Fundamentals Of Nursing Test 2

Front 1

What information should you know about each medication you will be administering to your patients?

Back 1

-Names
-Desired therapeutic effects
-Actions on body
-Forms & Dosages
-Appropriate routes
-Side effects
-Precautions

Front 2

What are appropriate resources for medication information?

Back 2

-Drug guide book
-Internet drug reference
-Pharmacist

Front 3

Which medications can be delegated to CNA?
to LPN?

Back 3

CNA- no medication administration can be delegated
LPN- can be delegated to give all medications except IV push, certain critical care IV piggy back meds, and chemotherapy

Front 4

Can you delegate a CNA to give an enema?

Back 4

Yes as long as it doesn't have meds in it

Front 5

What should the RN do when administering a new med to the patient for the first time?

Back 5

Educate the patient and/or family on the medication

Front 6

What is an example of a drug's generic and trade name?

Back 6

Tylenol and acetaminophen

Front 7

What should the RN know about the pharmacokinetics of each medication they will be administering?

Back 7

Absorption
Distribution
& metabolism of drugs by body

Front 8

What should the RN know about each drug action and response?

Back 8

Therapeutic effects
Side effects
Adverse effects
Interactions

Front 9

How is the therapeutic drug classification categorized?

Back 9

by disease state
ex: anti-hypertensive

Front 10

How is the pharmacologic drug classification categorized?

Back 10

by its action on the body
ex: ACE inhibitors, Beta Blockers, Vasodilators

Front 11

What information should you know about each medication you will be administering to your patients?

Back 11

-Names
-Desired therapeutic effects
-Actions on body
-Forms & Dosages
-Appropriate routes
-Side effects
-Precautions

Front 12

What are appropriate resources for medication information?

Back 12

-Drug guide book
-Internet drug reference
-Pharmacist

Front 13

Which medications can be delegated to CNA?
to LPN?

Back 13

CNA- no medication administration can be delegated
LPN- can be delegated to give all medications except IV push, certain critical care IV piggy back meds, and chemotherapy

Front 14

Can you delegate a CNA to give an enema?

Back 14

Yes as long as it doesn't have meds in it

Front 15

What should the RN do when administering a new med to the patient for the first time?

Back 15

Educate the patient and/or family on the medication

Front 16

What is an example of a drug's generic and trade name?

Back 16

Tylenol and acetaminophen

Front 17

What should the RN know about the pharmacokinetics of each medication they will be administering?

Back 17

Absorption
Distribution
& metabolism of drugs by body

Front 18

What should the RN know about each drug action and response?

Back 18

Therapeutic effects
Side effects
Adverse effects
Interactions

Front 19

How is the therapeutic drug classification categorized?

Back 19

by disease state
ex: anti-hypertensive

Front 20

What information should you know about each medication you will be administering to your patients?

Back 20

-Names
-Desired therapeutic effects
-Actions on body
-Forms & Dosages
-Appropriate routes
-Side effects
-Precautions

Front 21

How is the pharmacologic drug classification categorized?

Back 21

by its action on the body
ex: ACE inhibitors, Beta Blockers, Vasodilators

Front 22

What are appropriate resources for medication information?

Back 22

-Drug guide book
-Internet drug reference
-Pharmacist

Front 23

Which medications can be delegated to CNA?
to LPN?

Back 23

CNA- no medication administration can be delegated
LPN- can be delegated to give all medications except IV push, certain critical care IV piggy back meds, and chemotherapy

Front 24

Can you delegate a CNA to give an enema?

Back 24

Yes as long as it doesn't have meds in it

Front 25

What should the RN do when administering a new med to the patient for the first time?

Back 25

Educate the patient and/or family on the medication

Front 26

What is an example of a drug's generic and trade name?

Back 26

Tylenol and acetaminophen

Front 27

What should the RN know about the pharmacokinetics of each medication they will be administering?

Back 27

Absorption
Distribution
& metabolism of drugs by body

Front 28

What should the RN know about each drug action and response?

Back 28

Therapeutic effects
Side effects
Adverse effects
Interactions

Front 29

How is the therapeutic drug classification categorized?

Back 29

by disease state
ex: anti-hypertensive

Front 30

How is the pharmacologic drug classification categorized?

