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Medication > Nursing exam stage 1 > Flashcards

Nursing exam stage 1 Flashcards

1
Q

How many nurses need to hear a telephone order?

A

Two, check facility policy whether it be RNs, RN & EN or 2 ENS

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2
Q

When must the doctor sign telephone order?

A

Within 24 hours

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3
Q

What do you do if patient refuses to take medication?

A

Write R where you would normally put your initials with a circle around it and document in progress report

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4
Q

What factors affect absorption of a drug?

A

Route of administration.

  • formulation eg- liquid, slow releases
  • absence or presence of food in stomach
  • high fat meals
  • gastric mobility
  • presences of enzymes and bile salts
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5
Q

What does PV mean?

A

Per vagina

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6
Q

Drugs are absorbed quickest when given by which route?

A

Sublingual, intravenous and inhaled drugs

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7
Q

What is first pass metabolism?

A

When the drug is absorbed from the gastrointestinal tract, enters the hepatic portal, where some or all the drug may be broken down, reducing the availability of drug for therapeutic use

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8
Q

Why must drug therapy be carefully monitored in the young and elderly?

A

Young, have smaller body size and immature liver, elderly have decreased liver and kidney function

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9
Q

What is meant by drug tolerance?

A

Patient has a decreased response over time. Patient than requires larger doses to produce same response

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10
Q

What is half life of drug

A

Time it takes for half the drug concentration to be eliminated by the body

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11
Q

What is antagonistic?

A

Prevents the binding of the drug with the receptor or binds to the receptor and prevents it from producing its effect

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12
Q

What is an agonist?

A

Agonist drugs have an attraction or affinity for a receptor and stimulates it. Drugs bind with the receptor to produce its effects

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13
Q

Onset action mean?

A

Time interval that starts when the drug is administered and ends when therapeutic effect actually begins

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14
Q

Why must a medication be administered sublingually?

A

Prevents destruction of drug in the stomach, bypasses first pass metabolism

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15
Q

What is affinity?

A

How well drug binds to receptor

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16
Q

What is specificity?

A

Ability of a drug to target a specific site

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17
Q

What is adverse reaction?

A

Harmful, undesirable effect

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18
Q

Cardiac output is calculated by…

A

Stroke volume x heart rate

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19
Q

What do the letters ACE represent?

A

Angiotensin converting enzyme

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20
Q

How is an ACE inhibitor recognised?

A

Drugs end with ‘pril’

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21
Q

What is a side effect of an ACE inhibitor?

A

Dry cough, hyperkalaemia, hypertension

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22
Q

Side effects for block angiotensin II receptors?

A

Hypotension, dizziness, headache, gastrointestinal disturbance

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23
Q

Name 2 actions of an ACE inhibitor?

A

Dilates blood vessels, reduce fluid reabsorption in the kidneys

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24
Q

ACE- principle of treatment

A

Dilates arteries
Reduce cardiac output
Reduce blood volume

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25
Q

What does a Angiotensin II receptor blocker do?

A
  • reduce aldosterone secretion, increasing sodium and water excretion
  • causes vasodilation
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26
Q

Examples of Angiotensin II receptor blockers?

A

ending with ‘sartan’

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27
Q

Name 4 actions of beta blocker?

A
  • slows heart rate
  • dilates blood vessels
  • block excess stimulation of the heart as it can’t heart as hard
  • reduces oxygen demands of the heart
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28
Q

How is beta blocker recognised?

A

Drugs end in ‘lol’

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29
Q

What is the side effect of beta blockers?

A
  • bradycardia
  • heart blocks - blocked electrical activity
  • dizziness
  • postural hypotension
  • fatigue
  • tiredness
  • people may have less energy
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30
Q

Normal BP range?

A

100/60

31
Q

High BP and low BP?

A

High- ^140/^90

Low- under 100/ 60

32
Q

Nursing considerations for BETA blockers?

A

Monitor HR and BP

  • Postural hypotension may be aggravated by prolonged standing, hot environment
  • ask patient to report dizziness
33
Q

How do diuretics work?

A

Inhibit the reabsorption of sodium and chloride which increase water excretion through increase urine output

34
Q

Side effects of diuretics?

A

Dehydration, hypokalemia, hypotension

35
Q

Diuretic is prescribed bc at what times should it be taken and why?

A

08.00 and 12.00. To avoid nocturia

36
Q

Clinical consideration for Diuretics?

A

Monitor fluid and electrolyte status- daily weight U &he

  • observe for signs of dehydration
  • K+ replacement maybe needed with frusemide
37
Q

What type of drug is a statin?

A

Lipid lowering medication

38
Q

How do statins work?

