Exam 1 (CH 1-5 And 7) Flashcards
(106 cards)
1
Q
Intrinsic drugs
A
Hormones, enzymes, growth factors
2
Q
Extrinsic drugs
A
Outside factors (I.e: drugs) that produce identical effects to intrinsic drugs
3
Q
When do you give drugs to pregnant woman
A
When the benefit out weighs the risk
4
Q
3 drug names
A
Chemical- chemical composition
generic- 1st letter not capitalized, given by US adopted names council, short name
Brand- “trade/proprietary “ 1st letter capitalized, given by drug company
5
Q
What is PINCH and what does it stand for
A
High alert drugs
P- potassium I- insulin N- arcotics C- chemo products H- eparin (anticoags)
6
Q
Herbal product warnings
A
May interfere with pts prescribed meds
7
Q
Agonist
A
Enhances a drugs effects
8
Q
Antagonists
A
Blocks a drugs effect
9
Q
Pharmacodynamics
A
Drug on body
10
Q
Pharmacokinetics
A
Body’s effect on drugs A- bsorption D- istribution M- metabolism E- xcretion
11
Q
What constitutes a true allergic reaction?
A
The bodies release of antihistamine and inflammation
AKA: anaphylaxis
12
Q
MEC
A
Minimum effective concentration
: minimum amount of a drug in blood to cause intended reaction
13
Q
Steady state
A
Continuous balance of drug entry and exit
14
Q
Half life
A
Time needed for 1/2 of the drug to be eliminated from the body
15
Q
Paradoxical drugs
A
Drugs that cause opposite responses in children than adult
16
Q
Vital organ to metabolism
A
Liver
17
Q
Vital organ to elimination
A
Kidneys
18
Q
Teratogenic drugs
A
Drugs that cause birth defects
19
Q
Pregnancy categories
A
A, B, C, D, (X)
20
Q
8 pt rights
A
Right patient Right drugs Right dose Right route Right time Right documentation Right diagnosis Right response
21
Q
Who can prescribe meds
A
Physicians Practitioners Dentists Podiatrist PAs
22
Q
Standing order
A
Prescription on a regular basis
23
Q
Single dose order
A
Order given only once
24
Q
STAT
A
Order given immediately 1 time
25
PRN order
As needed order but still has a schedule to give
26
What are nurses in reference to drug administration
The final defense for detecting and preventing drug errors
27
Best way to prevent drug errors
medication reconciliations
| 5 steps
28
How many times should a calculation be checked?
Twice once by you and by a co worker
29
Principles of drug administration
```
Know PT history,
Allergies
Past ADR
LAB VALUES
AND ANY changes in condition
```
30
Enteral route entrance
Though GI tract by oral, NG or rectal
31
What do you have to make sure when administering enterally
If pt can swallow
32
Enteral route rate of absorption and commonality
Slowest absorption because it has to pass GI system.
| Most commonly given
33
When taking oral enteral drugs what do you do to the pt
Have them sit up right, test if they can swallow, have them finish the full glass of water
34
Feeding tube types
NG nasogastric
| PEG percutaneous endoscopic gastrostomy
35
NG tube precautions
Take sure that there is no CO2 tidal wave because that means tube is in lung and not stomach, hold med
36
Rectal considerations
Absorption affected by diarrhea
Do SIMS pose
Lay for 20 minutes
37
Parentral routes
ID, SC, IV, IM
38
Dump ID info
```
Injected between layers of skin
Sites: inner forearm
Common uses: TB test
Volume: 0.01- 0.1
Needle size: 3/8 in
Gauge: 25
Angle: 15
```
39
Dump SQ info
```
Between skin and muscle
Sites: upper arm, abdomen
Common uses: insulin/ heparin
Volume: 0.5 - 1.0 mL
Needle size: 3/8 in
Gauge: 25-27
Angle: 45 ( 90 in obese)
```
40
Dump IV info
```
In vein
Fastest and most dangerous form of admin
Rapid absorption
Sites: vein
Given by IVP ( intravenous push)
IVPB ( intravenous piggyback)
```
41
Dump IM info
```
In muscle
Sites: deltoid (arm), ventrogluteal, vastus lateralis (knee)
Volume: 1-3 mL
Needle size: 1-1.5 in
Gauge: 20-22
Angle: 90
```
42
Percutaneous route absorbed by and ways to administer
Absorbed by mucous membranes
```
Topical/ transdermal - don’t shave skin, thin layer
Buccal
Sublingual
Ear drops
Nose drops
Spray
Suppositories( vaginal)
```
43
Temp conversion formula
9C=5F-160
44
Fahrenheit freezing and boiling / normal
Freezing: 32
Boiling: 212
Normal: 97-100
45
Celsius freezing, boiling, normal
Freezing: 0
Boiling: 100
Normal: 36.1- 37.8
46
T/F
Household measurements are just as accurate as metric ones
F
47
3 systems of measurement
Apothecary
Metric
Household
48
Kg—-g—-mg—-mcg
King gram married mrs gram and had micrograms
49
KHDBDCM__M
Kids hate songs because dogs chase mailman many many mailman
50
Are insulin syringes interchangeable
No, use insulin syringes specific for insulin
51
Is “u” acceptable for units?
No spell out units
52
Why give IV?
