NSG 100 Test 1 Prep Flashcards
Pharmacology & Safety
What is the rationale of proper hand hygiene?
Reduces transmission of microorganism
What are the objectives of proper hand hygiene?
Define the risk assessments to patient care across the life span?
Age >85
Bone disorders
Coagulation disorders
Surgery
Identify the fall precautions and prevention interventions.
Height of bed allows ambulatory patient to get in and out of bed easily and safely.
Mats provide nonslippery surface for preventing falls and injuries.
Explain environmental safety assessments across the lifespan and patient care environment?
Define the Joint Safety Commission Patient Safety Goals
National Patient Safety Goals, which focus on problems in health care safety and how to solve them, updated and published annually. Once a goal becomes a standard, the goal number is retired and is not used again, and the standard must be adopted by all TJC. Two goals are (1) the “do not use” abbreviations and (2) the list of acceptable abbreviations.
Define the safe medication administration process from order to administration of medications to patients across the life span
Preparation
1. Perform hand hygiene.
2. Access patient’s drug administration record (MAR) or electronic health record (EHR).
3. Check patient’s drugs with the health care provider’s order for accuracy.
4. Obtain the patient’s drugs from automatic dispensing cabinet (ADC), remote stock, or pharmacy while checking the drug label with the patient’s drug order for accuracy.
5. Check drug allergies.
6. Prepare drugs for only one patient at a time.
7. Calculate the drug dose and perform a double-check of the calculation.
8. Check the expiration date on the drug label, and use the drug only if the date is current.
9. While preparing the drug, check the label against the MAR for accuracy.
10. If a unit dose is prescribed, open the packet at the patient’s bedside.
11. If a liquid is prescribed, measure in a calibrated syringe and put it into a drug cup (see Chapter 10; Fig. 10.2).
12. Never leave medications unattended.
Administration
13. Only administer drugs that have been personally prepared.
14. Identify patients by using at least two patient identifiers (e.g., name and birth date). Compare the patient’s name and birth date from the MAR, computer printout, or EHR with the information on the patient’s identification (ID) bracelet. If possible, ask the patient to state their name and birth date.
15. Assist patient into an appropriate position, depending on the route of administration.
16. Before administering compare label on medication with the MAR to complete the three checks.
17. Explain each drug and its action to the patient.
18. For patients who cannot hold the drug, place the cup to their lips. Introduce one drug at a time, and do not rush the patient.
19. Stay with the patient until all drugs have been taken.
20. Dispose of used supplies and perform hand hygiene.
21. Evaluate the patient’s response to the drugs.
22. Educate patients and family members about drug actions and side effects.
Define process of medication metabolism from absorption to excretion
Also known as the “pharmacokinetic” phase. 4 processes:
(1) absorption:
(2) distribution
(3) metabolism (biotransformation)
(4) excretion (elimination)
Define absorption
Absorption is the movement of the drug into the bloodstream after administration. Solid form drugs must be broken down via dissolution.
Where do most oral drugs enter the bloodstream?
After absorption across the mucosal lining of the small intestine. This occurs via passive transport.
Passive transport occurs through what process(es)?
Diffusion and facilitated diffusion.
Explain and differentiate diffusion and facilitated transport.
In diffusion, drugs move across the cell membrane from an area of higher concentration to one of lower concentration; does not require energy. Facilitated diffusion relies on a carrier protein to move the drug from an area of higher concentration to an area of lower concentration.
Define active transport.
___ transport requires a carrier, such as an enzyme or protein, to move the drug against a concentration gradient.
Define pinocytiosis
____ is a process by which cells carry a drug across their membranes by engulfing the drug particles in a vesicle.
Which drugs need a carrier, either an enzyme or a protein, to pass through the mucous membrane
Water-soluble
Large particles are able to pass through the mucous membrane if they are _____?
Nonionized
What factors slow gastric emptying time, which causes drugs to remain in the stomach longer.
Pain, stress, and foods that are solid, hot, or high in fat
Which route is faster: subcutaneous or oral?
SQ
Which absorption is slower: rectal or oral?
Rectal
Define the first-pass effect
In the liver, some drugs are metabolized to an inactive form and are excreted, thus reducing the amount of active drug available to exert a pharmacologic effect
Define bioavailability
Percentage of administered drug available for activity
What is the bioavailability of IV drugs?
100%
Define distrubution
Movement of the drug from the circulation to body tissues.
Distribution is influenced by what?
Vascular permeability and permeability of cell membranes
Regional blood flow and pH
Cardiac output
Tissue perfusion
Ability of the drug to bind tissue
Plasma proteins
Lipid solubility
Albumin, lipoproteins, and alpha-1-acid-glycoproteins AGP) are what kind of proteins?
Plasma proteins
