Study Guide – Exam 1 Fall 2008

1. Your patient needs to swallow a pill, but is unable to – what kind of problem
is this – dosage, route, time, etc

2. You are assessing the patient in terms of how the drug is working
and looking for side effects – what part of the nursing process is
this? Evaluation; Monitoring includes observing for therapeutic effects to
drug treatment as well as for adverse effects and toxicity.

3. Five rights of drug administration? Right Drug, Right Dose, Right Time,
Right Route, Right Patient

4. Bioequivalent: If two medications have the same bioavailability and same

concentration of active ingredient.

5. What are some reasons we give meds through the intravenous

route? Provides rapid onset (drug delivered immediately to bloodstream),
allows more direct control of drug level in blood, gives option of larger fluid
volume therefore diluting irritating drugs; avoids first-pass metabolism

6. Parenteral drug route – types, absorption, etc: Dosage forms that are
administered via injections. Fastest rouge by which a drug can be absorbed.
An intravenous injection delivers the drug directly into circulation
(intravenous drug absorbed the fastest); transdermal patches, intramuscular
injections, and subcutaneous injections (usually absorbed over a period of
several hours, days, or weeks). Drugs can be injected intradermally,
subcutaneously, intraarterially, intramuscularly, intrathecally, intraartiularly,
or intravenously.

7. drug’s half-life – define

8. duration of action

9. A med is highly protein bound – what does this mean? There are three
primary proteins that bind to and carry drugs to the bloodstream throughout
the body; albumin, 1-acid glycoprotein, and corticosteroid-binding globulin.
If a given drug binds to plasma proteins as part of its chemical attributes (to
reach their site of action), then there is only a limited amount of drug that is
not bound to protein.

10.Where would you place a sublingual tablet? Sublingual route are

absorbed into the highly vascularized tissue under the tongue – oral mucosa.

11.Absorption, distribution, metabolism, excretion: Pharmacokinetics

Absorption is the movement of a drug from its site of administration into the
bloodstream for distribution to the tissues; a term used to express the extent
 of drug absorption is bioavailability. Distribution refers to the transport of a
drug in the body by the bloodstream to its site of action; rapid distribution –
heart, liver, kidneys, and brain; slower distribution – muscle, skin, and fat.
Metabolism referred to a biotransformation because it involves the
biochemical alteration of a drug into an inactive metabolite, a more soluble
compound, or a more potent active metabolite; organ responsible for
metabolism of drugs is the liver, others include skeletal muscle, kidneys,
lungs, plasma, and intestinal mucosa. Excretion is the elimination of drugs
from the body; organ responsible for elimination is the kidney.

12.Why is drug transfer to the fetus more likely in the third trimester?
During the last trimester the greatest percentage of maternally absorbed
drug gets to the fetus. This is the result of enhanced blood flow to the fetus,
increased fetal surface area, and increased amount of free drug in the
mother’s circulation. Maternal factors can also play a role in determining
drug effects on the fetus. Any changes in the mother’s physiology that could
impact the pharmacokinetic characteristics of drugs (absorption, distribution,
metabolism, and excretion) can affect the amount of drug to which the fetus
may be exposed

13.What is polypharmacy

14.Confusion, forgetfulness, and increased risk for falls are common reactions
for the elderly taking which type of medication

15.What information needs to be taken into account in the pediatric population

to deliver accurate drug dosages

16.The elderly produce decrease hydrochloric acid (HCl) – how does this affect
drug administration, absorption, etc

17.Why is drug toxicity more likely in neonates

18.What is the best way for the nurse to give a liquid medication, which
tastes terrible to a 21/2 year old child? Mix medication in substance or
fluid that can make the medications taste better, i.e. sherbet or flavor ice
cream.

19.How do researchers prepare participants in a drug study – what must take

place

20.Schedule II narcotics, schedule III narcotics – can these meds be refilled

21.What does it mean when an informed consent has been signed by a patient
to receive an experimental medication
22.What do different cultures value – who values heat, alternative therapies, and
the balance of opposing forces

23.Hispanic culture

24.What drug legislation required proof of safety and efficacy for drugs? The FDA
classifies drugs according to their safety for use

25.Examples of med errors

26.How should a med order be written out? What is your action if you cannot
read the writing when transcribing an order

27.Measurable goal: Goals are objective, measurable, and realistic, with an

established time period for achievement of the outcomes, which are
specifically stated in the outcome criteria.

28.What is the best way to teach learn a manual skill such as drawing up insulin

29.What suggestions can be made to assist an elderly patient to remember to

take their medications

30.Pain/ analgesic agents