Complete Chp 5

Front 1

chapter 11

Back 1

Geriatric Pharmacology

Front 2

Physiologic Changes in elderly-

Back 2

GI- increased alkaline secreations- result: slower absorption of oral drugs.

Front 3

Physiologic Changes in elderly- cont'd

Back 3

Cardiac & Circ.- decreased blood flow and cardiac output;
result: impaired circ, delay of transport of drugs.

Front 4

Physiologic Changes in elderly- cont'd

Back 4

*Hepatic- decreased enzyme function;
result: drugs metabolized slower.

Front 5

Physiologic Changes in elderly- cont'd

Back 5

*Renal- decreased blood flow, decreased glomerular filtration rate;
result: drugs excreted completely.

Front 6

Terms

Back 6

Chapt 11

Front 7

Compliance-

Back 7

To follow regimen according to prescribed manner.

Front 8

Noncompliance-

Back 8

May not understand regimen or substitute food costs rather than drugs.

Front 9

Polypharmacy-

Back 9

Administration of many drugs.

Front 10

Nonadherence-

Back 10

Fails to ask questions, therefore drug regimen may not be understood.

Front 11

Nursing Interventions-

Back 11

Monitor Client's lab results-

Front 12

Nursing Interventions-

Back 12

Check clients serem drug levels-

Front 13

Nursing Interventions-

Back 13

Communicate with pharmacist or health care provider-

Front 14

Nursing Interventions-

Back 14

Observe client for adverse effects-

Front 15

Nursing Interventions-

Back 15

Recognize changes in clients appearance and behaviors.-

Front 16

Chapter 13

Back 16

The role of the nurse in drug research

Front 17

Basic Ethical Principles-

Back 17

1.Respect for person.
2.Beneficence.
3.Justice.
4.Truth telling

Front 18

Respect for person

Back 18

Autonomy- the right of self-determination.

Front 19

Beneficence

Back 19

The duty to not harm others

Front 20

Justice

Back 20

Requires all people be treated fairly.

Front 21

Truth telling

Back 21

Veracity- the principle that requires health care personnel to tell the truth and the whole truth.

Front 22

Informed Consent

Back 22

Promotion of individual autonomy. MD's responcibility to recieve informed consent.

Front 23

Nurses role during drug study

Back 23

to protect clients from any anticipated harm. Must know all aspects of study.

Front 24

Study designs-

Back 24

quasi-experimental: may contribute variable information but ultimately lack the power to ascribe cause because variables are uncontrolled.

Front 25

Controlled Group

Back 25

Recieve placebo- active control

Front 26

Experimental Group

Back 26

Receives treatment.

Front 27

Human Clinical Experimentation-

Back 27

Phase I
Phase II
Phase III and IV

Front 28

Phase I

Back 28

Primarily designed to "assess" safety. Determine dosage range based on "healthy" humans.
Pharmacokinetics- A.D.M.E.

Front 29

Phase II

Back 29

Demonstate safety and efficacy of the drug in subjects.

Front 30

Phase III & IV

Back 30

Phase III involves large numbers.
Phase IV- Examines potential new indications for approved drugs.

Front 31

Probability Sampling

Back 31

subjects are randomly selected from the entire population.

Front 32

Double Blind study

Back 32

The health care provider and subject are unaware of foms of therapy.

Front 33

Triple Blind study

Back 33

Researcher other than health care provider is also in the dark on forms of therapy.

Front 34

Single Blind study

Back 34

only subject is unaware of forms of therapy.

Front 35

Open-label study

Back 35

all parties, are aware of forms of therapy.

Front 36

The modernization act of 1997:

Back 36

Increased the minimum age for subjects of human experimentation. Requires pediatic evaluation.

Front 37

Chapter 3

Back 37

Principles of drug administration-

Front 38

The Rights of Drug Administration-

Back 38

The right assessment-
The right documentation-
The right to education-
The right evaluation-
The right to refuse-

Front 39

The right assessment-

Back 39

Requires appropriate data be collected before administration of the drug.

Front 40

The right documentation-

Back 40

Requires that the nurse imediately record the appropriate information about the drug administered.

Front 41

The right to education-

Back 41

Requires that clients receive accurate and thorough information about meds.

Front 42

The right evaluation-

Back 42

Requires that the effectiveness of the medication be determined by the client's response to the meds.

Front 43

The client has the right to refuse-

Back 43

Clients can and do refuse to take meds. Determine the reason for refusal.

Front 44

Tablets and capsules-

Back 44

Don't give to vomiting client-
Don't mix with large amts of food.-
Enteric Coated tabs must be taken whole.-

Front 45

Liquids-

Back 45

Read label to determine if dilution or shaken is required.
The "meniscus" is the line of desired dose.

Front 46

Transdermal-

Back 46

Don't cut patches use different sizes.-
Remove old patch before putting on new one.-

Front 47

Topical

Back 47

Applied to skin-
Don't double dip
Wear gloves so medicine doesn't absorb into nurses skin.

Front 48

Instillations-

Back 48

Drops, ointment, or sprays.
Child pull ear downwards.
Adult pull ear upwards.
Eyes pull lower lid down and administer drops. Place finger on lacrimal ducts to prevent systemic circulation.
Keep ear drops at room temp.

Front 49

Suppositories

Back 49

Keep refridgerated.
Use glove for insertion
Have client lie on left side and breathe through the mouth and relax anal sphincter.

Front 50

Vaginal suppositories

Back 50

Client should be lithotomy position.

Front 51

Parenteral

Back 51

Intradermal-
SubQ-
Intramuscular-
Z-track-
Intravenous-

Front 52

Intradermal

Back 52

Local effect. Example: TB testing. 10 - 15 degrees.
25-27 gauge needle.

Front 53

SubQ

Back 53

Systemic effect.
Abdomen, upper hips, upper back, lateral upper arms.
25-27gauge needle
45-90 degree angle.

Front 54

Intramuscular

Back 54

Systemic effect.
Sites- ventrogluteal,dorsogluteal, deltoid, and vastus lateralis(pediatrics).
20-23 gauge needle.
90 degree angle.

Front 55

Z-track

Back 55

Prevents meds from leaking back into the subQ tissue.
See page 41 for technique.

Front 56

Intravenous

Back 56

Systemic effect.
Peripheral veins.
adults- 20-21 gauge
infants- 24 gauge.
children- 22 gauge.

Front 57

See page 43

Back 57

Nusing Process for chapter 3

Front 58

Chapter 7

Back 58

Drug interactions and OTC.

Front 59

Absorption-

Back 59

When two drugs are taken at same time, the rate of absorption of one or both drugs can change.
Drugs that increase the ph of gastric juices decrease absorption of weak-acid drugs.

Front 60

Distribution-

Back 60

Drug's distribution to tissues can be affected by it's binding to plasma/serum protein.

Front 61

2 Drugs that are highly protein bound-and administered.

Back 61

can result in drug displacement.

Front 62

Biotransformation-

Back 62

Enzyme inducers- Drugs that promote induction of enzymes.

Front 63

Biotransformation-

Back 63

Cigarette smoking increases hepatic enzyme activity and can increase theophylline clearance. For smokers who take theoohylline the dose should be increased.

Front 64

Biotransformation-

Back 64

Enzyme inhibitor- decreases the metabolism of certain drugs.

Front 65

Excretion-

Back 65

Most drugs are filtered through the glomeruli and excreted in the urine.
review page 140 table 7-2. drug interactions.