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NR130pharmtest1
NR130 pharm study guide test 1
| Question | Answer |
|---|---|
| 1. Identify components of Pharmacodynamics | Biologic, chemical & physiologic reactions. Replace or act as substitutes for missing chem.; increase or stimulate cell activities; depress or slow cell activities; interfere w/function of foreign invading cells (i.e. microbes or neoplasm |
| 2. Identify the controlled substances categories. | Sch I – high abuse,no accepted medical use (heroin, Marijuana, LSD),Sch II – high abuse with severe dependence (narcotics, amphet, Barb),Sch III – less abuse than sch II & mod dependence (non barb , non-amphet stimus, ltd narcotics), Sch IV less abuse tha |
| 3. Describe the process of drug distribution | 3 factors:blood flow to tissues,drugs ability to leave blood, ability to enter cells(protein bound: Tightly bound-slow release,long duration. loose bound-quick release,quick excretion. |
| 4. What is endocytosis | Incorporation of material into a cell by extending cell membrane around substance |
| What is exocytosis | Opposite of endocytosis; involves removing substances from cell by pushing them thru cell membrane |
| What is phagocytosis | Allows cell, usually neutrophils or macrophage to engulf bacterium or foreign protein & destroy w/in cell by secreting digestive enzymes |
| What is pinocytosis | A form of endocytosis engulfs specific substances that have reacted with a receptor site on cell membrane. Allows cell to absorb nutrients, enzymes or other material |
| 5. Identify the Pregnancy categories | A,B, C, D, X; A is least X means don’t give |
| 6. Identify factors that influence drug metabolism | Liver, biotransformation, liophillic into hydrophilic, metabolite, first pass & hepatic enzyme induction (P450 enzyme in liver) |
| 7. Describe first-pass effects and identify which medications undergo this process | Drugs absorbed from small intestine into portal veins & transformed by liver into metabolites some active some not active. Result is a large amt of oral drug is destroyed and never reaches tissues. The portion of drug that gets through the first pass effe |
| 8. Describe half-life and the implications when administering medication | Time it takes for amt of drug in body to decrease to one half of the peak level. Half life is important in determining appropriate timing for a drug dose or to determine duration of drug effect in body. Affected by absorption, distribution, speed of biotr |
| 9. Identify nursing interventions to ensure safe administration of medications | Review contraindications & cautions of drug before administering and possible adverse effects. This helps focus on S/S of adverse effects. Obtain baseline before administering; teach pt about adverse effects & appropriate actions to alleviate potential a |
| 10. Identify nursing interventions for the client experiencing an anaphylactic reaction | Epinephrine, massage site to speed absorption, notify prescriber and discontinue drug. Teach pt to carry epinephrine and wear medic alert bracelet. S/S include hives, rash, difficulty breathing, Increased BP, panic, increased HR, respiratory arrest |
| 11. Identify contraindications for acetaminophen (Tylenol) | Allergy, pregnancy & lactation, hepatic dysfunction or chronic alcoholism (toxic liver effects) |
| 12. Identify nursing assessments for acetaminophen (Tylenol) toxicity | TEACH PT that it can cause liver failure & to avoid toxic doses. Assess for contraindications – allergies, pregnancy or lactation, hepatic or renal disease, cardiovascular dysfunction, hypertension, GI bleeding or peptic ulcers; Assess for baseline status |
| 13. Describe evaluation methods for the client taking allopurinol (Zyloprim) | Low Purine Diet, adverse effects: pruritis w/maculopapular rash, elevated LFT’s, acute gout syndrome. Evaluate hypersensitivity reactions from risk factors including renal dysfunction, hepatic disease, chronic alcohol abuse, thiazide diuretics. Potential |
| 14. Identify nursing education measures for the client taking probenecid (Benemid) | Uricosuric agents sh/be avoided in pts with renal dysfunction. Major side effects incl rash, GI intolerance, uric acid stone formation, low dose aspirin can block effects |
| 15. Identify nursing interventions for GI adverse reactions to medication | |
| 16. Identify nursing assessments with administration of opioids analgesics (Morphine) | Respiratory depression, CNS effects, GI depression, Constipation, drug-drug interactions, effectiveness of safety & comfort measures |
| 17. Identify nursing education measures for barriers of mass media information regarding medications | Internet, mass media & alternative therapies. PT EDUCATION key; site evaluation incl – navigation, contributors, feedback mechanism, dates, accuracy/reliability. Commercials have info required by FDA |
| 18. Identify nursing education measures for herbal medications | Ask pts what they are taking, any reactions. Some don’t report think they are not drugs or are embarrassed; herbals vary in ingredients, amount of active ingredient (more than needed), lack of good testing & regulation. CHECK WITH YOUR DR |
| 19. Identify education related to disposal of medications | Educate them not to flush down toilet or just throw them out. Proper disposal incl taking out of original containers, mix with coffee grounds or kitty litter & put in impermeable nondescript containers & throw out in trash or return to pharmacy in pharm t |
| 20. Identify nursing assessments for aspirin toxicity | Adults: Tinnitus & hearing loss, metabolic acidosis & respiratory alkalosis might be present; Children – hyperventilation, CNS effects, reyes syndrome |
