Exam 1 Terms Flashcards
(122 cards)
1
Q
What is the precautions on a drug label?
A
steps taken before to prevent harm
2
Q
relative contraindication
A
does the benefit outweigh the risk? vice versa
3
Q
absolute contraindication
A
used together could cause life threatening effect
4
Q
indications
A
what is the drug approved for?
5
Q
therapeutic classification
A
what is being treated by the drug (i.e. antihypertensive)
6
Q
pharmacologic classification
A
how the drug acts (i.e. beta blocker)
7
Q
bioavailability
A
how long and what it has to do in order to be absorbed and put into the blood stream
8
Q
reconstituions
A
creating a powder into a liquid for oral or parenteral admin
9
Q
what do you reconstitute oral meds with?
A
water
10
Q
what do you reconstitute parenteral meds with?
A
saline
sterile h20
follow label directions
11
Q
what is a suspension?
A
powder mixed with medicated liquid
12
Q
what do you do after reconstitution?
A
date and time of prep strength date and time of expiration store directions my initials
13
Q
what pills should not be crushed?
A
extended release
slow release
time crucial pills
14
Q
when should you crush a no crush pill
A
when the doc prescribes it
15
Q
when should you use the z track method?
A
during IM injections
16
Q
mixing meds rule of thumb
A
clear and clear you’re in the clear
clear and cloudy you’re getting noddy
17
Q
sharps precautions
A
drop in box immediately after covering (after injection)
change at 2/3 full
don’t reach in
18
Q
onset
A
how long does it take to start working?
19
Q
peak
A
when it is working most
20
Q
med order includes…
A
full name dob date and time of order name of med dosage route time and freq phys signature
21
Q
what are the four different types of orders?
A
single/1time
STAT
standing
PRN
22
Q
when should a STAT order be given?
A
within 30 min
23
Q
when should a single order be given?
A
within 1 hour
24
Q
when should a standing order be given?
A
until discontinued order has been given
25
ASA
aspirin
26
APAP
tylenol or acetaminaphin
27
10 traits of an ideal drug
```
effective
inexpensive
safe and no adverse effects
reversible
short duration with infrequent dose
no interactions
easy name
convenient
fast
eliminated quickly
```
28
what are the schedules of a controlled substance?
1 thru 5
29
what is an example of a schedule 1 drug
heroine
30
what is an example of a schedule 2 drug
morphine and codeine, cocaine
31
what is an example of a schedule 3 drug
buprenorphine
32
what is an example of a schedule 4 drug
the "AM's"
| alazaopram
33
what is an example of a schedule 5 drug
cough medicines
34
what are the five rights
```
med
dose
person
time
route
```
35
what is the nurses role to administer meds?
transcribe, verify, dispense and deliver
36
why are drugs enteric coated?
to be dissolved and absorbed in small intestine because it might bother the stomach
37
what is pharmacokinetics?
how the drug moves through the body
38
how do drugs move across a membrane?
through active and passive transport
39
what is passive transport?
transportation from a high to low concentration
40
what kind of drugs use passive transport?
small, non ionized and lipid soluble
41
what kind of drugs use active transport?
large, ionized and water soluable
42
what is active transport?
transportation that uses a carrier protein
43
what are the two types of active transport?
active and facilitated
44
what is facilitated diffusion?
active transport without energy
45
what is drug absorption
the movement of the site of administration to the blood
46
what are the two things that drug absorption determine?
intensity and onset
47
factors that affect absorption of a drug
```
dissolution of the drug (dissolving)
surface area
blood circulation
route
bioavailablity
```
48
what is the order of fastest drugs?
```
sublingual
subcutaenous
IM
PO
topical
```
49
metabolism
enzymatic alteration of drug structure
50
where does most metabolism take place?
liver and sometimes kidneys
51
what is the purpose of metabolism?
to change drugs from lipid to water soluble for an easier way to excrete them
52
what are prodrugs?
a drug that needs metabolism to become therapeutic
53
first pass effect
inactivation of a drug before reaching the target organ
54
what type of drugs experience the first pass effect?
PO oral - swallowed
| ones that reach the stomach and small intestine
55
what are the therapeutic consequences of metabolism?
```
accelerated renal excretion
drug inactivation
increased therapeutic action
activation of pro drugs
decrease toxicity
increased toxicity
```
56
how does drug excretion work?
drugs are metabolized into small compounds to be removed from body
57
how are drugs excreted?
renal
pulmonary
glandular
fecal
58
what happens when there is renal failure?
pt may retain the meds
59
what should you do with patients with renal failure who are on meds?
lab values!!
| make drug dosages lower
60
minimum effective dose
amount of drug required for effect
61
therapeutic range
range the drug has to release therapeutic action
62
what determines drug safety?
the closeness of toxic level range and therapeutic range
63
toxic concentration
level resulting in serious adverse effects
64
half life
length of time required for drug to reduce by 1/2 after admin
65
plateau
amount of drug absorbed equals amount excreted
66
how many half lives until usually eliminated?