A

Statins work by reducing the production of cholesterol in the liver

39
Q

When should statins be administered?

A

At night

40
Q

Side effects of statins?

A
  • constipation
  • diarrhoea
  • flatulence
41
Q

Clinical consideration for statin

A
  • cholesterol levels and liver function levels regularly monitored
  • avoid large quantities of grapefruit juice
42
Q

What type of medication is heparin?

A

Anti coagulant

43
Q

What test is used to monitor effectiveness of heparin?

A

APTT
Activated prothromboplastin time
Normal 26-39 secs
Therapeutic on heparin 50-90 secs

44
Q

Action of heparin?

A

Heparin prevents temporary clots converting to permanent clots
- slows the body’s clotting time

45
Q

Administration of heparin?

A

S/C or IV or infusion- not absorbed orally

46
Q

What is the action of Warfarin?

A

Warfarin inhibits liver production of various clotting factors

  • reduces ability of the blood to clot
  • it stops the production of new protein clotting factors but does not affect those already in the blood
  • takes 2-3 days to be effective
47
Q

Dose time warfarin is taken

A

8pm before next morning’s INR level

48
Q

Warfarin monitoring

A

INR- international normalised ratio

  • higher the INR the longer it takes for blood to clot
  • normal : 1.0-1.3
  • therapeutic range: 2.0-4.0
49
Q

Adverse effects

A
  • haemorrhage
  • rash
  • fever
  • jaundice
50
Q

Patient eduction

A
  • illness may change effect of warfarin- inform doctor
  • tell doctor or dentist well before any planned procedure or surgery
  • spinach affects warfarin levels
51
Q

Action of Asprin?

A

Inhibits platelet stickiness & clumping to reduce risk of clot formation

52
Q

Can paracetamol and NSAID be given together?

A

Yes, they are different classes of drug- different mechanisms of action

53
Q

What is anti tussive

A

Vought suppressant

54
Q

How does anti tussive work

A

Interrupts cough reflex in brain

55
Q

What does expectorant do

A

Stimulate mucus secretion in dry irritated areas of respiratory tract

56
Q

How does decongestant work

A

Causes vasoconstriction in mucous membrane to reduce swelling

57
Q

What does anti histamine do

A

Blocks the effects of histamine ( airway swelling, sneezing, throat irritation, rash)

58
Q

What condition might we give anti histamine

A

Allergies, rash and hayfever

59
Q

Heart rate

A

Normal- 60-100 BPM, regular rhythm
- measured as pulse

  • the number of times the heart beats each minute
60
Q

Stroke volume

A

Average volume 60-80mls per beat

  • the amount of blood pumped by ventricles per beat
61
Q

Cardiac output

A

Measured as L/min
Normal: 3.5-5 L/min

  • the amount of blood pumped by each ventricle in 1 min
62
Q

2 ways to alter stroke volume and therefore alter cardiac output

A

Starling’s law and Inotropic effect

63
Q

Starling’s law

A
  • more blood in = more blood out
  • the greater the stretch, the stronger the force of contraction
  • the more you fill the ventricle with blood the greater it will bounce back
64
Q

Inotropic effect

A

Increases stroke volume by strengthening the force of myocardial contraction

  • this is called a positive Inotropic effect
  • the stronger the squeeze, greater the outflow
65
Q

Why should you be careful when giving extra oxygen to a patient with COPD

A

If patients with COPD are given extra 02 the usual stimulus to breathe ( hypoxic drive) can be depressed leading to hypo ventilation and respiratory failure

66
Q

What does salbutamol do

A

Relaxes the smooth muscles of airways

67
Q

2 side effects of salbutamol

A

Tachycardia and muscle tremour

68
Q

Why is it important that the patient knows the difference between a reliever and preventer

A

So they use the right puffer in an acute episode of asthma/SOB

69
Q

How do corticosteroids aid in treating respiratory conditions

A

Reduces inflammation in the lungs

70
Q

Why should a patient rinse their mouth after using an inhaled steroid

A

To avoid oropharyngeal candidiasis and systemic absorption

71
Q

Why is it important to know if patient is taking and complementary medication

A

It may interact with medications that are prescribed for patient

72
Q

Action of PPI

A

Inhibits proton production

Lowers HCI production

73
Q

Drug and poison schedule

A

Schedule 1- traditional Chinese herbs
Schedule 2- pharmacy medicine
Schedule 3- pharmacy only medicine: available without prescription
Schedule 4- prescription only medicine: ordered by a doctor and available from pharmacy with prescription
Schedule 8- controlled substance: available by prescription but supply restricted to reduce dependence

Medication (1 decks)

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