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Pharm/Med > Pharm/Med Exam 1 > Flashcards

Pharm/Med Exam 1 Flashcards

1
Q

ADL

A

Activities of daily living

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2
Q

MDS

A

Minimum data set

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3
Q

Emergent
Urgent
Minor
Expectant

A

Emergent - highest priority
Urgent - can wait 2 hours
Minor - can wait several hours
Expectant - expected to die

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4
Q

Medication order should include

A

Medication order should include:
DDDFRS
Date
Drug
Dose
Frequency
Route
Signature

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5
Q

Medication specific NANDA diagnosis

A

Medication specific NANDA diagnosis:
Deficient knowledge
Risk for injury
Non-compliance
Problems related to drug therapy

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6
Q

NANDA-I

A

North American Nursing Diagnosis Association

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7
Q

Subjective or objective?

Pain scale (1-10)
Rebound pain
Crying
Facial expression

A

Pain scale - subjective
Rebound pain - objective
Crying - objective
Facial expression - objective

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8
Q

Included in assessment data regarding medication list

A

Medication list
Herbal/home/folk remedies
Alcohol/tobacco/caffeine
OTCs
Hormonal therapies
Etc.

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9
Q

Five steps to nursing care plan

A

Five steps to nursing care plan:
Assessment (data collection both objective and subjective)
Diagnosis (NANDA-I, Human needs statement)
Planning (patient-centered, patient included)
Implementation (interventions, patient-education)
Evaluation (monitor goals, objectives met? Recess if necessary)

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10
Q

3 parts to nursing diagnosis statement

A

3 parts to nursing diagnosis statement:
(Response to injury/illness) related to (factors involved) as evidenced by (data supporting theory).

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11
Q

Implementation step for medication administration considerations.

A

Medication administration in Implementation:
6 rights
Patient safety
Patient education
Drug storage
Accurate calculations

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12
Q

Five steps to nursing care plan

A

Assessment
Diagnosis
Planning (Patient-centered)
Implementation (Medication admin; Patient education)
Evaluation

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13
Q

Half-hour rule

A

Give medication a half hour before or after assigned time

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14
Q

6 rights of medication administration

A

6 rights of medication administration:
Patient
Drug
Dose
Frequency
Route
Documentation

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15
Q

TJC

A

The Joint Commission

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16
Q

Documentation items for medication administration

A

Documentation items for medication administration:
Drug
Dose
Route
Time
Date
Site of administration

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17
Q

Dose is in what measurement?

A

g, mg, mcg, units

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18
Q

Volume of a drug is measured in what?

A

mL, tabs, capsules, tsp, oz, cups…

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19
Q

What volume do you convert all meds to except for tablets?

A

mL

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20
Q

Definitions:
Dose
Volume
Concentration

A

Dose - amount ordered
Volume - what you see that contains the dose
Concentration - dose/volume

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21
Q

Do you ever reduce concentrations in calculations?

A

No, never reduce concentrations in calculations

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22
Q

Another name for metabolism

A

Biotransformation

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23
Q

Another name of biotransformation

A

metabolism

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24
Q

What is a drug effect?

A

Physiological reaction of the body to drug

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25
Q

What is a physiological reaction of the body to a drug?

A

Drug effect

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26
Q

What is a therapeutic drug effect?

A

Beneficial

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27
Q

What is a toxic drug effect?

A

Harmful

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28
Q

Three types of drug effects

A

Additive => 1+1=2
Antagonistic => 1+1<2
Synergistic => 1+1>2

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29
Q

Teratogenesis

A

Congenital abnormalities in fetus from antagonist reaction from drug

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30
Q

What type of drug effect is teratogenesis?

A

Antagonistic

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31
Q

What is an adverse drug event?

A

Event from administration or failing to administer a drug

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32
Q

What is an adverse drug reaction?

A

Allergic rx
Idiosyncratic rx
Medication error
Teratogenic
Mutagenic
Carcinagenic

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33
Q

What is an allergic drug rx?

A

An adverse effect that causes an allergic rx.

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34
Q

What is an idiosyncratic drug effect?

A

An unusual or unexpected but not allergic drug rx.

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35
Q

What is a medication error?

A

An adverse drug effect from administering the wrong medication.

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36
Q

What is the trough level of a drug?

A

The lowest level of the drug in the body

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37
Q

What is drug tolerance?

A

Reduced response to the drug from prolonged use

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38
Q

What are the two types of drug classes?