| 21. Identify nursing education measures regarding histocompatibility testing | HLA testing prior to transplantation. Post: Lifelong therapy, protect from infections, supportive measures for flu like symptoms, monitor nutrition- small freq meals, females use barrier contraception, provide education re: adverse effects such as infe |
| 22. Identify which cell cycles are more vulnerable to antineoplastic agents | S phase (DNA/RNA synthesis) and Mitotic phase. S phase drugs include antimetabolites; M phase are mitotic inhibitors |
| 23. Describe the processes of anaplasia | Cancer cells lose cellular differentiation and organization which leads to a loss of their ability to function |
| Describe the processes of angiogenesis | Abnormal cells release enzymes to generate blood vessels in the area to supply oxygen & nutrients to cells to help them grow |
| Describe the processes of autonomy | Ability to grow without usual homeostatic restrictions that regulate cell growth & control |
| Describe the processes of metastasis with regards to cancer cells | Neoplastic cells grow uncontrollably invading & damaging health tissue in the area and even undergoing metastasis- traveling from place of origin to develop new tumors in other areas of the body |
| 24. Identify nursing measures related to the safe administration of antineoplastic agents | Exposure- special precautions (ppe, double flushing). For pt monitor baseline blood counts, monitor for allergic reactions, bone marrow suppression complications, monitor for oncologic emergencies such as infections, pulm toxicity, Stomatitis, bleeding, |
| 25. Identify appropriate nursing interventions related to stomatitis as an adverse effect of antineoplastic agents | Oral care, no toothbrushes |
| 26. Identify common side effects of cisplatin (Platinol) | Neurotoxic –have amifostine and mesna to help limit effects such as N/V. Other S/E nephrotoxic, serious hypersensitivity reactions, ototoxic |
| 27. Identify common adverse effects of Tamoxifen | s/s of menopause ie hot flashes, rashes, n/v, vaginal bleeding, menstrual irregularities, edema, pain, CVA, pulmonary emboli. Also can cause CNS depression, bone marrow depression, GI toxicity, can change visual acuity, corneal opacities & retinopathy, |
| 28. Identify common adverse effects of azathioprine (Imuran) | Increased risk for infections and growth of neoplasms due to blocking effect on immune system; hepatotoxicity, renal toxicity, renal dysfunction, pulmonary edema. Pts may experience headache, tremor, secondary infections, GI upset, diarrhea, hypertension |
| 29. Identify clients at risk for infection related to immune function | Transplants, autoimmune disorders, cancer pts, using immunosuppression drugs |
| 30. Identify types of immunity provided by T-cells and B-cells | T Cells provide cellular immunity providing Cytotoxic T cells (chem. Released to guide phagocytes), helper T cells respond to immune activity to stimulate other lymphocytes; suppressor T cells. B Cells are humoral immunity. B cell changes to a plasma ce |
| 31. Identify education measures related to the administration of interferon alfa-2b (Intron-A) | interferons are chemicals secreted by cells invaded by viruses |
| 32. Identify measures related to rituximab (Rituxan) to minimize adverse effects | Protect from infections, supportive/comfort care for flu like symptoms, monitor nutritional status (small freq meals), instruct females to use barrier contraception, provide education on avoiding adverse effects, proper administration, waring signs, |
| 33. Identify nursing education measure related to the administration of methotrexate (Rheumatrex) | Follow regimen, maintain nutrition if GI effects are severe, plan for rest periods, cover head in extreme temps, avoid situations that can lead to infection, use safety measures due to dizziness headache or drowsiness |
| 34. Identify nursing interventions for the client experiencing transplant rejection | Use of immune suppressants like T & B cell suppressors, monoclonal antibodies; monitor response of drug, monitor for adverse effects, evaluate effectiveness of teaching plan, monitor effectiveness of comfort measures and compliance to regimen |
| 35. Identify recommended schedules for MMR vaccines in pediatric clients | Minimum age for dose 1 is 12 mos.; dose 1 to dose 2 is 4 weeks. Ex first dose 12 mos. 2nd dose 15 months |
| 36. Identify common side effects of vaccines | Hypersensitivity, immune/inflammatory reaction that is being stimulated: fever, rash, malaise, chills, fretfulness, drowsiness, anorexia, vomiting, irritability. Pain redness swelling even nodule formation at injection site |
| 37. Identify recommended schedule for Tetanus vaccines | Tdap, then booster every 10 years |
| 38. Identify evaluation methods to assess therapeutic response to a vaccine | |
| 39. Identify nursing assessments related to administration of immune sera | Assess for allergies to drugs or components; current pregnancy status, previous exposure to serum (hypersensitivity), evidence of thrombocytopenia or coagulation disorders, immunization history; perform physical to establish baseline status, inspect for s |
| 40. Identify common side effects of NSAIDs | Nausea, dyspepsia, GI pain, constipation, diarrhea, flatulence, potential for GI bleed, Headaches, dizziness, somnolence, fatigue, bleeding, platelet inhibition, and bone marrow depression. Rash & mouth sores, Allergies! |
| 41. Identify nursing assessments related to ototoxicity of medications | |
| 42. Identify nursing assessments related to administration of COX-2 inhibitors | GI effects, changes in bleeding time, and water retention. Possible cardiovascular issues, skin reactions including stevens-johnson syndrome |
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rivabard
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