week four Flashcards
Anaphylactic Reaction
A severe allergic reaction to a substance or chemical that happens quickly after exposure. Signs of this are: hives, rapid pulse, arrhythmia, fluid in lungs, low blood pressure, mental confusion, blue skin, swelling of throat, swelling of eyes or face, weakness, and wheezing.
Cumulative Effect
the increasing response to repeated doses of a drug that occurs when the rate of administration exceeds the rate of metabolism or excretion
Iatrogenic
unexpected side effects resulting from treatment by a physician
Idiosyncratic Effect
a different, unexpected or individual effect from the normal one usually expected from a medication; the occurrence of unpredictable and unexplainable symptoms
Pharmacodynamics
The process by which medications produce their effects in the body (mechanism of action, onset of action, peak effect, duration of action, half-life)
Mechanism of action
The process by which a medication produces its effects
Onset of Action
The time it tkaes for a drug to produce a therapeutic response
Peak Effect
The time it takes for a drug to reach its maximum therapeutic response
Duration of Action
The time the drug concentration is sufficient to elicit a therapeutic response
Half Life
The time it takes the body to eliminate half of the medication
Pharmacokinetics
The study of absorption, distribution, metabolism, and excretion
Receptor Site
where the drug attaches itself to a cell membrane
Substance Abuse
any unnecessary or improper use of chemical substances for nonmedical purposes
Urticaria
also hives; an acute allergic reaction in which round wheals (welts) develop on the skin, usually accompanied by intense itching
What is action affected by?
Developmental factors, gender, cultural, ethnic & genetic factors, psychological factors (what they might expect VS what really happens), environment, diet, illness and/or disease (ESP kidney, liver, cardiovascular), time of administration
Adverse Effect
an effect of a drug which may be unfavorable to the patient’s health; an action or effect, other than that which is desired, such as an allergic reaction
Dosage
the amount of a drug to be administered.
Drug Allergy
an immunologic reaction to a drug
Drug Tolerance
a condition in which successive increases in the dosage of a drug are required to maintain a given therapeutic effect
Drug Toxicity
A harmful effect of a drug on an organism or tissue resulting from an overdose, ingestion of a drug intended for external use, or from a buildup of a drug in the blood due to impaired metabolism or excretion
Generic Name
The name given to a drug by the United States Adopted Names Council. Also called the nonproprietary name. The generic name is much shorter and simpler than the chemical name and is not protected by trademark.
Nursing Implication
helps nurse apply the nursing process to pharacotherapeutics by providing a step by step guide to clinical assessment, implementation, and evaluations of the outcomes of pharmacologic therapy
Side Effect
any effect that is caused by a drug and that is different from the drug’s intended effect. not as severe as adverse effects
Trade Name
The brand name that a manufacturer gives a medication; the name is capitalized.
Therapeutic Effect (Use)
The desired or intended effect of a particular medication.
Alternagel
Aluminum hydroxide
Maalox
Magnesium/Aluminum Suspension
Medication Absorption
The process by which a medication passes into the bloodstream
Medication Distribution
The process by which a medication is transported from its site of absorption to its site of action (receptor site)
Medication Metabolism (biotransformation)
The process by which a medication is changed from its original chemical structure into a less active form, usually one that can be readily eliminated by the body
Medication Excretion
The process by which medications and/or their metabolites are eliminated from the body
Local Effect
The effects of a drug at the site where the drug is applied or in the surrounding tissues
Systemic Effect
General effects caused by distribution of drug throughout body.
What is the most important site for medication metabolism in the body?
