect of the other drug o Antagonist Reaction: • One medication blocks the other medication (Blocks the reaction) ▪ Categorize a Drug: ▪ Which drugs can be used for pregnant women: • Category A- No risk for human fetus • Category B- No risk for animal fetus; NO info in human fetus • Category C- Risk in animal fetus; NO info in human fetus • Category D- Possible fetal risk in Humans BUT in selected cases potential benefit vs risk may warrant use of these drugs in Pregnant woman (depends what is more beneficial to the patient) • Category X- CANNOT give to pregnant women (fetal abnormalities) o Medication reconciliation: • Every time a patient comes in to the hospital or transfer from a unit to another unit nurse reconcile all meds together to know which one’s patient will use or no longer use • It is Safety mechanism o Standards of [Show More]
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