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Pharm T3 Breakdown
| Question | Answer |
|---|---|
| Diluent | Fluid that makes mixture less concentrated. Fluid dilutes mixture. Used to convert dry substance to liquid. |
| Reconstitution | Combining dry mixture with fluid |
| Solution Concentration (Strength) | Amt of drug in quantity of solution expressed as ratio, fraction, or %. EX. 100mg/100mL or 1:1 EX. 1/2 strength or 50% solution |
| Suspension | Liquid where fine particles are dispersed throughout fluid by shaken or stirred. If left alone, solid particles settle. EX. Antibiotics are often oral suspensions |
| Bolus | Concentrated med solution given by IV over brief time. Often by IV push (direct inj into vein) |
| Continuous IV infusion | IV sol that flows continuously and doesn't have a stop or discontinue date/time. Pts that're NPO or surgical usually get Cont IV infusion. EX. Dextrose 5% in water at 75mL/hr. |
| Drop Factor (DF or Tubing Factor) | # of gtt per mL through IV tubing. Tubing diameter affects size of drop. Used to calculate flow rates on gravity devices. |
| Flow Rate | Rate which fld is delivered by IV infusion devices, usually in whole mL/hr. EX. Infuse [sol] at 100ml/hr. |
| Primary Infusion Line | Main IV line connected to Pt. May have 1+ primary line. First line is usually "dedicated" to fluid delivery, maintenance. Addtl lines reserved for meds or medicated solutions that're incompatible with other fluids. |
| Secondary Infusion Line | Tubing that connects to ports on primary line. Permits variety of addtl meds/flds to be added w/o disruption of primary line. |
| Intermittent Infusions | Small-vol medicated IV sol delivered at intervals. IVPB equip, syringe pumps, calibrated volume-control burette chambers are most common. |
| IVPB | Small-vol infusions (50-100mL) infused through short secondary tubing line that's PB to port on primary line. Intermittent medicated infusions are delivered over 20-60min. |
| IV Push (incorrectly addreviated as IVP) | IV concentrated, medicated, intermittent bolus dose of 1-50mL, usually administered by manual direct inj c syringe, sometimes via infusion pump. |
| Macrodrip | Gravity IV infusion tubing set that has wide diameter to deliver large drops, fast flow rates (10-20 gtt/mL DF) |
| Microdrip | Gravity IV infusion tubing set that has narrow diameter to deliver small drops, slow flow rates (60 gtt/mL DF) |
| PCA pump | Pt-controlled analgesia pump by remote push button. Programmed to dispense prescribed amts of analgesic narcotics & other meds at prescribed intermittent intervals c intermittent lockout intervals. |
| TKO/KVO | To Keep Open/Keep Vein Open. Flow rate order for min rate that will keep the IV line patent and prevent coagulation. |
| DM | Endocrine disorder affecting pancreatic insulin production. utilization, & carb, fat, P metabolism. Characterized by high blood glucose levels. |
| DM Type I | Little or no insulin production by beta cells. Usual onset in childhood. Treated with insulin hormone administration. |
| DM Type II | Some insulin production but not enough or resistance to insulin utilization. Controlled c dietary/lifestyle changes or treated c oral antidiabetics. Insulin may be added. |
| DKA (Diabetic Ketoacidosis) | Emergency condition diagnosed by high blood glucose levels (>250mg/dL), blood pH <7.3, elevated ketones in blood and urine, and often coma. Requires hospitalization and insulin therapy. |
| Glucagon | Blood glucose-raising hormone secreted by alpha cells. Released in response to fall below normal blood glucose levels. |
| Insulin | Blood glucose-lowering hormone produced by beta cells in pancreas. Starts entry of glucose into muscle cells for E storage. Lowers blood glucose levels. (INsulin helps glucose get IN to cells) |
| Hyperglycemia | Elevated glucose level in blood |
| Hypoblycemia | Decreased glucose level in blood |
| Insulin Resistance | Decreased tissue ability to respond to insulin. Glucose level rises. Hyperinsulinemia occurs. Occurs in Type II, obese, HTN Pts. |
