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pharmocology > PATHO AND PHARM (EXAM 1) > Flashcards

PATHO AND PHARM (EXAM 1) Flashcards

1
Q

What’s the main important thing to do when administering transdermal medication

A

Wear gloves!!

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2
Q

The steps to administering a transdermal medication

A
  1. Perform hand hygiene and wear gloves
  2. Remove the old patch
  3. Clean and prepare the skin
  4. Open the patch
  5. Remove the liner
  6. Place the patch on the area
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3
Q

When administering transdermal medication do you put it on the same spot

A

Nooo

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4
Q

Why do we wear gloves when administering transdermal medication

A

Because it can be absorbed thriugh the skin into your skin

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5
Q

How do you administer eye drops

A
  1. Hand hygiene wear gloves
  2. Ask patient to lay back in chair. Look at the ceiling
  3. Remove any discharge with a clean cloth.
  4. Draw the skin down until you can see the conjunctival sac
  5. Notify the patient so they won’t blink
  6. Administer drops
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6
Q

Should the top of the drop touch they eye

A

No

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7
Q

What will happen if the eye drop is placed directly where the cornea is

A

It may cause discomfort or damage

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8
Q

What do you do after the steps are completed

A

Gently pres the lacrimal duct with a cotton ball for 1-2 minutes to prevent systemic absorption through the lacrimal canal

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9
Q

What should the patient do to promote absorption after eye drops is administered

A

close eyes for 1-2 minutes

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10
Q

How do you administer eye ointment

A

You squeeze the ointment onto the conjuctival sac
Instruct the patient to close their eyes for 2-3 minutes

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11
Q

How long should the patient close their eyes for after administering eye ointment

A

2-3 minutes

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12
Q

What should the patient expect after administering eye ointment

A

Blurry vision. Do not drive!

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13
Q

When administering ear drops what temperature should it be

A

Room temperature

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14
Q

What position should the patient be in when administering ear drops

A

They should lay on their unaffected side

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15
Q

How long after the ear drops have been administered should the patient lay in this position
Why?

A

2-3 minutes
To make sure the drop reaches the unaffected area

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16
Q

Which way do you pull,the ear for children younger than 3

A

Pull down and back

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17
Q

Children older than 3 ear drop administered
And adults

A

Pull up and outwards

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18
Q

Where should you avoid allowing g the ear drops to fall

A

On the tympanic membrane

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19
Q

Where should the ear drops be aimed

A

At the side of the ear canal so it can run down

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20
Q

How do you prevent contamination of the ear drop

A

Keeping the tip of it clean. So do not let it touch the ear

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21
Q

What should you do before administering nasal medication and why

A

Blow your nose
Mucous can inhibit the medication

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22
Q

Steps on how to administer Nasal drops and spray

A
  1. Hand hygiene and gloves
  2. Ask patient to blow nose
  3. Tilt head back and toward affected side
  4. Administer
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23
Q

How do you administer with one nostril closed

A

Tilt the head to the closed side and hold breath

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24
Q

If the patient is using nasal spray how do you position

A

The patient looking down at their feet with the stay tip aimed towards the eye

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25
Q

How li g should the patient keep their head tilted back after installation drops

A

For 5 minutes

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26
Q

What kind of lubricant do you use when administering rectal suppositories

A

Water soluble

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27
Q

Why should you not use petroleum jelly when administering rectal medication

A

Because it may inhibit the absorption of the medication

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28
Q

What position should the patient lie in when administering suppositories

A

Left lateral recumbent position
Basically lying on the left side

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29
Q

What should the pt do when laying in this position

A

Breathe slowly through the mouth and relax anal sphincter

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30
Q

How do you administer the rectal suppository

A

Apply water soluble lubricant to the tip of the unwrapped suppository
Gently insert into the anus and beyond the internal sphincter

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31
Q

Where should the suppository go beyond
Why

A

The internal sphincter
Because it will not stick

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32
Q

In what position and how long should the patient stay in

A

Flat or on 1 side
30 minutes

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33
Q

Fluid volume deficit is?

A

Dehydration
Hypovolemia

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34
Q

What causes hypovolemia

A

Anything that makes you lose water

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35
Q

Contributing factors of hypovolemia

A

Vomiting
Diarrhea
Not drinking enough water
Fever
Blood loss
GI suctioning

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36
Q

Hypernatremia and hypovolemia

A

This is when there is too high of salt concentration in the body
This cause the cells to be dehydrated and shrink
Lose watet

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37
Q

What is usually the first sign of hypovolemia
Why?

