Quiz 1
1. Appropriate considerations when deciding to give a
medication.
Drug administration is dependent on the age group. First you must have the
The right patient , right drug, right dose, right time, right route, right
documentation, right reason, right
response, and right to refuse.
For older adults = must consider decreased organ function that leads to
increased adverse effects and
toxicity. Polypharmacy Non compliance Physiologic changes assoc. with aging
that affects deposition
and action of drug Sensory and motor deficits
Increased fat content, decreased albumin, decreased total body water leading to
increase risk toxicity
and decreased distribution of drugs.
For newborns and pediatrics = must consider: Their liver and kidneys are
immature that leads to many
occurrences affecting metabolism and excretion of drug admin. First, pass drug
elimination by the liver
is reduced due to immature liver. Low-fat content due to greater total body water.
Decreased protein
due to an immature liver. Excretion by the kidneys affects the glomerular filtration
rate, secretion, and
reabsorption Decreased excretion of drugs due to immature kidneys incapable to
perfuse kidneys at an
accurate rate
For pregnancy = one must consider Drug properties, fetal gestation, and
maternal factors
Overall, you must also consider allergies to drugs and food, dietary habits, lab
test, history of smoking
or alcohol, safety consideration
2. Half-life vs Polypharmacy vs. Duration of action of a drug vs. what population
deals with organ maturity vs liver maturity.
Half life = the time required for one half ( 50 %) of a given drug to be removed
from the body
Polypharmacy = the use of many different drugs concurrently in treating a
patient, often has several
health problems. Polypharmacy increases the risk of drug interactions and ADR
Duration of action of a drug = time period at which a drugs concentration is
sufficient to cause a
therapeutic response
Older adults, adolescents, toddlers older than 2 have organ maturity Neonates,
newborns, infants 0-12
months have liver and kidney immaturity
3. ADPIE is the acronym for what process and what actions may take place
during these phases.
A= Assessment
Data collection, review, and analysis from pt, family, group, or community
resources
Ex: medication profile, subjective and objective data, head to toe assessments,
medical records review
D= Diagnosis aka human needs assessment risk for fall
Occurs with the collection of patient data criteria done by the nurse
Ex: statement of Pt response to illness ( example would be anxiety ), statement
identifies factors related
to the response, statement lists cues, evidence, or data that supports nurses
claim
P= planning goal for patient
Identification of goals that can be objective, measured, and realistic with
established time period with
outcome criteria that states concrete description of Pt goals, expectations, and
effective admin. Of meds
Ex: reviewing possible procedures, reviewing new equipment, reviewing
techniques , and gathering info.
I = implementation patient eduaction
Initiating and completion of specific nursing actions as defined by nursing
diagnosis Goals, and outcome
criteria
Ex: nursing actions may me independent , dependent, or collaborative depending
upon prescribers
orders. Such as , interventions, the six( or nine) rights. Providing education
E = evaluation
Ongoing part of the nurses process that determines the status of goals and
outcomes.
Ex: monitoring Pt responses to drug therapy for expected or unexpected
reasons, clear documentation
4. Which organs deal with Distribution vs. Metabolism vs. Excretion vs.
Absorption?
Absorption = drugs that is absorbed in the small intestine but first must pass the
liver before reaching
circulation.
Distribution= drugs that enter the bloodstream are distributed to these areas of
the heart, liver, kidneys,
muscles, brain,skin, and fat.
Metabolism = drugs that have undergone biotransformation (insoluble to soluble)
mostly done by the
liver. Can also be done by the skeletal muscle, kidneys, lungs
Excretion = the elimination of drugs from the body mostly done by the kidneys.
Can also be done by liver
and bowel
Subjective Data = cannot be measured or seen , but is spoken information that is
felt or described from
the patient. Such as, complaints, problems, or needs Ex: patient states they feel
dizziness, headache,
nausea
Objective Data = information that is available through sense that is seen, felt,
heard, and smelled. Can
be measured. Ex: lab values ,temperature, weight, skin color, med profile, history,
age,allergies
5. Open-ended questions vs. Closed-ended questions, which one is better to use
for greater
clarification?
Open ended questions= cannot be answered with simple yes or no, but requires
extensive
details from respondent
Ex: can you explain what your diet is like at the moment?
Closed ended questions= any question for which the researcher providers
responder with
options to choose a response
6. Subjective data vs. Objective data.
Subjective Data = cannot be measured or seen , but is spoken information that is
felt or described from
the patient. Such as, complaints, problems, or needs Ex: patient states they feel
dizziness, headache,
nausea
Objective Data = information that is available through sense that is seen, felt,
heard, and smelled. Can
be measured. Ex: lab values ,temperature, weight, skin color, med profile, history,
age,allergies
7. Education vs.setting goals/outcomes vs. Drug history vs. Formulating human
needs is part of what phases of the nursing process?
Education= is part of implementation process
Setting goals and outcomes = is part of planning nursing process
Drug History = is part of assessment nursing process
Formulating human needs = is part of the diagnosis nursing process
8. First pass effect, which routes of medication administration surpasses this
effect?
First pass effect = is the initial metabolism in the liver of a drug that is absorbed
from GI tract before it
reaches systemic circulation through the bloodstream.
The route of medication admin. Surpassing first pass effect by directly absorbing
drug into circulation
9. Idiosyncratic reaction vs. Pharmacological reaction vs. Allergic Reaction.
Idiosyncratic reaction = idio = unknown Adverse effects that cannot be explained
by the known
mechanisms of action of the offending agent. Usually develops unpredictably in
susceptible patients only
Pharmacological reaction = any unexpected, unintended, or undesired excessive
response to medication
given at therapeutic dosages ( not an overdose).
Allergic reaction= immune response related to prior exposure to the drug. Ex:
re-exposure that triggers
allergic response
10. Tolerance vs. Addiction vs. Adherence to medication.
Tolerance = is seen in pharmacotherapeutics ; is the decreasing response to a
repeated drug dose
Addiction = is the physiological dependence with obsessive desire for drug
seeking euphoric effects of a
drug
Adherence to medication= medications that are taken correctly as prescribed. Ex;
taking meds on time,
understanding directions, refills
11. The maximum therapeutic response is known as.
Peak level = highest blood level where toxicity is mild due to given drug
12. Know the routes of medication administration and what each route indicates.
Sublingual = under the tongue
buccal= cheeks
Rectal
Route : parenteral
Intra = injection
Intramuscular = injection in the muscle Ex: intraarterial, intrathecal ( epidural),
intraarticular
intravenous= injection through veins
Subcutaneous
Route: Topical
Skin - lotions, ointments, patches
Optic - eye drops, eye ointments
Nasal - nose drops, sprays
Lung - inhalation
Vaginal - tablets, creams, gels, suppositories
Rectal- liquid enemas, suppositories, capsules, tablets, gel, foams , creams
The final/third trimester of pregnancy is where the greatest percentage of
maternally absorbing drugs
reach fetus due to increased blood flow