Pharm & the Nurse-Patient Relationship Flashcards
(78 cards)
Medication Error Index
Categorization of medication errors according to the extent of the harm an error can cause.
Sentinel event
An event that results in an unexpected, serious, or fatal injury following the administration (or lack of administration) of a medication.
Medication reconciliation
The process of tracking medications as the patient proceeds from one health care provider to another, in an attempt to reduce duplication, omissions, dosing errors or drug interactions.
E-prescribing
The transmission of prescription-related information through electronic transmission to a pharmacy or health care provider.
What type of drugs are less likely to cross the placenta?
Drugs that are water soluble, ionized, or bound to plasma proteins.
How do increased levels of progesterone in pregnant women affect the absorption of oral drugs?
Increased progesterone levels can delay gastric emptying, allowing a longer time for the absorption of oral drugs.
How do increased progesterone levels in pregnant women affect the absorption of inhaled drugs?
Progesterone increases tidal volume and pulmonary vasodilation, that may cause inhaled drugs to be absorbed to a greater extent.
How does increased blood volume in pregnant women affect drug distribution?
Causes dilution of drugs and decreases plasma protein concentrations, affecting drug distribution.
The metabolism in which drugs are increased during pregnancy?
Anticonvulsants. May need a higher dose during pregnancy
Why would doses of many medications need to be adjusted during the third trimester of pregnancy?
Blood flow through the Mother’s kidneys increases by over 50%, increasing drug excretion rates.
Teratogen
A substance, organism, or physical agent to which an embryo or fetus is exposed that produces a permanent abnormality in structure or function, causes growth retardation, or results in death.
Effects of teratogen exposure during Preimplantation period? (1-2 weeks)
All-or-none period. Exposure to a teratogen either causes the death of the embryo or has no effect.
Potential Effects of teratogen exposure during the Embryonic period (3-8 weeks)
Maximum sensitivity to teratogens due to rapid development of internal structures.
Structural malformation
Spontaneous abortion
Potential effects of teratogen exposure during the fetal period (9-40 weeks)
Period of maximize transfer of substances from the maternal circulation to the fetal blood
More likely to produce slowed growth or impaired organ function, rather than gross structural malformations
Why do medications have a prolonged duration of action during the fetal period?
Because the fetus lacks mature metabolic enzymes and efficient excretion mechanisms
Pregnancy drug risk category A
Adequate, well-controlled studies in pregnant women have not shown an increased risk of fetal abnormalities in any trimester of pregnancy
Pregnancy drug risk category B
No harm in animal studies but not enough human studies
OR
Adverse effect in animal studies but adequate human studies show no risk
Pregnancy drug risk category C
Animal studies: adverse effect Human: Inadequate studies OR Animal: No animal studies Human: Inadequate studies
Pregnancy drug risk category D
Humans: Studies have demonstrated risk to a fetus
HOWEVER, the benefits of therapy may outweigh the potential risk.
Pregnancy drug risk category X
Animals & humans: Positive evidence of fetal abnormalities or risks.
No indication for use in pregnancy
What are 5 potential effects of Tobacco use during pregnancy or while trying to get pregnant?
Difficulty getting pregnant Increased risk of: Miscarriage Premature delivery Sudden infant death syndrom (SIDS) Certain birth defects such as cleft lip or cleft palate
Infancy
The period from birth to 12 months
What is the preferred site for IM injections in an infant?
Vastus lateralis
What are the two preferred venous access sites for IV’s in infants?
The feet or scalp
