Nursing 211 Flashcards
The name Tylenol is known as this medication’s _____.
Trade name
trade name / brand name
used to market medication
trade name symbol
TM
medication’s composition or molecular structure
chemical name
Tylenol’s generic name
acetaminophen
official name that is listed in publications
generic name
Untied States Pharmacopeia is a list of all drugs.
USP
Aspirin is generic name for
Aspergum
The nurse is caring for a patient who has liver disease and a decreased albumin level. She is concerned that the patient:
may become toxic on normal doses of medication
Most medications bind to ____ to some extent.
albumin
When medications bind to albumin, they are unable to exert ________.
pharmacological activity.
When mediations bind to albumin, they are unable to exert pharmacological activity. Only the _____ or ____ medication is active.
unbound or “free”
Who could have reduced albumin?
- older adults
- liver disease
- malnutrition
Patients with reduced albumin have ______ risk for medication toxicity.
increased
With less albumin to bin d with the medication, there would be ___ “free” or active medication in the body.
more
A medication must pass through _____________ to reach certain organs.
biological membranes
The blood-brain barrier allows only _____ medications to pass into the brain and CSF.
fat-soluble
Most biotransformation occurs in the ____, although the lungs, kidneys, blood , and intestines also play a role.
liver
Patients are at risk for medication toxicity if their ___________ medications do not function correctly.
organs that metabolize
During the admission process, the patient states that he is supposed to be on daily aspirin but stopped taking it because it nauseated him. The nurse recognizes that the patient stopped taking his medication because :
of the medication’s side effects
predictable and often unavoidable secondary effects produced at a usual therapeutic drug dose.
side effects
Is almost an accusatory name given to patients who do not follow their medical regimen such as by taking their medications.
noncompliance
________ develop after prolonged intake of a medication, when a medication accumulates in the blood because of impaired metabolism or excretion, or when too high a dose is given.
toxic effects
Unpredictable responses to a medication.
allergic reaction
Allergic reactions are unpredictable responses to a medication. The medication acts as ________, which causes antibodies to be produced. With repeated administration, the patient develops an allergic response.
an antigen
The patient is admitted to hospital with pneumonia and is ordered to receive IV doses of antibiotics. He receives his first dose without any problems, but during his second dose, he begins to complain of shortness of breath and difficulty breathing. The nurse notes wheezes throughout his lung field. The nurse stops administration of the antibiotic and calls for help. She recognizes these symptoms as part of:
An anaphylactic reaction
_______ reaction ranges from mild to severe, depending on the patient and the medication.
an allergic
Among the different classes of medications, ______ cause a high incidence of allergic reactions.
antibiotics
Sudden constriction of bronchiolar muscles, edema of the pharynx and larynx, severe wheezing, and shortness of breath are characteristics of _____________.
severe or anaphylactic reactions
Sudden constriction of bronchiolar muscles, edema of the pharynx and larynx, severe wheezing, and shortness of breath are characteristics of severe or anaphylactic reactions. Some patients become severely hypotensive, necessitating emergency resuscitation measures. ______ is potentially fatal.
anaphylaxis
_________ reaction in which a patient overreacts or underreacts to a medication or has a reaction that is different form normal.
idiosyncratic
______ are predictable and often unavoidable secondary effects produced at a usual therapeutic drug dose.
side effects
Anaphylaxis is usually unpredictable initially and is avoided after the first reaction by listing the cause of the anaphylaxis in _____
the allergy alert section of the patient record
The patient has a diagnosis of chronic back pain that he has been treating at home for the past 2 years with oral morphine sulfate (MS Contin). Upon admission the hospital, the patient is medicated with morphine sulfate for his back pain, but the patient states that he has received no relief. The nurse notifies the physician, realizing that the reason for the lack of relief may be:
a result of mediation tolerance.
______ is a decreased physiological response that occurs after repeated administration of a medication.
medication tolerance
_______ can be physical or psychological.
drug dependence
In _______ dependence, patients have an emotional desire for a drug to maintain an effect. The person believes a desirable effect will result when taking the medication.
psychological
______ dependence is a physiological adaptation to a medication that manifests itself by intense physical disturbances when the medication is withdrawn.
physical
The patient is receiving vancomycin IV every 8 hours. The order is for a serum peak and trough level after the third dose. the mediation is given on an 8 AM, 4 PM, and midnight schedule. The third dose will be given at 4 PM. The nurse knows that she has to order the trough level for :
11:30 PM
the point at which the lowest amount of drug is in the serum is the ____________
trough concentration
Some medications doses (ex. vancomycin, gentamicin) are based on ____ and ________ serum levels
peak and trough
A patient’s trough level is drawn as a blood sample _______ the drug is administered.
