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NUR 325 > NUR 325 Exam 1 > Flashcards

NUR 325 Exam 1 Flashcards

1
Q

Brand name vs Generic drugs

A

Brand name: commercial name, capitalized
Generic: lowercase, name given by manufacturer, safest way to refer to the drug

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2
Q

What are the different types of oral medication forms?

A

tablet, capsule, powder, liquid

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3
Q

What is the order of absorption rate for oral medications (quickest to slowest)?

A

liquid, suspension, powder, capsule, tablet, coated tablet, enteric coated tablet

LSPCTCE
Lucas Says People Can’t Think Clearly Early

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4
Q

What types of oral medications cannot be altered?

A

-enteric-coated (EC)
-extended-release (ER)
-sustained-release (SR or XR)
-immediate-release (IR)

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5
Q

What are some factors that affect rates of absorption of PO meds?

A

-drug solubility
-mucosal permeability
-stability in the GI tract environment
-metabolism rate

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6
Q

What are 3 ways that a drug can be administered parenterally? What are the absorption rates and onset effects?

A

-IV: absorption is immediate and complete, onset actions are immediate
-IM: absorption varies (rapid if water soluble and good circulatory flow), onset actions vary
-SubQ: absorption varies (rapid if water soluble and good circulatory flow, more muscle mass increases absorption), onset actions vary

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7
Q

What parenteral injection is absorbed the quickest?

A

IV

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8
Q

What is absorption?
What are the factors that affect it?

A

Absorption is movement from administration site to various tissues

Factors: administration site, solubility, dosage, drug formula, etc.

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9
Q

Explain the first pass effect

A

Drugs entering the stomach or intestine are absorbed into the portal circulation and routed to the liver where they undergo metabolism prior to entering the systemic circulation, causing the body to utilize less of the drug than originally administered

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10
Q

What factors affect distribution to different parts of the body?

A

body weight, body composition, muscle mass, cellular binding, etc.

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11
Q

Define metabolism

A

a change in the drug that may make it more or less potent, soluble, or inactive

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12
Q

where does metabolism primarily take place?

A

liver

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13
Q

define “half-life”

A

the time it takes for the concentration of a drug in the body to be reduced by 50%

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14
Q

define “onset”

A

the amount of time it takes for a med to demonstrate a therapeutic response

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15
Q

define “peak”

A

the amount of time it takes for a med to achieve it’s full therapeutic effect

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16
Q

define “duration”

A

the amount of time the therapeutic effect lasts

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17
Q

peak vs trough levels. Why is this important?

A

-peak: point in time when med is at its highest level

-trough: point in time when med is at its lowest level

-this is important because it indicates the amount of drug present in the patient’s body and indicates if/when they need another dose

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18
Q

pharmacokinetics vs pharmacodynamics

A

pharmacoKINETICS: what the body does to the drug

pharmacoDYNAMICS: what the drug does to the body

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19
Q

define “adverse drug reactions”

A

ADR: occur when a medication is given at the APPROPRIATE DOSE. Non-theraputic, unintended, predictable or unpredictable, vary in severity

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20
Q

describe “off-label”

A

drug not used for original therapeutic use

ex. Benadryl for sleep or ketamine for headaches

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21
Q

describe the most severe type of ADR and how the patient could present in this case

A

-most severe type ADR is anaphylaxis

-pt might present with hives, facial/throat swelling, wheezing, light-headedness, vomiting, shock, tachycardia, hypotension, decrease in LOC

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22
Q

tolerance

A

the body’s decreased response to a drug over a period of time or repeated use

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23
Q

cumulative effect

A

aka drug sensitivity

may be caused by a metabolic change in the liver/kindey, occurs when the body is unable to excrete an existing dose of medication before another dose is administered

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24
Q

toxicity

A

excessive doses result in a negative physiologic effect and can be a result of impaired drug excretion/metabolism

may cause irreversible damage and potentially life threatening

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25
Q

contraindications

A

reasons why you shouldn’t give the med

the potential to cause a serious or life threatening ADR in relation to a specific factor (ex. food, combinations of meds, or specific populations)

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26
Q

drug-drug interactions

A

one drug changes the way another drug effects the body

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27
Q

additive effect

A

when the sum of effects of individual treatment = effects of combined treatment

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28
Q

synergistic

A

when sum of effects of individual treatment < effects of combined treatment

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29
Q

antagonistic

A

sum of effects of individual treatment > effects of combined treatment

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30
Q

teratogenic

A

teratogens are substances that may produce physical or functional defects in a fetus

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31
Q

what physiological factors are important to consider when administering drugs to an aging patient?

A

-increased body fat, decreased body water, decreased muscle mass, changes in renal/liver function

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32
Q

define and describe the physiological/psychological effects of acute stress

A

acute stress: immediate, temporary reaction to stressor

-physiological: palpitations, chest pain, headaches, stomach pain, nausea, sweating

-psychological: irritability, low mood, anxiety

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33
Q

define and describe the physiological/psychological effects of chronic stress

A

chronic stress: long term stress, individuals experiencing this often believe they have little control over their circumstances

-physiological: weak immunity, aches, low energy, hypertension, change in appetite

-psychological: insomnia, anxiety, strained relationships

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34
Q

non-pharmacological interventions for stress

A

mediation, breathing exercises, yoga, hypnosis, massage, nutrition

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35
Q

positive coping strategies for stress

A

social support, exercise, music therapy, relaxation, etc

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36
Q

ineffective/maldaptive coping strategies for stress

A

alcohol, substances, smoking, overeating, underrating, denial, avoidance

37
Q

appropriate assessment strategies for a client experiencing acute stress

A

-mental status exam
-gather relevant client information (health beliefs, coping strategies, etc)
-consult family members
-consult health records
-objective observations (vitals, appearance)

