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ABSN > N305 exam 2 > Flashcards

N305 exam 2 Flashcards

1
Q

Do some herbal products contain active substances as powerful (or even more effective) than currently approved medications?

A

Yes

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2
Q

Do herbal product formulations need proven safety of efficacy?

A

No

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3
Q

What is St. John’s wort used for primarily

A

Depression

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4
Q

What is ginkgo biloba used for primarily

A

Claudication

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5
Q

What is Hawthorn used for primarily

A

HTN

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6
Q

What are effects of St. John’s wort?

A

Increased sedation
Decreased anticoagulant effects
Interacts with - CNS depressants
- SSRIs
-warfarin

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7
Q

What regulatory act is there for herbal formulas

A

DSHEA
Dietary supplement health and education act.
-Exempts dietary supplements from regulation
-act allows FDA to remove any harmful herbal products

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8
Q

What is included in CAM
(Complementary and alternative medicine)

A

-herbal therapy
-nutritional supplements
-probiotics
-special diets
-massage
-meditation

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9
Q

Are all CAM therapies subjected to clinical and scientific study?

A

No

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10
Q

What is the nursing process

A

ADPIE
Assess, diagnose, plan, implement, evaluate

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11
Q

What is included in assessing

A

Collect, organize, validate, and document data

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12
Q

What is included in diagnosing (nursing process)

A

Analyzing data and identifying health problems/risks

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13
Q

What is included in the planning stage of nursing process?

A

Prioritizing problems
Formulating goals
Selecting and writing nursing interventions.

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14
Q

What is involved in the implementation stage of nursing process?

A

Reassess, implement nursing interventions, document

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15
Q

What is involved in the evaluating stage of nursing process?

A

Relate actions to goals/outcomes;
Determine if interventions worked.

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16
Q

What are things that would be assessed during medication administration

A

Allergies
Prescription meds/otc
Dietary supplements/diet
Social and medical history

Subject
(What the patient says or perceives)

and objective data
( lab test, diagnostics, physical assessment data)
-renal and liver function tests most important

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17
Q

What does the joint commission consider a primary role for nurses?

A

Teaching. (Patient education)

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18
Q

After providing patient education you should do what?

A

Ask patient to summarize key points

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19
Q

Patient teaching is a vital component of what stage in the nursing process

A

Implementation.
(Interventions)

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20
Q

Should you discuss medication with a client every time it is given?

A

Yes

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21
Q

What are the rights of drug administration?

A

Right …

Patient
Medication
Dose
Route
Time

Refusal

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22
Q

Can you give medications based on a verbal or phone order?

A

No. It can cause a medication error

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23
Q

What is the FDA safety and adverse event reporting program called

A

Med watch

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24
Q

Who are medication errors typically reported to?

A

Risk management team
Pharmacy
Provider

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25
Q

If a medication error occurs what do you put in the patients chart

A

You document what happened in the chart and what interventions you did after wards.

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26
Q

What are the most common medication errors

A

Improper dose
Wrong drug
Wrong route of administration

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27
Q

What is medication reconciliation?

A

Tracking meds as pt moves from one healthcare provider to another.

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28
Q

When does medication reconciliation occur?

A

-Initial admission
-Transferred to another setting/level of care (unit)
- at discharge

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29
Q

What are some risk reduction methods for medication errors?

A

-E-prescribing
-barcode assisted medication administered (BCMA)
- risk management departments

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30
Q

When educating a patient, what should be included to reduce risk of medication errors?

A

-know names of meds they are taking
- know side effects
- read the label
- carry a list of all meds (including otc and herbals)
- ask questions

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31
Q

In general, drugs that are water soluble, ionized, or bound to plasma proteins are less likely to cross the placenta.
T/f

A

True.

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32
Q

During pregnancy what changes happen that affects absorption

A

-Hormonal changes and pressure on expanding uterus on the blood supply to organs can affect absorption
- increase levels of progesterone delays gastric emptying = longer absorption time for oral drugs
- gastric acidity is also decreased; can affect some drugs
- progesterone affects respiratory system which can cause inhaled drugs to be absorbed to a greater extent.

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33
Q

What happens in pregnancy that affects excretion.

A

Blood flow in kidney increases by over 50% = increased excretion rate.

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34
Q

What happens during pregnancy that affects distribution and metabolism?

A

Increases cardiac output, increased plasma volume = dilution of drugs and decreased plasma protein levels affecting distribution; altered regional blood flow- uterus, kidneys, and skin is increased where skeletal muscles in decreased.
Altered lipid levels may alter drug transport and distribution.

35
Q

What is a teratogen

A

A drug that can cause significant adverse effects to a growing fetus.
Bad for baby.

36
Q

Teratogen Drug exposure during the preimplantation phase can cause what?

A

Death of the embryo or no affect at all

37
Q

Which period of pregnancy would the fetus be most likely to develop structural malformation and spontaneous abortion if exposed to a teratogenic drug?

A

The embryonic period (3-8 weeks)

38
Q

Exposure to teratogens during the fetal period ( 9-40 weeks) is more likely to produce what?

A

Slowed growth or impaired organ function

39
Q

What teratogenic category would warfarin and isoretinoin be in?

A

X

40
Q

What teratogenic category would you find lithium, ace inhibitors and nsaids in?

A

D

41
Q

Most prescription medicines are in what teratogenic category?

A

C

42
Q

Penicillins, azithromycin, an acetaminophen would be in what teratogenic category?

A

B

43
Q

Teratogenic Category A has what drugs in it?

A

Insulin
Prenatal vitamins
Folic acid
Levothyroxine (thyroid hormone replacement)

44
Q

Damages to liver and kidney in adulthood could influence what pharmacokinetic process?

