Exam 1 (CH 1-5 And 7) Flashcards

1
Q

Intrinsic drugs

A

Hormones, enzymes, growth factors

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2
Q

Extrinsic drugs

A

Outside factors (I.e: drugs) that produce identical effects to intrinsic drugs

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3
Q

When do you give drugs to pregnant woman

A

When the benefit out weighs the risk

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4
Q

3 drug names

A

Chemical- chemical composition
generic- 1st letter not capitalized, given by US adopted names council, short name
Brand- “trade/proprietary “ 1st letter capitalized, given by drug company

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5
Q

What is PINCH and what does it stand for

A

High alert drugs

P- potassium
I- insulin 
N- arcotics
C- chemo products 
H- eparin (anticoags)
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6
Q

Herbal product warnings

A

May interfere with pts prescribed meds

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7
Q

Agonist

A

Enhances a drugs effects

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8
Q

Antagonists

A

Blocks a drugs effect

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9
Q

Pharmacodynamics

A

Drug on body

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10
Q

Pharmacokinetics

A
Body’s effect on drugs 
A- bsorption
D- istribution 
M- metabolism
E- xcretion
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11
Q

What constitutes a true allergic reaction?

A

The bodies release of antihistamine and inflammation

AKA: anaphylaxis

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12
Q

MEC

A

Minimum effective concentration

: minimum amount of a drug in blood to cause intended reaction

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13
Q

Steady state

A

Continuous balance of drug entry and exit

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14
Q

Half life

A

Time needed for 1/2 of the drug to be eliminated from the body

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15
Q

Paradoxical drugs

A

Drugs that cause opposite responses in children than adult

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16
Q

Vital organ to metabolism

A

Liver

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17
Q

Vital organ to elimination

A

Kidneys

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18
Q

Teratogenic drugs

A

Drugs that cause birth defects

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19
Q

Pregnancy categories

A

A, B, C, D, (X)

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20
Q

8 pt rights

A
Right patient 
Right drugs
Right dose
Right route 
Right time
Right documentation 
Right diagnosis 
Right response
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21
Q

Who can prescribe meds

A
Physicians
Practitioners 
Dentists
Podiatrist 
PAs
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22
Q

Standing order

A

Prescription on a regular basis

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23
Q

Single dose order

A

Order given only once

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24
Q

STAT

A

Order given immediately 1 time

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25
Q

PRN order

A

As needed order but still has a schedule to give

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26
Q

What are nurses in reference to drug administration

A

The final defense for detecting and preventing drug errors

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27
Q

Best way to prevent drug errors

A

medication reconciliations

5 steps

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28
Q

How many times should a calculation be checked?

A

Twice once by you and by a co worker

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29
Q

Principles of drug administration

A
Know PT history, 
Allergies 
Past ADR
LAB VALUES 
AND ANY changes in condition
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30
Q

Enteral route entrance

A

Though GI tract by oral, NG or rectal

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31
Q

What do you have to make sure when administering enterally

A

If pt can swallow

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32
Q

Enteral route rate of absorption and commonality

A

Slowest absorption because it has to pass GI system.

Most commonly given

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33
Q

When taking oral enteral drugs what do you do to the pt

A

Have them sit up right, test if they can swallow, have them finish the full glass of water

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34
Q

Feeding tube types

A

NG nasogastric

PEG percutaneous endoscopic gastrostomy

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35
Q

NG tube precautions

A

Take sure that there is no CO2 tidal wave because that means tube is in lung and not stomach, hold med

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36
Q

Rectal considerations

A

Absorption affected by diarrhea
Do SIMS pose
Lay for 20 minutes

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37
Q

Parentral routes

A

ID, SC, IV, IM

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38
Q

Dump ID info

A
Injected between layers of skin
Sites: inner forearm
Common uses: TB test
Volume: 0.01- 0.1 
Needle size: 3/8 in
Gauge: 25
Angle: 15
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39
Q

