Pharm Test #1

Front 1

How do drugs and nutrients cross the fetus?

Back 1

by diffusion

Front 2

what trimester has generally the greatest danger of drug-induced developmental defects?

Back 2

1st trimester

Front 3

what are the three factors that contribute to the safety or potential harm of drug therapy during pregnancy?

Back 3

drug properties, fetal gestational age, and maternal factors

Front 4

the drug's chemistry, dosage, and concurrently administered drugs is referred to as?

Back 4

drug properites

Front 5

during what trimester is drug transfer to the fetus most likely to occur?

Back 5

last trimester

Front 6

why is drug transfer more common in the final trimester?

Back 6

because there is increased blood flow to the fetus, increased fetal surface area, and increased amount of free drug in the mother's circulation

Front 7

who implemented pregnancy safety categories?

Back 7

FDA

Front 8

which pregnancy safety category is under the description of "Studies indicate no risk to the human fetus?"

Back 8

Category A

Front 9

Which pregnancy safety category is under the description "Studies indicate no risk to the animal fetus; information for humans is not available"

Back 9

Category B

Front 10

Which pregnancy safety category is under the description "Adverse effects reported in the animal fetus; information for humans is not available"

Back 10

Category C

Front 11

Which pregnancy safety category is under the description "Possible fetal risk in humans has been reported;however, in selected cases consideration of the potential benefit versus risk may warrant use of these drugs in pregnant women"

Back 11

Category D

Front 12

Which pregnancy safety category is under the description of "Fetal abnormalities have been reported, and positive evidence of fetal risk in humans is available from animal and/or human studies. These drugs are not to be used in pregnant women

Back 12

Category X

Front 13

what type of infants are at a risk for exposure to drugs consumed by the mother?

Back 13

breastfed infants

Front 14

The ultimate decision as to whether a breastfeeding mother takes a particular drug depends on?

Back 14

risk/benefit ratio

Front 15

maximum age for a pediatric patient may be identified as?

Back 15

16 years of age

Front 16

younger than 38 weeks gestation?

Back 16

premature or preterm infant

Front 17

younger than 1 month

Back 17

neonate or newborn infant

Front 18

1 month up to 1 year

Back 18

infant

Front 19

1 year up to 12 years?

Back 19

child

Front 20

Why do pediatric patients handle drugs much differently than adult patients?

Back 20

because their vital organs are still immature

Front 21

what are some considerations for neonatal and pediatric patients when being prescribed meds?

Back 21

absorption, distribution, metabolism, and excretion

Front 22

What is important to know about absorption in neonatal and pediatric patients?

Back 22

gastric pH less acidic until 1 to 2 years of age, gastric emptying slowed, and intramuscular absorption faster and irregular

Front 23

more drugs enter the brain of a neonatal and pediatric patient because?

Back 23

their blood brain barrier is still immature

Front 24

what does not produce enough microsomal enzymes in a childs metabolism?

Back 24

an immature liver

Front 25

why are older children required to have a higher dose of meds compared to infants?

Back 25

because older children have increased metabolism

Front 26

what organ has to do with excretion?

Back 26

the kidney

Front 27

glomerular filtration rate and tubular secrection are affected in neonatal and pediatric patients due to?

Back 27

kidney immaturity

Front 28

a decreased perfusion rate of the kidneys may reduce?

Back 28

excretion of drugs

Front 29

Why is it not recommended to give little kids cold/cough meds?

Back 29

because their body can't excrete it fast enough so when parents give them meds every few hours their body isn't getting rid of it and its storing at toxic levels in the childs body

Front 30

what are some factors affecting pediatric drug dosages?

Back 30

skin is thin and permeable (limit baby lotion), stomach lacks acid to kill bacteria, lungs have weaker mucus barriers, body temperatures less well regulated and dehydration occurs easily, liver and kidneys are immature which impair drug metabolism and excretion

Front 31

when performing dosage calculations for pediatric patients what unit of weight should you always use?

Back 31

kilograms (NOT POUNDS)

Front 32

when performing dosage calculations for pediatric patients what unit of measure should you always use?

Back 32

centimeters (NOT INCHES)

Front 33

what is the most common method of dosage calculation for pediatric patients called and what is it measured in?

Back 33

body weight dosage calculations (mg/kg)

Front 34

what are ericksons 8 stages of development?