A

Tachycardia
This is because there isn’t a lot of fluid in the body so the heart is pumping faster to circulate and get more blood
The body tries to compensate for the low blood bolume

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38
Q

Other signs and symptoms of hypovolemia

A

Hypotension Orthostatic
Weight loss
Decreased skin turgor= takes longer
Dizziness
Weakness
Increased HR
Hypotension

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39
Q

What are some interventions for HYPOVOLEMIA

A

Administer fluids
Monitor lab values
Encourage the patient to drink water
Safety precautions
Monitor I&O

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40
Q

Why would you have a safety precaution for a patient who has HYPOVOLEMIA

A

Since they are weak and even confused they are more prone to falls

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41
Q

What is the normal capillary refill

A

Less than 2 sec

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42
Q

Another name for fluid volume excess

A

Hypervolemia

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43
Q

Another name for fluid volume excess

A

Hypervolemia

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44
Q

Contributing factors to Hypervolemia

A

Heart failure
Kidney injury
Cirrhosis of the liver
Intravenous fluids bolus
Prolonged corticosteroids therapy

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45
Q

Relationship between corticosteroids and Hypervolemia

A

They cause retain of water

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46
Q

Signs and symptoms of Hypervolemia

A

Edema
Weight gain
Crackles
Shortness of breath
Hypertension
Tachycardia
Bounding peripheral pulse
Orthopena

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47
Q

What is orthopena

A

Difficulty breathing when laying flat

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48
Q

Why do we have bounding pulses with Hypervolemia

A

Because of the excess fluid

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49
Q

Tachycardia and Hypervolemia

A

The heart is going to work hard because you are going to be having difficulty breathing.
Heart works harder to get oxygen

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50
Q

Orthopena and Hypervolemia

A

The fluid goes upward when lay on back

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51
Q

Intervention for Hypervolemia

A

Diuretic
Restrict fluid
Monitor I&O
Monitor weight
Monitor respiratory
Place patient in semi Fowler position

52
Q

What should you always do first when administering fluids

A

Listen to lung sounds

53
Q

What charge are cations

A

Positive

54
Q

What charge are anions

A

Negative

55
Q

What is potassium deficient
What is the value for it

A

Hypokalemia
Low potassium
Less than 3.5

56
Q

Contributing factors to Hypokalemia

A

Vomiting
Diarrhea
Corticosteroids
Gastric suction

57
Q

Signs and symptoms of Hypokalemia
HINT: EVERYTHING IS SLOW AND LOW

A

Polyuria
Fatigue
Anorexia
Nausea
Vomiting
Muscle weakness
Decreased bowel motility
Muscle cramps
Parenthesia

58
Q

What is another name for potassium excess

A

Hyperkalemia

59
Q

What is the range for hyperkalemia

A

Higher than 5.0

60
Q

What is the main contributing factor to hyperkalemia

A

Potassium conserving diuretics

61
Q

What are other hypokalemia contributing factors

A

Addison disease
Crush injury
Burns
Stored bank blood transfusions
Rapid IV administration of potassium
NSAIDs
Ace inhibitors

62
Q

Signs and symptoms of hyperkalemia

A

Muscle weakness
Cardiac changes
Cramps
Abdominal distention

63
Q

What is the top nursing interventions with potassium disturbances

A

Always monitor your patient cardiac
12 Lead EKG

64
Q

What is the main reason potassium chloride is given

A

For Hypokalemia

65
Q

What route should you never give potassium chloride

A

Intramuscular

66
Q

What route should you give potassium chloride

A

Oral
IV

67
Q

If your patient is on potassium supplement what should they not be on?
Why?

A

No salt substances because they are high in potassium

68
Q

What potassium level should you give potassium chloride

A

Less than 3.5
Hypokalemia

69
Q

What should you make note of when administering potassium chloride PO

A

The patient should sit up for 30 min after administration

70
Q

When you administer potassium chloride IV

A

When the patient is having difficulties swallowing

71
Q

What are some side effects of potassium chloride

A

Nausea
Vomiting
Diarrhea
Abdominal cramps
Phlebitis with IV

72
Q

Contraindications of potassium chloride

A

Addison disease
Renal insufficiency
Hyperkalemia
Severe dehydration
Acidosis
Potassium soaring diuretic

73
Q

Drug and potassium chloride

A

With any disease that causes high potassium levels or potassium retention

74
Q

Food and potassium chloride

A

Licorice excessive intake causes hypokalemia and sodium retention
Salt substitute

75
Q

What is the main adverse reactions with potassium chloride

A

Hyperkalemia
Oliguria
GI ulceration

76
Q

Life threatening effect of potassium chloride

A

Cardiac dysthymia
Respiratory distress
Ventricular fibrillation
Cardiac arrest

77
Q

If you have a patient who is on potassium supplements and i given oral potassium chloride what should you do?

A

Monitor with an EKG

78
Q

When should oral potassium be administered

A

With after meals
With a large glass of water

79
Q

What position should the patient sit in when given oral potassium?
For how long?

A

Upright
30 minutes

80
Q

What should you do with power, liquid solution of potassium supplements

A

Dilute!!