Dump SQ info

A
Between skin and muscle 
Sites: upper arm, abdomen
Common uses: insulin/ heparin
Volume: 0.5 - 1.0 mL
Needle size: 3/8 in
Gauge: 25-27
Angle: 45 ( 90 in obese)
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40
Q

Dump IV info

A
In vein 
Fastest and most dangerous form of admin
Rapid absorption 
Sites: vein 
Given by IVP ( intravenous push)
IVPB ( intravenous piggyback)
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41
Q

Dump IM info

A
In muscle 
Sites: deltoid (arm), ventrogluteal, vastus lateralis (knee) 
Volume: 1-3 mL
Needle size: 1-1.5 in
Gauge: 20-22
Angle: 90
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42
Q

Percutaneous route absorbed by and ways to administer

A

Absorbed by mucous membranes

Topical/ transdermal - don’t shave skin, thin layer
Buccal
Sublingual
Ear drops
Nose drops
Spray 
Suppositories( vaginal)
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43
Q

Temp conversion formula

A

9C=5F-160

44
Q

Fahrenheit freezing and boiling / normal

A

Freezing: 32
Boiling: 212
Normal: 97-100

45
Q

Celsius freezing, boiling, normal

A

Freezing: 0
Boiling: 100
Normal: 36.1- 37.8

46
Q

T/F

Household measurements are just as accurate as metric ones

A

F

47
Q

3 systems of measurement

A

Apothecary
Metric
Household

48
Q

Kg—-g—-mg—-mcg

A

King gram married mrs gram and had micrograms

49
Q

KHDBDCM__M

A

Kids hate songs because dogs chase mailman many many mailman

50
Q

Are insulin syringes interchangeable

A

No, use insulin syringes specific for insulin

51
Q

Is “u” acceptable for units?

A

No spell out units

52
Q

Why give IV?

A

Meds needed STAT
steady admin required
Pt controlled pain meds

53
Q

Flow rate and how to calculate

A

(mL/ Hr)

Divide total volume by total hours VTBI

54
Q

Macro drip info

For who?
Drop size?
Drip factors?

A

Macro drip for healthy people
Drops are large for fast infusion
In 10,15,20 gtts/ mL

55
Q

Micro drip

For who?
Drop size?
Drip factors?

A

For children and those at risk for fluid over load
Small drops
60 gtts/ mL

56
Q

Drip rate ?

A

Gtts/ min

57
Q

Controller mechanisms and obstruction details

A

Device that uses gravity to control flow

Will stop if obstructed to avoid infiltration

58
Q

Infusion pump mechanism and obstruction detail

A

Commuter based machine that pushes based on fluid

Will beep if pressure is changed but won’t stop

59
Q

What is needed for an IV ORDER

A

What fluid is being admin
Volume: how much is being admin
Duration: for how long
Rate: how fast to be infused

60
Q

What’s is IV LOCK

A

Lock that doesn’t let anyone mess with pump

61
Q

Define infiltration

A

The pulling or needle or catheter from vein that leaks fluid into tissues
Cool to touch
Swollen

62
Q

Define fluid overload

A

The rapid absorption of fluid

63
Q

Extravasation

A

The leaking of harmful substances into the skin causing tissue damage/ loss
No hard vein streak

64
Q

What do you do if your infusion falls behind schedule

A

Nothing, don’t play catch up,

Will cause complications

65
Q

Define Pain

A

Pain is whatever the pt says it is

66
Q

How to monitor 5th vital( pain)

A

As the pt, get their accounts and value

67
Q

What is pains greatest problem

A

Pain is so often under reported and under treated

68
Q

How much pain the pt feels

A

Pain intensity

69
Q

Pain threshold

A

Certain level of pain until pt starts to feel pain

70
Q

Persons ability to “stand” pain intensity

A

Pain tolerance

71
Q

What happens as your pain tolerance increases

A

You need more drug to create the same therapeutic effect

72
Q

Who do you use the numerical pain scale for

A

A A&O X3, X4 adult, communicative

73
Q

What pain scale would you use for a child and or those who are communicative

A

Wong baker” faces ”