A

Therapeutic or structure

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39
Q

Therapeutic and structure are the two types of what?

A

Drug classes

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40
Q

What is pharmacology?

A

Study of drugs

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41
Q

What is a drug?

A

Something that affects the physiological processes in the body. (Any chemical that affects the physiologic processes of a living organism.)

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42
Q

What is pharmacology?

A

Study of science of drugs (umbrella)

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43
Q

What is pharmacokinetics?

A

What happens to drugs when they enter the body.

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44
Q

What is drug incompatibility?

A

One drug chemically deteriorates another when mixed.

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45
Q

What is a prodrug?

A

The inactive form that is converted to an active form through metabolism

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46
Q

What is a prototypical drug?

A

The very first form of a drug.

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47
Q

What are the three types of drug names?

A

Chemical, generic, brand

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48
Q

What is the chemical name of a drug?

A

The scientific name based on the chemical composition and molecular structure of the drug. This is important to people who work with drugs at chemical level: chemists, pharmacists, researchers.

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49
Q

What is the generic name of a drug?

A

The non-proprietary name given as soon as the drug is shown to have therapeutic effect. Given by US Adopted Names Council.

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50
Q

What is the trade name of a drug?

A

The brand name, registered trademark, restricted by drug owner’s patent, usually catchy and easy to remember that is given to the drug by the manufacturer. Each manufacturer will give a generic drug that they are manufacturing a brand name different than the brand name of another manufacturer.

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51
Q

Do hospitals use generic or trade names?

A

Generic

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52
Q

Three phases of drug activity

A

Pharmaceutical, pharmacokinetic, pharmacodynamic

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53
Q

What is the pharmaceutical phase of drug activity?

A

Dissolution for absorption
Dosage form changes drug rx and dissolution rate

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54
Q

What is dissolution?

A

What happens to a drug in the pharmaceutical phase of drug activity. Drug made available for absorption.

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55
Q

Put these drug forms in order from fastest to slowest:

Capsules
Liquids, elixirs, syrups
Oral disintegration forms (buccal, sublin, oral wafers)
Suspensions
Enteric
Tablets
Coated
Powders

A

Fastest to slowest:
Oral disintegration
Liquids, elixirs, syrups
Suspensions
Powders
Capsules
Tablets
Coated
Enteric

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56
Q

What is the pharmacokinetic phase?

A

The second of the three phases of drug activity.
What the body does to the drug to make it available for action.
- Absorption
- Distribution
- Metabolism
- Excretion

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57
Q

In what phase of the drug activity are absorption, distribution, metabolism and excretion involved in?

A

Pharmacokinetics

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58
Q

In what phase of drug activity does the drug undergo dissolution?

A

Pharmaceutical

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59
Q

In what phase of drug activity does the dosage form affect the drug reaction?

A

Pharmaceutical

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60
Q

Where does the dissolution of solid drug forms occur in the body?

A

GI tract

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61
Q

What occurs in the drug activity phase of pharmacodynamics?

A

Receptor interaction

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62
Q

What is pharmacodynamics?

A

The third phase of drug activity which is what the drug does to the body.

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63
Q

Put these phases of drug activity in the correct order from beginning to end:

  • Ready for action
  • Pharmacokinetic phase
  • Effect
  • Pharmaceutical phase
  • Administration
  • Pharmacodynamic phase
  • Ready for absorption
A

Correct order from beginning to end:

  1. Administration
  2. Pharmaceutical phase
  3. Ready for absorption
  4. Pharmacokinetic phase
  5. Ready for action
  6. Pharmacodynamic phase
  7. Effect
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64
Q

What is pharmacology?

A

The study of the science of drugs.

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65
Q

Two dosage forms of drugs

A

Enteral and Parenteral

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66
Q

What are enteral drugs?

A

PO, oral (oral, sublingual, buccal, rectal)

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67
Q

What are parental drugs?

A

Anything other than enteral (IV, IM, subq, intradermal, interarterial, intrathecal, intraarticular)

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68
Q

Which dosage form of drugs has a gastrointestinal effect?

A

Enteral - absorbed through stomach or intestines

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69
Q

What forms of drugs are topical?

A

Transdermal patches, inhalers, ointment, gel, cream, drops, vaginal, rectal.

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70
Q

What forms are these drugs? Transdermal patches, inhalers, ointment, gel, cream, drops

A

Topical

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71
Q

Do parenteral drugs go through dissolution?

A

No.