30 minutes before
A patient’s trough level is drawn as a blood sample 30 minutes before the drug is administered. and the peak level is drawn ___________.
whenever the drug is expected to reach its peak concentration.
The hospital utilizes a unit dose system for mediation distribution. The nurse realizes that with this system:
Narcotics are kept in an area separate form the patient’s regular medications.
_______ are not kept in the individual patient drawer: they are kept in a larger locked drawer to keep them secure.
controlled substances
The ____ is the ordered dose of medication that the patient receives at one time.
unit dose.
The unit dose is the ordered dose of. medication that the patient receives at one time. Each tablet or capsule is wrapped in ________
foil or paper container
The unit dose is the ordered dose of. medication that the patient receives at one time. Each tablet or capsule is wrapped in foil or paper container. _____ come in prepackaged foil or paper cups.
liquid doses
The unit dose is the ordered dose of. medication that the patient receives at one time. Each tablet or capsule is wrapped in foil or paper container. Liquid doses come in prepackaged foil or paper cups. At a designated time each day, the pharmacist or a pharmacy technician _______________.
refills the drawers in the cart with a fresh supply.
When the metric system is used in calculating medication dosages, which of the following is true?
a. always include trailing zeroes, for example, 1.0
b. always include a zero before a decimal point
c. for medication calculation, use length, volume, and weight units.
d. use uppercase letters for subdivision of major units
always include a zero before a decimal point
metric dosage never have trailing zero
1.0 mg is incorrect use 1 instead
basic units in metric system
meter, liter, and gram
meter measures
length
liter measures
volume
gram measures
weight
for medication calculation use the ______ and ________ units
volume and weight
When using the Apothecary system for medication calculation, the nurse realizes that:
the symbol “ss” is used for the fraction 1/2
Apothecary system uses
Roman numerals and fractions
In using the system for household measurements in preparing medications, it is important for the nurse to understand that :
household units of measure are familiar to most people
disadvantage to household measurements
inaccuracy
The patient is complaining of severe pain in his leg. He does not have any pain medication ordered, so the nurse calls the doctor, who gives an order for a prn medication and a one-time dose of morphine sulfate to be given immediately. The morphine order is known as:
stat order
prn
given only when patient requires it
stat
immediately
The nurse is preparing to administer medication to her patient. He is alert and oriented. When the medications are reviewed with the patient, the patient says that he does not take metoprolol. The nurse should:
withhold the medication
While preparing a liquid medication, the nurse:
holds the medication cup at eye level
The amount of poured liquid should be even with the base of the ________.
meniscus
The appropriate way to identify the “right client” is to:
use at least two patient identifiers
A medication that is ordered pc is given:
after eating
pc
after meals
A preoperative medication to be given “on call” means that you give the medication
when the operating room staff members notify you that they are coming to get the patient for surgery
A medication that is ordered “t.i.d” may be given at:
10 AM, 2 PM, and 6 PM
3 times a day during the waking hours
tid
If the prescriber intends for you to give the q8h medication around the clock to maintain therapeutic blood levels of the medication, he/she will order it _____ instead of tid.
q8h
q8h
every 8 hours
When implementing appropriate technique for medication administration, the nurse is:
documenting the reason for medication refusal in the nurse’s notes
refusal to take medications
document and notify prescriber
medication prepared for by another nurse
do not give
use ____ technique for parenteral medications
sterile
As the client takes medication nurse should
remain with patient
Administration of controlled substances requires that the nurse:
report immediately discrepancies in narcotic counts
If you give only part of a premeasure dose of a controlled substance ____________.
a second nurse must witness disposal of the unused portion. Both sign required form.
____ narcotics frequently, during the opening of narcotic drawers and/or at shift change.
count
store all _____ in a locked, secure cabinet separate form the patient’s routine medication
narcotics
When the metric system is used in calculating mediation dosages, which of the following is true?
always include a zero before a decimal point. never have a trailing zero
When using the Apothecary System for medication calculation, the nurse realizes that :
the symbol “ss” is used for the fraction 1/2
The Apothecary System uses
ss for 1/2
Roman numerals and fractions
write the abbreviation or symbol for a unit before the amount or quantity.
