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NURS 1141 Wk 1-6 ICHS 92 Questions with Verified Answers
5 steps of nursing - CORRECT ANSWER 1. Assessment
- Human Needs Statement (NURS DIAG)
- Planning
- Implementation
- Evaluation Assessment - CORRECT ANSWER Collect and organize data Objective and Subjective Know all the meds they take Human Needs Statement - CORRECT ANSWER AKA Nursing Diagnosis related to, as evidenced by Planning - CORRECT ANSWER Prioritize human needs statement Identify outcomes SMART Implementation - CORRECT ANSWER Carry out the plan Nursing interventions 9 rights for drug therapy Evaluation - CORRECT ANSWER Are outcomes met? Continuous process Monitor pt response to drug therapy 9 rights of medication administration - CORRECT ANSWER Right drug Right dose Right time Right route Right patient Right documentation Right reason Right response
Right to Refuse Pharmacokinetics ADME - CORRECT ANSWER The process by which drugs are absorbed, distributed within the body, metabolized, and excreted. Absorbtion - CORRECT ANSWER The process by which nutrient molecules pass through the wall of the digestive system into the blood From the location of administration IV (fastest), IM, SQ, PO, PR Main site is GI Bioavailability - CORRECT ANSWER Rate at and the extent to which a nutrient is absorbed and used Factors that affect absorbtion - CORRECT ANSWER Route of administration Presence of food in the stomach Drug Formulation First pass effect - CORRECT ANSWER The initial metabolism in the liver of a drug absorbed from the gastrointestinal tract before the drug reaches systemic circulation through the bloodstream. Reduces the bioavailability of the drug to less than 100% Drug goes thru "metal detector" than back into blood stream Enteral- GI tract Parenteral- IV Loading dose - CORRECT ANSWER initial higher dose of a drug that may be given at the beginning of a course of treatment before dropping down to a lower maintenance dose. A loading dose is most useful for drugs that are eliminated from the body relatively slowly, i.e. have a long systemic half-life Distribution - CORRECT ANSWER Sent to specific areas of the body by body fluid. Binds to specific binding sites Highway of the body is the blood stream Albumin - CORRECT ANSWER Most common blood protein and carries the majority of protein-bound drug molecule
Pharmacodynamics - CORRECT ANSWER The mechanisms of drug action in living tissues Drug Indication (Therapeutic Effect) - CORRECT ANSWER Expected response to a medication What does it specifically do? What is its specialty? Agonist - CORRECT ANSWER Drug binds to the receptor; there is a response Partial Agonist - CORRECT ANSWER Drug binds to the receptor; the response is diminished compared with that elicited by an agonist. Antagonist - CORRECT ANSWER Drug binds to the receptor; there is no response. Drug prevents binding of agonists. Pharmacotherapeutics - CORRECT ANSWER Medical treatment that utilizes one or more pharmaceutical drugs to improve on-going symptoms, treat the underlying condition, or act as a prevention for other diseases Contraindications - CORRECT ANSWER Any patient condition, especially a disease state that makes the use of the given medication dangerous for the patient Why are you NOT going to give the medication? (ex: grapefruit juice plus statins) Drug Interactions - CORRECT ANSWER Drugs may interact with other drugs, with foods, or with agents administered as part of laboratory tests. Can create a desired or undesired effect at the same time. Acute Therapy - CORRECT ANSWER Involves more intensive drug treatment and is implemented in the acutely ill (those with rapid onset of illness) or the critically ill Maintenance Therapy - CORRECT ANSWER Does not eradicate preexisting problems the patient may have, but will prevent progression of a disease or condition
Supplemental Therapy - CORRECT ANSWER Supplies the body with a substance needed to maintain normal function Palliative Therapy - CORRECT ANSWER To make the patient as comfortable as possible Supportive Therapy - CORRECT ANSWER Maintains the integrity of body functions while the patient is recovering from illness or trauma Prophylactic Therapy - CORRECT ANSWER Prevent illness or other undesirable outcome during planned events Empirical Therapy - CORRECT ANSWER Based on clinical probabilities Idiosyncratic reaction - CORRECT ANSWER Not the result of a known pharmacologic property of a drug or of a patient allergy, but instead occurs unexpectedly in a particular patient Allergic reaction - CORRECT ANSWER Involves the patient's immune system Therapeutic Index - CORRECT ANSWER The ratio of a drug's toxic level to the level that provides therapeutic benefits Polypharmacy - CORRECT ANSWER The use of many different drugs concurrently in treating a patient, who often has several health problems. Older Adult Physiological Changes - CORRECT ANSWER Cardiovascular ↓ Cardiac output = ↓ absorption and distribution ↓ Blood flow = ↓ absorption and distribution Gastrointestinal ↑ pH (alkaline gastric secretions) = altered absorption ↓ Peristalsis = delayed gastric emptying Hepatic ↓ Enzyme production = ↓ metabolism ↓ Blood flow = ↓ metabolism Renal
