MIDTERM DECK - C Flashcards
T or F: The nurse can trust the pharmacy to send the correct medication.
False, always double check meds before administering them.
T or F: The nurse serves as a line of defense against medication errors.
True. Even if a dr prescribes a medicine that can cause harm, it is your responsibility to protect the patient!
What are the three basic goals for preadministration (of drugs) assessment?
- collect baseline data needed to evaluate therapeutic and adverse responses. (condition, weight, agec cond. of liver,BP, etc)2. Identify High Risk Patients (allergies, genetic factors, pregnant, old age, premature?)3. Assessing the patient’s capacity for self-care (can they pay for medication? administer for themselves? forgetful?)
______ is leakage of a fluid out of its container. example: IV fluid leakage.
Extravasation DELETE IN MIDTERM CARD DECK
You should know the specific indication for which the drug is being used. Why?
Depending on which indication used for (headache vs inflammation in the case of aspirin), the dosage changes. Without knowing what indication, you cannot double check the dose nor evaluate for the proper response to the dosage given. ie, given for pain, check for pain change, if no change you change dose. If it’s for inflammation, a change in pain is not necessarily going to tell you if the inflammation has decreased.
What is a PRN (pro re nata) medication order?
One in which the nurse has discretion regarding how much drug to give and when to give it (pro re nata = as needed)
There are four major components to implementing a care plan:1. Drug administration2. interventions to enhance therapeutic effects (exercise AND cholesterol med)3. interventions to minimize adverse effects and interactions (know side effects, foods that block absorption etc.)and 4. ___________ ___________
Patient education!!!
Over the course of drug therapy, patient must be evaluated. We check for 1) therapeutic response (is the drug working), 2) adverse reactions/interactions, 3)interventions to promote effects and 4) ________________
interventions to minimize adverse effects.
The nurse is responsible for educating the patient. List some areas we are responsible for. (Some examples are: Who to contact in the event that the patient has a reaction, duration of treatment, method of storage….)
- Drug name and therapeutic category (penicillin - antibiotic)2. Dosage size (take one pill)3. Dosing schedule (take on pill each day for five days in the morning)4. Route and technique of administration (Insert vaginal cream into vagina while lying on your side…etc.5. expected therapeutic response and when it should develop (you will experience a decrease in itching after two days of use).6. nondrug measures to enhance therapeutic effects (if you walk for 30 minutes a day you will decrease stiffness in your hips from rheumatoid arthritis).7. Duration of treatment (you will be on this drug for 7 days)8. method of drug storage9. Symptoms of major adverse effects and measure to minimize discomfort and harm (This drug is known to cause stomach issues. Please be sure to eat before taking the medication).10. Major adverse drug-drug and food-drug reactions (Do not take this with grapefruit because it neutralizes the drug. Don’t take aspirin with warfarin because your blood will become to thin and you are at high risk for bleeding out).11. Who to contact if experience any reactions or a lack of therapeutic effect.
What are the steps in the nursing process?
nursing process Lehne pg. 91) assessment (Roy has two levels2) analysis of the assessment aka nursing diagnosis3) planning (setting of goals)4) implementation aka nursing interventionf) evaluation (and modify when necessary)
Why is obtaining baseline data needed in order to evaluate therapeutic effect and adverse effects?
In order to know if we have produced the response we are looking for, we need to est. a baseline to measure against. Same goes for adverse effects we do not expect. Of course hair loss while undergoing chemo is expected… but if liver dysfunction exists and we had no baseline, we cannot tell if it was pre existing.
Why is safe medication storage important?
- Keep away from children2. Teens may abuse vitamins, cough syrup, cold meds and inhalable drugs.3. Elders people who are confused may take medication left on counter.
Why is it important to double check medication before administering to a child?
Babies and young children require lower dosages because their bodies are small and process drugs faster.
T or F: When charting units you should use “U”.
False. Do not use it because it may be mistaken for a zero. write the word unit.
T or F: The abbreviation that should be used for international unit is IU.
False. write international unit. Too easy to mistake IU for IV.
