Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Pharm Nurs 7
Pharmacology for Nurses Ch. 7
| Question | Answer |
|---|---|
| d Growth | The progressive increase in physical size |
| d Development 3 | The functional changes in physical, psychomotor, and cognitive capabilities of a person |
| Growth and physical development are: Predictable/ Unpredictable | Predictable |
| Psychomotor and cognitive development are: predictable/ Unpredictable | More varied than growth and physical development |
| Normal growth and development patterns occur when? | Throughout the life span |
| What is the importance of deviations from the norm in developmental patterns? | These deviations may signal a health pattern impairment |
| The development of a person links what components to make a unique human being? 4 | Biophysical, psychosocial, ethnocultural, and spiritual components |
| d Holistic care | Viewing the person as a whole |
| The nature of pharmacology requires that the nurse consider the ( ) of each person? | Individuality |
| 3 characteristics of a patient that relate to 2 characteristics of treatment? | The nurse must include the specifics of age, growth, and development of a client in relation to pharmacokinetics and pharmacodynamics. |
| Drug treatment and pregnant or lactating women | When possible drug treatment is postponed until after pregnancy and lactation and non-pharmacological alternatives are implemented |
| When are pregnant and lactating women treated with medication? | When they have had a serious condition prior to pregnagncy or they develope a serious condition during pregnancy |
| What changes occur in pregnancy which might alter drug pharmacokinetics and pharmacodynamics? 4 | Changes in gastrointestinal, cardiovascular, circulatory, or renal systems. |
| The placenta and drugs | The placenta is a semipermeable membrane: Some substances readily pass from the mother to fetus, while the transport of other substances is blocked. |
| The fetal membranes contains ( ) that ( ) certain substances as they ( ) | The fetal membranes contain enzymes that detoxify certain substances as they cross the membrane. |
| What 3 characteristics of drugs make them less likely to cross the placenta? | Water soluble, ionized, or bound to plasma proteins |
| Changes to drug absorption during pregnancy? 5 | Hormonal changes, blood supply to the abdominal organs changes, transit time of food and drugs in the GI tract is slowed, Gastic acidity is decreased, changes in the respiratory system. |
| What type of drugs may be taken in faster and to a greater extent by pregnant women? Why? | Inhaled drugs may be taken in to a greater extent due to increase in tidal volume and pulmonary vasodilation |
| 3 hemodynamic changes in pregnant women which affect the distribution and metabolism of drugs | Increased cardiac output, increased plasma volume, and change in regional blood flow |
| The increased blood volume in mothers causes (2) affection (1) | Dilation of drugs and decreased plasma protein concentrations affect drug distribution |
| 1 factor affecting distribution of drugs in mothers (but not metabolism) | alteration in lipid levels |
| Drug metabolism in mothers ( ) for certain drugs | Increases |
| Fat soluble drugs and lactation | Fat soluble drugs enter the milk and are passed to the nursing baby |
| Mothers' kidneys in 3rd trimester and affect on excretion | Blood flow may increase 40-50% which increases excreation rates |
| d teratogen | A substance, organism, or physical agent to which an embryo or fetus is exposed that produces a permanent abnormality in structure or function, causes growth retardation, or causes death. |
| There are/ are not absolute teratogens | Are not |
| The risk of a substance to become a teratogen is related to ( ) | The time of gestation when the drug is administered |
| preimplantation period- when? | Weeks 1 and 2 of the first trimester |
| What is the primplantation period called? Why? | All-or-none period. Exposure to a teratogen either causes the death of the enbryo or has no effect |
| Embryonic period- When? | Weeks 3 to 8 |
| Embryonic period and teratogens | The period of maximum sensitivity to teratogens |
| Fetal period- When? | 9 weeks to birth |
| fetal period and medications has what effect? Why? | Medications have a prolonged duration of action in the fetus. Occurs because the amount of substances transfered from the mother to the fetus is maximized at this time. |
| Drugs known or suspected of being teratogens is ( ). For most conditions, there are ( ) | Small, alternated drugs that can be given |
| Testing humans and teratogens | Testing mothers for teratogens is illegal |
| Categories of drugs for pregnant women Number? List them. Developed by who? | 5 A, B, C, D, X FDA |
| How do nurses determine the safety of drugs for mothers from the categories for pregnant women? | The FDA pregnancy labeling system is simplistic and gives no specific clinical information to help guide the nurse or their patients about a medicines true safety |
| Pregnant test animals and drug testing information (2) | Most information about fetal malformations and abnormalities comes from animal data. It is a crude approximation of the risk to a human fetus. |
