1-13-17 Flashcards
1
Q
What the patient/family states about the current/past illness.
A
Subjective Assessment (Symptoms)
2
Q
Test Results
What is observed by the health care provider.
A
Objective Assessment (Signs)
3
Q
Protecting healthy people from developing a disease or experiencing an injury. Ex: Eating healthy to avoid obesity.
A
Primary Prevention
4
Q
Intervene after an illness occurs to halt or slow the progress of disease in early stages. Ex: Taking care of diabetes so it doesn’t progress to heart problems.
A
Secondary Prevention
5
Q
Helps people manage complicated long-term health problems such as heart disease.
A
Tertiary Prevention
6
Q
Parts of Medical Histories
A
Current and prior illness Allergies Hospitalizations Treatments Specific complaints Current therapy (drugs, herbs, speech, etc)
7
Q
the nurse gives the patient an anti-anxiety medication and his anxiety is lowered.
A
therapeutic effect
8
Q
the nurse gives the patient a sleeping pill and the patient gets nauseated
A
side effects
9
Q
the nurse gives the patient a dose of penicillin for a bacterial infection and the patient develops itching and hives
A
hypersensitivity
10
Q
the nurse gives the patient a sleeping pill and he sleeps for 2 days
A
idiosyncratic
11
Q
the patient has been on pain medication for terminal cancer for one month and needs an increased dose to get the same effect
A
tolerance
12
Q
lab results show that the level of medication is above therapeutic level.
A
toxic reaction
13
Q
the patient complains of fatigue after he starts taking his medication to decrease depression.
A
side effect
14
Q
the nurse gives the patient a medication to decrease anxiety and the patient becomes overly anxious.
A
idiosyncratic
15
Q
The schedule controlled substance group that has the biggest risk for abuse and is used in patient care
A
Schedule II
16
Q
the schedule controlled substance group that has the least risk for abuse
A
Schedule V
17
Q
the schedule controlled substance group that is never used for medical purposes
A
schedule I
18
Q
the pregnancy category of drugs that can never be given to pregnant women
A
X
19
Q
the pregnancy category that is the safest for pregnant women to use
A
A
20
Q
the route of drug administration that provides the slowest rate of absorption
A
oral
21
Q
how much of a drug will be left in the body following two half lives if the original dosage was 500 mg?
A
125mg
22
Q
what type of enteral drug takes the longest to absorb?
A
entericoated
23
Q
What types of enteral drugs take the quickest to absorb?
A
liquids
powders
buccal tabs
wafers
24
Q
What kind of route requires the medication to be given under the tongue?
A
sublingual
25
What kind of route requires the medication to be given between the cheek and gum?
buccal
26
where is the chief location of drug metabolism in the body
liver
27
if a know drug is classified as an "enzyme" inducer, will the patient need a bigger or smaller dose?
bigger
28
if a know drug is classified as an "enzyme" inhibitor, will the patient need a bigger or smaller dose?
smaller
29
what kind of drug receptor interaction is a drug antidote based on?
antagonistic
30
what is the key to keeping the elderly and the children safe from cumulative drug effects regarding dosage?
start low and go slow
31
what type of drugs require routine monitoring of blood serum levels to keep the patient safe?
narrow therapeutic index
32
patients with G6PD deficiency should avoid drugs that cause further...
