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Nursing > Safe Administration of Drugs throughout the Life Cycle > Flashcards

Safe Administration of Drugs throughout the Life Cycle Flashcards

RNUR/PNUR 1030

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1
Q

What are the 4 phases of lifespan changes that have dramatic pharmacokinetic changes?

A

Pregnancy
Newborn
Pediatric
Older Adult

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2
Q

Drugs cross the placenta by

A

diffusion

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3
Q

What are factors affecting safety with drug therapy during pregnancy?

A

Drug Properties (chemistry, dosage, concurrently administered drugs)
Fetal gestational age
Maternal Factors

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4
Q

In the first trimester, the fetus is at the greatest risk for

A

drug-induced developmental defects

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5
Q

In the first trimester, what is developing at their most rapid rate?

A

Skeleton, muscle, limbs, and visceral organs

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6
Q

What should you NOT do during drug therapy in your first trimester of pregnancy?

A

Self treatment of illness

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7
Q

In the third trimester of pregnancy, what is a concern during drug therapy?

A

The greatest percentage of maternally absorbed drug gets to the fetus

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8
Q

Any change in the mom’s physiology can

A

affect the amount of drug to which the fetus may be exposed to.

Example: Changes in liver and kidney functions

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9
Q

The FDA does not have safety categories. INSTEAD, drug manufactures must

A

identify specific risks in PREGNANCY and BREASTFEEDING.

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10
Q

What are the three subsections in the prescribing phase for pregnancy labeling information?

A

Pregnancy
Lactation
Female and Males of reproductive potential

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11
Q

Breastfed infants are at risk for

A

exposure to drugs consumed by the mother

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12
Q

Drug levels in breast milk are usually

A

lower than those in the maternal circulation

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13
Q

What should you consider regarding drug therapy while breastfeeding?

A

Risk-to-benefit ratio

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14
Q

Infants and children generally require

A

lower doses than adults. (Duh, they are smaller)

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15
Q

Pediatric patients handle drugs much differently because

A

of the immaturity of their vital organs.

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16
Q

What category is between BIRTH and 1 MONTH of age?

A

Neonate

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17
Q

What category is between 1 MONTH and 12 MONTHS of age?

A

Infant

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18
Q

What category is between 1 and 12 YEARS of age?

A

Child

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19
Q

In pediatrics, altered maturity of organs can

A

affect drug dosage

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20
Q

In pediatrics, Tetracycline may

A

permanently discolor teeth

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21
Q

In pediatrics, system steroids may

A

suppress growth

(think of smol peepee)

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22
Q

In pediatrics, Gastric pH is less acidic until

A

1 to 2 years of age

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23
Q

In pediatrics, Gastric emptying slowed can affect

A

absorption in neonate and pediatric patients

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24
Q

In pediatrics, What route of drug administration is faster and irregular?

A

Intramuscular

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25
Q

In pediatrics, Greater total body water means

A

lower fat content
(when talking about dosing lower because of distribution)

26
Q

What alters metabolism and excretion of drugs in pediatrics?

A

Immature liver and kidneys

27
Q

In pediatrics, what causes more drugs to enter the brain which then alters metabolism and excretion?

A

Immature blood brain barrier

28
Q

Factors Affecting Pediatric Drug Dosages:

Skin is

A

thin and permeable

29
Q

Factors Affecting Pediatric Drug Dosages:

Stomach

A

lacks acid to kill bacteria

30
Q

Factors Affecting Pediatric Drug Dosages:

Body temperatures

A

less well regulated and dehydration occurs easily

31
Q

Factors Affecting Pediatric Drug Dosages:

Liver and kidneys are

A

immature, impairing drug metabolism and excretion

32
Q

In pediatrics: ALWAYS CONSIDER

A

organ maturity

33
Q

What are 4 methods of dosage calculations in pediatric patients?

A

Body surface area method
Always use weight in KILOGRAMS
Always use CENTIMETERS
Body weight dosage calculations

34
Q

What is the most commonly used body weight dosage calculation in pediatrics?

A

mg/kg

Example: 30mg/kg, patient weighs 20kg

They would get 600mg

35
Q

What occurs with advancing age?

A

Decline an organ function

36
Q

Drug therapy in OLDER adults is most likely to result in

A

Adverse effects and toxicity

37
Q

Who is considered an older adult?

A

Age 65 years and older

38
Q

What percentage of older adults is on at least one medication?

A

87%

39
Q

What percentage of older adults is on at least five medication’s

A

36%

40
Q

With older adults, taking multiple medication’s can

A

Increase the risk of drug interactions

41
Q

What is the term used for simultaneous use of multiple medications?

A

Polypharmacy

42
Q

What is important to educate the patient or caregiver when dealing with poly pharmacy?

A

The dangers of multiple drug use

43
Q

More complicated medication regimens with older adults can

A

Predispose the patient to self medication errors

44
Q

Older adults gastric pH is

A

Less acidic and gastric emptying slowed

45
Q

In older adults, blood flow to the

A

G.I. tract reduced and absorptive surface reduced (which results in decreased absorption and distribution)

46
Q

In older adults, what can affect medication distribution in the body?

A

Lower total body water percentages and increase fat content.

47
Q

Older adults, decrease in total body, water leads to

A

Decrease distribution of some drugs, as antibiotics may lead to risk of toxicity

48
Q

In older adults, decreased production of proteins by the liver results in

A

Decreased protein binding of drugs, which increases circulation of free drugs

49
Q

Older adults, microsomal enzymes are decreased due to

A

Decrease production by the aging liver

50
Q

Older adults, liver blood flow is reduced, which decreases

A

Hepatic metabolism

51
Q

An older adults, decreased metabolism, leads to

A

Potential for drug toxicity

52
Q

In older adults, glomerular filtration is decreased by

A

40 to 50% (which affects excretion of drugs)

53
Q

An older adult is difficult for drugs to be excreted due to

A

Decrease blood flow and number of intact nephrons are decreased

54
Q

An older adults drugs are cleared less effectively because of

A

Decreased excretion

55
Q

What is an important indicator of renal function?

A

Creatinine clearance

56
Q

An older adults, if creatinine clearance is abnormal

A

Drug dosages may need to be adjusted

57
Q

What are two pediatric considerations for safe medication administration?

A

Mixing medication’s to disguise, the taste and age-appropriate terminologies for the child

58
Q

What are five safety considerations with pediatric patients and medications?

A

Avoid oral aspiration, injury with injections, teach parents about the medication, alert, parents for any side effects, and keep all medication’s out of the reach of children

59
Q

What are four steps to take if there’s a poisoning in the home?

A

Poison prevention, education is essential, do not induce vomiting, do not use home activated, charcoal, and if poisoning occurs, call the poison control center or 911

60
Q

What are older adult considerations for safe administration of medication’s?

A

Take as directed, do not double up doses, or discontinue without guidance from a prescriber

61
Q

What did you take into consideration prior to teaching an elderly patient about medication’s?

A
  1. Appropriate time – not in pain & not tired
  2. Prepare the patient before teaching
     Glasses
     Hearing aid
  3. Private, comfortable & quiet, well-lit environment
  4. Keep lesson clear & brief
  5. Allow for questions, feedback & return demo
  6. Provide handouts to reinforce information
62
Q

To promote compliance when teaching an elderly patient, you should

A

Assess knowledge deficit, assess any confusion, concerning drugs, financial concerns, or how they can pay for meds

Nursing (5 decks)

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