38
Q

list the defense mechanisms

A
  1. denial
  2. rationalization
  3. projection
  4. repression
  5. regression
  6. compartmentalization

DRP RRC

39
Q

denial

A

refusal to acknowledge or accept reality to avoid emotional impact

40
Q

rationalization

A

justify pr explain undesirable behaviors to avoid emotional discomfort/save face

41
Q

projection

A

attribute negative or uncomfortable thoughts/feelings/motives onto someone else

42
Q

repression

A

conceal unpleasant or painful thoughts/memories/beliefs in hopes of forgetting about them completely

43
Q

regression

A

movement back to a more comfortable place in time

44
Q

compartmentalization

A

categorize life experiences into segments to avoid facing anxieties

45
Q

factors that can alter a patient’s stress level

A

relationship issues, work, financial strain, food insecurity, injury, illness, etc.

46
Q

concept of pain

A

pain is whatever the person experiencing it says, existing whenever he says it does

47
Q

acute pain

A

-sudden, < 3 months, improves over time, usually can identify precipitating event

-SNS activation, increased HR, RR, BP, diaphoresis (sweating, pallor (paleness), anxiety, agitation, confusion, urine retention

48
Q

chronic pain

A
  • > 3 months, typically does not go away, can have periods of increasing and decreasing pain

-fatigue, declined activity, withdrawl

49
Q

psychosocial consequences of untreated pain

A

-fear
-anger
-depression
-anxiety
-difficulty maintaining relationships
-suicidal thoughts

50
Q

physiological consequences of untreated pain

A

-urinary retention
-weakened immune system
-GI disturbances
-muscle weakness
-hormonal imbalances

51
Q

nociceptive pain and the 2 types

A

pain caused by damage to body tissues

somatic: bone, joint, muscle, skin, or connective tissue pain; sharp and localized, throbbing

visceral: within body cavity affecting internal organs, harder to identify

52
Q

neuropathic pain

A

pain due to nerve/nervous system damage

described as burning, shooting, stabbing, shock-like, pins and needles

53
Q

mixed pain syndrome

A

nociceptive pain as a result of neuropathic pain

54
Q

pain classifications

A

-nociceptive
-neuropathic
-mixed pain syndrome

55
Q

pain assessment

A

PQRST

-Provoked (what causes or increases the pain?)

-Quality (dull, burning, stabbing, throbbing)

-Region (location)

-Severity (1-10)

-Time (when did it start and how long does it last?)

56
Q

nursing interventions for managing pain

A

-schedule pain interventions as needed
-review provider orders for analgesics
-be proactive (takes less meds to prevent pain than treat pain)
-instruct clients to report reoccurring pain
-help reduce fear and anxiety
-include both non-pharmacological and pharmacological measures

57
Q

non-pharmacological interventions for pain

A

-repositioning, thermal interventions, massage, splinting, exercise

58
Q

Aspirin
generic name & drug category

A

acetylsalicylic acid

first gen NSAID

59
Q

Advil/Motrin
generic name & drug category

A

ibuprofen

first gen NSAID

60
Q

Celecoxib
generic name & drug category

A

celebrex

second gen NSAID

61
Q

Tylenol
generic name & drug category

A

acetaminophen

non-opioid analgesic

62
Q

Ultram
generic name & drug category

A

tramadol

centrally acting non-opioids

63
Q

Morphine
drug category

A

opioid agonist

64
Q

Butorphanol
drug category

A

opioid agonist-antagonist

65
Q

Narcan
generic name & drug category

A

naloxone

opioid antagonist

66
Q

acetylsalicylic acid brand name

A

aspirin

67
Q

ibuprofen brand name

A

Advil, motrin

68
Q

Celebrex brand name

A

celecoxib

69
Q

acetaminophen brand name

A

Tylenol

70
Q

tramadol brand name

A

ultram

71
Q

What does COX-1 do?

A

protects gastric mucosa, enhance platelet aggregation, promotes renal function

72
Q

what does COX-2 do?

A

causes inflammation, pain, and fever in response to injury

73
Q

1st gen vs 2nd gen NSAIDS

A

1st gen: inhibits both COX-1 and 2 and prostaglandin production

2nd gen: only inhibits COX-2
-gastric effects decreased but increased risk for cardiovascular events due to vasoconstriction and platelet aggregation

74
Q

what role do prostaglandins serve?

A

contributors to the inflammatory response from injury

75
Q

what safety issues should the nurse be aware of related to opioid agonists?

A

-renal/liver impairment from opioid abuse can affect meds in terms of effectiveness and ADR

-insufficient prescribing for opioid dependent clients could have a different effect than on a client that is not dependent

-client must be educated on risks and pain management

-withdrawl can cause harm to client

-possible OD

76
Q

alzheimer’s dementia

A

-chronic, progressive, neurodegenerative bran disease
-most common form of dementia
-cannot be prevented or cured; cannot slow progression

77
Q

anterograde amnesia

A

can’t learn and recall new information

78
Q

retrograde amnesia

A

can’t remember info from the past

79
Q

aphasia/dysphasia

A

difficulty producing/comprehending language

80
Q

agraphia

A

inability to write

81
Q

agnosia

A

impaired ability to recognize objects or persons

82
Q

apraxia

A

inability to perform purposeful movements/manipulate objects, although sensory and motor ability is intact

83
Q

hemispatial neglect

A

inability to process and perceive stimuli on one side of the body despite intact senses

84
Q

flight of ideas

A

topic of speech changes within a sentence

85
Q

confundabulation

A

making up answers

86
Q

clanging

A

use of meaningless, rhyming words

87
Q

pressured speech

A

frantic, energetic, jumbled speech

88
Q
A

NUR 325 (3 decks)

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