The liver
Routes of medication excretion
Primary route is by the kidneys released as urine. Others are feces, breath, perspiration, saliva, and breast milk
Antagonistic Interaction
the effect of one medicine is canceled or reduced when taken with another medicine
Synergistic Interaction
an interaction that occurs when drugs that are taken together combine their actions so that the total effect is greater than either drug would produce alone
Client
Takes medications and reports response
Nurse
responsible for safe and accurate administration of medications, monitors and evaluates, client education
Doctor
Decides appropriate treatment; evaluates it and continues or discontinues the treatment
Pharmacist
Prepares and dispenses medications; monitors and evaluates; client education
Sources of medication information in the health care facility
pharmacopoeia or formulary, nursing pharmacology textbooks and reference drug handbooks, physicians’ desk reference, product package inserts (provide detailed information), nursing journals, pharmacist (when information can not be found elsewhere), and valid internet sites
Nursing Implications
benefits, minimize risks, assessments, storage, preparation, administration, interactions and contraindications, client education
What are the major features of the Controlled Substance Act?
research on abuse, prevention through resources for education, treatment and rehabilitation, enhanced law enforcement, classification system based on abuse potential and medical use of each drug, with limits on how often a prescription can be filled
PRN
as needed
STAT
once, immediately
Seven Parts of a Medication Order
Client’s Full Name, Date including year and time the order is written, Name of Medication, Dose to be given (including frequency), Route of Administration, Frequency of Administration, Signature of Prescriber and their title (must be legible)
Nursing responsibilities associated with controlled substances
must be stored double locked or in computerized system and each dose must be recorded, wasting is witnessed by two nurses and counted at the end of each shift by outgoing and oncoming nurses
Six Rights of Medication Administration
Right Medication, The Right Client, At the Right Time, In the Right Dose, VIA The Right Route, With The Right Documentation
Nursing responsibilities associated with a medication error
first check or assess the client, always acknowledge the error, notify the MD/provide follow-up treatment, document the facts in the client’s record, full out an incident report, and learn from the error
Common Causes for medication errors
failure to read the label, failure to understand the purpose, failure to check the client’s I.D. (two forms of ID), failure to question an unclear order, misreading the label, preparing the wrong dose, using the incorrect route
How does the RN evaluate the client’s response to prn medications?
monitor the client’s response, documents the effect of the medication including both objective and subjective data, as well as any side/adverse/secondary effects. monitor serum blood levels when appropriate for both therapeutic blood levels as well as toxic blood levels and may also check other blood work for signs of side effects
Nursing responsibilities associated with the administration of prn medications
collaborate with client, listen to a client’s complaints, do teaching. judge whether the drug is needed and if it is safe. Assess and evaluate before and after PRN administration. Document data that supports decision to give the PRN, date and time PRN administered and client’s response to PRN.
Standing
Given routinely and perhaps for an unlimited time
Single
Given only once
Factor: developmental
kidney function, immature liver and kidneys, pregnancy
Factor: gender
body fat and water distribution, hormones
Factor: Culture, Ethnicity, and Genetics
abnormal sensitivity or different metabolism, ethnopharmacology (dose and toxicity, enzyme production), a big body needs a big dose
Factor: Diet
Nutrients can effect action (vitamin K and coumadin is an example)
Factor: Environment
hot = vasodilation, cold = vasoconstriction
Factor: Psychologic
what they think might happen (placebo)
Factor: Illness and disease
circulatory, liver, or kidney disease have an effect, consider the patient’s condition and reason the medication is given
Factor: Time of Administration
Meals and sleeping patterns
Rounding rules for tablets (not scored)
5 or up, round up. 4 or below, round down.