Back 34

infancy(birth to 1 year old), toddler hood (1-3), preschool age(3-6), school age(6-12), adolescence(12-18), young adulthood (18-45), middle adult hood(45-65), older adult hood (over 65)

Front 35

what is the age for "older adults"

Back 35

older than age 65

Front 36

what age group has a high use of medications?

Back 36

older adults

Front 37

the simultaneous use of multiple medications is called?

Back 37

polypharmacy

Front 38

What is the age approval range for meds?

Back 38

13-65 years old

Front 39

older adult patients handle drugs physiologically differently than adult patients due to?

Back 39

decline in organ function that occurs with advancing age

Front 40

the older adult patients are more likely to not take meds due to noncompliance or non adherence..what does this mean?

Back 40

some patients want to take their meds but truly cannot afford the medicine

Front 41

What are the most important organs from the standpoint of the breakdown and elimination of drugs?

Back 41

liver and the kidneys

Front 42

gastric pH less acidic, gastric emptying slowed, movement through GI tract slowed because of decreased muscle tone and activity, blood flow to GI tract reduced, absorptive surface of GI tract reduced

Back 42

absorption

Front 43

lower total body water percentages, INCREASED fat content, decreased production of proteins by the liver resulting in decreased protein binding of drugs (and increased circulation of free drugs)

Back 43

Distribution

Front 44

When the aging liver produces fewer microsomal enzymes and blood flow is reduced, what does that affect?

Back 44

drug metabolism

Front 45

When excretion is not properly working in the older adults, what can that cause when the patient is taking meds?

Back 45

a toxic effect on the body due to meds not being excreted out of the body fast enough

Front 46

Decreased glomerular filtration rate and decreased number of nephrons

Back 46

excretion

Front 47

What type of common complications are associated with the medications "sedatives and hypnotics"?

Back 47

confusion, daytime sedation, ataxia, lethargy, increased risk for falls

Front 48

what types of common complications are associated with the medication "Thiazide diuretics"?

Back 48

electrolyte imbalance, rashes, fatigue, leg cramps, dehydration

Front 49

what are some considerations that should be taken for medication administration of older adults?

Back 49

age, allergies to drugs and foods, dietary habits, financial status and any limitations, list of all health-related care providers, (sensory, visual, hearing, cognitive, and motor-skill deficits), list of medications, existence of polypharmacy, self-medication practices, lab test results, history of smoking/alcohol, risk situations related to drug therapy

Front 50

what does KSA stand for?

Back 50

knowledge, skills and attitudes

Front 51

what are the six major initiatives of QSEN?

Back 51

patient-centered care, teamwork & collaboration, evidence based practice (EBP), quality improvement, safety, and informatics

Front 52

A research-based organizational framework for professional nursing practice that ensures the delivery of thorough, individualized, and quality nursing care to patients

Back 52

the nursing process

Front 53

What are the five steps of the nursing process?

Back 53

assessment, diagnosis, planning, implementation, evaluation

Front 54

data collection, review, and analysis?

Back 54

assessment

Front 55

What are some examples of objective data?

Back 55

blood pressure reading, specific drugs that the patient is taking, calling the pharmacy to get a med list

Front 56

what type of data involves the patient describing how they feel?

Back 56

subjective data

Front 57

These are used to communicate and share information about the patient and the patients experience?

Back 57

nursing diagnosis

Front 58

failure to act in accordance with a wish or command

Back 58

non-compliance

Front 59

what are some common nursing diagnoses related to drug therapy?

Back 59

deficient knowledge (never used it before), risk for injury (especially in elderly if they fall), noncompliance

Front 60

How would you write a nursing diagnosis?

Back 60

the problem related to etiology (causes) as evidence by signs and symptoms

Front 61

which step of the nursing process identifies goals and outcome of criteria?

Back 61

planning

Front 62

in the planning phase of the nursing process, what do the goals need to contain?

Back 62

they need to be patient focused, measurable, realistic, and established within an achievable time period

Front 63

Initiation and completion of specific nursing actions as defined by the nursing diagnoses, goals, and outcome criteria

Back 63

implementation

Front 64

Implementation of nursing actions may be?

Back 64

independent, dependent, or collaborative

Front 65

What are the six rights of medication administration?

Back 65

Right drug, right dose, right time, right route, right patient, right documentation

Front 66

ongoing part of the nursing process that determines the status of the goals and outcomes of care?

