ATI Pharmacology Exam Study Guide | ATI Study guide

Pharmacology Proctored ATI Study Guide Chapter 1: Pharmacokinetics and Routes of Administration • Absorption (depends on route) § Route of admin affects the rate and amount of absorption o Oral: § GI pH an ...

Pharmacology Proctored ATI Study Guide Chapter 1: Pharmacokinetics and Routes of Administration • Absorption (depends on route) § Route of admin affects the rate and amount of absorption o Oral: § GI pH and emptying time § Presence of food in the stomach or intestines § Form of meds (liquid/XR) § Sit upright or put your chin to your chest to aid in swallowing o Sublingual/buccal § Quick absorption systemically through highly vascular mucous membranes § Must make sure it is fully absorbed before you eat or drink o Inhalation via mouth/nose § Rapid absorption through alveolar capillary networks § Metered-dose inhaler: shake and press, inhale for 3-5 seconds and then hold for 10 seconds before exhaling § Dry powder: DO NOT SHAKE o Intradermal, topical § Slow, gradual absorption o SQ/IM § Highly soluble meds have rapid absorption (10-30min), poorly soluble have slower absorption § Blood perfusion at site of injection affect absorption o IV § Immediate and complete § 20 gauge – standard • Distribution o Transportation of meds to sites of action by body fluids o Plasma binding protein: meds compete for protein binding sites within bloodstream, primarily albumin. The ability of med to bind to protein can affect how much med will leave and travel to target tissues. • Metabolism o Primarily occurs in the liver but can take place in the kidney o Factors that influence metabolism: § Age (infants/older adults require smaller doses) § First pass effect: liver inactivates some meds on first pass through and thus require sublingual or IV route (may need higher dose) • Excretion o Eliminated through the kidneys o Kidney dysfunction can result in elevated levels of medications. • Med Response For More Nursing Materials Visit: WWW.qwivy.COM WWW.qwivy.COM 1 / 4 o Maintain plasma levels between minimum effective concentration and the toxic concentration: • Therapeutic index (TI) o High TI has a wide safety margin. o Low TI requires monitoring of serum levels; higher risk of toxicity o Tough levels: obtain immediately before next dose. • Half-life o Time it takes a medication level to drop in the body by 50%. o Short vs long half-life: long half-life has greater risk for med accumulation in body. • Agonist: enhance/produces an action • Antagonist: blocks the action • Routes of admin: o Oral/Enteral: § 90 degrees upright § do not mix with large amounts of food § lean chin in to help facilitate swallowing o Sublingual/buccal § Keep med in place until completely dissolved o Transdermal § Wash skin with soap and water then dry it thoroughly before placing patch. Place patch on hairless area and rotate sites to prevent irritation. o Drops: § Place drop in center of sac. § Avoid placing directly on cornea. § If blink repeat process. § Apply gentle pressure with finger and a clean facial tissue on the nasolacrimal duct for 30-60 seconds to prevent systemic absorption. o Ears: § Have client lay on unaffected side. § Up and out for adults § Down and back for children o Inhalation: § MDI • Shake vigorously 5-6 times • Take a deep breath and then exhale • Slow deep breath for 3-5 seconds from MDI • Hold breath for 10 seconds after § DPI • DO NOT SHAKE DEVICE • Place mouthpiece between lips and take a deep breath • Hold breath for 5-10 seconds For More Nursing Materials Visit: WWW.qwivy.COM WWW.qwivy.COM 2 / 4 o NG/Gastrostomy tubes § To prevent clogging flush tube before and after each med with 15- 30ml of warm sterile water. o Suppositories: § Left lateral sims position. § Remain flat or left lateral for 5 min after insertion. o Intradermal: § Used for allergy testing § Used for tb testing § Small amount of solution (no more than 0.1ml) § 10-15-degree angle bevel up. o Z-track: for iron Chapter 2: Safe Med Admin and Error Reduction • Types of Prescriptions: o Routine/standard: regularly scheduled meds o Single/one time: asap or a specific time o Stat: once and immediately o PRN: as needed o Standing: specific circumstances or specific units: ex: heparin protocol • Taking a phone prescription: o Have 2nd nurse on line if possible o Read-back prescription o Verify and sign within 24 hours • Med rec: o Take place at admission, transfer of clients, and discharge. • RIGHTS OF SAFE MED ADMIN: o Right client o Right med o Right dose o Right time o Right route o Right documentation o Right client education o Right to refuse o Right assessment o Right evaluation • Evaluation o Report all errors and implement corrective measures immediately § Complete incident report within time frame the facility specifies (usually 24 hours) and it should include • Client id, name and dose of med, time and place of incident, accurate and objective account of event, who you notified, what actions you took, your signature.