Exam 1

Question 1

What are the 4 pharmacokinetic phases?

Answer 1

Absorption: mvmt into the capillaries/blood stream
Distribution: mvmt from blood into tissue and cells
Excretion: mvmt out of the body
Metabolism: change in the drug structure

Question 2

What happens if you alter any of these 4 phases?

Answer 2

Serious consequences (deadly); can make drug not even work

Question 3

What does enteral mean?

Answer 3

via GI tract

Question 4

What does parenteral mean?

Answer 4

via injections

Question 5

Do RNs get to choose the route of administration?

Answer 5

NO.

Question 6

What could happen if you give a medication via the wrong route?

Answer 6

level could become too high

Question 7

Which medication route has the most rapid (and complete) absorption rate?

Answer 7

IV

Question 8

What is the BBB (blood brain barrier)?

Answer 8

helps protect the brain from toxins; It is located between the blood and the brain & it doesn’t have pores.

Question 9

What organ metabolizes most drugs?

Answer 9

Liver

Question 10

What may happen to a drug level if a client goes into liver failure?

Answer 10

Drug won’t be metabolized.

Question 11

What drugs can cross the BBB?

Answer 11

Lipid soluble

Question 12

What organ excretes most drugs?

Answer 12

Kidneys

Question 13

What might happen to a client’s drug levels if they go into kidney failure?

Answer 13

May not excrete; toxicity then becomes an issue.

Question 14

What two lab tests measure how well a client’s kidneys are functioning?

Answer 14

BUN - 0.5-1.5

Creatinine - 10-20

Question 15

What does agonist mean?

Answer 15

Activate receptors

Question 16

What does antagonist mean?

Answer 16

Block receptors

Question 17

What does partial-agonist mean?

Answer 17

Partially activate receptors

Question 18

Why is it important to learn “how” drugs work?

Answer 18

To see how they react in the body; understand why so you can apply knowledge.

Question 19

What are the 3 types of names for a drug?

Answer 19

Trade
Generic
Chemical

Question 20

Which type of drug name is the most important to learn?

Answer 20

Generic

Question 21

Are generic medications the same as brand name versions?

Answer 21

Yes

Question 22

What is a black box warning?

Answer 22

When a drug has severe adverse effects that the FDA wants to bring to prescriber’s attention; hence the heavy black border around these meds.

Question 23

Should you give a medication if there is a contraindication relevant to your client?

Answer 23

NO

Question 24

What does the term narrow therapeutic index mean?

Answer 24

Smaller index window; making does toxicity windows trickier

Question 25

Why must nurses know the signs of toxicity when they are administering drugs with a narrow therapeutic index?

Answer 25

So they can know what to look for when a client may have toxicity issues.

Question 26

What symptoms do CNS depressants cause?

Answer 26

Brake pedal to your brain. Can cause a person to stop breathing. Sleepy, draggy.

Question 27

Is it a good idea to drink alcohol while taking a CNS depressant? Why or why not?

Answer 27

NO; it too is a CNS depressant.

Question 28

What symptoms do CNS stimulants cause?

Answer 28

Like pushing the gas pedal. Anxiety, irritability, insomnia. May have you extremely talkative. Strong doses can cause seizures.

Question 29

What is acute dystonia?

Answer 29

Severe, sudden spasms of large muscle groups

Question 30

What is akathisia?

Answer 30

Constant squirming; severe restlessness.

Question 31

What is Parkinsonism?

Answer 31

Identical to Parkinson's dz, except it is caused by a medication Slow movements, loss of facial expressions, drooling, rigidity, tremors, stooped posture & shuffling gait

Question 32

What could happen if EPS go untreated?

Answer 32

Could turn into worse conditions & even permanent ones

Question 33

Is tardive dyskinesia permanent?

Answer 33

Once it develops, yes!

Question 34

What are some S/S of tarydive dyskinesia?

Answer 34

Smacking of lips Lateral movement of jaw Facial grimacing Twisting movements of the extremities

Question 35

What are 4 common anticholinergic side effects?

Answer 35

Cant see Cant spit Cant pee Cant defacate (poop)

Question 36

How can you help relieve each of the side effects in the previous question?

Answer 36

- Eye drops & sunglasses can help w/ vision problems. - Frequent sips of water & sugarless candy can help with dry mouth. - Urine retention can be alleviated by voiding before taking the medication. - Water, walking & fiber help w/ constipation.

Question 37

What is orthostatic hypotension?

Answer 37

When you move from a horizontal position to a vertical position, gravity pulls much of your blood to your lower extremities. Your sympathetic NS has to do a bunch of things to increase the pressure in your legs so that blood will be forced to your brain.

Question 38

Is orthostatic hypotension dangerous?

Answer 38

It can be.

Question 39

Why do we worry about prolonged QT intervals?

Answer 39

It can lead to abnormal heart rhythms called "torsades de pointes" which means twisting of the points, which can then lead to ventricular fibrillation and then to RIP.