Back 66

evaluation

Front 67

Nursing diagnoses have been developed through a formal process conducted by?

Back 67

NANDA-I

Front 68

any chemical that affects the physiologic processes of living organisms

Back 68

drug

Front 69

study or science of drugs

Back 69

pharmacology

Front 70

Describes the drug's chemical composition and molecular structure?

Back 70

chemical name

Front 71

Name given by the Unites States Adopted Names council

Back 71

generic name

Front 72

(non proprietary name)

Back 72

generic name

Front 73

the drug has a registered trademark; use of the name is restricted by the drug's patent owner (usually the manufacturer)

Back 73

trade name

Front 74

proprietary name

Back 74

trade name

Front 75

What name do we have to know the drug by?

Back 75

the generic name

Front 76

Which name is NEVER capitalized?

Back 76

generic

Front 77

Which name is ALWAYS capitalized?

Back 77

TRADE NAME

Front 78

the study of how various drug forms influence the way in which the drug affects the body

Back 78

pharmaceutics

Front 79

dissolving of solid forms and their absorption

Back 79

dissolution

Front 80

name the drug absorption of various oral preparations from fastest to slowest?

Back 80

oral disintegration, liquids/syrups, suspension solutions, powders, capsules, tablets, coated tablets, and enteric-coated tablets

Front 81

what does xl, xr, cr indicate?

Back 81

extended release pills (takes them longer to be released in the body)

Front 82

The study of what the body does to the drug

Back 82

Pharmacokinetics

Front 83

What are the 4 different phases of pharmacokinetics?

Back 83

absorption, distribution, metabolism, excretion

Front 84

the movement of a drug from its site of administration into the bloodstream for distribution to the tissues

Back 84

absorption

Front 85

extent of drug absorption

Back 85

bioavailability

Front 86

drug passes through the liver before it goes into full systemic circulation; it may get metabolized partially in the liver...what is this know as?

Back 86

first pass effect

Front 87

are IV's 100% bioavailable?

Back 87

yes

Front 88

Why are bioavailability and first pass effect important?

Back 88

because IV and oral meds will be in different dosages from each other due to their bioavailability

Front 89

The drug is absorbed into the systemic circulation through the mucosa of the stomach and/or small or large intestine (GI tract)

Back 89

enteral route

Front 90

what are some examples of enteral route?

Back 90

oral, sublingual, buccal, rectal

Front 91

this type of route absorbed meds under the tongue

Back 91

sublingual route

Front 92

drugs administered through the oral mucosa between the cheek and the gum

Back 92

buccal route

Front 93

What is the fastest route by which a drug can be absorbed?

Back 93

parenteral route

Front 94

any route of administration other than the GI tract and most commonly refers to injection

Back 94

parenteral route

Front 95

application of medications to various body surfaces

Back 95

topical route

Front 96

drug delivery through adhesive parches (absorbed into skin)

Back 96

transdermal route

Front 97

drugs are delivered to the lungs as micrometer-sized drug particles through what type of route? example:inhaler

Back 97

inhaled route

Front 98

directed into the muscle through a shot; not as fast as IV, but faster than oral

Back 98

intramuscular

Front 99

directed into fatty tissue

Back 99

subcutaneous

Front 100

injections under the more superficial skin layers immediately underneath the epidermal layer of skin and into the dermal layer are known as what type of injections?

Back 100

intradermal

Front 101

injection into the artery

Back 101

intraarterial

Front 102

a spine injection

Back 102

intrathecal

Front 103

injection into the joints

Back 103

intraarticular

Front 104

why are ointments sometimes hard to use on patients?

Back 104

because absorption rates may vary depending on the person and the type of ointment being used

Front 105

What are some examples of topical routes?

Back 105

skin, eyes, ear, nose, lungs (inhalation), rectum, vagina

Front 106

transport of a drug bu the bloodstream to its site of action

Back 106

distribution

Front 107

what are the 1st and 2nd areas where drugs will be distributed to the fastest?

Back 107

first are areas with greatest blood supply then second are extra-vascular areas

Front 108

occurs when the presence of one drug increases or decreases the actions of another drug that is administered concurrently (at different times)

Back 108

drug-drug interaction

Front 109

The most common blood protein and carries the majority of protein bound drug molecules

Back 109

albumin

Front 110

some drugs like to bind to albumin but not all of the drug stays bound so those molecules can pass through?

