Pharm class Flashcards

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1
Q

core ethical principles

A

respect for person: pt should be treated as independent person capable of making decisions in their own best interests.

beneficence: Nursing practice that does good and avoids harm.
justice: requires that the selection of research subjects be fair.

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2
Q

patient centered

A

focus on patient care

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3
Q

nursing process

A

organize patient information around a medical diagnose. is used by nurses for the appropriate delivery of patient care and drug administration. describe the who, what , where, why and how of nursing practice.

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4
Q

thiazide (diuretic)

A

management of mild to moderate hypertension. treatment of edema

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5
Q

assessment

A

subjective data: current health history, patient

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6
Q

increase medication adherence (the extend to which a patient continues an agreed on mode of treatment without close supervision)

A

1) ensuring access to providers across the continuum of care and implementing team-based care;
2) educating and empowering patients to understand the treatment regimen and its benefits;
3) reducing barriers to obtaining medication, including cost reduction

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7
Q

Which information will the nurse include in the patient teaching? (Select all that apply.)

A

administration technique.
instructions regarding drug discontinuation.
foods to avoid when taking a certain drug.
side effects to report to health care provider.

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8
Q

Which is a correctly written goal by the nurse?

A

patient will independently administer the prescribed dose of insulin at the end of 1 hour of instruction.

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9
Q

What is the first step of the nursing process when working with patients receiving drug therapy?

A

assessment

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10
Q

Before information about drug therapy is presented to a patient, it is most important for the nurse to

A

assess the patient’s readiness to learn

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11
Q

The Nursing Alliance for Quality Care (NAQC)

A

Supports highest-quality safe patient-centered health care

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12
Q

NAQC and ANA

A

Published guidelines supporting core principles

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13
Q

Six-step decision-making approach

A
Concept
Assessment
Patient problems
Planning
Nursing interventions
Evaluation
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14
Q

Concept

A

Influences delivery of patient care
Focuses on patient-centered model of care
Pertain to patient’s problems
Includes health, illness, and health promotion
Includes preventive, primary, acute, and chronic health care

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15
Q

patient problems

A

identifies patient needs

better identifies clinical practice and the plan of care.

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16
Q

Pharmacogenetics

A

Study of how a patient’s genomes affect drug response
Helps individualize optimal drug treatment regimens
Helps decrease drug reactions
Promotes drug regimen adherence
Reduces overall healthcare costs

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17
Q

Patients who benefit most from pharmacogenetics

A

Those taking multiple prescription drugs
Those not responding to current therapy
Those having adverse drug reactions
Those taking black box warning drugs

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18
Q

Individual Variation in Metabolism of Select Drugs

A
Mercaptopurine 
Irinotecan
Abacavir
Warfarin
Clopidogrel
Opioids
Mental health drugs
Carbamazepine
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19
Q

Legal and Ethical Issues

A

Privacy
Who has access to patient’s genetic information?
Who owns genetic information
Concerns about patient “labeling”
Autonomy
Patient may consent to or refuse genetic testing
Patient may change their mind about testing
Justice
Equal and fair treatment for all

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20
Q

Nursing Process: Pharmacogenetics

A

Assessment
Assess family history back three generations.
Determine side effects/adverse effects to drug therapy
Concept
Safety
Planning
Integrate patient preferences and family implications into developing evidence-based plans of care
Nursing Interventions
Refer identified patients to genetic counseling as needed
Guide patients in the implications and uses of genetic results.
Ensure patient knows to report genetic findings to all healthcare providers.
Evaluation

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21
Q

A patient has liver and kidney disease. He is given a medication with a half-life of 30 hours. The nurse expects the duration of this medication to

A

increase

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22
Q

When assessing older adults and those with renal dysfunction, the nurse knows that creatinine clearance is usually

A

decreased

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23
Q

A patient sustains significant burns to the skin and is experiencing fluid shift associated with edema in the fluid overload phase. The nurse would anticipate that this will interfere most with which phase of pharmacodynamics?

A

Distribution

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24
Q

Which nursing actions would be most appropriate for ensuring patient safety with a medication that has a low therapeutic index?

A
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25
Q

Pharmacokinetic phase

A

Absorption
Distribution
Metabolism
Excretion

26
Q

Pharmacodynamic phase

A

Receptor binding
Postreceptor effects
Chemical reactions

27
Q

Pharmacokinetics

A

Drug absorption
Drug movement from GI tract into bloodstream
Disintegration
Breakdown of oral drug form into small particles
Dissolution
Combining small drug particles with liquid to form a solution

28
Q

Absorption methods

A

Passive transport
-Diffusion
-Facilitated diffusion
Active transport
—Requires energy to move drug against a concentration gradient
Pinocytosis
—Cell carries drug across membrane by engulfing drug particles.