Question 40

Is it OK to take food with a medication?

Answer 40

Depends on the medication.

Question 41

If a client is to receive several doses of an opioid medication, what problem are they likely to experience?

Answer 41

Constipation

Question 42

What does neutropenia mean?

Answer 42

Loss of white blood cells (WBCs)

Question 43

What is thrombocytopenia?

Answer 43

Loss/destruction of platelets

Question 44

What is hemolytic anemia?

Answer 44

A premature loss/destruction of RBCs

Question 45

What are eight S/S of hepatotoxicity?

Answer 45

``` J aundice A norexia U paper ab pain N nausea /vomiting/ diarrhea D ark urine I increased need for sleep (fatigue) C lay-colored stool E ncephalitis (inflammation of the brain) & Ecchymosis ```

Question 46

What are the 2 lab tests that can tell us if a client's liver in injured?

Answer 46

AST 1-36 | ALT 1-36

Question 47

What are the 2 lab tests that can tell us if a client's kidneys aren't functioning properly?

Answer 47

Creatinine 0.5-1.5 | BUN 10-20

Question 48

What should you always check for before giving a medication?

Answer 48

Allergies/ allergic reactions

Question 49

What does NKDA stand for?

Answer 49

No Known Drug Allergies

Question 50

What is anaphylactic shock?

Answer 50

causes a client's airway to close & sudden drop in BP

Question 51

How do we treat anaphylactic shock?

Answer 51

``` Give epinephrine (EpiPen) Maintain airway & monitor client ```

Question 52

What are the 3 groups most at risk for developing an adverse reaction?

Answer 52

Children Older adults Pregnant women ( & their babies )

Question 53

How are drugs usually dosed for children?

Answer 53

Child's weight | Sometimes by age.

Question 54

Which group is prone to reduced serum albumin levels?

Answer 54

Older Adults

Question 55

What might happen if a client has reduced serum albumin levels and they are taking a protein-bound drug?

Answer 55

The drug will get stuck onto one of these molecules & more than likely stay stuck. Meaning it is not going to do anything & its inactivated.

Question 56

What is teratogen?

Answer 56

Meds that are harmful to the fetus. | Monster makers.

Question 57

Which pregnancy risk category is safest for the fetus?

Answer 57

A

Question 58

Which pregnancy risk category is most dangerous for the fetus?

Answer 58

X

Question 59

What are 3 vaccines pregnant women must avoid?

Answer 59

Measles Mumps Rubella (MMR) Varicella Vaccines

Question 60

Which drugs will cross the placenta?

Answer 60

Lipid soluble

Question 61

Which drugs will enter the breastmilk?

Answer 61

Lipid soluble

Question 62

When is the safest time for a breastfeeding mother to take a medication?

Answer 62

After breastfeeding

Question 63

What are the "ten" rights of safe medication administration?

Answer 63

``` Client Medication Dose Route Time Documentation Client education Right to refuse Assessment Evaluation ```

Question 64

What type of error has caused the most fatalities?

Answer 64

Med administration erros

Question 65

What should you do if an order calls for multiple pills or vials for a single dose?

Answer 65

Read the med label, use the right containers, check armbands, tell clients what you are giving them.

Question 66

Is it OK to put an oral medication in an IV syringe? Why or why not?

Answer 66

NO

Question 67

Is it OK to put insulin in a regular syringe? Why or why not?

Answer 67

No; units needed not mL

Question 68

Besides the armband the lists your client's name, birthdate, etc., whats one other armband you should always look for?

Answer 68

Allergy armband

Question 69

What should you do if you don't see an allergy armband on your client?

Answer 69

Ask the client if they have any allergies that could possibly not be noted. NKDA or NKA

Question 70

How can you encourage your client to become part of the safety?

Answer 70

Be humble; tell clients what you are giving them.

Question 71

What should you do if you're certain that a med is correct but your client expresses a doubt or concern?

Answer 71

Say "I checked this a little earlier, but let me check again. I want to be 100% sure this is the right medication for you."

Question 72

Whats the 1st thing a nurse should do if a client receives the wrong med?

Answer 72

Assess the client.

Question 73

Which med errors must be reported?

Answer 73

ALL.

Question 74

When documenting an error in a client's chart, what style of writing should you use?

Answer 74

Have a very matter of fact style. Be factual. Be precise.

Question 75

Whats the purpose of incident reports?

Answer 75

So administrators can review safety issues that are occurring in the facility. Help them recognize and fix errors in the Healthcare delivery system

Question 76

Is it OK to document in the client's chart that you completed an incident report?

Answer 76

NO.

Question 77

What are 3 occasions a med reconciliation should be performed?

Answer 77

- Patient coming into hospital. - Patient is transferred to a higher or lower level of care. - Patient is discharged.

Question 78

Who completes a med reconciliation?

Answer 78

Provider

Question 79

How does a nurse assist in the med reconciliation process?

Answer 79

Just make sure the provider remembers to perform a med reconciliation.