Back 30

by its action on the body
ex: ACE inhibitors, Beta Blockers, Vasodilators

Front 31

What is a therapeutic effect?

Back 31

what is the expected expect of the drug

Front 32

What are side effects?

Back 32

Predictable symptoms that occur as a consequence of normal dosage. Can be mild such as postural hypotension or severe/life threatening such as liver or renal toxicity or teratogenic fetal harm

Front 33

What are adverse effects?

Back 33

unexpected events
-allergic reaction: mild versus anaphylactic
-idiosyncratic reaction
-Toxic

Front 34

What population are more responsive to calcium channel blocker anti-hypertensives?

Back 34

older adults & african americans

Front 35

What population are Beta Blockers & ACE inhibitor anti-hypertensives more effective in?

Back 35

caucasians

Front 36

What did the Controlled Substances Act of 1970 focus on?

Back 36

Strict controls on distribution

Front 37

What is an idiosyncratic reaction?

Back 37

Results in the opposite effect of what it should have

Front 38

What is a control schedule?

Back 38

Drugs with a significant potential for abuseare classified into 5 categories or schedules
Schedule I: highest potential for abuse- illicit drugs (heroin,LSD, Marijuana)
Schedule II: (Morphine, Dilaudid)
Schedule III: (Vicodin, Meperidine)
Schedule IV: (valium, xanax)
Schedule V: lowest potential for abuse (OTC cough suppressant with codeine)

Front 39

What are the nurses responsibilities of controlled substances according to the controlled substances act of 1970?

Back 39

-Nurses must keep an accurate record of every controlled substance in stock on their unit
-All controlled substances are stored using a double locked system
-Keys to medication areas are under the control of nurses on the unit at all times
-Discarding of controlled substances must be witnessed & co-signed by another nurse
-(2) Two nurses reconcile the count of all controlled substances at every shift change
-Written renewal orders are required q 72 h for all schedule II & III drugs

Front 40

What are the 4 ways medications travel through the body?

Back 40

Absorption
occuring at site of administration
Distribution
transport of medication in bloodstream and into cells
Metabolism
biotransformation (mostly by liver
Excretion
Removal from body (mostly by kidneys)

Front 41

What factors affect absorption of medications?

Back 41

-Surface area and contact time
-Blood flow at site of administration
-Solubility (water versus lipid soluble) lipid soluble molecules more easily absorbed
-Drug form
-Route of administration
-Age: older adults-gastric emptying time slower, peristalsis slower

Front 42

What are some factors that affect distribution of medications throughout the body?

Back 42

-Systemic circulatory status
-Protein-binding properties of drug
-Membrane permeability properties : blood brain barrier-selective to highly lipid-soluble substances such as antidepressants, dilantin, nicotine, caffeine, and alcohol
-Age: older adult- less muscle and total body water increases concentration of water-soluble drugs, lower serum protein increases amounts of free drug in circulationand risk for toxicity, blood-brain barrier effectiveness diminishes

Front 43

What does protein-binding have to do with medications?

Back 43

-Most drugs bind to serum proteins (like albumin) in varying degrees
-When bound to a protein the drug cannot enter the cell
-Only unbound "free" can enter cell and create effect
-(2) drugs given concurrently & highly bound to the same site on a plasma protein will compete for the binding site resulting in a greater proportion of free drug and potential for toxicity

Front 44

What is an agonist?

Back 44

Medication that has the ability to bind & mimic receptor activity and create and/or increase an endogenous effect

Front 45

What is an antagonist?

Back 45

Medication that has ability to bind & block receptor activity and prevent and/or decrease an endogenous effect

Front 46

What is a bronchodilator?

Back 46

ex: albuterol
Used for asthma attacks, classified as beta-agonists
They attach to adrenergic receptors in the sympathetic nervous system (SNS) and mimic the action of norepinephrine

Front 47

What are Beta-blockers?

Back 47

ex: atenolol
used to decrease blood pressure, classified as alpha-antagonists
They attach to the adrenergic receptors in the SNS and block the action of norepinephrine

Front 48

What is saturability and when does it occur?

Back 48

Drug receptor binding is saturable.
This occurs when all available receptors are occupied.
Once all available receptors are saturated, increasing the drug concentration will not increase the risk of adverse side effects.

Front 49

What factors affect metabolism of medications?

