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Pharm first exam

Units 1-3

What should the nurse teach a patient first about adverse drug reactions? Seek medical help immediately
What happens when a patient has a deficiency of the enzyme needed for drug elimination? The drug remains in the body much longer.
What is the effect of poor circulation due to heart failure on drug metabolism and elimination? It can lead to slower drug metabolism and elimination resulting in a toxic buildup of drug blood levels.
What is the risk for a pregnant woman in taking Category D drugs? They have been tested and are known to greatly increase the risk of birth defects.
What precaution should parents take prior to giving OTC drugs to children? Have the dosage confirmed by their physician or pharmacist.
May a patient refuse a drug? Yes but the nurse should investigate why. The nurse needs to make sure the patient understands why the drug has been prescribed and the consequences of refusing to take it.
What should the nurse do if a patient's vital signs are of concern prior to administering a drug? Look for limitations of the order; if none notify the physician and ask if the drug may be given.
How is Prilosec dosed? In delayed release capsules.
What route is the fastest for pain relief? The rates of absorption and action are very rapid with the intravenous route.
What are the 6 rights of safe drug administration? Right patient, drug, dose, route, time and documentation.
What does the STAT order mean? Give the drug as soon as available.
What is a red flag for a possible drug error? When a patient does not recognize a drug that is being given.
What is the most important question to ask a patient before administering a new drug? Are you allergic to any drugs?
True or false: Any side effect or response a patient has after starting a new drug should be investigated even when it is an expected side effect of the drug. TRUE
What is the first thing the nurse does in her investigation? Assess the patient. Check the vital signs for changes.
Where should a transdermal patch be placed on a child? Between the shoulders on the back; out of the child's sight.
What are the limitations for a patient who cannot swallow? They should not have any drug, drink or food by the oral route.
How can a nurse tell if the feeding tube is in the trachea and not in the stomach? When carbon dioxide comes from the feeding tube.
What are common signs of infiltration? The IV site is red and swollen; hurts and there is no blood return.
What is the nurse's best action when an IV has infiltrated? Discontinue the IV and notify the prescriber.
When is the best time to teach a patient? When the patient is not distracted or uncomfortable.
What is an effective way to motivate a patient? Focus on the positive aspects of the new knowledge or skill.
What should the nurse obtain before teaching a patient about a new drug? Ask the patient what he wants to know. This determines what the patient already knows and what concerns him most.
What should the nurse teach a patient receiving IV drug therapy? To call if the patient feels any pain or burning at the IV site.
What should the nurse do if the IV site develops phlebitis (inflammation of the vein)? The vein will feel hard and cordlike. Discontinue the infusion and remove the catheter.
What should the nurse do if she/he observes pus oozing from the IV site? Discontinue the IV. You do not need an order. But, you should notify the prescriber of your action.
What complication should the nurse be alert for with an IV infusion of potassium chloride? Potassium chloride is an irritant that can traumatize the vein and stimulate the reponse of phlebitis. Check the vein above the insertion site for vein hardness and a cordlike feel.
What is the best action a nurse can take to reduce the risk for chemical trauma when administering a known chemical irritant drug? Diluting a drug can reduce the chemical trauma but it is necessary to check first with the pharmacist to determine which specific fluid can be used to dilute the drug.
What is the nurse's best action if the patient presents with shortness of breath due to fluid overload? The nurse should slow the IV and notify the prescriber immediately.
What must the nurse remember about pain? Pain may occur more frequently among older adults but is never considered "normal".
What is the best way to assess a patient's need for pain medication? Ask the patient to rate the pain.
What is the nurse's best response to a patient afraid of becoming addicted to opioids prescribed for pain relief? The use of opioid drugs when used for relief of acute pain rarely result in addiction.
What must the nurse remember about stress tiggers with chronic pain? Adaptation to the presence of chronic pain is physiologic. The usual alterations in vital signs do not appear.
What is the nurse's best action to assess a patient sleeping 1 hour after receiving an opioid analgesic. Attempt to rouse the patient by calling his/her name and lightly shaking their arm.
What must the nurse ask the patient before administering Celebrex? Are you allergic to sulfa drugs?
Which OTC analgesic does not interfere with blood clotting? Acetaminophen
What precaution should a patient take who is taking acetaminophen? Acetaminophen can cause severe liver damage and this is more likely when combining the drug with alcohol.
What is a adverse effect of nortriptyline? It can cause fluid retention which can result in weight gain which can make heart failure worse.
Why is pain the fifth vital sign? Because that is how often pain should be assessed, when you take vital signs.
Where is pain perceived? Brain
What are the characteristics of acute pain? Sudden onset, identifiable cause, limited duration, triggers physiological changes, improves with time even when not treated.
What are the characteristics of chronic pain? Present daily for 6 months, persists or increases with time, may not have an identifiable cause, and does not trigger the stress response.
What is pain intensity? How much pain the patient feels.
Who is the FLACC pain rating scale used for? Infants and patients who are not alert
Who is FACES pain rating scale used for? Children and non verbal adults
What are nociceptors? Sensory nerve endings that when activated trigger the message sent to the brain that allows perception of pain.
What is localized pain? Patient feels pain that is confined to the site where the tissue damage is located.
What is projected pain? Patient feels the pain all along the path of the nerve from the point of damaged tissue to the spinal cord.
What is radiating pain? A person feels the pain all around and extending out from
What is referred pain? A person may sense pain in an area that is not close to the tissue causing the pain.
What is pain threshold? The smallest amount of tissue damage that makes a person aware of having pain.
What is pain tolerance? A person's ability to endure or stand the pain intensity.
How is the best pain relief obtained? When drugs are taken on a regular basis rather than PRN.
What is the mechanism of action of opioids? They alter the perception of pain.
Why should the patient be checked for pain relief after 30 minutes? It helps determine if the drug is right for the patient's pain, if the dose needs to be changed, or if the pain control strategy needs to be adjusted.
What is a side effect on older adults taking Demerol? Can make the chest muscles tighter, making breathing and coughing more difficult. Thus the risk for pneumonia and hypoxia is greater.
What is a common side effect of opioids? Constipation
What is the mechanism of action of NSAIDs? They act at the tissue where pain stops and do not change a person's perception of pain, like opioids.
What are the S&S of salicylate poisoning? Fever, rapid heart rate, and respirations, abdominal pain, nausea, vomiting, confusion, tinnitus.
Why must you check the blood pressure of a person taking NSAIDs? NSAIDs can cause retention of sodium and water leading to higher blood pressure.
Why should indomethacin and celecoxib be avoided in the last 3 months of pregnancy? They can cause a blood vessel important to fetal circulation (the ductus arteriosus) to close which would impair the oxygen supply to some fetal tissues.
What are the most common antidepressant drugs used for pain control? Amitriptyline, nortriptyline, paroxetine and sertraline.
Created by: judypilcher
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