Pharm Final Flashcards
Client and wife are taking the same drug but are experiencing different side effects, they want to know if they are doing something wrong?
No, differences such as sex can result in different side effects.
Client wants to know how long before topical medication will start working?
It might take a few days to see noticeable improvement in rash.
When preparing clients antihypertensive medication atenolol (Tenormin) ordered 50 mg daily, nurse notices HCP has ordered 100 mg daily, nurse should?
Read HCP most recent note indicating a reason for increasing the medication and of not found contact HCP.
What is accurate regarding the Institute for Safe Medication Practices (ISMP)?
It publishes a monthly consumer newsletter regarding medication errors.
Nurse administers vaccine and understands that?
Vaccines are naturally produced in animal cells or microorganisms.
Best definition for the term “adverse reaction?”
A harmful or undesirable response to a medication.
Elderly client presents with low HR and BP, client indicates HCP prescribed 3 new meds and are now on 10 total meds, what is most accurate?
Client is experiencing adverse reactions due to the 3 new medications added.
Nurse provides med education to client taking Schedule IV drug learning has occurred when client states what?
The Dr has given me a prescription with 4 refills. I need to come back for a checkup in 4 months.
Nursing instructor teaches student nurses about pharmacological classification of drugs, learning has occurred when students say?
A calcium channel blocker blocks calcium channels in the heart.
Nurse getting ready to administer new medication to client when they state they think they had the medication once before and had a reaction, what does nurse do?
Ask client what type of reaction and contact HCP to check history of allergies.
Nurse preparing clients med, what is NOT legal responsibility of nurse?
Identify clients diagnosis, determining the dosage.
What is most important to remember about Food, Drug, and Cosmetic Act?
It prevented sale of drugs that had not been thoroughly tested before marketing.
Physician ordered Schedule II drug for client nurse determines learning has occurred when client states what?
I need to see my doctor before my prescription runs out so I can get a refill.
During admission client tells nurse that he snorts cocaine, what is the best assessment question?
How often do you snort cocaine and how many lines each time?
Nurse checks MAR and observes client is on 6 meds. When determining side effects, nurse should be concerned if?
Two of three six medications have bradycardia as a side effect.
HCP prescribes lisinopril (Zestril) 10 mg PO every day, why type of order is this?
Routine order
Nurse suspects client is not taking antihypertensive med because BP still elevated, what therapeutic question can be asked that will assess for noncompliance?
Taking medication is difficult for many people. What are some of your concerns about the medication?
Elderly client has GI bleeding, client says they took aspirin. Best education?
A plan to teach the advantages and disadvantages of aspirin including taking enteric coated.
Nursing student assigned to new client and checks MAR observing client is on 4 medications, when determining interactions between these meds what is safety concern?
Two of the meds cause drowsiness.
Client receives drug that’s excreted in bile. What will the best nursing assessment of the effect of this drug on the client?
It will have a prolonged action.
Client is malnourished and has low serum albumin. Physician ordered aspirin, a highly protein bound drug. What effect will this have on client?
Client will be at risk for toxicity, due to there being no protein for the drug to bind to.
Client admitted to hospital in chronic renal failure and is on several medications. Assessment?
The client may have drug toxicity from all of the drugs.
Client prescribed phenobarbital sodium (Luminal) for seizure disorder, this drug has long half life of 4 days. Based off the half life it will most likely be prescribed?
Once a day.
Prior to administering medications, the student nurse reviews the therapeutic index of their medications on their list. What best describes narrow therapeutic index?
Clients will need to have serum blood levels monitored due to low safety margin.
Contraindications
Indicate why a medication should NOT be given.
Toxicity
A serious adverse reaction usually caused by excessive dosing.
Mechanism of action
How the medication produces its desired therapeutic effect.
Therapeutic effect
Primary action for which the medication is prescribed.
Client has brain infection. Physician initially prescribed water soluble antibiotic. Another physician changed the order to lipid soluble antibiotic. Client is confused. What nursing education plan best instructs the client? Lipid soluble medications are…
More effective in treating their illness.
Med dosages may need to be decreased for which reasons?
Liver failure and concurrent use of med by same pathway.
Client wants to know why newer drug is more effective than older drug?
Research into receptors helps “fine tune” drugs to be more effective. Newer drugs are altered to affect your cells receptors in a different way.
