Exam 2; fundamentals of nursing Flashcards
For the generic name, what is capitalized
nothing, first letter is not capitalized
For the brand name what is capatalized
the first letter
Which of the following is a generic name
A. amlodipine
B. Augmentin
C. Lanoxin
D. Cardizem
amlodipine
Drug classifications– what are the variety of methods (list the 3)
Body system: ex. cardiac
Therapeutic: ex. antihypertensive
Pharmacologic action: ex. calcium channel blocker
Further classifications of medications: prescription, nonprescription, illegal or recreational drugs
prescription: must need a physician order
non prescription: anything you can buy OTC
illegal or recreational drugs: not FDA approved no therapeutic action
Which of the following medication names for the nurse use most frequently when communication with HCP
A. chemical
B. brand
C. generic
D. common
C
Which source of information is best for the nurse to obtain drug information?
A. physicians desk reference
B. nursing journals
C. united states pharmacopeia and national formulary
D. electronic databases
D
What are you supposed to do when wasting a med
require a witness of a 2nd RN
Which entity is responsible for monitoring drug safety in the US
A. drug enforcement agency
B. department of justice
C. U.S. food and drug administration
D. world health organization
C
Which of the following is an example of a schedule I drug
A. lisinopril
B. acetaminophen
C. cocaine
D. ritalin
c
(schedule I is highest risk, schedule V is the lowest)
The student nurse is looking up a medication in preparation for clinical. The student nurse pays careful attention to which of the following? (select all that apply)
A. generic name
B. brand name
C. FDA approval status
D. therapeutic classification
E. pharmacologic classification
A
B
D
E
What do receptors do
lock and key: forms a chemical bond
What do agonist do
stimulate a response
What do Antagonists do
do not stimulate a response
Partial Agonists
stimulate a response and inhibit other responses
Which of the following describes the action of a receptor?
A. stimulates a response
B. does not stimulate a response
C. inhibits a response
D. forms a chemical bond
D
Routes of Drug Administration: enteral, parenteral, percutaneous
Enteral: anything that goes via GI tract (nasogastric, Po, Pr) (slowest)
Parenteral: subpasses the GI tract (IM, IV, SubQ) (fastest)
Percutaneous: absorbed through skin (skin mucous membranes, inhalation, sublingual, topical)
What are the Drug Stages after administration: in order
ADME
Absorption
Distribution
Metabolism
Excretion
What does absorption do?
drug is transferred from entry site into the body’s circulating fluids
What does distribution do?
drugs are transported throughout the body- by body fluids to the sites of action
What does metabolism do?
the process whereby the body inactivates and breaks down drugs
What does excretion do?
The elimination of drug metabolites and in some cases the drug itself from the body
- kidneys major organ of excretion; some excreted in feces
Why is it important to administer medications with an adequate amount of water?
to increase absorption
List the four organs that receive the distributive drug most rapidly
heart
brain
liver
kidney
Which organ is largely responsible for the metabolism of medications
liver
What is half life
the amount of time required for 50% of the med to be eliminated from the body
Which of the following would give an indication of the ability of the patient to excrete medications
A. pulmonary function test
B. Renal function test
C. Liver function test
D. cardiac enzyme test
B. renal function test
Factors influencing drug action
age
weight
body size
disease/ illness
tolerance
accumulation
In what way might the student nurse caring for a client with renal failure expect the dosage of some medications to altered?
A. lower dosage
B. higher dosage
C. normal dosage
D. average dosage
A. lower dosage
what is therapeutic effect
intended action of the medication, can have multiple
what is toxic reaction
dangerous damaging effects to an organ or tissue, overdosing
what is idiosyncratic reaction
unexpected, unusual, or abnormal response that happened
patient over or under reacts to a medication
What is additive and synergistic effect
two meds with similar actions are administered for an increased effect
What is antagonistic, displacement, and interference
one med interferes with the action of another.
Placebo vs. nocebo
placebo: position expectations
nocebo: negative expectations
which of the following best describes an idiosyncratic reaction
A. expected outcome
b. toxic reaction
c. unusual response
d. minimal response
C
Drug accumulation may result in which of the following
A. placebo effect
B. dependence
C. Displacement
D. toxicity
D
Which of the following best describes an anaphylactic reaction
A. desired response
B. toxic response
C. maximum response
D. life threatening response
D
7 rights of drug administration
patient
drug
dosage
time
route
documentation
reason
The nurse receives the following order: tylenol #3 1 tablet as needed for incisional pain. This is an example of which kind of order?
A. standing
B. routine
C. PRN
D. stat
C
The nurse is making rounds with a patient’s physician when the physician gives the nurse a verbal order for a routine medication. What does the nurse do next?
A. enters the order when the nurse returns to the desk after rounds to chart
B. refuses the order
C. does not follow the order because it is not official
D. obtains the chart and asks the physician to enter the order
D
What are the nurses responsibilities
verification, transcription, verification of orders transcribed by others, variance reports
What are the rules of documentation (3)
if you didn’t chart it, it didn’t happen
nursing process
teaching and discharge planning
The student nurse will perform which of the following tasks before administering medications (select all that apply)
A. be sure to document all medications as given
B. understand why the client is taking the medication and what effects to watch for
C. perform hand hygiene
D. apply knowledge gained from chart review and physical assessment
E. educate the client about each medication
B, C, D, E
What are the three checks of medication administration safety
- before you pour: check the medication label against the MAR
- after you pour verify the label against the mar
- at the bedside check the medication again
what are regulations of high alert medications
no verbal orders
use both generic and brand names
double checking dose with another nurse
patient education
List two reasons why it is important to administer a medication at the right time
half life
med is time sensitive for a procedure
When are medication errors most likely to occur
skipping the 7 rights
getting too busy and passing off an assignment
How many times should the nurse review the medications before administering them to a patient
3
How do you administer meds if a patient is visually, tremors, touch sensory, or swallowed impaired (7)
- ask client how he/ she desires to take medications
- tell client color, shape, size, and name of each med for client to identify
- only touch med if you wear clean gloves
- client must be awake and alert
- hold med cup and put it up clients mouth
- place med on spoon and feed to client
- check clients mouth area to ensure med is swallowed
When does a nurse withhold administration?