A

Metabolism and excretion

45
Q

Can drugs be secreted into breast milk?

A

Duh. Yes

46
Q

What are the most common upsets that school aged children are seen for at clinics?

A

Respiratory and GI infections

47
Q

What often occurs in older adults that can lead to a build up of medications and lead to toxicity?

A

Dehydration.

48
Q

What are some normal physiological changes with older adults that affect pharmacokinetics?

A

Decreased absorption
Decreased metabolism (liver)
Reduced excretion. (Renal)

49
Q

What are the 5 factors of the holistic model of pharmacotherapy?

A

Psychosocial variables
Environmental factors
Cultural influences
Genetics
Gender

50
Q

What should the nurse include when completing a psychosocial history for a client in regards to a new medication being prescribed?

A

Lifestyle preferences
Sexual practices
Religious beliefs
Alcohol intake

51
Q

A client with depression is being started on a new medication. Which psychosocial interventions should the nurse anticipate being prescribed for this client?

A

Psychotherapy
Self-help instruction
Physical exercise
Improved sleep hygiene

52
Q

An adolescent client with type 1 diabetes has several admissions for inadequate blood glucose control. Which psychosocial issue should the nurse consider that may be impacting the clients adherence with prescribed medications?

A

Viewed as being weak
Embarrassed to have to take medication
Viewed as being unhealthy
Viewed as being dependent

53
Q

Ethnicity is

A

Genetics and biological similarities

54
Q

Culture is

A

A set of values, beliefs, and traditions that provide meaning for an individual or group.

55
Q

Which individuals have genetic variances in plasma renin that decreases the effects from Beta Blockers ?

A

African Americans

56
Q

People with Asian descent are genetically predisposed to respond differently to what 2 medications?

A

Warfarin (Coumadin)- enzymes alter the response.
And
Codeine- a gene interferes with the analgesic properties.

57
Q

What genetic difference exsists in caucasians that should be noted when administering medication.

A

They have a gene that decreases metabolism of isoniazid (TB drug), can cause toxic build up.

-they are characterized as slow acetylators.

58
Q

A patient wants to know if a dietary supplement is free of pesticides. What would your response be?

A

The label must state that the product is free of contaminants such as pesticides.
FDA rule

59
Q

What herb-drug interaction should be considered for a young female who plans to take St John wort?

A

It reduces the effectiveness of oral contraceptives.

60
Q

In herbal medicine, which biologically active substance is measured for its therapeutic effects with standardized labeling?

A

The entire herb

61
Q

Salves and ointments are considered an herbal solid formulation. T/f?

A

True.

62
Q

How is the liquid extracted from an herb in an herbal tincture?

A

Active chemicals are extracted from the plant using solvents, then concentrated into varying strengths.
Solvents such as alcohol, water, or glycerol are used.

63
Q

Who should a patient report severe side effects of an herbal supplement to?

A

The company directly using contact information on the bottle.
They will have to report it to the fda within 15 days

64
Q

Ginseng and digoxin interact how?

A

Ginseng can increase the metabolism of digoxin and cause drug toxicity.

65
Q

Herbal supplements are allowed to include what information on their label- in regards to health claims?

A

Claims about a products effect in body structure and function

66
Q

What are marker substances in herbal products?

A

They are used to achieve consistency when standardizing the strength or dose of an herbal product.

67
Q

What is ethnocentrism?

A

The belief that one’s own culture is superior to somebody else’s.

68
Q

Cultural competency begins how?

A

By identifying one’s own beliefs and values to have an idea of where you’re coming from.

69
Q

What herb has been used for over 5000 years to improve physical endurance and concentration and reduce stress?

A

Ginseng

70
Q

What plant has been used topically to aid in wound healing?

A

Aloe

71
Q

What herb is used to promote relaxation and sleep; however, prolonged use may cause yellowing of nails and skin and is associated with risk of liver toxicity?

A

Kava

72
Q

What herb is used for its immunostimulant effect to reduce cold symptoms and recovery time when taken early in illness

A

Echinacea

73
Q

What herb is used to relieve the symptoms of benign prostatic hyperplasia?

A

Saw Palmetto

74
Q

Both the seed and oil of this plant are used to reduce high cholesterol levels

A

Flax

75
Q

The dried leaf of this plant is used by some to prevent organic brain syndrome

A

Gingko

76
Q

A genetic polymorphism does what to drug metabolism

A

Alters the speed

77
Q

In a patient with Genetic polymorphism what drug action should be expected ?

A

Receptors may no longer accept the drug

78
Q

What is the purpose of identifying a nursing diagnosis for the patient

A

Evaluate effectiveness
Establish goals
Establish outcomes
Plan interventions

79
Q

What agencies are involved in reporting medication errors?

A

FDA
The division of medication error prevention and analysis (dmepa)
National coordinating council for medication error reporting and prevention (ncc merp)

80
Q

What analytical tool should the nurse expect to be used to determine why a patient received an incorrect med?

A

RCA. Root cause analysis

81
Q

An older client reports compliance with treatment and diet for type 2 diabetes mellitus, yet the blood glucose remains high. What factor should the nurse consider that could interfere with the success of this treatment?

A

Decreased GI motility
Leads to decreased absorption of meds

82
Q

Older clients should be instructed to increase fluid intake especially with what kind of medication?

A

Water soluble

83
Q

What age related factor influence the effectiveness of medications in older adults?

A

⬇️absorption
Altered distribution and metabolism
⬇️elimination

84
Q

What clinical manifestation can occur if teratogenic drugs are taken during the embryonic period

A

Malformation of internal structures
Spontaneous abortion

ABSN (9 decks)

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