Client taking med with narrow therapeutic range and long half life and wants to know why his blood is drawn so often. Response?
To be sure you have the correct amount of med in your system.
Client taking many different medications and wants to know how they get to all the right places. Nurse says hat depends on?
Blood flow to tissues, protein in body, whether it is fat based or water based.
Client received loading dose followed by lower dose and wants to know why?
You had a larger dose initially so that the medication would work more quickly.
Nurse proving med education to hypertensive client. Focus is on enhancing absorption of medications. Statement that proves learning has occurred?
I need to be careful about taking the medication with certain foods.
Anticholinergic drugs block effects of?
Acetylcholine
Best description of drugs therapeutic effect?
The desirable response based on its intended purpose.
When counseling a client who is prescribed hepatotoxic med, nurse should include what safety education?
Avoid alcohol.
Protein binding of drugs refers to the…
Complex formed with the med and plasma proteins.
Increase med dosages for what reasons?
Increased med metabolizing enzymes, increased renal excretion, peripheral vascular disease depending on liver/renal function.
Client receiving anti seizure med with half life of 2-3 hours. You would expect dosage to be given?
Every 6 hours.
What is true regarding distribution?
Adequate blood flow is necessary for drug distribution.
Client has low serum albumin levels. Physician orders glipizide a highly protein bound drug to lower blood sugar for this diabetic client. What effect will this have?
Client will be at risk for hypoglycemia.
The four major components of pharmacokinetics? How drugs…
Are converted to a form that is easily removed form body, are transported, removed, move from site of administration to circulation.
When drugs bind with receptors what response occurs?
Pharmacologic effects of agonism or antagonism occur.
Client develops decreased renal function and requires an alteration in antibiotic dosage. What would physician base this change on?
Creatinine and BUN.
Client receiving narrow therapeutic level drug this requires order from physician for?
Peak and trough levels.
Client stopped taking med with long half life and is experiencing less drowsiness and no seizures. Best explanation?
Drug’s previous doses have not been completely eliminated from the body but are partially eliminated making her less drowsy.
What age related factor could effect pharmacokinetics of drug administered to 87 yr old?
Reduced ability of liver to metabolize.
Nurse administers atropine to client experiencing shortness of breath and fatigue with 2nd degree heart block. Response?
Increase HR. Due to atropine blocking parasympathetic action of acetylcholine and inducing symptoms of fight or flight.
Client diagnosed with Parkinson’s. Client wants to know how this medication will help?
This med will help you eat and walk. The goal is to increase ability of client to perform ADLs.
Nurse completed med education about neostigmine (Prostigmin) an indirect cholinergic drug, for client with myasthenia gravis. Nurse determine learning has occurred with what statement?
It is really important to take my medication on time before eating.
Client is quadriplegic and receives oxybutynin (Ditropan) an anti cholinergic drug to increase bladder capacity. What is important assessment by nurse?
Is client constipated.
Client takes levodopa (Larodopa). Nurse understands effective learning has occurred when?
Client states they must increase fiber in diet. Constipation is side effect from this medication.
Alzheimer’s clients wife education statement?
The medication may help symptoms for a little while.
Physician orders bethanechol (Urecholine) a cholinergic drug for client with urinary retention. Client also has enlarged prostate. Nursing action?
With hold medication and call HCP.
Nurse preparing to administer meds to a group of clients. One med is benztropine (Cogentin) an anti cholinergic. This drug is contraindicated in which client?
Client with tachycardia because anticholinergic drugs increase the HR.
Pramipexole (Mirapex) an antiparkinsons med can cause what adverse reaction?
Hallucinations.
Expected pharmacological action of benztropine (Cogentin)?
Blocks acetylcholine at muscarinic receptors, which assists in maintaining balance between dopamine and acetylcholine in brain.
You made med error and reported it. Purpose of this?
Prevent future med errors.
Nurse planning teaching for client and family, which information should be include for Alzheimer’s client?
Symptoms are progressive, meds may decrease symptoms but there is no cure, meds may be taken with food, dry mouth is expected.
Nurse discussing donepezil hydrochloride (Aricept) with family of Alzheimer’s client. Explain what side effects?
Muscle cramps, dizziness, insomnia, headache.
To increase absorption of levodopa/carbodopa client should avoid?
Eating cheeseburgers made form lean ground sirloin.
