Complete Exam 1 Study Guide-NUR2474 Pharm
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Exam 1 Review Guide NUR2474 Pharmacology
Quiz 1 1.
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Nursing process as it relates to med administration a. 6 Rights of Med Admin i. Patient ii. Drug iii. Dose iv. Time v. Route vi. Documentation b. Extra rights to med admin i. Assessment ii. Evaluation iii. Patient to education iv. Patient to refuse care c. Biggest medication error is misinterpreting prescriptions i. Do not assume if something is unclear about an order. Clarify with prescriber. ii. TORB and VORB d. Pre- and post- medication administration assessment and interventions i. Pre 1. If patient is complaining of pain 10/10, intervene (prn meds, standing orders, call physician for new orders) then assess. 2. Collection of baseline data to evaluate therapeutic effects and adverse effects 3. Identification of high-risk patients 4. Assessment of the patient’s capacity for self-care 5. Allergies? a) Collect history. What happens during an allergic reaction? b) If patient is having an allergic reaction: primary intervention is to STOP THE MEDICATION THAT IS CAUSING THE REACTION. 6. If patient refuses drug, determine why. INVESTIGATE. ii. Post 1. Therapeutic response 2. Adverse reaction and interaction 3. Adherence to treatment 4. Satisfaction with treatment Patient teaching for medication therapy in general (safety, compliance, etc.) a. Teaching i. Safety 1. If medication causing certain side effects, consult physician. ii. Compliance 1. It is important not to stop or change a medication without consulting the physician. 2. Take medications as prescribed and for the reason they are prescribed. Side effects vs adverse effects vs allergies a. Side effects i. Nausea, vomiting, expected and unavoidable reactions, drug effects produced at therapeutic level. b. Adverse effects
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i. Noxious, unintended, and undesired effect that occurs at normal drug doses, harmful at therapeutic level. c. Allergies i. Redness, itching, hives, swelling; A condition in which the immune system reacts abnormally to a foreign substance. Intended effect, teratogenic effect, paradoxical effect, tolerance a. Intended effect i. Maintenance of vital signs within expected limits ii. Decrease in the risk of seizures iii. Decrease in the intensity of withdrawal manifestations iv. Substitution therapy during alcohol withdrawal b. Teratogenic effect i. Drug-induced birth defect ii. Birth defects are not limited to distortions of gross anatomy; they also include neurobehavioral and metabolic anomalies c. Paradoxical effect i. Opposite the intended drug effect ii. Common example 1. Insomnia and excitement that may occur when some children and older adults are given benzodiazepines for sedation. d. Tolerance i. Pharmacodynamic tolerance 1. Reduced responsiveness to a medication that clients take over time. ii. Metabolic tolerance 1. Metabolism of medication increases over time and the effectiveness of the medication declines. iii. Cross-tolerance 1. Become tolerant to a medication that is chemically similar to another medication they became tolerant of. Half-life of medications a. Defined as the time required for the amount of drug in the body to decrease by 50% b. Percentage versus amount c. Determines the dosing interval d. Modafinil (CNS suppressant; narcolepsy) i. about 15 hours e. Phenytoin (Seizures) i. 8-60 hours 1. lower doses: 8 hours 2. higher doses: 60 hours f. Fluvoxamine (SSRI) i. About 15 hours g. Citalopram (SSRI) i. About 35 hours h. Duloxetine (SNRI) i. 12 hours
Quiz 2 6.
Donepezil (Aricept) therapy in patients with Alzheimer’s disease a. Alzheimer’s Disease
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