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69 Cards in this Set
- Front
- Back
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What are the steps of the nursing process?
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1. Assessment 2. Nursing Diagnosis 3. Planning 4. Implementation 5. Evaluation |
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What is the difference between subjective and objective data? Give an example of each. |
i.e.: headache, allergies, health history Objective data is what the nurse observes/sees. i.e.: BP, HR, lab results |
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How do you formulate a nursing diagnosis?
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Nursing diagnoses can be found on the North American Nursing Diagnosis Association International (NANDA-I) list. |
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What are the three steps involved in making a nursing diagnosis?
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1. Patient's response to illness 2. Identifies the factor(s) related to the response 3. Patient's data that supports the diagnosis (signs/symptoms) |
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It is essential that the goals and outcomes listed in the planning process are _____________, ____________, ______________, and _____________.
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measurable, realistic, specific, objective |
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What is implementation?
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actual tasks/care plan is carried out
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Why do nurses need to evaluate the patient after providing care/implementing care plan?
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Reassessing the patient is necessary to see if the intervention worked. Goals & outcomes are monitored and new data is collected and analyzed. DID IT WORK? |
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What are the six rights of medication administration?
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Right dose Right time Right route Right patient Right documentation |
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True or false: nurses are able to take verbal/over-the-phone orders from prescribers.
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True! However, the order must be signed by the prescriber within 24 hours (or as per hospital protocol). |
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Why are trailing zeros not allowed?
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Because 2.0 mg could be mistaken for 20 mg! That increases the chance for medication error and jeopardizes patient safety! |
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Which two populations/age groups are more sensitive to drugs, and therefore a high risk for overdose?
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Children (immature organs) and the elderly (organ deterioration). |
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True or false: Q.I.D. is an acceptable abbreviation that can be used when documenting medication administration time.
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False! Just write it out! Decreases error! |
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The current time is 1400. A nurse is instructed to give a patient medication at 1330, however was too busy to administer it at the right time. What should she do?
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It's okay to administer the medication now, based on the 1/2 hour before and after rule.
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If there is a medication error, what steps does the nurse need to take to document it? Where do these documents go?
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An incident report must be completed, however it is not part of the patient's medical chart. |
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Define a drug.
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any chemical that affects the physiologic processes of a living organism |
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What are the three types of drug names? Which of the three is universal and used in the NCLEX? |
Chemical, generic, trade |
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Why would you use the trade name?
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Patient's are typically more familiar with brand name drugs. |
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Define pharmacology.
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What is the different between pharmacokinetics and pharmacodynamics? |
Pharmacodynamics: what the drug does to the body (the effects of drugs and their mechanisms of action) |
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Explain why enteric-coated tablets are absorbed slower than buccal tablets.
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Enteric-coated tablets are suited to be absorbed in the intestines while buccal tablets are most likely meant to be absorbed through the mucous membranes in the mouth. |
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Why wouldn't you crush extended release drugs?
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They have longer absorption and duration of action, meaning they stay in the body longer. They are formulated to last longer; crushing them would decrease the time and make them work faster than intended.
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What do the following abbreviations stand for? SR, SA, CR, XL, XT |
SA - sustained action CR - control release XL - extended length XT - extended time |
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What are the four processes of pharmacokinetics?
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Absorption, Distribution, Metabolism, Excretion |
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Why is it important that the nurse knows whether the patient has a functioning liver and kidneys? |
Although metabolism and excretion can occur in other places in the body, the liver and kidneys are the major organs responsible for these two vital functions in pharmacokinetics.
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Where are acidic drugs absorbed?
Alkaline drugs? |
Acidic drugs are absorbed in the stomach. Alkaline drugs are absorbed in the small intestine. |
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Why are most drugs fat-soluble?
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Fat-soluble drugs are more readily absorbed through the phospholipid bilayer of cells. Water-soluble drugs cannot easily pass the membrane and therefore require active transport mechanisms. |
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How is bioavailability affected by "first-pass effect"?
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They are inversely related. If a drug has high first-pass effect, it has low bioavailability. |
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How would you administer a drug with high first-pass effect? |
Parenteral: IV, IM, SC Topical |
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Albuterol is administered using a nebulizer. How would you classify this route?
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How would you classify a drug given rectally (i.e.: suppository)? |
Enteral or Topical |
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What factors influence drug distribution?
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Blood supply, protein-binding, water/fat-soluble, blood-brain barrier |
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Regarding blood supply and drug distribution, what are the areas of rapid distribution? Areas of slow distribution?
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Slow: muscle, skin, fat, bone |
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True or false: A patient comes in with a sinus infection. You would administer a lower dose of oral antibiotic.