hemolysis
33
the patient has end stage cancer and is receiving pain medications around the clock
palliative therapy
34
the patient is taking insulin for his diabetes
supplemental therapy
35
the patient is taking blood pressure medication to keep his blood pressure within range so that he doesn't have a stroke
maintenance therapy
36
the patient is receiving medications in the intensive care unit to treat his heart dysrhythmias
acute therapy
37
a child receives a flu vaccine
prophylactic therapy
38
the patient comes into the ER after a car accident and is being given IV fluids and blood products while he wait for a surgical room to open up
supportive therapy
39
the nurse runs two different types of medication in an intravenous infusion line and notes that the medications have clumped together
incompatibility
40
the patient is taking two different types of BP meds so that together they can lower his BP better than either of them alone
additive
41
the patient revives and anti-anxiety med and a pain reliever med in one injection prior to surgery and is so relaxed he falls asleep even though that is not the typical reaction from either medication when given alone
synergistic
42
narcan is given to stop the heroin from interacting at receptor sites that the patient lives
antagonistic
43
Unknown cause of disease Ex. Seizures
Idiopathic
44
Cause of disease by treatment, procedure or error. Ex: medication adverse affects, chemo treatments lead to damaged nerve cells.
Latrogenic
45
Promotes the development of disease, not always. Ex: smoking leads to cancer, but not always.
Predisposing factors
46
Presever health and prevent spread of disease. Ex: taking blood sugars and blood pressures
Prophylaxis Measures
47
Look at etiology and predisposing factors. Ex: vaccinations and education. Smoking cessation.
Prevention
48
how a disease is started
pathogenesis
49
no manifestations because of the great reserve capacity of organs.
subclinical state
50
early in development of disease, client has non-specific signs
prodromal period
51
Clinical evidence that a disease is present. Local vs. systemic.
Manifestation of Disease
52
Collection of signs and symptoms, affecting more than one organ, signs vs symptoms
Syndrome
53
Manifestations of disease subside, ex: chemo works well but does not cure.
Remission
54
Manifestations of disease increase.
Exacerbations
55
Conditions that triggers an acute episode. Ex: cardiac patient shovels snow and has heart palpitations.
Precipitating factors
56
Period of recovery and return to heathy state.
Convalescence or Rehabilitation
57
Probability of recovery or other outcomes. Ex: cancer has 85% chance of going into remission.
Prognosis
58
of people with the disease within a group
morbidity
59
of deaths due to disease
mortality
60
Infections that can be spread from person to person
Communicable disease
61
Decrease in size of cells, reduced tissue mass.
Atrophy
62
Increase in size of cells, enlargement of tissues.
Hypertrophy
63
Increase in number of cells. Enlarged tissue mass.
Hyperplasia
64
Mature cell type is replaced by different mature cell type. Lining of respiratory tract in smokers.
Metaplasia
65
Cells vary in size and shape within a tissue and rate of mitosis is increased. Ex: chronic infection, precancerous change
Dysplasia
66
New growth, commonly called a tumor.
Neoplasia
67
Decreased oxygen delivery to tissues due to circulatory problems. Leads to hypoxia (reduced oxygen in tissues)
Ischemia
68
Necrotic tissue invaded by bacteria
Gangrene
69
any chemical that affects the physiologic processes of a living organism. Includes: prescribed medications, alcohol, sunscreen, and herbal remedies.
Drug
70
Describes the drugs chemical composition and molecular structure.
Chemical name
71
Most official name, used in drug books, only one type of name per drug. Signified by using noncaps in first word.
Generic name
72
The drug has a registered trademark, created by manufacturer. Drug can have several names.
Trade name
73
3 categories of drugs
prescription
nonprescription
controlled substance
74
largest category of drugs, potentially harmful unless use is supervised
prescription drugs
75
Drugs that are designated as safe when taken as directed. no prescription needed.
over the counter drugs
76
over the counter drug labeling requirements
dose, adverse reactions, contraindications, and precautions
77
Controlled substance act of 1970
Regulated controlled substances. Established classification list (schedules)
78
phase of drug activity where the dosage is formed (pills, liquid, powder, etc...)
Pharmaceutical Phase
79
what the body does to the drug during drug activity (adsorption, distribution, metabolism, excretion)
pharmacokinetic phase
80
what the drug does to the body during drug activity. (effects)
Pharmacodynamic phase
81
Parenteral drugs
injectable forms
82
drugs that only treat a certain area (aerosols, ointments, patches, inhalers, suppositories)
topical drugs
83
All
Drugs
Must
Exit
Absorption
Distribution
Metabolism
Excretion
84
Movement of drug from site of administration to the bloodstream.
