NUR 202 Pharmacology: Midterm Study Guide

Question 1

Factors affecting the excretion of drugs

Answer 1

1. Drugs are retained for extended time
2. Dosage must be reduced

Question 2

Factors affecting drug adsorption

Answer 2

1. Drug formulation
2. Dose
3. Route of administration
4. Size of drug molecule
5. Surface area of absorptive site
6. Digestive motility
7. Blood flow
8. Lipid solubility of a drug
9. Degree of Ionization
10. pH of local environment
11. Drug-drug/food-drug interactions
12. Dietary supplement/herbal product-drug interactions

Question 3

How plasma proteins affect drug distribution

Answer 3

1. Many drug molecules form drug-protein complexes - binding to proteins - never reach target cells
2. Cannot cross capillary membranes
3. Drug not distributed to body tissues

Question 4

Dose-response relationship

Answer 4

the relationship between the different doses and the responses they generate

Question 5

Median effective dose (ED50)

Answer 5

1. Middle of frequency distribution
2. Dose that produces therapeutic response in 50% of a group
3. Sometimes called “average” or “standard” dose
4. Many patients require more or less

Question 6

Pharmacogenetics

Answer 6

The study of the interrelation of hereditary constitution and response to drugs

Question 7

Increase in CAM therapies

Answer 7

Increase in CAM therapies
1. Don’t need a prescription
2. Considered more “natural”
3. May be cheaper than prescriptions
4. Focus more on treating person as individual and promote disease prevention

Question 8

Herb-drug interactions

Answer 8

1. Can lead to loss of therapeutic affect
2. Toxic effect of drugs
3. Increased side or adverse effects

Question 9

Herbal preparations

Answer 9

substances of plant origin believed to have medicinal properties

Question 10

Prescription medication

Answer 10

Use of plant products regulated by FDA and are purified

Question 11

Regulation of DSHEA

Answer 11

Strengths:
1. Aims to make dietary supplements safer
2. Forbids manufacturers and distributors from producing and selling mislabeled products
Weaknesses:
1. Not necessary to demonstrate effectiveness prior to marketing
2. Manufacturer not required to prove safety
3. Labels not monitored for accuracy in product amount or claims of benefits

Question 12

Reducing drug exposure while breast feeding

Answer 12

Reducing drug exposure while breast feeding
1. Administer drugs right after breast-feeding
2. Teach mother to avoid alcohol, illicit drugs, and tobacco
3. Drugs with short half lives are preferable
4. Drugs with long half lives should be avoided
5. Select drugs with high protein binding ability
6. Avoid all OTC herbal and dietary supplements

Question 13

Infant pharmacologic implications

Answer 13

1. Intramuscular medication or orally in buccal
2. May be fussy; use calming voice and distractions

Question 14

Components of pharmacokinetics

Answer 14

1. Absorption
2. Distribution
3. Metabolism
4. Excretion

Question 15

Loading dose

Answer 15

use of a higher dose than what is usually used for treatment to allow the drug to reach the critical concentration sooner

Question 16

Maintenance dose

Answer 16

the dose of drug that maintains or keeps the drug in the therapeutic range

Question 17

Drug’s dosing to its safety

Answer 17

Drug’s dosing to its safety
1. Drugs with larger margin of safety allow fore more wiggle room to adjust dose to reach therapeutic effect
2. Drugs with small margin of safety don’t have much wiggle room and can easily cause overdose or toxicity

Question 18

Efficacy

Answer 18

effect you get from the drug

Question 19

Potency

Answer 19

how strong a drug is

Question 20

Therapeutic index

Answer 20

1. measure margin of safety
2. median lethal dose/median effective dose

Question 21

Toddler pharmacologic implications

Answer 21

1. Don’t refer to medication as candy
2. Do not give them options
3. Keep explanations short and simple
4. Use oral liquid medications - provide flavors to allow for more compliance

Question 22

Preschooler pharmacologic implications

Answer 22

1. Don’t refer to medication as candy and keep away from children
2. Use distractions like toys to help with process
3. Use oral liquid medications - provide flavors to allow for compliance

Question 23

School aged child pharmacologic implications

Answer 23

1. Start to explain things a little more
2. May be able to start taking pill oral medication
3. Praise and reward

Question 24

Adolescent pharmacologic implications

Answer 24

1. Start to explain things like an adult
2. Discuss drug abuse and peer pressure
3. Compliance and adherence with medications

Question 25

Polypharmacy concerns

Answer 25

1. Elderly patients may be prescribed multiple medications to treat different things 2. Usually prescribed by multiple doctors 3. Can lead to double prescription or toxicity from drug interactions

