Unit 1- questions

Question 1

nurse is caring for a man w/ worsening liver dz. When monitoring his meds, it is important to know that a pt w/ liver dz may have impaired drug…

Answer 1

• metabolism

* important b/c could lead to toxic serum drug levels

Question 2

the physician has changed pt’s med from PO to path to avoid first-pass effect. Why has the formulation changed?

Answer 2

• first pass-effect is rapid inactivation of certain oral drugs, resulting in no therapeutic effects
• drugs at risk are administered parenterally or topically to bypass liver temporarily

Question 3

pt presctibe med w/ t1/2 of 24 hrs. First dose given 8 AM Mon. When will drug reach peak?

Answer 3

• Friday

* drugs peak at 4 t1/2s

Question 4

why is it important to know when a drug peaks?

Answer 4

• tells you when the drug will start working and be most effective
• indicates patients response to drug therapy

Question 5

which organ system most important for excretion

Answer 5

•kidney

Question 6

how to evaluate kidney fxn

Answer 6

• I/O

* renal panel (creatine; BUN)

Question 7

how does impaired kidney fxn impact care of pt.

Answer 7

•important in order to avoid toxicity

Question 8

albumin 2.4 g/dL (norm: 3.4-5.4); how dose it affect pt response to drug therapy

Answer 8

• decreased amnt of protein to bind to drugs
• low protein means there is more med in serum, so at higher risk for toxicity/adverse effects/side effects
• disrupts balance b/t free and bound drug molecules

Question 9

how to increase albumin levels

Answer 9

•albumin IV
•PO protein intake
*albumin important for wound healing and maintaing fluid balance

Question 10

why important to know onset/peak/duration of insulin

Answer 10

• should see it effect blood glucose levels
• will give you idea when most likely to see hypoglycemia
• gives idea when to admin food (or understand why dr. orders snack)

Question 11

pump vs. subQ route for insulin

Answer 11

• based on compliance
• pump is more complicated than subQ
• pump delivers basal rate throughout day, then pt can give boost at meal time based on carb intake

Question 12

it would be a priority for RN to respond to which symptom if exhibited by pt receiving insulin therapy for diabetes?

Answer 12

•profuse sweating and difficult to arouse

Question 13

when obtaining new vial of NPH insulin from ref rig…the nurse notes the suspension is partially froze. What should he/she do

Answer 13

•discard vial and obtain new one from pharm

Question 14

pt prescribe 5 units of insulin aspart and 25 units insulin detemir to be admin at 0800. What should the nurse do?

Answer 14

• draw up the two in different syringes

* can’t be mixed