Rounding rules for liquids
Carry the calculation to two or three decimal places and round to the nearest tenth or hundredth if needed ex. 4.23 = 4.2 on a 5mL syringe
cc
cubic centimeter
g or gm
gram
gr
grain
kg
kilogram
mcg
microgram
mg
milligram
mL
milliliter
tbsp or T
tablespoon
tsp
teaspoon
DSSP
two teaspoons
1000 mcg
1 mg
60 mg
gr 1
1 g
1000 mg
5 mL
1 tsp
1 cc
1 mL
1 kg
2.2 lbs
1 oz
30 mL
1 qt
1 liter
1 liter
1000 mL
Buccal
toward the inside of the cheek
Medication Dispensing System
hardware/software system for dispensing drugs in a controlled and secure manner by qualified personnel can be a medication cart, cabinet, room or automated dispensing cabinet
Placebo
something presented as a drug, but having no actual effect
Sublingual
under the tongue
Topical
direct application of medication to the skin, eye, ear, nose (inhalation) or other parts of the body
Transdermal
a method of administering medication through the unbroken skin via patch or ointment
P.O. Time
30-60 minutes
I.M. Time
10-15 minutes
I.V. Time
immediate
Sublingual Time
rapid absorption but takes time to dissolve
Topical/Transdermal Time
constant amount released slowly over long period of time
P.R. Time
unpredictable absorption
Subcutaneous Time
poor blood supply to subcutaneous tissue as opposed to muscles leads to slow absorption
Capsule
A gelatinous container to hold a drug in powder, liquid, or oil form
Enteric coated tablet
Medication designed to dissolve in the small intestine rather than the stomach
Elixir
A sweetened and aromatic solution of alcohol used as a vehicle for medicinal agents
Extended (sustained) Release Capsule/Tablet
Preparation that allows for slow and continuous release over a designated time period
Liquid/Solution
Medication dissolved in another substance
Suspension
One of more medications finely divided in a liquid such as water
Syrup
An aqueous solution of sugar often used to disguise unpleasant tasting medications
Nursing responsibilities associated with changing the form of a medication
The nurse can not independently change the form of a medication. When oral medications are ordered and the client develops vomiting, the physician will have to be contacted to change the form of medication administration.
Client situations in which the administration of oral medications is contraindicated
vomiting, gastric or intestinal suction, unconscious, unable to swallow, unable to take anything by mouth (NPO)
ATC
around the clock
ā
artery
h
hour
OD
right eye or overdose. DO NOT USE *
po
by mouth
qid
four times a day
I.M.
intramuscular
OU
both eyes. DO NOT USE *
prn
as needed
q4h
every four hours
tab
tablet
cˉ
with
bid
twice daily
S.C.
subcutaneous. DO NOT USE *
tinct.
tincture
gtt
drop
mEq
milliequivalent
pc
after meals
p bar
after
sl
sublingual
ac
before meals
hs
at bedtime or half strength. DO NOT USE *
OS
left eye. DO NOT USE *
pr
per rectum
qod
every other day. DO NOT USE *
stat
immediately
s bar
without
OTC
over the counter
q
each, every
tid
three times a day
cap
capsule
I.V.
intravenously
QD
Once a day/every day. DO NOT USE *
Elix
Elixer
gr
grain
qh
every hour
qs
as much as needed, as much as suffices
D/C
discharge or discontinue. DO NOT USE *
XR
extended release
SR
slow release
Alternagel
Aluminum hydroxide
Maalox
Magnesium/aluminum suspension
Use of Magnesium/aluminum suspension
adjunctive therapy in the treatment of peptic ulcer pain and to promote healing of duodenal and gastric ulcers. useful in a variety of GI complaints including hyperacidity, indigestion, reflux esophagitis
Action of Magnesium/aluminum suspension
neutralizes gastric acid after dissolving in gastric contents. pepsin is inactivated if pH is raised to 4 or greater.
side/adverse effects of magnesium/aluminum suspension
aluminum salts: constipation. magnesium salts: diarrhea. magnesium salts: hypermagesemia. aluminium salts: hypophosphatemia.
Nursing implications for magnesium/aluminum suspension
magnesium and aluminum are combined as antacids to balance the constipating effects of aluminum with the laxative effects of magnesium.
Use of aluminum hydroxide
antacid, hyperphosphatemia in chronic renal failure, adjunct in gastric, peptic, duodenal ulcers, hyperacidity, reflux esophagitis, heartburn, stress ulcer prevention in critically ill, GERD
Action of aluminum hydroxide
Neutralizes gastric acidity, binds phosphates in GI tract, these phosphates are then excreted
Side/adverse effects of aluminum hydroxide
constipation, obstruction, anorexia, fecal impaction, hypophosphatemia, hypercalciuria
Nursing implications for aluminum hydroxide
avoid phosphate foods, increase fluids to 2L/ day unless contraindicated, not for prolonged use in patients with low serum phosphate or patients on low sodium diets, stools may appear white or speckled, check with prescriber after 2 week of self-prescribed antacid use, separate other medication by 2 hours, assess pain, phosphate, calcium levels, and constipation