Back 110

vascular system

Front 111

what type of drug can be administered to someone who has a failure to thrive diagnoses?

Back 111

highly protein bound drug

Front 112

if protein levels are low, what are albumin levels like?

Back 112

albumin levels are usually low

Front 113

This is also referred to as "biotransformation"

Back 113

metabolism

Front 114

This involves biochemical alteration of a drug into an inactive metabolite, a more soluble compound, a more potent active metabolite, or a less active metabolite

Back 114

metabolism

Front 115

inactive drug converted to active form by the liver

Back 115

prodrug

Front 116

What organ is used for metabolism?

Back 116

liver

Front 117

if a drug is a prodrug, then what type of condition must the liver be in?

Back 117

patient must have a good liver to activate the drug when passed through the liver

Front 118

what lab tests do you perform to check for liver function?

Back 118

bilirubin, AST, ALT, Alk-phos

Front 119

very large class of hepatic enzymes that control reactions that aid in the metabolism of medications

Back 119

cytochrome P-450 enzymes

Front 120

what is another name for cytochrome P-450 enzymes?

Back 120

microsomal enzymes

Front 121

"fat loving"

Back 121

lipophilic

Front 122

"water loving"

Back 122

hydrophilic

Front 123

what body organ is used for excretion?

Back 123

kidney

Front 124

what are the lab tests done to check kidney function?

Back 124

BUN (blood, urea, nitrogen), creatinine (CR)

Front 125

Elimination of drugs from the body?

Back 125

excretion

Front 126

What is the primary excretion?

Back 126

renal excretion

Front 127

drugs that are eliminated by this route are taken up by the liver, released into the bile, and eliminated in the feces

Back 127

biliary excretion

Front 128

Between the BUN and the creatinine tests, which one can change based on diet?

Back 128

BUN

Front 129

What does it mean when creatinine levels are > than 1.1?

Back 129

then kidneys are stressed and not functioning like they should be

Front 130

time required for half (50%) of a given drug to be removed from the body

Back 130

half-life

Front 131

refers to the physiological state in which the amount of drug removed via elimination is equal to the amount of drug absorbed with each dose

Back 131

steady state

Front 132

what helps to keep consistent drug levels and max therapeutic benefits?

Back 132

steady state

Front 133

highest blood level

Back 133

peak level

Front 134

lowest blood level

Back 134

trough level

Front 135

If peak blood level is too high, what may occur?

Back 135

toxicity

Front 136

Physiological reaction of the body to the drug

Back 136

drug effect

Front 137

time required for the drug to elicit a therapeutic response (usually between 30-60 minutes)

Back 137

onset of action

Front 138

time required for a drug to reach its maximum therapeutic response; happens within duration of action

Back 138

peak effect

Front 139

the length of time that the drug concentration is available to elicit a therapeutic response

Back 139

duration of action

Front 140

peak and trough values are measured to verify adequate drug exposure, maximize therapeutic effects, and minimize drug toxicity.

Back 140

therapeutic drug monitoring

Front 141

what is the therapeutic index?

Back 141

the point between the peak level and toxic level

Front 142

what is the therapeutic range?

Back 142

the point from where the patient first starts to feel the effect of the drug until it becomes toxic

Front 143

How is narrow therapeutic range likely to be monitored?

Back 143

through labs

Front 144

The study of what the drug does to the body and how its working inside the body

Back 144

pharmacodynamics

Front 145

What are the three mechanisms of action in pharmacodynamics?

Back 145

1. receptor interactions

2. enzyme interactions

3. nonselective interactions

Front 146

drugs that completely attach to receptor site and mimic response

Back 146

agonist drug

Front 147

drugs that attach to receptor site but block the response

Back 147

antagonist

Front 148

These drugs can either physically interfere with or chemically alter cellular structures or processes

Back 148

nonselective interactions

Front 149

substances that catalyze nearly every biochemical reaction in a cell?

Back 149

enzymes

Front 150

can be defined as a reactive site on the surface or inside of a cell?