Medication Reconciliation - CORRECT ANSWER Process in which medications are reviewed and "reconciled" at all points of entry and exit to/from a health care entity Cognitive - CORRECT ANSWER The domain involved in the learning and storage of basic knowledge. It is the thinking portion of the learning process and incorporates an individual's previous experiences and perceptions; the learning/thinking domain. Affective - CORRECT ANSWER The most intangible domain of the learning process. It involves affective behavior, which is conduct that expresses feelings, needs, beliefs, values, and opinions; the feeling domain. Psychomotor - CORRECT ANSWER The domain involved in the learning of a new procedure or skill; often called the doing domain. OTC - CORRECT ANSWER Nonprescription drug. Easy to use and monitor. Prescription Drug - CORRECT ANSWER Must be obtained through a written prescription from a physician and can be purchased only at a pharmacy Herbal/Dietary Supplement Concerns - CORRECT ANSWER Crucial to patient safety to consider any other contraindications, cautions, and potential drug-drug and drug-food interactions Cultural Factors - CORRECT ANSWER Beliefs, values, and genetics that can interfere with drug therapy. Herbal Drug Interactions - CORRECT ANSWER Pg 88 Safety - CORRECT ANSWER Many examples exist of allergic reactions, toxic reactions, and adverse effects caused by herbs. Some herbs have been shown to have possible mutagenic effects and to interact with drugs Formula - CORRECT ANSWER Ordered/Available x Volume or Quantity Ratio - CORRECT ANSWER Available/Vehicle = Dosage/"x"
Dimensional Analysis - CORRECT ANSWER Solve for your end goal Analgesics - CORRECT ANSWER Medications that relieve pain without causing loss of consciousness (sometimes referred to as painkillers). Analgesics /Opioids - CORRECT ANSWER Indication: Synthetic drugs that bind to opiate receptors to relieve pain. Used to manage moderate to severe pain Adverse Effects: Cardiovascular-Hypotension, flushing, bradycardia Central nervous-Sedation, disorientation, euphoria, lightheadedness, dysphoria Gastrointestinal-Nausea, vomiting, constipation, biliary tract spasm Genitourinary-Urinary retention Integumentary-Itching, rash, wheal formation Respiratory-Respiratory depression and possible aggravation of asthma Antidote: Naloxone and naltrexone are opioid antagonists that bind to and occupy all of the receptor sites (mu, kappa, delta) Transdermal Patches - CORRECT ANSWER To be used only by patients who are considered opioid tolerant Giving fentanyl transdermal patches to non-opioid-tolerant patients may result in severe respiratory depression Monitor for RESPRIATORY DISTRESS No heat pack Remove old patch, before applying a new Keep away from children Addiction (Psychological Dependence) - CORRECT ANSWER A chronic, neurobiologic disease whose development is influenced by genetic, psychosocial, and environmental factors (same as psychologic dependence). Tolerance (Physical Dependence) - CORRECT ANSWER The general term for a state in which repetitive exposure to a given drug, over time, induces changes in drug receptors that reduce the drug's effects (same as physical dependence).
- Hot or cold packs
- Hypnosis
- Imagery
- Massage
- Meditation
- Music therapy
- Pet therapy
- Physical therapy
- Reduction of fear
- Relaxation
- Surgery
- Therapeutic baths
- Therapeutic communication
- Therapeutic touch
- Transcutaneous electric nerve stimulation
- Yoga Visceral pain - CORRECT ANSWER Originates from organs and smooth muscles Superficial pain - CORRECT ANSWER Originates from the skin and mucous membranes Deep Pain - CORRECT ANSWER Occurs in tissues below skin level Acetaminophen (Tylenol) - CORRECT ANSWER Max Dose;
- 4000 mg/day (healthy patient)
- 3000 mg/day (older adult)
- 2000 mg/day (liver disease or chronic alcohol consumption) Adverse Effects; skin disorders, nausea, and vomiting OD treatment; Acetylcysteine-preventing the hepatotoxic metabolites of acetaminophen from forming Combo Drugs;
General Anesthetics - CORRECT ANSWER Drugs that depress the central nervous system (CNS) or peripheral nerves to produce decreased or loss of consciousness or muscle relaxation Indications: produce profound neurosensory depression to allow for surgical procedures Elderly Considerations: higher risk for cardiac dysrhythmias, hypotension, respiratory depression, atelectasis, and/or pneumonia during the postanesthesia and postoperative phases Adverse Effects: hypotension, nausea, vomiting, and confusion, malignant hyperthermia Interactions: antihypertensives and beta blockers Malignant Hyperthermia - CORRECT ANSWER An uncommon but potentially fatal, genetically linked adverse metabolic reaction to general anesthesia. Signs include a rapid rise in body temperature, tachycardia, tachypnea, and muscular rigidity Treated with cardiorespiratory supportive care as needed to stabilize heart and lung function, along with the skeletal muscle relaxant dantrolene Moderate Sedation - CORRECT ANSWER Indication: Conscious sedation, and procedural sedation are synonymous terms for anesthesia that does not cause complete loss of consciousness and does not normally cause respiratory arrest. Commonly used drugs:
- Opioid analgesics—morphine sulfate, fentanyl
- Benzodiazepines—midazolam, diazepam
- Barbiturates—pentobarbital, methohexital, thiopental
- Miscellaneous agents—nitrous oxide, ketamine, propofol, dexmedetomidine
Fab 4 For Drug Cards - CORRECT ANSWER Drug Class Action Indication (therapeutic effect) Side Effects Drug Class - CORRECT ANSWER Drug Category What does it do? Ex: Antibiotic Drug Action - CORRECT ANSWER Chemical action of a drug What does it do in the body? Drug Side Effect - CORRECT ANSWER An expected reaction to a drug. Most common is upset stomach. Not a surprise or emergency reaction
