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NUR 105-chpt 3

Lifespan Considerations

In Pregnancy, a drug listed as Category A means what? No risk
In Pregnancy, a drug listed as Category B means what? No risk to animals (no info on humans)
In Pregnancy, a drug listed as Category C means what? Adverse for animals (no info on humans)
In Pregnancy, a drug listed as Category D means what? Possible fetal effects (risk to benefit ratio)
In Pregnancy, a drug listed as Category X means what? Fetal risk increased (prohibited use in pregnancy)
True or False. Drug levels in breast milk are higher than in blood. False
Neonate Considerations for drug therapy are: Immaturity of organs, a decreased first pass elimination, decreased GFR, decrease in gastric emptying, decrease in fat content, an increase in topical absorption, increase in gastric pH, and and increase in body water
Pediatric Considerations for drug therapy are: Skin is thin and permeable, stomach lacks acid to kill bacteria, lungs lack mucus barriers, body temperature is poorly regulated, liver is immature, and kidneys are immature.
How do you determine pediatric dosage? (BSA of child/BSA of adult) X (adult dose)= estimated child
When administering medication, what is the best way to do so for an infant? administer swiftly administer comfort (mom,dad, or nurse) Allow self-comforting (thumb or pacifier)
When administering medication, what is the best way to do so for a toddler? Give brief/concrete explanation (administer) Accept some aggression (comfort) Increase understanding through play (concrete understanding)
When administering medication, what is the best way to do so for a pre-school aged child? Brief/Concrete Explanation (do it) Accept some aggression Parent is important to comfort Use magical thinking (this medicine is magic and will make you better)
When administering medication, what is the best way to do so for a school aged child? Explain Allow some control Provide comfort Set behavior limits Provide activities to release aggression
When administering medication, what is the best way to do so for an adolescent? Prepare in advance Allow expression (without losing face) Participation
How is absorption affected by the elderly (geriatric) patient? Gastric ph is decreased Gastric emptying is slowed bc less muscle tone & motor activity Gi tract is slower bc of decreased muscle tone & motor activity Blood flow to GI tract is slowed bc of decreased cardiac output Gi tract movement is slower bc
How is distribution affected by the elderly (geriatric) patient? Water weight is decreased Fat content is increased bc of decreased lean body mass Protein binding sites are decreased by aging liver and decreased protein intake
How is metabolism affected by the elderly (geriatric) patient? Aging liver produced less microsomal enzymes Liver blood flow reduced by 1.5%/year after age 25 thus decreasing hepatic metabolism.
How is excretion affected by the elderly (geriatric) patient? GFR decreases due to decreased blood flow (40-50%) The number of intact nephrons decreases
Physical assessment, allergies, med history, unusual responses, OTC medicines, age realated issues, growth and dev, polypharmacy, list all MD's, home remedies, dietary habits, self med practices, limitations, kidney and liver function are ex's of what? Nursing Assessment date to be collected on elderly (geriatric) adult.
The nurse is reviewing factors that influence pharmacokinetics in the neonatal patient. Which factor puts the neonatal patient at risk with regard to drug therapy? A) immature renal system B) hyperperistalis in GI tract C) Irregular temperature regulation D) Smaller cirulatory capacity (a)
The physiologic differences in the pediatric patient compared with the adult patient affect the amount of drug needed to produce a therapeutic effect. The nurse is aware that one of the main differences is that infants have.... A) increased protein in circulation B) fat composition lower than 0.001% C) more musculat body compostion D) water compostion of appx 75% (d)
While teaching a 76 yr old pt about the adverse effects of his meds, the nurse encourages him to keep a journal of the adverse effects he experienced. This intervention is impt for the elderly patient bc of the alterations in pharmacokinetics, such as: A) increased renal excretion of protein-bound drugs B) more alkaline gastric pH, resulting in more adverse effects. C) decreased blood flow to the liver, resulting in altered metabolism D) less adipose tissue to store fat soluable drugs (c
When the nurse is reviewing a list of meds taken by an 88 yr old pt, he says "i get dizzy when i stand up". also nearly fainted a time or two in afternoons. Systolic drops 15 points when she stands. What med could be responsible? A) NAIDs B) Cardiac glycosides C) Anticoagulants D) Antihypertensives (d)
A preganant pt who is at 32 weeks has a cold and calls the office to ask about taking OTC med that is rated as pregnancy category A. Which answer by the nurse is correct? A) "this drug causes problems in the human fetus, so you should not take this medication" B) "Studies indicate there is no risk to the human fetus, so its okay to take it as directed, if you need it." (b)
The nurse is preparing to administer an injection to a preschool aged child. Which approaches are appropriate for this age group? A)Explain to child in advance about injection B)Provide brief, concrete explanation about injection C)Encourage participation D)Make use of magical thinking E)Provide comfort measures after injection (b, d, e)
What is polypharmacy? The use of many different drugs concurrently in treating a pt, who often has several health problems.
What is a nomogram? A graphic tool for estimating drug dosages using various body measurements
A neonate is how old? younger than one month
A pediatric pt is how old? 12 or younger
An infant is how old? 1 month to 1 year
Premature is born when? less than 38 weeks gestation
Which physiologic factor is most responsible for the differences in the pharmacokinetic and pharmacodynamic behavior of drugs in neonates and adults? A) Infant's stature B) Infant's smaller weight C) Immaturity of neonatal organs D) Adults longer exposure to toxins (c)
When considering drug therapy in pediatric patients, the nurse recongnizes that which group of drugs is the most toxic for children? A) phenobarbital, morphine, asprin B) phenobarbital, codeine, atropine C) theophylline, atropine, digoxin D) morphine, atropine, digoxin (a)
Most drug references recommend that pediatric dosages be based on which of the following? A) total body water content B) fat to lean mass ratio C) heigh measured in centimeters D) milligrams per kilogram of body weight (d)
When considering drug dosages in elderly patient, the nurse recognizes that drug dosages in the elderly should be based: A) more on age than height or weight B) more on weight than age C) on the total body water content D) on the glomerular filtration rate (GFR) (b)
When giving meds to the elderly, the nurse should keep in mind the changes that occure due to aging. WHich of the following statements regarding changes in elder pts are true? A)total body water content is increased as body composition changes B)gastric pH is less acidic bc of rduced hydrocholric acid production C)protein albumin binding sites are reduced bc of decreased protein (b,c,d)
Created by: jessicaspring