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72
Q

The injectable drugs have a pH that matches what?

A

Blood

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73
Q

What is the fastest route of drug administration?

A

IV

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74
Q

Which drugs are absorbed through the blood stream?

A

IV

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75
Q

Which drugs are absorbed through the muscle?

A

IM

76
Q

Why do you have to calculate IV medication carefully?

A

Because it’s distributed directly.

77
Q

Can extended release drugs be sprinkled on soft food?

A

Yes.

78
Q

Can enteric drugs be crushed?

A

No.

79
Q

What is bioavailability?

A

The extent of drug absorption

80
Q

What is the extent of drug absorption?

A

Bioavailability

81
Q

What three drug forms can you add to soft food?

A

Capsules, powders, liquid

82
Q

What are the two drug classifications?

A

By structure (beta-blockers) or therapeutic use (antibiotics).

83
Q

What are pharmaceutics?

A

The study of how various drug forms influence the way the drug affects the body - dissolution.

84
Q

Steps in pharmacokinetic phase of drug effects.

A

Absorption
Distribution
Metabolism
Excretion

85
Q

What questions do absorption, distribution, metabolism and excretion ask?

A

Absorption: How will it get in?
Distribution: Where will it go?
Metabolism: How is it broken down?
Excretion: How does it leave?

86
Q

What is absorption?

A

Movement of drug from its site of administration into the blood stream for distribution to tissues

87
Q

Factors affecting absorption.

A

Route of administration
Bioavailability (extent of drug absorption)
First pass effect (Large proportion of drug is chemically changed into inactive metabolites by the liver - much less is bioavailable)

88
Q

Definition of enteral drugs.

A

Absorbed into the systemic circulation through the oral or gastric mucosa or small intestine.

89
Q

Definition of distribution.

A

Transport of a drug by the bloodstream to its site of action.

90
Q

What is the most common blood protein that carries the majority of protein-bound drug molecules?

A

Albumin

91
Q

What are the areas that facilitate rapid drug distribution?

A

Highly vascular areas: Heart, kidneys, brain, liver
Less vascular areas: muscle, skin, fat

92
Q

After a drug is absorbed, where does it go?

A

Bloodstream

93
Q

Do metabolism and excretion begin at distribution?

A

Yes.

94
Q

What can delay distribution and therapeutic effect?

A

Protein-binding, blood-brain barrier

95
Q

What are the two forms of drugs that bind to proteins?

A

Bound and unbound

96
Q

What is the bound form of a drug?

A

That which is bound to a protein like albumin. This slows absorption because the protein cannot move through the capillary walls.

97
Q

A bound drug is active/inactive?

A

Inactive as long as it’s bound to protein.

98
Q

Will bound drugs in be system longer or shorter?

A

Longer

99
Q

What is the duration of a protein-bound drug?

A

Longer

100
Q

What happens when a drug that tends to bind to protein is administered to a patient with low protein levels?

A

The drug may be more bioavailalble and therefore the therapeutic effect may be stronger. More “free” or unbound medication will be absorbed.

101
Q

What is the type of drug interaction that can occur when two protein binding drugs are administered simultaneously?

A

Drug-to-drug. Will compete for binding. Action of one drug will be higher than other.

102
Q

The bound form of a drug is active or inactive?

A

Inactive

103
Q

The free form of a drug is active or inactive?

A

Active

104
Q

What is a synergistic drug effect?

A

Synergistic 1 + 1 > 2, the effect of two drugs with similar actions is greater than the sum of the individual effects.

For test: Effect will be more when 2 drugs that have similar effects are administered.

105
Q

What is an additive drug effect?

A

Additive 1 + 1 = 2, the effect of two drugs is equal to the sum of the individual effects alone.

106
Q

When two drugs with similar effects are administered will the effect be more or less?

A

More. This is synergistic effect.

107
Q

What is biotransformation?

A

Metabolism or biochemical alteration of a drug into an:
- Insoluble metabolite
- A more soluble compound
- A more potent active metabolite (prodrug)
- A less active metabolite

108
Q

Which organ is most responsible for the metabolism of drugs?

A

Liver

109
Q

What does metabolism depend on?

A

Enzymes

110
Q

What step in pharmacokinetics are enzymes involved in?

A

Metabolism

111
Q

What is excretion?

A

Elimination of drugs from the body

112
Q

What organ is most responsible for excretion?

A

Renal tubules in kidneys

113
Q

What are other routes of excretion in the body besides kidneys?