| FDA warning for theraputic substances and pregnancy | No prescription drug, Over-the-counter medicine, herbal product or dietary suppliment should be taken during pregnancy unless the physician verifies that the therapeutic benefit to the mother clearly outweighs the potential risk to the unborn |
| Patient education and women of childbearing years | Nurses should ask all women of childbearing age if there is a possibility of pregnancy |
| What is the order of danger to the fetus in the FDA pregnancy category ratings? | A, B, C, D, X With a being no known danger and X being prohibited |
| Three potential teratogens which are not in the FDA categories? | Alcohol, nicotine, and illicit drugs |
| FDA pregnancy category A- Test subjects, Results | Studies with pregnant women, no increased risk of fetal abnormality |
| FDA pregnancy category B- Test Subjects (2) | Animal studies have shown no risk to fetus, and there are no studies with pregnant women |
| FDA pregnancy category C- test subjects (2) | Animal studies have shown a risk to fetus, and there are no studies with pregnant women |
| FDA pregnancy category D- risks, benefits | Observational studies in pregnant women show a risk to fetus, The benefits of therapy may outweigh the risks |
| FDA pregnancy category X- findings, use | Observational studies in women and animals show positive evidence of fetal abnormalities. No use for pregnant women. |
| d. Pregnancy Registries | Help to identify drugs that are safe to take during pregnancy. They gather information from women who took medication during pregnancy. |
| ( ) drugs are secreted into brest milk. ( ) of these drugs cause injury to infants. | Many...Few |
| For drugs contraindicated during lactation, ( ) | effective, safe alternatives are available |
| Drugs with(3) are less likely to enter breast milk | ionized, water soluble, bound to plasma proteins |
| 2 sources of published guidelines for drugs and lactating mothers | The American Academy of Pediatrics and drug guides |
| Lactating mothers should take drugs when? | The benefit to the mothers clearly outweighs the risk to the infant. |
| A possibility for pharmacotherapy and lactating mothers | Postponing pharmacotherapy until after the baby is weaned. |
| 5 factors that affect drug exposure through lactation | 1- The time between drug exposure and lactation 2- Mother's use of illegal drugs, tabacco, and alcohol, 3 amount of drug administered, 4 amount of drug that reaches the infant tissue, 5 infant's ability to metabolize drugs |
| 3 recommendations for drug use during lactation | 1- Drugs with shorter half-lives are preferable, 2- Drugs with high protein-binding ability should be selected, 3- All OTC herbal products and dietary supplements should be avoided |
| The nurse's history and prenatal assessment should (3) | 1- eliminate potentially hazardous substances 2- substitue alternative drugs 3- adjust medical doses |
| Nurses should place a focus on ( ) of pregnant or lactating mother | drug educaton |
| In teaching drug education to pregnant and lactating mothers, nurses should thoroughly inform ( ) | Nurses should thoroughly inform patients of risks to self and child |
| 3 physiological changes during growth and development in childhood which can affect pharmacokinetics and pharmacodynamics | 1- physiological variations 2- maturity of body systems 3- greater fluid distribution in children |
| d pediatric patient | From birth to 16 years weighing less than 50 kg |
| d infancy | First year of life |
| d neonatal | First 4 weeks of life |
| 3 RN goals for infants | 1- safety of infants 2- Proper dosing of prescription drugs 3- teaching parents how to administer medication properly |
| A primary goal of infants and medications | Have the infant ingest the entire dose without spitting it out. It is difficult to estimate the amount spit out. |
| special proceedures for drug administration for an infant. 1 example | Drugs are often administered to infants by special proceedures. For example, the infant should be held and cuddled when administering medication |
| d toddler | age 1 to 3 |
| toddlers and poisons | parents must be educated that all poisons, including medication, must be properly stored away from toddlers |
| process of giving medicines to toddlers- education, administration, after | Short explanation before giving the medicine then imediately give the medicine and comfort the toddler afterward |
| Oral medication for toddlers that tastes bad should be ( ) | mixed with sweet gooey substances like jam, syrup, or fruit puree. |
| Should bad tasting medicine be placed with milk, orange juice, cereal or other healthy food when given to toddlers? | No, because toddlers will associate the healthy food with a bad taste |
| Injections for toddlers should be given ( ) | At specific locations |
| For invasive proceedures, having a parent close by will usually (2) | Decrease the toddlers anxiety, and increase cooperation |
| Should the nurse give an invasive proceedure to a toddler alone? Why? | No, bring an assistant to help restrain the toddler if necessary |
| One of the leading causes of poisoning for children under the age of 6 and a potential source | iorn poisoning, vitamin overdose |
| d. preschoolers | Age 3 to 5 |