29
Q

Factors affecting absorption

A

Blood flow, pain, stress, pH
Exercise, hunger, fasting
Food texture, fat content, temperature
Route of administration

30
Q

Drug movement from GI tract to liver

A

Via portal vein
First pass effect
Bioavailability

31
Q

Factors affecting bioavailability

A
Absorption 
First-pass metabolism
Drug form
Route of administration
Gastric mucosa and motility
Administration with food and other drugs
Changes in liver metabolism
32
Q

Drug distribution

A
Movement of drug from circulation to body tissues
Influencing factors
Protein binding
Free drugs
Volume of drug distribution (Vd)
33
Q

Drug metabolism (biotransformation)

A
Process of body chemically changing drug into a form to be excreted
Prodrug 
Half-life (t½)
Steady state
Loading dose
34
Q

Drug excretion (elimination)

A
Kidneys
Liver (bile)
Lungs
Saliva
Sweat
Breast milk
35
Q

Pharmacodynamics

A
Study of the way drugs affect the body
--Primary effect 
Desirable response ()
--Secondary effect
Desirable or undesirable
36
Q

Drug response relationship

A

—Body’s physiologic response to changes in drug concentration at site of action
—Potency
Amount of drug needed to elicit specific physiologic response
—–Maximal efficacy
Point which increasing a drug’s dosage no longer increases desired therapeutic response
—-Therapeutic index (5-10)
Relationship between therapeutic dose and toxic dose

37
Q

Pharmacodynamics

A

Onset
-Time it takes for drug to reach minimum effective concentration
Peak
-Highest concentration in blood
Duration
-Length of time drug exerts a therapeutic effect

38
Q

Therapeutic drug monitoring

A

Peak drug level

Trough drug level

39
Q

Pharmacodynamics

Receptor theory

A

Drugs act by binding to receptors
To activate receptor
To produce a response
To inactivate a receptor

40
Q

pharmacodynamics-

Four receptor families

A

Cell membrane–imbedded enzymes
Ligand-gated ion channels
G protein–coupled receptor systems
Transcription factors

41
Q

Agonists

A

produce the desire response. Activate receptors

Produce desired response

42
Q

Antagonists

A

Prevent receptor activation

Block response

43
Q

bethanechol

A
44
Q

epinephrine

A

alergic reactions

45
Q

pharmacodynamics

A

i know the side effects of medications

46
Q

psychotoxic drugs

A

affects the cells. used for cancer patients

47
Q

Mechanisms of drug action

A
Stimulation 
Depression
Irritation
Replacement
Cytotoxic action
Antimicrobial action
Modification of immune status
48
Q

Pharmacokinetic interactions

A

Changes occurring in absorption, distribution, metabolism, and excretion

49
Q

Drug interactions

A

Altered drug effect due to interaction with another drug

50
Q

Pharmacodynamic interactions

Additive

A

Sum of effects of two drugs

51
Q

Synergistic

A

Effect of two drugs is much greater than effects of either drug alone.

52
Q

Antagonistic

A

One drug reduces or blocks effect of other drug

53
Q

Drug-nutrient interactions

A

Food may increase, decrease, or delay drug response

54
Q

Drug-laboratory interactions

A

Drugs may cause misinterpretation of test results.

55
Q

Drug-induced photosensitivity

A

Drug induced skin reaction caused by sunlight exposure.

cancer drugs, prograph or chemotherapy

56
Q

Nursing Process: Pharmacokinetics and Pharmacodynamics

A

-Concept
Caring intervention, safety
–Assessment
Determine potential for drug interaction problems.
Identify patient’s current drugs.
—Patient problems
Anxiety, need for health teaching
—–Planning
The patient will describe rationale for therapeutic regimen.
—Nursing interventions
Advise patient not to eat high-fat foods before ingesting an enteric-coated tablet.
Monitor therapeutic range of drugs that are more toxic or have narrow therapeutic ranges.
Notify health care provider of drugs ordered that have antagonistic effects.
—-Evaluation

57
Q

A patient has liver and kidney disease. He is given a medication with a half-life of 30 hours. What is the expected duration of this medication?

A

increase

58
Q

When assessing older adults and those with renal dysfunction, the nurse would expect the creatinine clearance to be which of the following?

A

decreased

59
Q

A patient sustains significant burns to the skin and is experiencing fluid shift associated with edema in the fluid overload phase. The nurse would anticipate that this will interfere most with which phase of pharmacodynamics?

A

Distribution

60
Q

Which nursing actions would be most appropriate for ensuring patient safety with a medication that has a low therapeutic index?

A

Monitoring serum peak and trough levels

61
Q

What is the primary site of metabolism for most drugs?

A

liver