81
Q

Should eternic costed or extended release potassium supplements be crushed or chewed

A

Noooo

82
Q

What should you tell the patient not to do with enteric coated and extended release potassium

A

Do not chew or crush

83
Q

What else can you advise the patient? Hint: suck on tablet
Why?

A

Do not suck on tablet
It causes stomach ulcerations

84
Q

What should you do with a patient on patssium therapy

A

Potassium levels must be drawn to monitor progress

85
Q

What should you always monitor with a patient on K+ therapy IV

A

The EKG

86
Q

Who is IV therapy indicated for with potassium

A

Those who cannot tolerate oral therapy with patients with severe hypokalemia

87
Q

How should you never with potassium chloride

A

Rapid infusion
Bolus

88
Q

How should you never give potassium chloride

A

Bolus
Never given fast

89
Q

How should you give potassium chloride

A

Slowwww

90
Q

When administering IV potassium chloride what should you always mix it with

A

If fluid
Always dilute it

91
Q

What do we use when administering IV potassium chloride

A

Use an infusion pump
Give it slow

92
Q

What is the maximum rate

A

40 meq

93
Q

Infuse slowly at what rate

A

10 meq

94
Q

Why do we always monitor the IV SITE
What should you look for

A

Avoid extravasation or infiltration
Redness

95
Q

Why shouldn’t you give infusion fast with potassium chloride

A

Cause hyperkalemia and dead😵

96
Q

What are the symptoms of toxicity with potassium chloride

A

Slow irregular heartbeat
Fatigue
Muscle weakness
Parenthesia
Confusion
Dyspnea
Peaked t wave

97
Q

What should you monitor with symptoms of toxicity with potassium chloride

A

Monitor EKG and heart

98
Q

Name the 3 types of isotonic crytalloids

A

Lactated ringers
0.9% sodium chloride
5% dextrose water

99
Q

What is the main use of a lactated ringer

A

Corrects dehydration or hypovolemia

100
Q

What are the contraindications of a lactated ringers?
Which patient should you not use it in?

A

Patients with liver dysfunction
Patients with kidney disese

101
Q

What does lactated ringers correct

A

Dehydration

102
Q

Why is hyperkalemia a contraindication for lactated ringers

A

The lactated ringers will increase the potassium even more

103
Q

What might lactated ringers cause and why?

A

It may cause fluid volume excess
Because they require large excess of fluid

104
Q

What is the main use of sodium chloride 0.9%

A

Corrects dehydration
Corrects sodium depletion

105
Q

What does sodium chloride and solid

A

It increases sodium

106
Q

What is a contraindication with 0.9% of sodium chloride

A

It requires large infusion
Lead to fluid volume excess

107
Q

What is sodium chloride 0.9% used for

A

Sodium depletion
Corrects dehydration

108
Q

What is 5% dextrose in water used for

A

Providing calories

109
Q

When giving fluids what is one of the first things you should do
Why?

A

Always listen to the lungs first to check if fluid is in the lungs

110
Q

Name a hypotonic crystalliod

A

0.45% sodium chloride

111
Q

When would you administer a hypotonic crystalloid

A

Volume replacement in hypernatremia.
Remember that hypernatremia causes low fluid volume

112
Q

What is normal saline

A

0.9% sodium chloride

113
Q

What is half normal saline

A

0.45% sodium chloride

114
Q

What are the contraindications and precautions of 0.45% sodium chloride

A

Patients with or suspected increased intracranial pressure, patients with liver disease, shock, or trauma or burns

115
Q

Hypertonic crystalloids

A

3% NACL
5% NACL
5% dextrose in 0.9 NACL
5% dextrose in 0.45 NACL
5% dextrose in lactated ringers

116
Q

What are the purposes of hypertonic crystalloids

A

Corrects hyponatremia
Decrease ICP
Dextrose provide calories

117
Q

What are some contraindications and precautions of hypertonic crystalloids

A

Fluid volume excess

118
Q

Hypertonic crystalloids are contraindicated in which patients

A

Cardiac disease
Renal disease
Dehydration
Diabetic ketaacidosis

119
Q

When would you recommend a hypotonic crystalloid

A

For volume replace with hypernatremia

120
Q

When would you recommend hypertonic crystalloids

A

Hyponatremia
Decreases icp
Dextrose for calories

121
Q

Name the collioids

A

Dextran
Albumin
Hetastartch

122
Q

What is dextran used for?
How did it work?

A

Restore intravascular volume
Pull the fluids from the cell into the vascular shape

123
Q

What is hetastarch used for

A

Restoring intravascular volume

124
Q

Who should you not give hetastarch

A

Someone with bleeding disorder
It causes an increase in clotting time

125
Q

What is albumin used for

A

Regulate plasma volume and tissue fluid volume balance

126
Q

Who should you it give albumin with. Contraindications?

A

Ace inhibitors

pharmocology (14 decks)

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