Test 1 - Lecture 3

Question 1

Six Rights of Medication

Answer 1

1. ) Right drug
2. ) Right patient
3. ) Right dose
4. ) Right route
5. ) Right time
6. ) Right documentation

Question 2

Assessment

Answer 2

What the drug does?
Head to toe assessment and Vitals
Ask questions
Is patient on other meds?
LOC?
Check labs
High risk (Kidney problems)

Question 3

Three sources of assessment

Answer 3

The patient interview and history (subjective data)
The physical examination (objective data)
The medical record

Question 4

1 Nursing diagnosis of medication

Answer 4

Knowledge deficit

Question 5

Nursing diagnosis for antihypertensives

Answer 5

Risk for injury

Question 6

Nursing process step for Deadline established to evaluate drug effects

Answer 6

Planning

Question 7

Nursing process step for History of an allergy to a drug

Answer 7

Assessment

Question 8

Nursing process step for Instillation of eye drops

Answer 8

Implementation

Question 9

Nursing process step for writing expected outcomes with the patient

Answer 9

Planning

Question 10

Nursing process step for observing a patient demonstrate proper self-medication with insulin

Answer 10

Evaluation

Question 11

Nursing process step for risk for injury due to the medication’s sedating effects

Answer 11

Diagnosis

Question 12

Nursing process step for recording secondary effects of medication

Answer 12

Evaluation

Question 13

Polypharm

Answer 13

on multiple drugs

Question 14

Most misused drugs

Answer 14

ADD meds

Question 15

Noncomplience

Answer 15

Why are they not taking?

Get to the root

Question 16

True or False: The margin between desired therapeutic effects and adverse consequences of the drug therapy is called the therapeutic index.

Answer 16

False: drug therapy is called the risk benefit ratio

Question 17

True or False: Nonadherence is the inability to follow a recommended drug therapy regimen

Answer 17

True

Question 18

True or false: A patient who responds with hyperactivity to a drug that normally causes sedation has an adverse effect known as idiosyncratic excitement.

Answer 18

False: Paradoxical excitement

Question 19

True or False: A geriatric patient is also known as an older adult

Answer 19

True

Question 20

True or False: The practice of one patient taking several drugs simultaneously is called drug abuse

Answer 20

False: Polypharmacy not drug abuse

Question 21

True or False: An older adult is any patient older than 65 years with a debilitating medical problem

Answer 21

False: Frail elderly not older adult

Question 22

True or False: Matching the patients previous drug therapy with their currently prescribed therapy is called medication reconciliation

Answer 22

True

Question 23

Summarize the normal physiologic changes with age that affect absorption in an elderly patient receiving drug therapy.

Answer 23

Increased gastric pH levels, slowed blood flow, decreased GI motility, and reduced surface area of the GI tract

Question 24

Summarize the normal physiologic changes with age that affect distribution in an elderly patient receiving drug therapy.

Answer 24

Decreased body mass, reduced levels of plasma albumin, less effective blood-brain barrier, declining cardiac output, extreme changes in body weight, poor nutrition or dehydration, inactivity or extended bed rest.

Question 25

Summarize the normal physiologic changes with age that affect metabolism in an elderly patient receiving drug therapy.

Answer 25

Decreased size of the liver. decreased number of metabolically active hepatocytes, decreased blood flow to the liver, decreased ability to remove many bi-products, and overall efficiency of the liver is reduced.

Question 26

Summarize the normal physiologic changes with age that affect excretion in an elderly patient receiving drug therapy.

Answer 26

Decreased glomerular filtration rate, decreased renal tubular secretion, and decreased renal blood flow.

Question 27

Because of age related changes of the body, absorption of drugs in the elderly patient

Answer 27

Delays onset of action

Question 28

In the elderly patient, the dosage of fat-soluble drugs may need to be _____ to avoid toxicity.

Answer 28

Decreased

Question 29

What may occur as a result of physiologic changes in the elderly patient's metabolism.

Answer 29

Increased half life. In the elderly phase 1 metabolism slows resulting in the extended half lives of many drugs.

Question 30

Planning - First Step

Answer 30

Identify desired goal or outcome | Identify specific evaluation criteria to be used to determine if outcome has been met

Question 31

Planning - Second step

Answer 31

Develop a list of interventions Specific nursing actions designed to achieve desire goal Interventions based on research evidence to promote evidence-based nursing practice

Question 32

Implementation

Answer 32

Puts nursing plan into action Knowledge, skills, and principles applied to achieve desired outcome Involves drug administration based on interventions developed in planning phase Maximize therapeutic response and prevent adverse events Subject to modification Includes providing patient teaching Documentation is an essential part of the implementation phase Interventions make up plan of care tailored to the individual patient

Question 33

Digoxen

Answer 33

Narrow therapeutic window. Must do apical pulse for 1 full minute before giving.

Question 34

Lasix

Answer 34

Give over 2 minutes or may give hearing loss or drop patient blood pressure.

Question 35

Evaluation

Answer 35

Compares current health status with desired outcome Determines if plan of care is appropriate or needs modification Used to determine drug efficacy or adverse effects

Question 36

Questions to ask yourself in the evaluation phase

Answer 36

Was the outcome or goal achieved? Was the nursing management effective? If not, what went wrong?`

Question 37

#1 question we should ask our self when giving a drug

Answer 37

Why is the drug ordered?

Question 38

Other questions we should ask our self when giving a drug

Answer 38

Is pt on lowest dose possible? Simplify treatment “Start low and go slow”