4.5
67
loading dose
high amount given to prime blood stream to induce quick therapeutic response
68
efficacy
max response produced from a particular drug
69
potency
amount of drug needed to produce a therapeutic effect
70
rule of thumb for dosing and potency
less dose given for more potent drug
71
how do most drugs produce their effect?
binding onto receptors!
72
how is intermittent variability measured?
by frequency distribution curve
73
what is the median effective dose?
the amount required to produce 50% therapeutic effect in patients
74
what is the standard dose?
median effective dose
75
what is the nurses role in medication dosage accuracy?
monitor the patient and change as needed
look at lab values
vitals
assessment
76
what is the therapeutic index?
it describes drug safety
77
how to compute therapeutic index?
median lethal/median effective
78
what is the four different types of pharmacokinetic drug drug interactions
absorption
distribution
metabolism
excretion
79
what is the absorption drug drug interaction?
changing GI speed
80
what is the distribution drug drug interaction
ph change
receptor change
more unbound particles raise blood serum levels
81
what is the excretion drug drug interaction
increased and decrease excretion
82
what is the three pharmacodynamic drug drug interactions
additive
synergystic
antagonistic
83
what is the additive drug drug interaction
two drugs produce a combined summation effect
84
what is the synergistic drug drug interaction
enhanced response
85
antagonistic drug drug interaction
action being canceled
86
what are the drug and food interaction?
drug absorption
drug metabolism
drug toxicity
drug action
87
what is the idiosyncratic effect?
unusual or unexpected reactions unrelated to the drug often due to genetic variability
88
what is the iatrogenic effect?
causing another problem from treatment
89
what is the side effect of dependence?
the organ does not function the same after treatment stops
90
what are some geriatric considerations and drug effects (7)
```
absorption
distribution
metabolism and excretion decreased
polypharmacy
pathology
ability to self manage meds
lack of understanding meds
```
91
what do geriatrics need in regards to dosage?
a smaller dose
92
how does illness and disease affect nutrition? (4)
nutritional requirements may increase
intake may increase or decrease
absorption and metabolism of meds and nutrients
excretion (diarrhea, constipation, bloating)`
93
7 ways that drug affect nutrition
```
cause nausea and vomitting
inhibit and stimulate appetite
alter sense of smell or taste
alter saliva secretion
alter oral mucosa
delay gastric emptying
absorption and excretion of nutrients
```
94
what are our goals when providing nutritional support?
provide adequate nutrients
deliver in through route that is most useful
prevent disability - give them ability!
restore patient function
95
how much fat, carbs, fiber should we have in our diet
65 g fat
300 g carbs
25 g fiber
96
how do we prevent malnutrition?
CALORIES
MACRO
MICRO
97
what does the nurse do when assessing nutritional status?
Antropometric
Biochemical (lab val)
Clinical assessment (appearance?)
Dietary (what do they know?)
98
what happens to your hematocrit when you are dehydrated?
it increases
99
how much water should we be drinking in a 24 hour period?
2 to 2.5 liter
100
what is the normal range for albumin and what does it test for?
3.5 to 5.5 g/dL
| does their diet include protein?
101
what is the normal range for pre albumin and what does it do?
15 to 36 mg/dL
shorter half life of albumin
better indicator for protein stat
102
what is the normal range for hematocrit and what does it mean?
men 38 to 50%
women 35 to 45%
looks at anemia.. low iron, b12, folate
103
what is the normal range for blood urea nitrogen and what does it mean?
7 to 20 mg/dL
end product of protein digestion and metabolism
tests kidneys
dehydration and a lot of protein can increase this
104
why do they use clear liquid diets
to give the bowels a rest
105
why do they soft low fiber diets
for dental problems and choking
106
why do they give mechanical soft diets
for chewing problems
107
why do they give high fiber diets
to create peristalsis and prevent constiparion
108
what are some ways to prevent aspiration?
```
oral care
rest between meals
small frequent meals
no distractions
time meds
keep hydrated
```
109
what does a standard formula contain? for an enteric feeding
whole proteins that require normal digestion and absorption
110
what does a hydrolyzed formula contain? or an enteric feeding
partially or total digested proteins carbs and fats and usually for those who have problem digesting and absorbing
111
how to avoid re feeding syndrome
assess! low and slow
| electrolyte imbalance? check.
112
what should you look for in residual for feedings?
more than 50 % don't feed
or
2x the hourly continuous rate
113
what should be done first before feeding he patient?
raise head of bed!
114
polymeric feedings
pt absorbs whole nutrients
115
modular feedings
macronutrients, not nutritioanlly complete
116
elemental feedings
predigested nutrients
117
specialty feedings
target what is needed by the body for certain disorders
118
what is included in dumping syndrome?
diarrhea, vomitting and cramping and distension
119
how should a nurse manage dumping syndrome?
slow tube feedings
avoid bacterial growth
administer at room temp
assess new meds that may contribute
120
what is PPN
peripheal parenteral nutrition
temporary
isotonic solution
121
what is TPN
hypertonic solution
total parenteral nutrition
long term
central vein
122
what is a precaution for TPN?
blood glucose readings