Absorption
85
reduces bioavailability of drug to less that 100%. Oral drugs are given in larger doses because of this effect. Only effects oral drugs that go through GI.
first-pass effect
86
do parenteral drugs need higher or lower doses?
lower. 100% of drug is being used, unlike oral meds where the GI and liver destroy some.
87
Has slower absorption and longer duration of action than parenteral and enteral.
Topical route
88
Adhesive patches, good for patients who can't tolerate oral administration, use of alternating sites.
Transdermal route
89
Drug distributed to various body tissues and target sites- interacts with specific receptors in body.
Distribution
90
primary site of metabolism
liver
91
Drugs that increase or speed up drug-metabolism enzymes. Result: decreased pharmacological effects.
Enzyme Inducers
92
Drugs that decrease or delay drug-metabolism enzymes. Result: increased effect of drug.
Enzyme Inhibitors.
93
main organ os excretion
kidneys
94
about how many half-lives does it take for the body to completely eliminate the drug?
5
95
onset of action for oral drugs
one hour
96
onset of action for parenteral drugs
15-30 minutes
97
onset of action for intravenous drugs
immediate- 15 minutes
98
time it takes for a drug to reach its maximum therapeutic response
peak effect
99
length of time that a drug concentration is high enough to cause a therapeutic response.
duration of action
100
highest blood level of drug. if too high = toxicity
Peak
101
lowest blood level of drug. draw blood right before next dose. if too low = drug is non therapeutic
trough
102
side effect vs adverse reaction
mild vs severe and life threatening
103
swelling of face, lips and throat
angioedema
104
unusual, abnormal reaction to drug, different than expected reaction . Not a side effect or averse reaction, believed to be due to genetic deficiency. Ex. being sedated for long periods of time from sleeping pill.
Idiosyncratic reaction
105
Decreased response to a drug, requires increased dosage for desired effect. Ex: opioids used for terminally ill pain control.
Drug tolerance
106
Patients with liver and kidney disease: body is unable to metabolize and excrete one dose of drugs before next dose is given. Start low and go slow.
Cumulative drug effect
107
hereditary disease where certain drugs cause hemolysis of RBC's. Causes low RBC count.
G6PD Deficiency
108
drug is administered in large dosages, blood concentration levels exceed therapeutic levels.
toxic reactions
109
genetically determined abnormal response to normal dose of drug. Inherited traits cause abnormal metabolism of drugs.
Pharmacogenetic disorder
110
combined effect of two drugs is equal to sum of each drug given alone. 1+1=2
additive effect
111
drugs interact with each other and produce a sum greater than the sum of the separate actions. 1+1 > 2
synergistic effect
112
one drug interferes with action of another: Neutralization/decrease in effect of one drug. 1+1 < 2
antagonistic effect
113
some meds are incompatible and cannot be rain in the same line (IV).
incompatibility
114
detects changes in cell membranes from viruses to cancer. essential role in activation of immune response.
Major histocompatibility complex
115
group of proteins that flow freely in the blood. first part of the immune system that greets invaders.
complement system
116
Triggers inflammation
Attracts phagocytes by coating invading cells with proteins (antibodies)
next step is antigen presentation
Complement system
117
Directly kills invading antigens
| Helper T cells, Memory T cells, suppressor t cells, cytotoxic t cells
T Lymphocytes
118
Main regulators of the immune response
| Activates B cells and Killer T cells after a phagocyte
Helper T cells
119
Produced at every encounter and have long memory. Mounts faster and stronger immune response each time encounters a specific antigen.