vital signs
sedation
GI/Kidney
NPO status
Labs
(are all not within defined limits)
What are some important things to remember when administering nitroglycerin ointment
don gloves
new application site
measure dose on application paper
spread in thin layer, without rubbing
cover area with plastic wrap and tape
A two year old child is being treated for an external ear infection. What is the correct ear position for the nurse to administer ear drops
pull down and back
How to administer ear drops for 3- year- olds and up
pull up and back
When instilling ophthalmic drops, which steps does the nurse take to minimize the risk of systemic absorption
placed a gloved finger against the inner canthus for 1 to 2 minutes
A patient is being instructed on the use of a dry powder inhaler for newly diagnosed asthma and has successfully demonstrated an ability to use it. the patient asks the nurse how to tell when it is time to replace the inhaler. How does the nurse respond?
before the gauge on the canister nears zero
With the number of gauge of the needle, what is something to remember
the lower the number the larger the diameter
Which of the following needle gauge sizes, which is the largest in diameter?
A. 18
B. 20
C. 22
D. 25
A
Which needle gauge size is best for the administration of subcutaneous medications?
A. 25
B. 22
C. 18
D. 15
A
(22= IM)
(25= subq)
True or false: you use blunt needles for drawing up medications and inserting into patient
false: only for drawing up med
What angle is the needle held at when administering through intradermal route, subcutaneous route, and intramuscular route
5-15 degrees
45-90 degrees
90 degrees
How much can you administer in the upper half of your body and lower half of your body
Upper: no more than 1 mL
Lower: no more than 2 mL
What is the main concept of Havinghurst
failure to master a task leads to imbalance for the individual and difficulty mastering future tasks and interacting with others
What is the main concept of Sigmund Freud
development is maintained by instinctual drives
What is the main concept of Jean Piaget
cognitive development requires 2 core competences: -adaption (adjust to and interact with environment)
assimilation (the integration of new experiences with one’s own system of knowledge)
accommodation (the change in one’s system of knowledge by processing new information)
What is the main concept of Erickson
personality evolves throughout the lifespan
(8 stages, trust vs mistrust, autonomy vs shame and doubt… ect.)
What is growth
physical: height, weight, sexual maturation
What is development
more mental: right from wrong, deciding on a career path, recognizing they are closer to the end of life
Physical,Motor, Cognitive, and Psychosocial development: 1 month to a year
physical: weight gain, length, teeth, feeding, sleep
Motor: milestones of infant development
Cognitive: visual exploration, learn by doing, ma-ma, da-da, cooing, laughing
Psychosocial: trust vs. mistrust
Physical,Motor, Cognitive, and Psychosocial development: 1 year to 3 years
physical: 5 lbs per year, respirations and heart rate slow, pot belly
Motor: walking, running, squatting, jumping, climbing, riding on toys. zipping a zipper, buttoning a button, clapping hands
Cognitive: rapid language development, recognizes different objects, solve problems by thinking
Psychosocial: autonomy vs. shame and doubt
Physical,Motor, Cognitive, and Psychosocial development: 4 to 5 years
Physical: height and weight, proportionate body
Motor: tricycle, summersault, stairs with ease
Cognitive: trial and error to solve problems
Psychosocial: Initiative vs. Guilt (right vs. wrong)
Physical,Motor, Cognitive, and Psychosocial development: 6 to 12 years
Physical: slimmer appearance, immune system develops
Motor: tie shoes, print names, bath and feed themselves. By age 9 motor is of an adult
Cognitive: concrete operations
Psychosocial: industry vs. inferiority
Physical, Cognitive, and Psychosocial development: 12 to 18 years
Physical: Growth spurt, blood pressure increases, pulse decreases, by end of adolescence all vital organs reach adult size
Cognitive: Think abstractly, open to scientific reasoning and logic, becomes aware of consequences
Psychosocial: identity vs. role confusion
Physical, Cognitive, and Psychosocial development: young adult 19 to 40 years
physical: growth and development is complete by age 25
cognitive: patterns of thinking are not altered after adolescence according to piaget
psychosocial: intimacy vs. isolation. intimate relationships, around 30 a time of self evaluation making changes in life
Physical,Cognitive, and Psychosocial development: middle adulthood 40 to 64 years
physical: graying or thinning hair, menopause and andropause
cognitive: able to problem solve, reflect on past and anticipate future, reaction time slows
Psychosocial: generativity vs. stagnation (realize the difference between their early aspirations and their actual achievements)
Who has the longer life expectancy, men or women?
women
What are the four theories of aging
wear and tear
genetic
cellular malfunction
autoimmune reaction
Which theory of aging focuses on the accumulation of metabolic waste?
wear and tear
List appropriate strategies to assist the elderly to maintain physical activity in a safe, independent, and emotionally enriching environment
assistive walking device, good eating habits, good nights sleep, ROM, activities
List 4 leading causes of death in elderly
- cancer
- heart disease.
- diabetes
- alzheimer disease
,Which is a normal developmental change of aging?
A. confusion and dementia
B. dry skin
C. joint pain
B
It is important for the nurse to understand the structure of the client’s family so that he or she can:
A. address the various family members correctly
B. tailor visiting hours to the family’s needs
C. Avoid embarrassing moments during client interventions
D. Develop a holistic plan that includes the whole family
D
