Lifespan Flashcards
Teratogenic
Birth defect!!
Teras-monster
Teratogenic: to create a monster
When do women need to use meds during prego?
Pre-existing Illness
Complications r/t pregnancy
Thx of conditions unrelated to pregnancy
When possible, drug therapy is postponed until after pregnancy and lactation. Which acute and chronic conditions must be managed during pregnancy?
Epilepsy
Std
Gestational diabetes
HTN
Pharmacokinetics of prego!? ADME
A- increases
D- increases
M- variable
E- increases
The nurse educator is explaining the factors that impact the transfer of medications across the placenta. Which factor would be responsible for higher concentrations of a drug being transferred to the fetus through the placenta?
Plasma drug concentration of mother
RISK FACTORS
A
Must take these; adequate well-controlled studies in pregnant women have not shown an inc. risk of fetal abnormalities to the fetus in any trimester.
Prenatal multivitamins, insulin, thyroxine, folic acid
RISK FACTORS
B & C
B-Animal studies have no incidence of harm to fetus, however no well controlled studies on women. OR animal studies have shown an adverse effect, but adequate and well controlled studies in prego women have failed to demonstrate risk to fetus.
EX. Penicillin/ibuprofen/acetaminophen/azyrhromycin.
C-animal studies have shown an adverse effect and there are no adequate and well controlled studies for women OR no animal studies and no adequate studies in prego women.
EX. Most prescription meds, anti microbial a such as clarithromycin.
RISK FACTORS
D
ONLY if mom’s life is in danger.
All adequate studies have demonstrated risk to fetus BUT the risk outweighs the potential risk.
EX. ACE inhibitors, alcohol, alprazalam, angiotensin receptor blockers
RISK FACTORS
X
Adequate studies show only fetal abnormalities and risks.
EX. Clomiphene, statins, testosterone, warfarin…
Student nurses are learning about the FDA pregnancy categories. What is the BEST information for the nurse educator to include?
Cat provide a framework for safe use of drugs in prego women
Cat X has been assoc with teratogenic effects.
A prego client tells a nurse at the first prenatal visit that she heard it is good to take an OTC iron prep during prego. Which statement by the nurse would be the best response?
“Safe to take iron during prefo, but tell your health care provider you are using it: many of them already contain iron
Pharmacotherapy of ped’s patients
A-increase D- increases (Inc d/t surface area of mass) M- decrease E- decreased (M/E are dec due to immature organs)
= lower doses! For peds
Infant who was prescribed and anti-infective gentamicin is brought to the ED with oliguria, hematuria, cloudy urine, fever. Which diagnosis would the nurse anticipate to find?
Neohrotixicuty
Children are given drugs in
Mg/kg
Dec metabolism and excretion in infants leads to
Longer time for IV to get OUT of body (dec M&E)
Faster peak in drug (inc A&D)
Be considerate!
You don’t ASK kids, consider necessity to tell kids and tell parents. Involve parents…ask them to hold child.
Nurse wants to teach class to parents re: toddlers and household exposure to meds. Which info should be included??
- poisoning is common for toddlers!
- all medications should be locked up and stored out of reach
- prescriptions come in flavored elixirs and can be mistaken for candy
- toddlers out everything in their mouths
Best approach for med administration for preschool aged child
Brief explanation, quick administration
Safety for Ped patients!!
Dosages!
Adverse reactions
Adherence
33 lbs
150 mg
Bottle- 100mg/5mL
100mg/5mL = 150mg/X
Geriatirc pharmacotherapy
ADME = decreased!!
Why is poly pharmacy is so prevalent in the elderly population?
Clients taking multiple and many drugs increases risk for Comirbidities
Therapeutic Range in older adults
TR is smaller and may need higher dose before getting into range
Nurse notices several medications are in the same class as drugs listed on the clients’ intake form. What should the nurse do?
Ask PCP if he is aware!
Safety for geriatrics!
Adherence
Misuse
Adverse drug interactions
When there is sedation or confusion for older adults
INCREASED fall risk
The nurse is caring for a 78 yr old patient who has multiple medications ordered to treat various health problems. The nurse considers that which common age-related physical changes are most likely to require a reduction in medication dosage for this client?
- Inc. rate of drug retention
- Dec. total body fluid proportionate to body mass (drug plasma concentration)
- Dec. rate of drug metabolism by the liver
Individual variations in drug responses
Psychosocial
Cultural/Ethnic Variables
Genetic influences
Gender influences
A client diagnosed with cancer tells the nurse, “this is a punishment from God for the sins I have committed. Some of the women at my church say so.” Which intervention best meets her needs?
Plan to contact the client’s minister to make a visit.
A client who is taking several prescribed oral medications for the tx of chronic heart failure tells the nurse. “I usually take all my meds with my breakfast” the nurse’s best response includes which statements?
- Review each drug to determine the best times and conditions for taking it?
- Has the swelling in your lower legs decreased??
