NURS 331 Flashcards
five steps of nursing process
assessment, nursing diagnosis, planning (goals and outcome criteria), implementation, evaluation
objective data
student nurse observation and physical assessment. medication record, lab tests, diagnosis tests and trends, patient safety, vital signs
subjective data
patient reported or other reliable source
holistic assessment
individual as a whole
creating nursing diagnosis
identify problem, define characteristics, list signs and symptoms
9 Rights of nursing
right drug, right dose, right time, right route, right patient, right documentation, right reason, right response, right to refuse
drugs have both
therapeutic and adverse actions
drug
any substance used in the diagnosis, cure, treatment, or prevention of a disease or condition
generic name
standard name, not capitalized
trade name
manufactures name, capitalized
pharmacologic
structure Ex: nitrates or benzodiazepine
therapeutic
beneficial use Ex: vasodilator or anxiolytic
pharmacodynamics
study of what the drug does to the body
4 mechanisms of action
receptor, enzyme, nonselective, unknown
agonist drug
mimics natural chemical response
antagonist
blocks receptor site
drug receptor binding is
reversible, selective, and is on a grade (the more receptors filled the greater the response)
pharmacokinetics
what the body does to the drug (absorption, distribution, metabolism, excretion)
enteral
through the intestines (orals)
sublingual
under the tongue
ultimate outcome for medication administration
safety
buccal
between the gum line and cheek
parenteral
injectables (IV,IM)
topical
creams, eye drops, and transdermal patches
bioavailability
amount of drug available for absorption
bioavailability directly into the blood
100%
bioavailability of sublingual
100%
first pass effect
drug passes through liver before reaching circulation
nursing considerations
sepsis, ability to safely take oral meds, food, water, antacids, gastric dumping
nursing consideration for IV
rapid onset, risk for infection, continuous monitoring, and compatibility issues
nursing considerations for IM
longer duration, risk for infection, delayed onset, nursing technique
drug is first distributed to areas
of high blood flow and areas of low blood flow second
topical
works locally
transdermal
works systemically
free drug
drug that is not bound to protein
most common blood protein
albumin
pharmacogenomics
same drug, but different response in different bodies
what type of drugs affect the body
unbound drugs. bound drugs are inactive
low albumin levels
causes more drugs in circulation which can lead to higher toxicity
drugs eliminated by
kidneys, lungs, liver, bowel, sweat, mammary glands
GFR
test used to check how well the kidneys are working. Specifically, it estimates how much blood passes through the glomeruli each minute. This gives us an idea of how fast a drug can be metabolized
half life determines
how often the drug is administered
what patients may have increased half life of a drug
hepatic or renal disease
peak level
highest blood level of a drug
trough level
lowest blood level of a drug
toxicity
occurs if the peak blood level of the drug is too high
acute therapy
short term
maintenance
ongoing
palliative
comfort or relief/end of life
prophylactic
antibiotics
contraindication
specific situation in which a drug, procedure, or surgery should not be used because it may be harmful to the person
supportive therapy
recovery
supplemental therapy
replacement
medication bound to albumin will be
reabsorbed
free drug will be
eliminated
polypharmacy
the simultaneous use of multiple medications
comorbidity
the simultaneous presence of two chronic diseases or conditions in a patient
prescription cascade
the process whereby the side effects of drugs are misdiagnosed as symptoms of another problem resulting in further prescriptions
atrophy
decrease or shrinkage in cellular size
assessment
objective data that includes info available through the senses
Ex: what is seen, felt, heard, and smelled. lab and assessment reports
subjective dat includes spoken info shared by the patient
nursing diagnosis
after the assessment phase the nurse analyzes data about the patient and formulates nursing diagnosis
planning
identification of outcomes that are patient oriented and provide time frames
implementation
nurse intervenes on behalf of the patient to address specific patient problems and needs
evaluation
monitoring if nursing outcomes are met
steady state
state in which the amount of drug removed via elimination is equal to the amount of drug absorbed with each dose
onset of action
time required for the drug to elicit a therapeutic response
duration of action
length of time that the drug concentration is sufficient to elicit a therapeutic response
orphan drug
special category of drugs that have been identify to help treat patients with rare diseases
idiosyncratic reaction
any abnormal or unexpected response to a medication other than a allergic reaction
medication reconciliation
procedure to maintain an accurate and up to date list of medications for all patients between phases of health care delivery
atrophy
decrease in overall cell size due to decrease in blood flow, use, hormonal stimulation, or nervous system stimulation.
hypertrophy
increase in the size of cells in response to increase of mechanical load. most common in kidney and heart
hyperplasia
increase in the amount of cells in response to injury or hormonal stimulation
metaplasia
cellular adaptation in which a stem cell in reprogrammed after a mature cell of the same type has been exposed to a stimulus
dysplasia
abnormal change in the size, shape, and distribution of mature cells. usually associated with cancer. can be reversed
hypoxia
common cause of cellular destruction. caused by reduction of oxygen in the air, loss of hemoglobin, reduction in the number of RBC, or dysfunction of the respiratory/cardiac systems.
free radical
electrically uncharged atom that is unstable because it has an unpaired electron which can form a chemical bond and result in toxic result
oxidative stress
damage from free radicals
type of free radicals formed when cells are reperfused
reactive oxygen radicals
carbon monoxide does what to cells
direct effect on cellular respiration and causes hypoxia by depriving cells of oxygen
carbon monoxides affinity for hemoglobin is ____ times that of oxygen
300 times
alcohol is metabolized into what in the liver
acetaldehyde which is a toxic metabolite
cancers associated with alcohol
neck, head, esophagus, and breast
folic acid is needed to
produce RBC
folic acid deficiency leads to and what cause it?
leads to decrease intestinal absorption, increase in liver retention, increase loss of folate in the urine and fecal. this is caused by alcoholism