Back 49

-Bioavailability properties of the medication after biotransformation through liver (called "first-pass" effect)
-Hepatic dysfunction and disease
-Change in amount of liver enzymes used in the biotransformation process : decreased in malnutrition and in older adults, fast vs. slow acetylator

Front 50

What factors affect excretion of medications?

Back 50

-Renal function capacity : older adult has decreased glomerular filtration rate
-Plasma half-life properties of the drug
-Physiological drug effects of onset/peak/duration and therapeutic index (TI)

Front 51

What happens when drugs stay in the system for a long period of time (because they have a long half life)?

Back 51

Toxicity builds up

Front 52

What is the therapeutic index (TI)?

Back 52

Margin between therapeutic level and toxic level

Therapeutic drug monitoring is required for medications with low TI (narrow margin)
-Peak and trough levels measured in blood
-ex: aminoglycoside antibiotics (mysins)

Front 53

What should the RN assess related to patient medications?

Back 53

-Patient history and diagnoses
-Allergies
-Medication reconciliation
-Swallowing ability
-Patient knowledge and attitude
-Current health status: ex nausea?
-Lab values, BP, HR parameters
-Diet and fluid restrictions
-Use of herbals, caffeine, alcohol, street drugs

Front 54

What should the RN know about medication administration regarding lab values?

Back 54

-Medications may be prescribed based on lab results
-Medications may alter body functioning and lab values may denote this
-Nursing responsibility includes incorporating lab data with medication administration

Front 55

What should the RN know about medication administration regarding parameters?

Back 55

-Many medication orders are dependent on specific parameters such as:
*vital signs: hold for SBP <100
*Lab values: hold for INR >3
*Sliding scale: administer certain amount of insulin based on blood glucose level

Front 56

What is the normal blood glucose serum value?

Back 56

70-105 mg/100mL

Front 57

What is the normal Blood Urea Nitrogen (BUN) serum value?

Back 57

10-20 mg/100mL

Front 58

What is the normal creatinine serum value?

Back 58

0.5-1.2 mg/100mL

Front 59

What is the normal Potassium (K) serum value?

Back 59

3.5-5.0 mEq/L

Front 60

What is the normal Albumin serum level?

Back 60

3.5-5 g/dl

Front 61

What are the nursing responsibilities regarding medication reconciliation as stated in NPSG 8

Back 61

Accurately and completely reconcile medications across the continuum of care
-a process exists for comparing the patient's current medications with those ordered while under the care of the health facility of HCP
-a complete and reconciled list of medications is communicated & documented upon transfer of a patient to another health facility or HCP
-upon discharge a complete and reconciled list of medications is provided and explained to the patient or patient's family

Front 62

What are creatinine levels significant of?

Back 62

kidney function

Front 63

What are BUN levels significant of?

Back 63

liver function

Front 64

What must be on a complete drug order in order for the RN to be authorized to administer the medication?

Back 64

-Patient name
-Drug name
-Dose
-Route
-Frequency
-Date
-Signature

Front 65

In order for a drug order to be accurate and legible, what should be considered?

Back 65

-Clearly written
-No use of inappropriate abbreviations
-Safe dosage and appropriate route
-Indicated for patient dx
-Correct transcription
-Use of "read back" for verbal or telephone orders

Front 66

What does STAT mean on a drug order?

Back 66

given immediately & only once

Front 67

What does NOW mean on a drug order?

Back 67

given within 90 minutes

Front 68

What is a unit dose?

Back 68

individual patient supply loaded by pharmacy into med cart drawers

Front 69

What is stock?

Back 69

kept on the floor for frequent use
ex: tylenol, ASA, insulin

Front 70

What are controlled substances?

Back 70

not on med cart, locked in narcotic cabinet

Front 71

How many identifiers must the RN use when providing care, treatment, and services?

Back 71

2 identifiers
-Patient name
-Patient medical record number
-Patient date of birth

Front 72

What are some nursing strategies to implement safe medication administration?

Back 72

-Follow six rights and three checks
-Utilize best practice standards for administration
-Question unusually lage or small doses
-Use 2 nurse procedure for high-alert medications
-Check before crushing or splitting medications
-Avoid being interrupted or distracted
-Do not leave medications at bedside or unattended
-Never sign for a medication you did not give yourself
-Calculate drug dosages accurately & double check, verify with another nurse when necessary