T or F: You should always use a zero before a decimal.
True. This helps spot the decimal.
T or F: You should write out morphine sulfate or magnesium sulfate.
True. Can be confused for each other MS, MS04, MgSO4
What abbreviation should be used for micrograms?
mcg. you may also write out micrograms but DO NOT use the greek symbol.
Can you use the @ symbol when charting?
No. It can be mistaken for a 2. write the word at.
1 cc is equal to 1 ml. Which abbreviations should we use and why?
use mL or milliliters. cc may be mistaken for U (units)
What are some questions we can ask ourselves to identify whether or not an adverse reaction has occurred?
- Did symptoms appear shortly after the drug was first used?2. Did symptoms abate when the drug was discontinued?3. Did symptoms reappear when the drug was reinstituted?4. Is the illness itself sufficient to explain the event?5. Are other drugs in the regimen sufficient to explain the event?
As a result of concerns over patent medicine (questionable remedies), congress passed it’s first federal drug law in 1906 called?
Pure Food and Drug Act of 1906, which required accurate labeling of drugs to prevent substitution or mislabeled ingredients.
A new law replaced the Pure Food and Drug Act of 1906, with more specific regulations including holding the drug developer responsible for drug safety. What was this law called?
The Food, Drug and Cosmetic Act of 1938.
This governing body oversees the safe development of new drugs…
FDA (Food and Drug Administration)
This governing body regulates manufacture and distribution of narcotics, stimulants, depressants, hallucinogens, and anabolic steroids as well as substances used in their production
DEA (Drug Enforcment Agency)
This federal organization ensures occupational sagety by enforcing standards and providing workplace safety training…
OSHA (Occupational Safety and Health Administration)Enacts laws geared toward protecting health-care workers from patients’ diseases and requires yearly education to ensure safety of workers.
Controlled substances are categorized in schedules from I to V. Which is the most controlled with the highest abuse potential? Least?
Most is I; least is V
What are some examples of drugs that are in schedule I? Are schedule I drugs approved for medical use?
Heroin, LSD…No!
Why are schedule II drugs so restricted?
Subject to high abuse and severe dependence risk: morphine and opium
Schedule III drugs are right in the middle… what is the chance for dependency? Examples?
Lower abuse potential than schedule II, moderate to low dependence risk; steroids and codeine.
Do drugs in schedule IV such as Valium and Xanax have abuse potential? Dependence risk?
low abuse potential; low dependence risk
What type of drugs are in schedule V?
OTCs like cough medicine
Drug development takes a long time and is expensive. Before bringing a new product to market, it must go through ______ ________.
Clinical trials
What is the purpose of pre-clinical trials?
to determine safe dose and to evaluate drug safety profile.
What is the main difference in preclinical versus clinical trials?
Animals are used in pre/Humans in clinical
What are the goals of phase I in clinical trials?
- evaluate drug metabolism 2. pharmacokinetics 3. Biologic effects
Clinical trials have three phases. What happens during phase I?
Drug is tested for safety using 20-100 healthy volunteers (unless severe side effects…then tested in ill). Test best administration of the drug and the highest dose to be given without serious side effects.
What happens during phases II and III of clinical trial?
Drug is tested on several hundred patients to see if it works, dosage range, safety and effectiveness.
Upon completing phase III, the manufacturer can apply for conditional approval from FDA. What happens in phase IV?
Postmarketing surveillance. It’s allowed to be used by public under surveillance.
What is the most reliant way to objectively assess drug therapies?
RCTs - Randomaly Controlled Trials
What are three factors that make RCTs reliable?
Control groups, randomization, and blinding (blind tests)
Why is it hard to know what adverse effects will take place with long-term use of drugs?
Clinical trial periods are short.
Drugs have three types of names. What are they?
- chemical name (n-acetyl-para-aminophenol) 2. generic or non-proprietary name (acetaminophen) 3. Trade or proprietary name (brand name - tylenol)
If there is a new med on the market that does the same thing as a drug that has been on the market for years, which do you prescribe?
The old. It has known side effects and effectiveness. The new one might have unknown risks.