In using the system of household measurements in preparing medications, it is important for the nurse to understand that :
household units of measure are familiar to most people
the disadvantage of household measurements is _____.
their inaccuracy
The patient is complaining of severe pain in his leg. He does not have any pain medication ordered, so the nurse calls the doctor, who gives an order for a prn medication and a one-time dose of morphine sulfate to be given immediately. The morphine order is known as a:
Stat order
prn orders
only as patient needs it
stat orders
drug given immediately and only once
single one-time orders
medication ordered for a specific time
Which statements about the purpose of the immune system are true?
a. the immune system provides protection from and eliminates or destroys microorganisms
b. the immune system is able to identify non-self proteins and cells
c. the immune system removes foreign proteins and other substances
d. the immune system protects against allergic/anaphylactic reactions
e. the immune system is able to prevent healthy body cells from being destroyed
Which factors may affect the function of the immune system?
a. nutritional status
b. environmental conditions
c. drugs
d. previous/current disease
e. age
The immune system responsible for self-tolerance has the ability to do what?
a. recognize self versus non-self
c. recognize different proteins on cell membranes
e. identify non-self which includes all invading cells and organisms
From where do most immune cells originate?
Bone marrow
How does the body determine self from non-self cells?
leukocytes use human leukocyte antigens
A patient has sustained a severe right ankle sprain, and the nurse is explaining the process of inflammation to the patient and family. Which information does the nurse include?
a. the presence of inflammation does not always indicate that an infection is present.
b. it occurs in response to tissue injury
e. how widespread the symptoms are depends on the intensity and severity of the initiating injury
The nurse is instructing a patient with an immune system disease about what the major functions of immunity are. Which information does the nurse include?
a. immunity requires three immunity processes
b. inflammation process is natural immunity.
d. antibody-mediated immunity produces new red blood cells.
e. cell-mediated immunity circulates T-lymphocytes
The actions of leukocytes provide the body protection against invading organisms. Which is not one of those actions?
production of cytokines that decrease specific leukocyte growth and activity
Which statement about the inflammatory response is true?
response is the same whether the insult to the body is a burn or otitis media
The inflammatory response is present in which conditions?
a. sprain injuries to joints
b. surgical wounds
c. poison ivy
d. scalding burn injury
e. appendicitis
Which cell types associated with the inflammatory response participate in phagocytosis?
macrophages and neutrophils
the body produces the most of which type of white blood cell?
neutrophils
The nurse is preparing to administer medication to her patient. He is alert and oriented. When the medications are reviewed with the patient, the patient says that he does not take metoprolol. The nurse should:
withhold the medication
While preparing a liquid medication, the nurse:
holds the medication cup at eye level
Pour liquid mediations away from the ____ to ensure that liquid will not run down a label, making it difficult to read.
label
The appropriate way to identify the “right client” is to:
use at least 2 patient identifiers
A medication that is ordered pc is given:
after eating
A medication that is ordered “t.i.d.” may be given at:
10 AM, 2 PM, and 6 PM
When implementing appropriate technique for medication administration, the nurse is:
documenting the reason for medication refusal in the nurse’s notes
Administration of controlled substances requires that the nurse:
report immediately discrepancies in narcotic counts
To prevent medication errors, the nurse should:
clarify illegible orders with the prescriber
The client is to receive a medication via the buccal route. The nurse plans to implement the following action:
place the medication inside the cheek
Oral medications are indicated for the client who is:
taking a daily dose of vitamins
The parenteral route of a drug is ordered. The nurse administers this medication:
intramuscularly
The nurse is caring for a patient who has been getting morphine sulfate regularly every 4 hours for the last 2 weeks. The patient has a history of renal failure and liver disease. While on rounds, the nurse finds the patient is lethargic with a respiratory rate of 6 breaths per minute. The nurse expects that the physician will order naloxone (Narcan) to counter the ___________ of the morphine.
toxic effects
When do most medication errors occur?
a. During hospital admission
b. during transfer from one unit to another
c. during discharge home
d. during discharge to another facility
Factors that affect the rate of distribution of a medication depend on which of the following?
circulation
cell membrane permeability
protein binding
lipid solubility
In the context of mediation interactions, the term summation refers to 2 drugs being given to produce a result equal to the sum effects of each drug. This allows for:
a smaller dose of each drug
reduction in the risk of adverse effects
The hospital has implemented a computerized physician order entry system (CPOE) to eliminate the need for written orders. The benefits of this system include which of the following?
automatic drug allergy checks
automatic dosage indications
identification of potential drug interactions
The 6 rights of medication administration include which of the following?
the right medication
the right patient
the right route
the right documentation
medication errors include which of the following?