Back 150

receptor

Front 151

The clinical use of drugs to prevent and treat diseases

Back 151

pharmacotherapeutics

Front 152

any condition that makes drug therapy dangerous to the patient

Back 152

contraindications

Front 153

involves more intensive drug treatment and is implemented to those with rapid onset of illness

Back 153

acute therapy

Front 154

therapy that will prevent progression of a disease or condition

Back 154

maintenance

Front 155

therapy that supplies the body with a substance needed either because it cannot be made by the body or because it is produced in insufficient quantity

Back 155

supplemental therapy

Front 156

goal of this therapy is to try and make the patient as comfortable as possible

Back 156

palliative therapy

Front 157

therapy that maintains the integrity of body functions while the patient is recovering from illness or trauma

Back 157

supportive therapy

Front 158

drug therapy provided to prevent illness or other undesirable outcomes during planned events

Back 158

prophylactic therapy

Front 159

therapy that is given based on clinical probability; when a certain pathologic condition has a high likelihood of occurrence based on the patients initial presenting symptoms

Back 159

empiric therapy

Front 160

beneficial affect

Back 160

therapeutic action

Front 161

side effect of a drug that needs to be addressed

Back 161

adverse affect

Front 162

a greater level of harm and can be life threatening

Back 162

toxic effects

Front 163

ratio of toxic level to level of therapeutic benefit

Back 163

therapeutic index

Front 164

value of drug that is in your blood

Back 164

drug concentration

Front 165

asking patient how they are doing or knowing what their disease is

Back 165

patient condition

Front 166

decreasing response to repeated drug doses

Back 166

tolerance

Front 167

physiologic or psychological need for a drug

Back 167

dependence

Front 168

physiological need for a drug to avoid physical withdrawal symptoms

Back 168

physical dependence

Front 169

also known as addiction and is the obsessive desire for the euphoric effects of a drug

Back 169

psychological dependence

Front 170

alteration of one drug by another

Back 170

drug interactions

Front 171

when two drugs with similar actions are given together they can have what type of effect?

Back 171

additive effects

Front 172

2 drugs interact and combine so that effect is great when given together

Back 172

synergistic effects

Front 173

2 drugs interact in body and overall effect decreases

Back 173

antagonistic effects

Front 174

2 meds interact and form chemical reactions which form a precipitate and that is dangerous to the body

Back 174

incompatibility

Front 175

any undesirable occurrence involving medications

Back 175

adverse drug event

Front 176

stop medication abruptly or too soon

Back 176

adverse drug withdrawal event

Front 177

preventable situation in which there is a compromise in the "Six Rights" of medication use

Back 177

medication error

Front 178

any reaction to a drug that is unexpected and undesirable and occurs at therapeutic drug dosages

Back 178

adverse drug reaction

Front 179

extension of the drug's normal effects in the body

Back 179

pharmacologic reaction

Front 180

patients immune system recognizes it as foreign body and tries to attack it (patient suffers from hives, swollen throat, etc.)

Back 180

hypersensitivity (allergic) reaction

Front 181

not the result of a known pharmacologic property of a drug or of a patient allergy, but instead occurs unexpectedly in a particular patient

Back 181

idiosyncratic reaction

Front 182

occurs when the presence of two or more drugs in the body produces an unwanted effect

Back 182

a drug interaction

Front 183

structural defects in the fetus

Back 183

teratogens

Front 184

permanent changes in the genetic composition of living organisms and consist of alterations in chromosome structure, number of chromosomes, or the genetic code of the DNA

Back 184

mutagenic

Front 185

cancer-causing effects of drugs, other chemicals, radiation, and viruses

Back 185

carcinogenic effects

Front 186

The study of natural (versus synthetic) drug sources (examples: plants, animals, minerals)

Back 186

Pharmacognosy

Front 187

study of the economic factors influencing the cost of drug therapy

Back 187

pharmacoeconomics

Front 188

Science of the adverse effects of chemicals on living organisms

Back 188

toxicology

Front 189

deals specifically with the care of poisoned patients

Back 189

clinical toxicology

Front 190

this medicine is based on science, evidence, and research

Back 190

western medicine

Front 191

deals with herbal substances and nonspecific scientific alternatives

Back 191

eastern medicine

Front 192

Body of knowledge for understanding the specific impact of cultural factors on patient drug response

Back 192

Ethnopharmacology

Front 193

What has a huge influence on how one person may react to a drug compared to someone else?

Back 193

genetics

Front 194

Are there resources available to seek additional info about cultural factors?

Back 194

yes; many online resources like CDC, etc.

