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Exam 4

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Answer
Special Considerations for Administrating Medications to Specific Age-Groups   Infants and Children, Older Adults, Polypharmacy, and Self-Prescribing of Medications.  
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Infants and Children   Children vary in age;weight;surface area;and the ability to absorb, metabolize, and excrete medications.  
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Polypharmacy   Happens when a patient uses two or more medications to treat the same illness, when a patient takes two or more medications from the same chemical class, or when the patient uses two or more medications with the same or similar actions to treat different  
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Self-Prescribing of Medications   Educate the patient on the dangers of self-prescribing of medications and tell the patient to take medications only if perscribed by his or her health care provider.  
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Oral, Buccal, Sublingual Routes   Routes are convenient and comfortable for patient, economical, sometimes produce local or systemic effects, and rarely cause anxiety for patient. Avoid when pt. has alterations in GI fx.  
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Parenteral (Sub-Q, IM, IV, ID, Epidural) Routes   Route provide means of administration when oral drugs are contraindicated, more rapid absorption occurs than with topical or oral routes, IV infusion provides drug delivery when pt is critically ill. Risk of infection, expensive, avoid with bleeding tend  
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Topical   Skin applications primarily provide local effect, painless, limited side effects. Extensive applications are bulky and often impair physical mobility. Do not apply if skin abrasions are present.  
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Transdermal   Provide prolonged systemic effects, limited side effects. Leaves oily or pasty substance on skin and soils clothing.  
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Eyes, Ears, Nose, Vaginal, Rectal, Buccal and Sublingual   Local application to involved sites provides therapeutic effects, aqueous solutions are readily absorbed and capable or causing systemic effects. Some embarassment with rectal or vaginal meds.  
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Inhalation   Provides rapid relief for local resp problems, provides easy access for introduction of general anesthetic gases. Some local agents cause serious sytemic effects.  
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Intraocular Disk   Advantageous in that it does not require frequent administration like eye drops. Local reactions can occur. Pt. must be taught how to insert and remove disk, expensive, and contraindicated with eye infections.  
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What are the factors to include in assessing a client's needs for and responses to drug therapy   Access patient's perceptual or coordination problems, patient's current condition, patient's attitude about medication use, patient's knowledge and understanding of medication therapy, and patient's learning needs.  
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List 6 rights of drug administration   Right Dose, Time, Pt., Route, Med, and Documentation.  
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Describe the process of elmination   Depends on the fx of the kidneys, ureters, bladder and urethra. The kidneys remove wastes from the blood and urine. The ureters transport urine from the kidneys to the bladder. The blader holds urine until the urge to urinate develops and urine leaves t  
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Normal range of urine production   1-2L per day.  
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Urine Composition   95% water and 5% solutes. Solutes include electrolytes and organic solutes such as urea, uric acid, creatinine, and ammonia.  
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Factors Influencing Urinary Elimination   Medication usage, mobility status, enviornmental barriers, sensory restrictions, past illness, major surgery, urinary diversion, personal habits, fluid intake, age.  
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Techniques used to assess urinary elimination   History, patterns, symptoms, factors affecting, skin and mucous membranes, kidney flank, bladder, urethral meatus, I&O and Urine Cx.  
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Identify cx.for normal and abnormal urine.   color (normal pale straw to amber) hematuria not normal. clarity, cloudy not normal. odor.  
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Nursing interventions for clients with urinary elmination problems   Adequate hydration, ensure pt. comfort and privacy, allow time, integrate pt. habit, access to toilet, appropriate position.  
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Describe techniques for collectin urine specimens   Clean-voided or midstream specimen, sterile specimen (from new drainage bag or indwelling catheter), 24h urine specimen.  
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Diuretics   Loop diuretics, potassium-sparing diuretics, thiazides and thiazide-like diuretics.  
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Role of GI organs in digestion and elimination.   peristalsis and in small intestine there is both digestion and absorption.  
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Explain how psychological and physiological factors influence bowel elimination.   Age, Diet, Position during defecation, pregnancy, diagnostic tests, fluid intake, activity, psychological factors, personal habits, pain, medications, surgery and anesthesia.  
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Constipation   symptom and usually includes infrequent bowel movements, difficult passage of feces, inability to defecate at will, and hard feces. Common causes include changes in diet, medications, inflammation, environmental factors and lack of knowledge about regula  
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Impaction   results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that the patient is unable to expel. Oozing of diarrhea stoll develop.  
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