Meds needed STAT
steady admin required
Pt controlled pain meds
53
Flow rate and how to calculate
(mL/ Hr)
Divide total volume by total hours VTBI
54
Macro drip info
For who?
Drop size?
Drip factors?
Macro drip for healthy people
Drops are large for fast infusion
In 10,15,20 gtts/ mL
55
Micro drip
For who?
Drop size?
Drip factors?
For children and those at risk for fluid over load
Small drops
60 gtts/ mL
56
Drip rate ?
Gtts/ min
57
Controller mechanisms and obstruction details
Device that uses gravity to control flow
Will stop if obstructed to avoid infiltration
58
Infusion pump mechanism and obstruction detail
Commuter based machine that pushes based on fluid
Will beep if pressure is changed but won’t stop
59
What is needed for an IV ORDER
What fluid is being admin
Volume: how much is being admin
Duration: for how long
Rate: how fast to be infused
60
What’s is IV LOCK
Lock that doesn’t let anyone mess with pump
61
Define infiltration
The pulling or needle or catheter from vein that leaks fluid into tissues
Cool to touch
Swollen
62
Define fluid overload
The rapid absorption of fluid
63
Extravasation
The leaking of harmful substances into the skin causing tissue damage/ loss
No hard vein streak
64
What do you do if your infusion falls behind schedule
Nothing, don’t play catch up,
| Will cause complications
65
Define Pain
Pain is whatever the pt says it is
66
How to monitor 5th vital( pain)
As the pt, get their accounts and value
67
What is pains greatest problem
Pain is so often under reported and under treated
68
How much pain the pt feels
Pain intensity
69
Pain threshold
Certain level of pain until pt starts to feel pain
70
Persons ability to “stand” pain intensity
Pain tolerance
71
What happens as your pain tolerance increases
You need more drug to create the same therapeutic effect
72
Who do you use the numerical pain scale for
A A&O X3, X4 adult, communicative
73
What pain scale would you use for a child and or those who are communicative
Wong baker” faces ”
74
Who do you use the FLACC scale for
```
F- ace
L- egs
A- ctivity
C- rying
C- onsoluability
```
Someone who is noncommunicative and infants
Pain scale is objective
75
Describe how pain is felt
Your brain perceives pain, it is not actually “felt”
76
How often do you check for pain
Every 4 hours or as often as you asses your pt
77
Who or what sends signals to your brain to let you know there is injury?
Nociceptors
78
Describe acute pain
Causes
Duration
S&S
Causes: immediate identifiable pain
Duration: short lasting
S&s: physiological changes (high BP)
79
Chronic pain
Causes
Duration
S&S
Causes: unidentifiable
Duration: pain that lasts longer than 6 months
S&S: doesn’t trigger physiological response
80
What is addiction
Psychological need for the “high” without pain
81
Name: physiological changes in autonomic NS when opioids are used long term when not needed for pain
Dependence
82
What happens when you suddenly stop opioids after dependence has been established
Withdrawl;
Vomiting
Nausea
Delirium
83
Schedule 1
No medical use
Heroin
84
Schedule 2
Very high potential for abuse And dependence with medical use
Fentanyl
85
Schedule 3
Hugh potential for abuse and dependence with medical use
Steroids
86
Schedule 4
Potential for abuse and small dependence with medical use
Benzos
87
Schedule 5
Lowest potential for abuse and dependence, medical use
Cough syrup with codeine
88
What characterized an analgesic
Any drug that controls pain
Opioid and non opioids
89
What makes an opioid an opioid?
If it consists of an addictive chemical
90
What do you check before administering opioids
O2 and resp rate
91
How do you get the best pain relief?
Taking pain meds on regular schedule v PRN the
92
Do opioids alter perception of pain
Yes
93
Side effects of opioids
Constipation, nausea and vomiting, drowsiness, dizziness, (sedation)
94
Opioid ADR
```
Respiratory depression
addiction
dependence
tolerance
withdrawal
Reduced vision (falling in elders)
```
95
Fentanyl forms
Patch, spray, lollipop
96
Opioid PT teachings
Take with food and fluids
do not drive
change position slowly
if opioids are taken for true pain addiction is unlikely
97
Can you substitute narcotics
No! They act differently on different pain receptors
98
Opioid anecdote
Narcan ( naloxone)
99
Acetaminophen name
Max amount per day
Risks
Actions it does not do
Tylenol
3g per day
Liver and kidney damage
Does not have anti inflammatory affects
100
Acetaminophen anecdote
Acetylcysteine
101
NSAIDS types and uses
Aspirin ibuprofen(4x a day), naproxen (2x a day)
For inflammation
102
Adjuvant pain meds
```
Antidepressants not immediately
Anticonvulsants (neuropathic pain)
Pregabalin - lyrica
Gabapentin- Neurontin
Muscle relaxers
Must be for muscle spasms
```
103
Can opioids cross placental barrier?
Yes
| Narcan needed for babies who’s moms abused of meds while pregnant and used opioids
104
How many times should an order be checked ?
3 times
1. Look at order
2. What Preparing medication
- is it accurate?
3. At bedside right before administering
105
2 pt identifiers
Name and DOB
106
8 drug errors
```
Omission error
Wrong patient
Wrong drug
Wrong route
Wrong rate
Wrong dose age form
Wrong time
Prep error
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