Front 195

variation in response to a drug because of a patient's age, gender, size, and/or body composition

Back 195

drug polymorphism

Front 196

same drug may result in a different result in a different individual

Back 196

drug polymorphism

Front 197

A type of warning that appears in a drug's prescribing information and is required by the U.S. food and drug administration to alert prescribers of serious adverse events that have occurred with the given drug

Back 197

black box warning

Front 198

The customary beliefs, social forms, and material traits of a racial, religious, or social group

Back 198

culture

Front 199

The study of the effect of ethnicity on drug responses, specifically drug absorption, metabolism, distribution, and excretion as well as the study of genetic variations to drugs

Back 199

ethnopharmacology

Front 200

acceleration of the usual investigational new drug approval process by the FDA, usually for drugs used to treat life-threatening diseases

Back 200

expedited drug approval

Front 201

An act that protects health insurance coverage for workers and their families when they change jobs. It also protects patient info. If confidentiality of a patient is breached, severe fines may be imposed

Back 201

Health Insurance Portability and Accountability Act (HIPAA)

Front 202

Written permission obtained from a patient consenting to a specific procedure

Back 202

informed consent

Front 203

A drug not yet approved for marketing by the FDA but available for use in experiments to determine its safety and efficacy

Back 203

Investigational new drug (IND)

Front 204

When performing a cultural assessment, how do you know when you need an interpreter?

Back 204

First you need to know what type of information you are interpreting so you can decide if a family member would be an okay interpreter or if you need a trained professional

Front 205

When was the federal food and drug act originated?

Back 205

1906

Front 206

A special type of negligence or the failure of a professional and/or individual with specialized education and training to act in a reasonable and prudent way

Back 206

malpractice

Front 207

a legal term established under the Harrison Narcotic Act of 1964. The term is currently used in clinical settings to refer to any medically administered controlled substance and in legal settings to refer to and illicit or "street" drug; also referred to as opioid

Back 207

narcotic

Front 208

The failure to act in a reasonable and prudent manner or failure of the nurse to give the care that a reasonably prudent (cautious) nurse would render or use under similar circumstances

Back 208

negligence

Front 209

A special category of drugs that have been identified to help treat patients with rare diseases

Back 209

orphan drugs

Front 210

Drugs available to consumers without a prescription, Also called nonprescription drugs

Back 210

over-the-counter drugs

Front 211

The study of genetics in drug response

Back 211

pharmacogenetics

Front 212

What do you need in order to be able to access a patients records or ask information about a patient to another health care provider?

Back 212

a need to know

Front 213

Primary purpose of the FDA is to protect patients and ensure drug effectiveness

Back 213

Food and Drug administration (FDA)

Front 214

Any meds administered that are a controlled substance

Back 214

narcotics

Front 215

"prescription drugs" really differentiated between over the counter or written prescription

Back 215

legend drugs

Front 216

an act that states that any nutritional supplement has a safety precaution and wont case harm to the person but no guarantee it will be effective or that there will be the same amount of each ingredient in each one

Back 216

Dietary supplement Health and Education Act of 1994

Front 217

How are controlled substances categorized?

Back 217

in schedule c1-c5

Front 218

What are the categories for schedule c1?

Back 218

high abuse potential,medical use not accepted , and dependency potential is sever physical and psychological

Front 219

What are the categories for schedule c2

Back 219

High abuse potential,medical use is accepted, dependency potential is sever physical and psychological

Front 220

What are the categories for schedule C3

Back 220

Abuse potential is less than C2, medical use is accepted , Dependency potential is moderate to low physical or high psychological

Front 221

What are the categories for schedule C4?

Back 221

Abuse potential is than C3, medical use is accepted, dependency potential is limited physical or pschological

Front 222

What are the categories for schedule C5?

Back 222

Abuse potential is less than C4, medical use is accepted, Dependency potential is limited physical or pschological

Front 223

What are the dispensing restrictions for schedule C1?

Back 223

Only with approved protocol

Front 224

What are the dispensing restrictions for schedule C2?

Back 224

Written prescription only, no refills, and container must have a warning label

Front 225

What are the dispensing restrictions for schedule C3?

Back 225

Written or oral prescription that expires in 6 months, no more than 5 refills in a 6 month period, container must have warning label

Front 226

What are the dispensing restrictions for schedule C4?

Back 226

Written or oral prescritpion that expires in 6 months, no more than 5 refills in a 6 month period, container must have a warning label

Front 227

What are the dispensing restrictions for schedule C5?