| Insulin Shock | Blood glucose <60mg/dL. Cause by OD of insulin or taking insulin and eating at wrong time. |
| Units | Measurement of therapeutic effectiveness. |
| Blood Glucose (BG) | BG test. |
| Fasting Blood Sugar (FBS) | Fasting 8-12hr shows current blood glucose level |
| Fructosamine | Determines avg blood glucose level over past 2 wks |
| Glycosylated Hemoglobin (A1c or HbA1c) | Determines avg blood glucose lever over past 2-3 mo. Measures amt of glucose attached to hemoglobin in RBC. |
| Postprandial Glucose Test | 2h pc blood glucose test. Results are elevated in diabetics. |
| Normal level of Fasting Blood Glucose level | 70-100 mg/dL |
| Reconstituted meds can be used ONLY: | If the reconstituted med is appropriately labeled: Pt's name. Date/time of prep. Diluent type. Amt added. Concentration per mL p dilution. Nurse's sig. Discard date/time. |
| Parenteral meds are Sterile or Non-Sterile? | Sterile |
| Diluent for reconstitution of parenteral meds are Sterile or Non-Sterile? | Sterile |
| Adult avg IM inj is X mL? | No more than 3 mL |
| You should select a dilution that permits at least X mL of IM inj. | 0.5 mL |
| Orders can be written in 3 ways to indicate the strength or concentration of a solution. | %, Fraction, Ratio |
| Concentrate | Med needs to be diluted |
| Inactive Diluents | NS, SW, Bacteriostatic Saline |
| Dilute In | In Addition To (Add enough diluent to make total) |
| Dilute To | Total (subtract the med amt from the total amt = how much diluent is needed) |
| Macrodrip tubing has a DF of: | 10, 15, or 20 gtt/mL (DF10, DF15, DF20) |
| Microdrip tubing has a DF of: | 60 gtt/mL (DF60) |
| D stands for | Dextrose |
| L/R stands for | lactated Ringer's |
| When do you use microdrip tubing? | With peds and blood or more viscous meds |
| One calculation needed for all infusion rates? | Determination of # of mL/hr |
| Flow rates of mL/hr and gtt/min are rounded: | To nearest whole # |
| On gravity dependent devices, the Primary or Secondary flows first? | Whichever one is higher |
| If answer is >60 gtt/min then: | Recheck answer bc it's probably wrong |
| mL/hr and gtt/min will be = if using DF of? | DF60 bc there are 60min in an hour |
| Which renal function tests should you know about when dealing with Potassium? | BUN, Creatinine, and K level |
| You should never administer K: | Undiluted |
| What can undiluted K cause? | Tissue necrosis, vessel damage, and cardiac arrest |
| Hypokalemia | Too little K |
| Hyperkalemia | Too much K |
| S/S of Hypokalemia | Small elevation of blood pressure. Cardiac arrythmia. Muscular weakness. Myalgia. Muscle cramps. Constipation. Flaccid paralysis. Hyporeflexia. Tetany. |
| S/S of Hyperkalemia | Malaise. Palpitations. Muscle weakness. Mild hyperventilation. Cardiac arrhythmia. Death |
| Insulin is given by what route? | SQ |
| What insulins can be given by IV? | Humulin R and Lispro (Humalog) |
| Intermediate and Long acting insulins should be ____ before drawing up. | Gently rolled (Cloudy is rolled, clear isn't) |
| Lantus and Levemir insulins are both short, intermediate, or long acting? | Long acting insulin |
| Which insulins do not have a peak? | Lantus and Levemir |
| Which insulins can't be mixed with other insulins? | Lantus and Levemir |
| Which insulins should be given at the same time q day? | Lantus and Levemir |
| Can insulins come premixed? | Yes, Novolog Mix 70/30. Humalog Mix 75/25. Novolin 70/30. Humulin 70/30. Humulin 50/50. |
| Should you roll or shake insulins that are premixed? | Yes. |
| Insulin IV infusions are usually mixed with concentrations of ___unit/mL or ___unit/mL | 0.5 unit/mL or 1 unit/mL |
| What is regular or short acting insulin normally mixed with? | NS |
| What type of insulin do insulin pumps contain? | Short or regular insulin |
| What basal rate are short acting (regular) insulin given at in insulin pumps? | Slow continuous basal rate |
| What Pts are insulin pumps normally used for? | Diabetics with blood sugar that's difficult to control. |
Created by:
mcwilliams05
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