Memory T cells
120
Produces antibodies - not directly kills
B lymphocytes
121
produces specific protein called antibody
plasma cells
122
Bind to specific antigen to destroy it
Immunoglobulins
Significant in development of immunity to various diseases
Antibodies
123
most common antibody in the blood
| major antibacterial, antiviral, and anti toxin antibody
IgG
124
first to increase immune response
| involved in blood incompatibilities
IgM
125
found in secretions
| defends on body surfaces
IgA
126
binds to mast cells in skin and mucous membranes
Causes release of histamine
Hypersensitivity/allergic reactions
IgE
127
attached to and activates B cells
| antigen receptor
IgD
128
tissue matching for transplant
Extensive HLA (MHC) typing
129
occurs when person first exposed to an antigen. antigen recognized and processed. takes 1-2 weeks for the process to complete.
primary response
130
repeat exposure to same antigen. more rapid response.
secondary response
131
venom antidote
antivenins
132
provides long lasting or permanent immunity
| herd immunity
active immunity
133
provides quick immunity such as in case of exposure to hep. B or rabid dogs.
Passive immunity
134
people allergic to MMR are sensitive to...?
egg or neomycin
135
people allergic to yeast could be sensitive to which vaccine?
Papillomavirus Vaccine (Guardisil)
136
Vaccine used for whooping cough
Diptheria, Tetanus toxoid, and Pertussis Vaccine (DTap)
137
Vaccine thats good against 23 strains that cause pneumonia. Used primarily in adults. Given to elderly, high risk children, smokers, and immunocompromised.
Pneumococcal Vaccine
138
Live virus (attenuated)
flumist
139
vaccine for prevention of shingles (chicken pox)
Herpes Zoster Vaccine
140
The immunity that is conducted by T lymphocytes
Cell-Mediated Immunity
141
the type of immunity acquired after an individual gets a disease
active immunity
142
antibody that is responsible for hypersensitivity reactions
IgE
143
antibody that is the most common in the blood
IgG
144
the immunity that is conducted by a B lymphocytes
humoral immunity
145
the type of response led by memory cells in the acquirement of immunity
secondary response
146
the vaccine given to protect the elderly and high risk individuals against pneumonia
pneumovax
147
antibody found in secretions
IgA
148
the immune cells that engulf antigens
phagocytes (dendritic cells, macrophages)
149
type of vaccine you can't give to individuals allergic to neomycin
MMR
150
the t-cell that specializes in bacteria, viruses and cancer cells
Killer-T cells (cytotoxic)
151
another name for antibodies
immunoglobulins
152
the type of vaccine in which the antigen is somewhat alive
attenuated vaccine
153
they type of T call that activates both B and T cells after antigen presentation
helper T cells
154
The type of vaccine in which the antigen (virus) is somewhat alive
attenuated vaccine
155
another name for antibodies
immunoglobulins
156
antibody that is responsible for hypersensitivity reactions
IgE
157
the vaccine given to protect individuals from the flu each year
influenza vaccine
158
antibody that is the first to increase in immune response
IgM
159
type of protection that includes the skin and mucous membranes
innate immunity
160
first part of the immune system that greets invaders
complement system
161
first step of the complement system when encountering a foreign invader.