74
Q

Who do you use the FLACC scale for

A
F- ace
L- egs
A- ctivity 
C- rying 
C- onsoluability

Someone who is noncommunicative and infants
Pain scale is objective

75
Q

Describe how pain is felt

A

Your brain perceives pain, it is not actually “felt”

76
Q

How often do you check for pain

A

Every 4 hours or as often as you asses your pt

77
Q

Who or what sends signals to your brain to let you know there is injury?

A

Nociceptors

78
Q

Describe acute pain

Causes
Duration
S&S

A

Causes: immediate identifiable pain
Duration: short lasting
S&s: physiological changes (high BP)

79
Q

Chronic pain

Causes
Duration
S&S

A

Causes: unidentifiable
Duration: pain that lasts longer than 6 months
S&S: doesn’t trigger physiological response

80
Q

What is addiction

A

Psychological need for the “high” without pain

81
Q

Name: physiological changes in autonomic NS when opioids are used long term when not needed for pain

A

Dependence

82
Q

What happens when you suddenly stop opioids after dependence has been established

A

Withdrawl;

Vomiting
Nausea
Delirium

83
Q

Schedule 1

A

No medical use

Heroin

84
Q

Schedule 2

A

Very high potential for abuse And dependence with medical use

Fentanyl

85
Q

Schedule 3

A

Hugh potential for abuse and dependence with medical use

Steroids

86
Q

Schedule 4

A

Potential for abuse and small dependence with medical use

Benzos

87
Q

Schedule 5

A

Lowest potential for abuse and dependence, medical use

Cough syrup with codeine

88
Q

What characterized an analgesic

A

Any drug that controls pain

Opioid and non opioids

89
Q

What makes an opioid an opioid?

A

If it consists of an addictive chemical

90
Q

What do you check before administering opioids

A

O2 and resp rate

91
Q

How do you get the best pain relief?

A

Taking pain meds on regular schedule v PRN the

92
Q

Do opioids alter perception of pain

A

Yes

93
Q

Side effects of opioids

A

Constipation, nausea and vomiting, drowsiness, dizziness, (sedation)

94
Q

Opioid ADR

A
Respiratory depression 
addiction
dependence
tolerance
withdrawal
Reduced vision (falling in elders)
95
Q

Fentanyl forms

A

Patch, spray, lollipop

96
Q

Opioid PT teachings

A

Take with food and fluids
do not drive
change position slowly
if opioids are taken for true pain addiction is unlikely

97
Q

Can you substitute narcotics

A

No! They act differently on different pain receptors

98
Q

Opioid anecdote

A

Narcan ( naloxone)

99
Q

Acetaminophen name
Max amount per day
Risks
Actions it does not do

A

Tylenol
3g per day
Liver and kidney damage
Does not have anti inflammatory affects

100
Q

Acetaminophen anecdote

A

Acetylcysteine

101
Q

NSAIDS types and uses

A

Aspirin ibuprofen(4x a day), naproxen (2x a day)

For inflammation

102
Q

Adjuvant pain meds

A
Antidepressants not immediately 
Anticonvulsants (neuropathic pain) 
            Pregabalin - lyrica 
            Gabapentin- Neurontin 
Muscle relaxers 
            Must be for muscle spasms
103
Q

Can opioids cross placental barrier?

A

Yes

Narcan needed for babies who’s moms abused of meds while pregnant and used opioids

104
Q

How many times should an order be checked ?

A

3 times

  1. Look at order
  2. What Preparing medication
    - is it accurate?
  3. At bedside right before administering
105
Q

2 pt identifiers

A

Name and DOB

106
Q

8 drug errors

A
Omission error 
Wrong patient 
Wrong drug
Wrong route
Wrong rate
Wrong dose age form 
Wrong time 
Prep error