A

Billary, bowel, sometimes exercise, less common breathing, bowels

114
Q

What is the half-life of a drug?

A

Time required for half of a given drug to be removed from the body.

115
Q

What is the measure of the rate at which a drug is eliminated from the body?

A

Half-life

116
Q

After how many half-lives is a drug effectively removed from the body?

A

Five

117
Q

If the half-life of a drug is 2 hours, how long will it take that drug to be eliminated from the body?

A

10 hours

118
Q

What is a steady state?

A

The physiologic state in which the amount of drug removed via elimination is equal to the amount of drug absorbed with each does.

119
Q

How do we maintain a steady state of drug administration?

A

IV drip
Administer drugs on regular schedule
Adminster another does when drug level reached 50%.

120
Q

What is the peak level?

A

The highest level of a drug in the blood

121
Q

What is the trough level?

A

The lowest blood level of a drug

122
Q

When can drug toxicity occur?

A

When the blood level of a drug exceeds the peak level.

123
Q

What is therapeutic drug monitoring?

A

Monitoring the blood level of a drug to ensure that it does not exceed the toxic level.

124
Q

What level of drug in a blood is higher: peak of toxic?

A

Toxic.

125
Q

The nurse is giving a med that has a high first-pass effect. The route is changed to IV. What can the nurse expect?

A

The IV does will be lower because of the first-pass effect.

126
Q

The first pass effect is what?

A

The metabolism of a drug before it becomes systemically available. It reduces the bioavailability of a drug.

127
Q

With what drug route does the first-pass effect normally occur?

A

Oral

128
Q

Why do IV doses need to be lower than PO doses?

A

Because of first-pass effect

129
Q

What route is slowest?
IV
IM
Subq
PO

A

PO

130
Q

When administering two drugs that are highly protein bound, what should the nurse watch for?

A

Increase in risk of drug-to-drug interaction

131
Q

What is the study of physiochemical properties of drugs and how they influence the body called?

A

Pharmacodynamics

132
Q

What state best describes pharmacokinetics?
- Adverse effects and toxic reactions to meds
- Physiologic interaction between a drug and body cells
- Converts meds into active chemical substance
- What the body does to the drug after it is administered.

A

What the body does to the drug after it is administered.

133
Q

Another term for metabolism

A

Biotransformation

134
Q

What is the mechanism of drug actions in living tissues

A

Pharmacodynamics

135
Q

What is the therapeutic effect?

A

What change we should see in the body; what the drug should do.

136
Q

When a drug is specifically designed to match up with something it’s supposed to fix, is what type of drug action?

A

Receptor

137
Q

All cells have what type of sites?

A

Receptor sites

138
Q

What drugs are designed to find certain receptor sites?

A

Chemothereapy

139
Q

What is in grapefruit juice that blocks some receptor sites?

A

Certain proteins

140
Q

Why are there precautions are eating before taking meds?

A

Certain foods might block receptor sites

141
Q

Receptor sites come into play in what phase of drug administration?

A

Pharmacodynamics

142
Q

What is pharmacotherapeutics?

A

The desired therapeutic outcome

143
Q

What two things should the therapeutic effect of drugs (pharmacotherapeutics) consider?

A

Therapeutic administration should be individualized and collaborative.

144
Q

What things come together in a collaborative effort to administer pharmacotherapeutics?

A

Provider, healthcare history

145
Q

What are the goals of individualized, collaborative drug administration (pharmacotherapeutics)?

A
  • Curing disease (infection)
  • Eliminating or reducing symptoms (acid reflux)
  • Stopping/slowing disease process (BP meds)
  • Preventing disease or unwanted condition (statins, vaccinations)
  • Improving quality of life (seizures)
146
Q

What is the difference between a contraindication and an adverse effect?

A

A contraindication renders a particular form of treatment improper or undesirable because of a disease state or patient characteristic. (pregnancy, children, elderly, drug addiction)
An adverse effect is an undesirable direct response to one or more drugs (allergic rx)

147
Q

A patient has a rash, is itchy and sleep after morphine. Adverse affect?

A

No, is side effect.

148
Q

What are the types of drug therapy?

A
  • Acute (more intensive drug treatment)
  • Maintenance (chronic condition managed with med)
  • Supplemental (Pt using to fill need)
  • Palliative (relieve symptoms)
  • Supportive (give one drug with another to support function)
  • Prophylactic (prevents something)
  • Empiric (drug admin when clinical probability of condition is high due to patient’s presentation)
149
Q

What is the therapeutic index?