inflammation
162
type of vaccine is comprised of a weakened toxin
toxoid
163
the test that measures specific antibodies
Titers
164
gene coding used for tissue typing in transplants
HLA
165
the type of replacement therapy given to protect individuals who have weakened immune systems
gammaglobulin
166
HAART is designed to prevent this
Resistance
167
the type of infection caused by normal flora in an immunosuppressed individual
opportunistic infection
168
if this is suppressed too much, individuals have to wait to take Zidovudine (Retrovir)
bone marrow
169
GI effect seen in individuals with AIDS
malnutrition
170
A temporary state of immunosuppression in women
pregnancy
171
individuals need this injection ASAP when having an anaphylactic reaction
epinephrine
172
the type of reaction seen in a type 3 hypersensitivity reaction
autoimmune
173
low platelets in the blood
thrombocytopenia
174
individuals with SLE have this reaction in their blood vessels which eventually causes ischemia and necrosis
inflammation
175
Drug classification given to individuals with SLE to control the disease by decreasing immune response
corticosteroid
176
low leukocytes in blood
leukopenia
177
the adverse affects seen in people taking Ritonavir (Norvir)
hyperglycemia
178
an over-the-counter medication given ASAP when individuals begin to experience signs of an allergic reaction
antihistamine
179
the drug given to prevent organ rejection by suppressing T lymphocytes
cyclosporine
180
another name for hives
urticaria
181
another name for itching
pruritus
182
The type of lab test that signifies inflammation in the body
ESR
183
symptoms seen in patients with AIDS
lymphadenopathy
184
This type of drug should be given by mouth asap when individual starts to show signs of an allergic reaction
corticosteroids
185
another name for the swelling of the face lips and throat
angioedema
186
the typical butterfly mask seen in individuals with SLE is exacerbated with exposure to this
Sun
187
this type of reaction is seen in a type 2 cytotoxic hypersensitivity reaction
transfusion
188
the adverse affects of cyclosporine identified by increases in the BUN and creatine in the body
nephrotoxicity
189
the type of organ rejection that occurs months/years after the transplant is done
chronic
190
pneumocystitis carni is the #1 cause of what in individuals with AIDS
death
191
this drug therapy is used to treat cancer and causes immunosuppression in an individual
chemotherapy
192
low red blood cells in the blood
anemia
193
this gland shrinks in old age
thymus
194
the type of immune response seen in type I hypersensitivity reactions
allergic
195
the phase of HIV in which the individual is asymptomatic
latent
196
kidney damage has this type of course in SLE
progressive
197
Kaposis sarcoma is this type of disease specific to those with AIDS
cancer
198
shrinking of thymus gland
decreased antibody response to antigens
decreased circulating memory B cells (slow response)
increased autoantibodies (autoimmune problems, fighting own cells)
Elderly immunosuppression
199
Secondary deficiencies in immunodeficiency
loss of immune response from specific cause, may occur at any time of life
infections, splenectomy, malnutrition, immunosuppressant drugs, chemotherapy
200
Test to find HIV antibodies in blood
Western Blot Test
201
What cells does HIV destroy?
Helper T cells (CD4 lymphocytes)
202
Highly active antiretroviral therapy, includes at least three medications, used to treat AIDS.
HAART
203
adverse effects of Zidovudine (Retrovir, ZDV)
bone marrow suppression (you have to stop taking this medication if bone marrow blood cell counts are too low)
severe anemia and neutropenia
HAART medication
204
Adverse effects of Ritonavir (Norvir)
hyperglycemia
fat redistribution (buffalo hump)
increased cholesterol and triglyceride levels
HAART medication
205
GI effects of AIDS
chronic severe vomiting and diarrhea
| ulcers in mouth -> severe weight loss-> malnutrition
206
Early antihistamine drugs
diphenhydramine (Benadryl)
| Corticosteroids (prednisone)
207
IgG antibodies react to antigen located on cell membrane and cause lysis of cell in which stage of hypersensitivity. Ex: incompatible blood infusion
Type II cytotoxic hypersensitivity
208
Examples of Type III hypersensitivity
SLE
rheumatoid arthritis
scleroderma
209
Impaired blood supply to major organs, ischemia and necrosis of tissue
Erythrocyte sedimentation rate (ESR) is high
SLE
210
Signs: butterfly mask, joint inflammation, kidney damage, Pleurisy of lungs, Carditis of heart, raynauds phenomenon (white hands bc low circulation), anemia, leukopenia, thrombocytopenia, depression, and mood changes
SLE
211
SLE treatment
Corticosteroid
avoid sun exposure
avoid excessive fatigue
212
type of hypersensitivity characterized by a delayed response by sensitized T lymphocytes
Type IV hypersensitivity
213
vaccine for shingles
Herpes Zoster