Back 227

Written prescription or over the counter (varies with state law)

Front 228

What is the U.S. FDA drug approval process?

Back 228

Preclinical testing, clinical testing, investigational drug studies, and expedited drug approval

Front 229

In order to get informed consent, what are the three things you need to explain to the patient?

Back 229

the purpose of the test, procedure, and possible benefits and risks involved

Front 230

Current medical ethics require that all new drugs undergo laboratory testing using both in vitro (tissue or cell) and animal studies before any testing in human subjects can be done

Back 230

preclinical testing

Front 231

what are the four clinical phases?

Back 231

phase 1- usually involves small number of healthy subjects to determine optimal dosage range Phase 2- involve small # of volunteers who have the disease to determine therapeutic dosage range Phase 3- involve large # of patients who are followed by medical research centers and these patients provide info about rare adverse effects that may not yet have been observed during previous smaller studies Phase 4- postmarked studies to obtain further proof of the therapeutic and adverse effects of the new drug

Front 232

"voluntary recall" Providers can prescribe meds but patients need to understand there are high risk for certain side effects

Back 232

Black Box warning

Front 233

What are the three different classes for a recall of a drug?

Back 233

class 1-most serious; drug product carries a reasonable probability of serious adverse health effects or death Class 2- less sever; use of drug products may result in temporary or medically reversible health effects, but probability of lasting major adverse health effects is low Class 3- Least severe; use of drug product is not likely to result in any significant health problems

Front 234

Can a nurse be eligible for malpractice or negligent?

Back 234

yes

Front 235

Self-determination and the ability to act on one's own; related nursing actions include promoting a patient's decision making, supporting informed consent, and assisting in decisions or making a decision when a patient is posing harm to him/her self

Back 235

autonomy

Front 236

The ethical principle of doing or actively promoting good; related nursing actions include determining how the patient is best served

Back 236

beneficence

Front 237

The duty to respect privileged information about a patient; related nursing actions include not talking about a patient in public or outside the context of the health care setting

Back 237

confidentiality

Front 238

The ethical principle of being fair or equal in one's actions; related nursing actions include ensuring fairness in distributing resources for the care of patients and determining when to treat

Back 238

justice

Front 239

The duty to do no harm to a patient; related nursing actions include avoiding any deliberate harm while rendering nursing care

Back 239

nonmaleficence

Front 240

The duty to tell the truth; related nursing actions include telling the truth with regard to placebos, investigational new drugs, and informed consent

Back 240

veracity

Front 241

A broad term used to refer to any errors at any point in patient care that cause or have the potential to cause patient harm

Back 241

medical error

Front 242

These have preventable adverse drug effects

Back 242

medication errors

Front 243

encouraging medical personnel to report errors to investigation can occur to hopefully make those situations safer and prevent them from occurring again in the future

Back 243

just culture

Front 244

Any undesirable occurrence related to administration of or failure to administer a prescribed medication

Back 244

adverse drug event

Front 245

Unexpected, unintended, or excessive responses to medications given at therapeutic dosages

Back 245

adverse drug reactions

Front 246

an immunologic reaction resulting from an unusual sensitivity of a patient to a certain medication

Back 246

allergic reaction

Front 247

Any abnormal or unexpected response to a medication, other than an allergic reaction, that is unusual to an individual patient

Back 247

idiosyncratic reaction

Front 248

During what steps can errors occur in the medication process?

Back 248

at any step

Front 249

where do half of all errors in medication begin? what is the second most common error?

Back 249

half of all errors begin in prescribing and then 2nd is administering

Front 250

what are some issues contributing to error?

Back 250

organizational issues (work load is too much), educational system issues, sociological factors (nurse says outloud "this is 5mg right?" and the other nurse automatically assumes she is right and doesn't really notice if its wrong), use of abbreviations (can easily be mistaken for other meanings)

Front 251

What are some types of medication errors?

Back 251

1. no error, although circumstances or events occurred that could have led to an error 2. medication error that causes no harm (patient receives more meds than prescribed but it doesn't actually do harm to the body). 3. medication error that does cause harm 4. medication error that results in death

Front 252

What are some ways of preventing medication errors?

