Exam 1 Flashcards
What does USP mean?
US pharmacopeia
What does USP check for?
Identity, potency, and purity
What does FDA regulate that USP does not?
Appropriate pricing for medications
What is a SMART goal?
Specific Measurable Attainable Realistic Time frame
What is the correct route for the administration of a unit of insulin?
subq usually the stomach area
Why can’t insulin be administered orally?
It is digestible
Which act provides for the privacy of patient health information?
HIPAA
What is the the primary purpose of federal legislation in drug standards?
ensuring public safety
How long before a meal should insulin be injected?
30 minutes for regular insulin
True or false? Controlled substances should be locked away from patients, and all staff members should have keys for necessary access.
False!
All staff should not have keys to the controlled substances; only authorized persons should have keys. All other statements indicate preferred procedures for controlled substances.
A nurse is to administer a dose of furosemide (Lasix). The nurse is aware that Lasix is the ________ for the drug.
Brand name
A patient has liver and kidney disease. He is given a medication with a typical half-life of 30 hours. What will happen to the half-life of the drug in this instance?
It will be longer
When assessing older adults and those with renal dysfunction, the nurse knows that creatinine clearance is usually __________
decreased
What are the 4 stages of the pharmacokinetic phase?
Absorption
Distribution
Metabolism
Excretion
Which nursing actions would be important for ensuring patient safety with a medication that has a low therapeutic index?
Monitoring serum peak and trough levels
Where are most drugs metabolized?
the liver
What are the symptoms of dehydration? (hypovolemia)
Lethargy, lightheaded or dizzy, low BP, decreased urine output, lack of skin turgor
What are the signs/symptoms of hypervolemia?
edema, fluid in lungs (crackles), SOB, high blood pressure
What should we monitor when treating with diuretics?
BP, urine output, potassium levels
What patient education should be provided when taking diuretics?
Stand up slow, eat a potassium rich diet (possible supplementation)
What are signs of chronic opiate abuse? (heroin, methadone, morphine, codeine, fentanyl)
small pupils
bradypnea
needle marks
What are signs of chronic cocaine abuse?
agitation paranoia tachycardia tachypnea diaphoresis hypertension
What are signs of meth abuse?
anorexia tachycardia hypertension insomnia skin breakdown and sores (skin picking) tooth decay
What does protein bound mean?
Linked to polypeptides; not freely circulating in the plasma. Drugs or toxins that are heavily protein-bound have less impact on body receptors and metabolic functions than those that circulate in a free (unbound) state.
Can you give a patient two protein bound medications together?
NO
drugs compete for protein binding and negative side effects of one or the other will increase dramatically
Which herbal remedies can increase bleeding?
Garlic
Gingko
Ginger
What is APIE or ADPIE?
Assessment (Diagnosis) Plan Implementation Evaluation
Why are infants and the elderly more at risk for drug toxicity?
Infants and elderly have decreased liver and kidney clearance
What are drug calculations for children based on?
Age
Weight
Height
If the half life of a drug is 4 hours, how much of the original dose is left after 12 hours?
1/8 of the original
What are the 6 rights or medication admin?
Right patient Right drug Right dose Right time Right route Right documentation
What are the parts of QSEN competency?
QI Safety Informatics EBP Teamwork
What is tolerance?
A decreased sensitivity to a substance to which one has been previously or repeatedly exposed
What is dependence?
physically dependent on a substance - not necessarily part of addiction
What is intoxication?
cognitive and physical impairment from drugs or alcohol
What is substance use disorder?
compulsive drug use despite consequences, inability to stop using the drug
What drugs do African-Americans respond poorly to?
several classes of antihypertensive agents (beta blockers and angiotensin-converting enzyme inhibitors)
What is ethnopharmaocology?
the study of drug responses that may be unique to an individual owing to social, cultural, and biologic phenomena
What are symptoms of nicotine withdrawal?
depression
headaches
irritability
Hypernatremia
Thirst, decreased urine, WATER FOLLOWS SODIUM
Hyponatremia
cramps, twitching, weakness, altered consciousness
Hyperkalemia
cardiac arrest
Hypokalemia
arrhythmia, hypotension, anorexia, muscle weakness, cramps
Hypercalcemia
decreased neuromuscular irritability, confusion, fatigue, nausea
Hypocalcemia
muscle spasms, tetany, convulsions
Hypermagnesemia
weakness, diminished reflexes, hypotension, respiratory depression
Hypomagnesemia
tetany, muscle cramping, seizures
Na levels
135-145 mEq/L
Ca levels
8.5-10.5 mg/dL
K levels
3.5-5 mEq/L
Mg levels
1.5-2.5 mEq/L
True or false? the manifestations of cocaine use include
cardiac dysrhythmias and violent behavior.
true
What are 3 physiologic changes of aging that can affect drug activity?
increased fat-to-water ratio
decreased liver enzyme production
loss of nephrons
drugs proven to be a risk to the human fetus are included in which FDA pregnancy category(ies)?
C
D
X
In what instances is the nurse required to chart the patients response to medications?
sedatives opioids antiemetics analgesics adverse reactions
WHAT ARE THE MANIFESTATIONS OF HYPOCALCEMIA?
TWITCHING
SEIZURES
SPASMS
A patient is noted to have a serum potassium level of 5.6 mEq/L. The first action the nurse would anticipate would be to
decrease potassium intake
What is probably the most undiagnosed electrolyte deficiency?
Hypomagnesemia
Which herb is thought by some to decrease memory loss associated with aging?
gingko biloba
True of false? Users of St. John’s wort should avoid tyramine-rich foods while taking the supplement.
True