A

Ratio of drug’s toxic level to the level that provides therapeutic benefit.

150
Q

Drug concentration

A

Concentration of drug in blood

151
Q

Patient condition

A

Concurrent disease or other medical condition

152
Q

When is most drug available in the blood?

A

During peak levels

153
Q

Patient monitoring involves the therapeutic index?

A

Yes.

154
Q

Patient monitoring considers what two things?

A

Patient condition and drug concentration.

155
Q

Patient condition and drug concentration are important in what?

A

Patient monitoring

156
Q

What two organs are monitored during some drug administration?

A

Liver/kidneys

157
Q

What is drug tolerance?

A

Decreasing response to repeated drug doses.

158
Q

What is drug dependence?

A

Physiologic or psychological need for a drug

159
Q

What is physical drug dependence?

A

Physiologic need for a drug to avoid physical withdrawal symptoms

160
Q

What is psychological drug dependence?

A

Addiction. Obsessive desire for the euphoric effects of a drug.

161
Q

In adverse drug effects, what is a pharmacologic rx?

A

A pharmacologic reaction is an extension of the drug’s normal effects in the body.

162
Q

In adverse drug effects, what is hypersensitivity?

A

An allergic reaction

163
Q

In adverse drug effects, what is an idiosyncratic reaction?

A

An abnormal, unexpected response that is peculiar to an individual patient.

164
Q

In adverse drug effects, what is a drug interaction?

A

What happens when there is more than one drug administered.

165
Q

What is a teratogenic drug effect?

A

Causes structural defect in fetus

166
Q

What is a mutagenic drug effect?

A

Causes permanent change in genetic composition

167
Q

What is a carcinogenic drug effect?

A

Causes cancer

168
Q

In antagonistic drug effects, what happens?

A

A combination of 2 drugs results in drug effects that are less than the sum of the two drugs’ effects. 1 + 1 < 2.

169
Q

In drug interactions, what are incompatibilities?

A

For parenteral drugs, cannot administer one with the other.

170
Q

What type of drug therapy treats acutely ill, rapid onset or critically ill patients?

A

Acute - antibiotics

171
Q

What type of drug therapy is used to to prevent the progression of a disease such as hypertension?

A

Maintenance (BP meds)

172
Q

What type of drug therapy is used to support the body’s needs for normal activity?

A

Supportive - insulin

173
Q

What type of drug therapy is used to prevent illness?

A

Prophylactic - antibiotics before dental surgery

174
Q

What type of drug therapy is used to relieve patients of symptoms or pain or stress of serious disease but not correct disease?

A

Palliative

175
Q

What type of drug therapy is administered based on clinical knowledge that the condition being treated is likely present?

A

Empiric

176
Q

Collaborative effort in pharmacotherapeutics involves what two things?

A

Provider’s knowledge of condition and medication and the patient’s history and medication list.

177
Q

What step in the nursing process are pharmacotherapeutics involved?

A

Implementation

178
Q

When monitoring a patient, what information is objective?

A

Temp, BP, level of consciousness, blood tests for levels

179
Q

Dependence is associated with drug tolerance. T/F

A

True

180
Q

What are the two types of drug dependence?

A

Physical and psychologically

181
Q

What is physical dependence?

A

The body’s physiologic dependence on the drug that results in withdrawal symptoms.

182
Q

What is psychological dependence

A

“Addiction” or obsessive need for a drug for the euphoric effects.

183
Q

Difference between pharmacotherapeutic drug interactions and adverse effects, name each.

A

Interactions:
Antagonistic effects - combo os 2 drugs results in effects that are less than the sum (1 + 1 < 2)
Incompatibilities - Cannot administer at same time (IV meds - precipitant)
Synergistic - 1 + 1 >2
Additive - 1 + 1 = 2

Adverse Effects:
1. Allergic rx - hypersensitivity
2. Idosyncratic rx - unexpected, abnormal or unusual rx
3. Drug interaction - presence of one or more drugs
4. Medication error
5. Teratogenic - structural damage in fetus
6. Mutagenic - causes permanent genetic damage
7. Carcinogenic - causes cancer

184
Q

Peak and trough levels of drugs are part of what step?

A

Pharmacokinetics

185
Q

This statement is an example of what? “Foot pain related to patient complaint of pain and accident as evidenced by redness, swelling.”

A

Nursing diagnosis statement

Pharm/Med (4 decks)

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