| Differences between school aged children and younger children with medicine 4 | 1- offer longer, more detailed explanations 2- praise cooperation 3- offer simple choices when appropriate 4- allow child to take his/her own medicine |
| d. school age children or middle childhood | Age 6 to 12 |
| d. adolescence | age 13-16 |
| Should nurses teach parent of teens to store prescription medicines safely? Why? | Yes, teens might try to experiment with the drugs |
| Patient education: Parents of teens and drug abuse | parents of teens should be taught the signs and symptoms of drugs commonly abused by teens |
| psychological needs of teens (3) | independence, respect, control |
| Three health areas of special importance to teens | 1- abuse of alcohol, tobacco, and illicit drugs 2- eating disorders 3- Issues related to sexual intercourse, pregnancy and sexually transmited diseases |
| When communicating with teens, allow ( ) | time for questions |
| d young adulthood | age 18- 40 |
| For young adults, there is a minimum need for prescription drugs unless ( 2 ) | chronic diseases, such as diabetes or immune-related conditions exist, or for birth control |
| Is medical compliance good for young adults? Why? | Yes. They understand its benefits in terms of longevity and feeling well |
| Are vitamins, minerals, and herbal supliments commonly used with young adults | Yes |
| patient education and young adults (2) | Educate about sustance abuse and treatment or sexually transmitted diseases |
| d. middle adult | aged 40 to 65 |
| What happens about age 45? | Changes related to excessive stress |
| Sandwich generation | another name for middle adults who often care for their children and their parents |
| Two ways to treat with stress. Which way is better | Medication or a healthy lifestyle. The later is better. |
| 4 healthy lifestyle modifications for middle adults | limiting fat intake, maintaining an optimum weight, and exercising, not smoking |
| 5 illnesses often requiring drug therapy for Late middle age adults | Cardiovascular disease, hypertension, diabetes, cancer, and obesity |
| d older adult | 65 and older |
| Age related changes that occur in older adults can influence ( ) altering both ( ) | The patients response to drugs... altering both therapeutic and adverse effects |
| p. polypharmacy, common for ( ) | Taking multiple drugs concurrently, common for older adults |
| One reason for excessive polypharmacy | Visiting multliple physicians and pharmacies |
| Polypharmacy dramatically increases the risk for (2) | adverse effects and drug interactions |
| patient education related to polypharmacy (2) | Nurses should urge patients to report all prescriptions and OTC products each visit and teach patients to use one pharmacy |
| Although predictable physiological and psychosocial changes occur with aging ( ) | much variability exists among patients |
| Older adults with cognative decline and memory loss can benefit from ( 3 ) | aids to drug administration such as alarmed pill containers, medicine management boxes, and clearly written instructions |
| older adults have (more/fewer) adverse drug events | more |
| Older patients with arthritis should have ( ) unless ( ) | screw top bottles unless there are young children in the household |
| The principle complications of drug therapy in older adults (4) | 1- due to degeneration of organ systems 2- multiple and severe illness 3- polypharmacy 4- unreliable compliance |
| Older adults and pharmacokinetics- What happens? What is the nursing response? | degeneration of organs systems affects all phases of pharmacokinetics, adjustment in therapy |
| Most pharmocokinetic changes in older adults are due to (2) | reduced hepatic and renal drug elimination |
| 3 changes in absorption in older adults | decreased gastric motility, decreased blood flow to digestive organs, increased gastric pH |
| 5 elements that slow drug distribution in older adults | 1- increased body fat 2- reduced plasma level 3- less body water 4- liver produces less albumin 5- decreased cardiac output |
| How does the decrease in albumin in older adults affect drug distribution? | less albumin results in decreased plasma protein binding ability. Thus increased levels of free drugs in the system, thereby increasing the potential for drug-drug interactions in the body |
| 5 Effects of reduced drug metabolism in older adults | 1- decreased production of liver enzymes in older adults 2- decreased first pass metabolism 3- Increases half-life of drugs 4- increases plasma drug concentrations 5- increases tissue drug concentrations |
| What is the most common cause of adverse drug reactions in older adults? | The accumulation of toxic amounts of drugs secondary to impaired renal excretion |
| 4 causes and 1 result of reduced drug excretion in older adults | 1- reduced renal blood flow 2- reduced glomular filtration rate 3- decreased activity of tubular secretion 4- decreased nephron function; these 4 result in decreased drug excretion for drugs processed by the kidneys |
| d- glomerular filtration rate | rate of urine production |
| d- tubular secretion | process of substances moving out of the peritubular capillaries into the renal tubule for excretion of urine |
| d- nephron | The functional unit of the kidney |
Created by:
twininger1
Popular Nursing sets