Question 26

Assessment

Answer 26

1. Collect data 2. Organize data 3. Validate data 4. Document data

Question 27

Diagnosis

Answer 27

1. Analyze data 2. Identify health problems, risks, and strengths 3. Formulate diagnostic statements

Question 28

Planning

Answer 28

1. Prioritize problems/diagnosis 2. Formulate goals/desired outcomes 3. Write nursing interventions

Question 29

Implementing

Answer 29

Implementing 1. Reassess the client. 2. Determine the nurse's need for assistance 3. Implement the nursing interventions 4. Supervise delegated care 5. Doc. nursing activities

Question 30

Evaluating

Answer 30

1. Collect data related to outcomes 2. Compare data with outcomes 3. Relate nursing actions to patient goals/outcomes 4. Draw conclusions about problem status 5. Continue, modify, or terminate the patient's care plan

Question 31

Subjective data

Answer 31

things a person tells you about that you cannot observe through your senses; symptoms

Question 32

Objective data

Answer 32

what the health professional observes by inspecting, palpating, percussing, and auscultating during the physical examination

Question 33

Assessment prior to medication administration

Answer 33

1. Chief complaint 2. Allergies 3. Past medical history 4. Family history 5. Drug history 6. Health management 7. Reproductive history 8. Personal-social history

Question 34

Key nursing interventions

Answer 34

1. Administer medications 2. Continue assessment of patient 3. Monitor drug effects 4. Carry out interventions in planning phase 5. Provide patient teaching

Question 35

Aim of intervention

Answer 35

1. Patient returned to optimal level of wellness 2. Safe and effective administration of medications

Question 36

Measure of outcomes and revise care

Answer 36

1. Document effects of medication and the administration 2. Therapeutic use and outcomes 3. Monitoring side effects 4. Medication administration

Question 37

Factors contributing to medication error

Answer 37

1. Omitting one of the rights of drug administration 2. Failing to perform an agency system check 3. Failing to take into account for patient variables such as age, body size, and renal or hepatic function 4. Giving medications based on verbal orders or phone orders 5. Giving medication based on an incomplete order or an illegible order 6. Practicing under stressful work conditions

Question 38

Patient teaching

Answer 38

1. Review techniques of medication administration 2. Remind the patient to take the medication as prescribed for as long as prescribed 3. Instruct the patient not to alter dosages without consulting a physician 4. Caution the patient not to share medications 5. Inform patient of side effects and adverse effects to watch for

Question 39

Eternal administration

Answer 39

Advantages: 1. Convenient 2. Overdose can be countered by retrieval of undigested medicines through vomiting 3. Safest route because skin barrier is not compromised 4. Uses vast absorptive surfaces if oral mucosa, stomach, or small intestine Disadvantages: 1. Difficulty swallowing for some patient 2. May be inactivated if tablets or capsules crushed or opened 3. Can be inactivated by enzymes 4. Depends on patient gastrointestinal mobility and motility 5. First pass metabolism: inactivation of drug by liver

Question 40

Parenteral administration

Answer 40

Advantages: 1. Bypasses first pass effect and enzymes 2. Available to patients unable to take medication orally Disadvantages: 1. Only small doses can be used 2. Possible pain and swelling at injection site

Question 41

Topical administration

Answer 41

Advantages: 1. Fewer side effects 2. Produce a local effect topically 3. Provides high local concentration without affecting general circulation Disadvantages: 1. Absorbed very slowly 2. Absorption into systemic circulation is common and can lead to adverse effects

Question 42

Nursing responsibility regarding pharmacology

Answer 42

1. Management of therapeutic and adverse effects of medication 2. Management of medication adherence 3. Management of patient education and medication self management 4. Medication safety management

Question 43

Bioavailability

Answer 43

the proportion of a drug or other substance which enters the circulation when introduced into the body and so is able to have an active effect.

Question 44

Western medicine

Answer 44

the most common form of medical care in the United States, which uses medication and surgery to treat the signs and symptoms of illness

Question 45

Ethnic characteristics

Answer 45

culturally based and relate to cultural similarities that connect groups

Question 46

Cultural characteristics

Answer 46

a person's age, religion, and national and ethnic background

Question 47

Gender differences in response to medication

Answer 47

1. Adherence to medication may be different 2. One gender may experience more adverse effects 3. Differences in genetics, height, weight, muscle and fat mass may effect response

Question 48

Diet influences on psychotherapeutics

Answer 48

1. What they eat can affect responses to drug 2. Presence of food can alter response 3. Certain drugs can change enzyme in the liver 4. Healthy diets helps drugs and elicits more therapeutic response 5. Poor nutrition can decrease tolerance of side effects and therapeutic effect 6. When malnourishes albumin is missing which allows for drugs to be unbound

Question 49

Health literacy

Answer 49

a person's capacity to learn about and understand basic health information and services, and to use these resources to promote one's health and wellness