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False! A stronger dose of oral antibiotic is necessary because it's difficult for the drug to be distributed to the sinus cavities. |
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True or false: protein-binding is a characteristic which increases the duration of action for a drug. |
True! If a drug binds to the surface of a protein, it stays within the bloodstream longer (does not readily leave the bloodstream into interstitial fluid). |
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True or false: heroin can cross the blood-brain barrier.
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True! Heroin as well as other street drugs and opioids can pass through the blood-brain barrier. |
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Define metabolism.
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Changing the chemical structure of the drug to get it out of the body.
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Other than the liver, where else in the body can metabolism occur?
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Skeletal muscle, kidneys, lungs, plasma, intestinal mucosa |
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Acetaminophen has a half-life of 2 hours and 500 mg is administered. In 2 hours how much is left?
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250 mg after 2 hours |
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Most drugs are considered to be effectively removed after how many half-lives?
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five half-lives (~97%) |
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Explain the relationship between onset, peak, and duration.
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Onset is the time it takes for the drug to elicit a therapeutic response. After the initial therapeutic response begins, the peak describes how long it takes to reach it's maximum potential. The duration includes both the onset and peak, and is the time a drug concentration is sufficient to elicit a therapeutic response. |
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At which point during drug monitoring is the patient most susceptible to toxicity?
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Peak level because it is the highest drug concentration level. |
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Why is it important to note the trough level?
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True of false: the narrower the TI, the safer the drug.
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False! TI is the therapeutic index of the drug. If it is too narrow, the drug is considered toxic. If the TI is wide it is considered safe (provides a larger margin of therapeutic drug concentration). |
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How are nonselective interactions different than receptor interactions?
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With receptor interactions, drugs bind to a receptor to elicit a bodily response. Nonselective interactions don't have anything to do with receptors (i.e.: antibiotics). |
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Drug binds to the receptor; there is no response. Drug prevents binding of agonists. This describes what type of drug? |
Antagonist |
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How is acute therapy different from maintenance therapy?
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Acute therapy provides immediate relief while maintenance therapy maintains a bodily function within normal range for an extended period of time. |
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True or false: tolerance can be described as the physiologic or psychological need for a drug.
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False! Tolerance is a decreasing response to repeated drug doses. The description provided was the definition of dependence. |
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What is an idiosyncratic reaction? |
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Which racial group is predicted to be nearly 1 in 3 U.S. residents in 2050? |
Hispanics |
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What is the function of the DEA?
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Drug Enforcement Agency - responsible for monitoring and controlling the distribution of drugs (i.e.: opioids) |
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___________ are the actions that a reasonable and prudent nurse with equivalent preparation would do under similar circumstances.
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Standards of care |
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True or false: medication errors are inevitable (there's nothing you can do to prevent them).
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False! Medication errors are preventable. |
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True or false: Nurses are the ones solely responsible for medication errors.
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Patients are also contributors to medication error. |
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What are some examples of beneficial policies and procedures to help minimize medication error?
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Correctly storing medication, reading drug label, avoiding drug transfer between containers, avoiding overstocking to prevent expiration, monitoring compliance, remove outdate reference books
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Which population/age group are you most likely to observe polypharmacy?
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Geros! Elderly patients usually have to take multiple prescriptions and they may or may not have conflicting pharmacologic actions |
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What does medication reconciliation mean?
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Medications are "reconciled" at all points of entry and exit to/from a healthcare facility. Ensures patient is taking the same types of medications as at home. |
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What are the three domains of learning?
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Affective - feelings, needs, beliefs, values Psychomotor - doing & skills |
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Give at least three examples of nursing diagnoses that pertain to patient education.
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Deficient knowledge, impaired memory, ineffective self-health management, readiness for enhanced self-health management, noncompliance, risk for falls, risk for injury, sleep deprivation |
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How would you ensure a diabetic patient knows how to administer his own insulin shot?
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Return demonstration. Have the patient show you that they know how to use the equipment. |
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Partial agonist
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Medications attach and produce only a small response or prevent other reactions from occurring
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True or false: the duration of action of a medication corresponds to the rate of metabolism.
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True! |
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What factors influence the rate of absorption?
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administration route, ability of a medication to dissolve, blood flow to the administration site, body surface area, and lipid solubility of the medication
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___________ is the study of medications and their origin, nature, properties, and effects on living organisms. |
Pharmacology
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________________ describes how a medication enters the body, passes into body fluids and/or tissues, and influences the route of medication administration.
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Absorption
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What would make a patient high risk for an ADE?
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Pregnant women and patients with chronic disorders (i.e.: hypertension, epilepsy, heart disease, psychoses)
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Where do you record a patient's allergies?
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MAR (Medical Administration Record) |
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True or false: Patients hospitalized for acute episodes of illness usually do not develop tolerance.
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True! |
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What is cross-tolerance?
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Cross-tolerance is a phenomenon that occurs when someone who is tolerant to the effects of a certain drug also develops a tolerance to another drug.
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