Administration of the wrong medication
administration via the wrong medication
inaccurate prescribing
failing to administer a medication
Patients who are at increased risk for adverse medication effects include:
very young patients
patients taking more than 4 medications
Patients wit renal and /or hepatic disease
patients who treat themselves with over-the-counter medications
The eighth leading cause of death in the US is ______.
medical error
The most common type of medical error is a ______.
medication error
Any response to a drug that is harmful, unintended, and occurs at doses normally used in humans for prophylaxis, diagnosis, or therapy for disease is known as an _____________
adverse drug effect
To avoid penalties and prevent the delay of accreditation, hospitals need to comply with the ___set by The Joint Commission.
National Patient Safety Goals
______ is the study of how medications enter the body, reach their site of action, are metabolized, and exit the body.
pharmacokinetics
The intended or desired physiological response of a medication is known as its.
therapeutic effect
____ are predictable and often unavoidable secondary effects of a medication produced at a usual therapeutic drug dose.
Side effects or adverse effects
A potentially fatal adverse drug event (ADE) is known as _______.
anaphylaxis
When a medication accumulates in the blood because of impaired metabolism or excretion, the patient may be at risk for _____ of that medication.
toxic effects
An unpredictable effect of a medication in which a patient overreacts or underreacts to a medication or has a reaction different from normal is called an ______.
idiosyncratic reaction
A decreased physiological response that occurs after repeated administration of a medication is known as ___________.
medication tolerance
Medication dependence by which a person has an emotional desire for a drug to maintain an effect is known as __________.
physical dependence
A drug interaction in which the combined effect of drugs is greater than the sum of each individual agent acting independently is known as _______.
synergistic effect
The highest serum concentration of a medication in the body is known as the ______.
peak concentration
The point at which the lowest amount of drug is in the serum is the _____.
trough concentration
All medications have a ____, which is the time it takes for excretion processes to lower the serum medication concentration by half.
serum half-life
The period of time it takes after a medication is administered for it to produce a therapeutic effect is known as the ________.
onset of medication action
The time it takes for a medication to reach its highest effective level of concentration is known as its ______.
peak action
The length of time during which the medication is present in a concentration great enough to produce a therapeutic effect is known as that drug’s ______.
duration of action
The ___________ of a drug is the blood serum concentration reached and maintained after repeated, fixed doses.
plateau
A medication distribution system that utilizes individual patient drawers and whereby medication is packaged according to what the patient would receive at one time is known as the _________ system.
unit dose
A spoken order for a medication or treatment delivered by a prescriber directly to a nurse on a face-to-face basis is known as a ___________.
verbal order
The client is to receive 200 mg of a medication. There are 100 mg scored tablets available. The nurse prepares ___.
2 tablets
The dose ordered for a client is 75 mg IM. The medication is available in a 50 mg/mL solution. The nurse prepares _______.
1.2 ml
A common problem for older adult patients is the use of a number of different medication, prescribed or not, for one or more health problems. This problem is know as __________.
polypharmacy
Calculation indicates that 2 tsp of medication is to be administered to the client. The nurse pours _________.
10 mL
insulin
Uses: diabetes
Most common side effects: blurred vision, dry mouth, Hypoglycemia, hyperglycemia, hypomagnesemia, hypolalemia, rash, urticarial, pruritus, swelling, redness, stinging, warmth at injection site, cough, respiratory tract infection, dyspnea, reduced pulmonary function
metoprolol
uses: hypertension
side effects: fatigue, dizziness, depression, hypotension, bradycardia, heart failure, AV block, edema, nausea, diarrhea, constipation, heartburn, dyspnea, wheezing, rash.,
ibuprophen
uses: rheumatoid arthritis, osteoarthritis, arthritis, mild to moderate pain, and fever, anti-inflammatory, migrane
Side effects: dizziness, headache, nervousness, edema, fluid retention, tinnitus, abdominal pain, bloating, constipation, decreased appetite, diarrhea, dyspepsia, epigastric distress, flatulence, heartburn, nausea, nonnecrotizing enterocolitis, vomiting rash