Back 252

1.Multiple systems of checks and balances should be implemented to prevent medication errors (warning signs popping up on the machine saying "your taking out a higher dose than prescribed")2. Prescribers must write legible orders that contain correct information, or orders should be entered electronically 3. Authoritative resources, such as pharmacists or current (within the past 3-5 years) drug references or literature, must be consulted.

Front 253

How many times do nurses need to check the medication order before giving the drug?

Back 253

3 TIMES!!!

Front 254

When should be your last and final check of the six rights of medication administration?

Back 254

at the bedside right before you are going to give the patient the medication

Front 255

What are the two common "patient identifiers"?

Back 255

name and date of birth stated by the patient

Front 256

When does the "two patient identifiers" need to be asked?

Back 256

the patient must state their name and date of birth EVERYTIME the nurse enters the room and before the administration of meds (if patient cant state name/birth then the nurse must visually see it on their bracelet)

Front 257

If you cant read a medication order from a physician what do you need to do?

Back 257

call the physician to get clarification on the order

Front 258

Do you use a "trailing zero" when writing a medication order? why/why not?

Back 258

NEVER, because the trailing zero can be misread such as 1.0mg might be mistaken for 10mg

Front 259

Do you use a "leading zero" for decimal dosages?

Back 259

ALWAYS! because if there is no zero then .25 might be misread as 25 instead of its correct meaning of 0.25mg

Front 260

What does MAR stand for?

Back 260

med administration record

Front 261

The moment a patient questions their meds, what do you need to do?

Back 261

you need to question them as well and figure out if that really is the right med (maybe the patient has seen it as a blue pill but now its white because the dosage has increased)

Front 262

Who usually has the most consistency and the best understanding of medications that the patient is taking?

Back 262

the patient and/or family members because they are usually aware of what medications the patient is on

Front 263

Who do you need to report medication errors to?

Back 263

the prescriber and nursing management or charge nurse

Front 264

what are the two things you need to do for documentation after making a medication error?

Back 264

1. need to document in patient record by being very factual and noting the medication administered, actual dose, observed changes in the patient conditions, prescriber notified and follow up orders DO NOT MENTION INCIDENT REPORT HERE 2. Write an incident report-this never goes in the medical record. This is an internal document that can't be used in a court of law. It drives investigation process so something can be done to try and prevent the error from happening again

Front 265

Continuous assessment and updating of patient medication information (done at all points of entry and exit to or from a health care entity) It is designed to ensure that there are no discrepancies between what the patient was taking at home and in the hospital

Back 265

medication reconciliation

Front 266

What are the three steps to medication reconciliation?

Back 266

1.Verification 2. Clarification 3. reconciliation

Front 267

When performing an assessment regarding medication reconciliation, what types of questions should you start out with?

Back 267

ask the patient open ended questions and gradually move to yes-no questions to help determine specific medication information

Front 268

level at which basic knowledge is learned and stored

Back 268

cognitive domain

Front 269

conduct that expresses feelings, needs, beliefs, values, and opinions

Back 269

affective domain

Front 270

involves the learning of a new procedure or skill and is often called the "doing domain"

Back 270

psychomotor domain

Front 271

the patients choice not to take meds (they think the doctor is just prescribing them meds that they dont need just to over charge them)

Back 271

noncompliance

Front 272

Patient wants to take the med but cant afford it

Back 272

nonadherence

Front 273

for adults, it is recommended that material be written at what reading grade level?

Back 273

8th grade reading level

Front 274

medications that are legally available without a prescription

Back 274

over-the-counter drugs

Front 275

The OTC drug review states that the med has to have what 3 things?

Back 275

safety & efficacy, appropriate labeling standards, and reclassification

Front 276

what are the potential hazards of using over the counter drugs?

Back 276

1. may postpone effective treatment of more chronic disease states 2. may delay treatment of serious or life-threatening disorders 3. may relieve symptoms of a disorder but not the cause 4. toxicity 5.interactions with current prescription medications may occur 6. abuse

Front 277

what is the max amount of acetaminophen that should be taken?

Back 277

3g every 24 hours

Front 278

what is hepatic toxicity

Back 278

liver damage

Front 279

using herbs to heal

Back 279

herbal medicine

Front 280

orally administered alternative medicines, including herbal supplements

Back 280

dietary supplement

Front 281

plant components, including bard, berries, roots, leaves, gums, seeds, stems, and flowers, used for their medicinal qualities

Back 281

herbs

Front 282

Natural does not mean safe! true or false?

Back 282

true