NR 293 Pharmacology for Nursing Content Areas to Review for Exam 1 (Latest 2021)

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NR 293 Pharmacology for Nursing Content Areas to Review for Exam 1 1/18/2021 All Reading Assignments, (ATI), Lecture Materials, handouts are all testable material. Be prepared for math question su... ch as dosage calculations. Apply Nursing Considerations (to the drugs/drug classes listed below)  Assessments to include vital signs, physical assessment, labs  Drug administration: safety, route considerations  Drug toxicity (signs/symptoms) and antidote if applicable  Patient teaching (ex. nutrition, adverse effects, infusion considerations, laboratory reviews)  Health care collaboration  Nursing process Things to Consider: - Know the GENERIC names - Grapefruit juice is usually a good bet - Common Side Effect = HEADACHE/ GI UPSET - herbal supplements that start with G (ex. garlic, ginger, gingko biloba)  risk of bleeding - most meds are contraindicated for pregnancy - pt should not stop meds suddenly & if dose is missed don’t double dose - alcohol should not be consumed w/ most meds - gram + = staph & strep Chapter 1: The Nursing Process and Drug Therapy **5-9 Rights of Medication Administration with ability to determine which “right” was not followed. Right Client (uses 2 patient identifiers ex. name, DOB, MR number) Right Medication Right Route Right Dose Right Time Right Documentation (after admin) Right to Refuse Chapter 2: Pharmacological Principles and Chapter 5: Medication Errors *4 Phases of Pharmacokinetics: 1. Absorption - depends on route of administration EX. Oral meds (takes a while) considerations = food in stomach, pH of GI, liquid form vs enteric-coated aka extended release & *first pass effect (oral meds are inactivated on their 1st pass through liver, may need to give pt higher dose Sublingual absorbs very quickly, pt should wait until its completely absorbed Inhalation absorbed very quickly, travels through alveoli Intradermal/Topical slow & gradual rate of absorption IM absorption depends on solubility of the med IV is immediate absorption 2. Distribution (med travels to site of action) - binding proteins are req. [ex. albumin] 3. Metabolism (med is activated or broken down) - due to enzymes; primarily happens in liver & kidneys, lungs, bowel, blood Infants - organs are immatures so metab. doesn’t happen effectively = high risk of toxicity Older adults’ liver/kidneys dysfunction impacts metab. & slows it down also higher risk for toxicity 4. Excretion - primarily happens through kidneys Minimum Effective Concentration (MEC) /Therapeutic Index - we want to attempt to keep plasma levels between the minimum effective concentration & toxic concentration - certain meds have a high therapeutic index (TI) aka big range between MEC & toxic concentration -other meds have low TI making therapeutic level & toxic level very close together (ex. vancomycin) there’s a  risk for toxicity so blood draws are req. to check trough & peak levels assuring you’re not getting into toxic range 1/2 Life = period of time needed for med to be reduced by 50% if med has longer ½ life (stays in body longer) have  risk of toxicity *Agonists vs. Antagonist Meds Agonist = helps produce an action [ex. morphine binds w/ opioid receptors] Antagonist = blocks normal receptor, opposing action Routes of Administration & Nursing Considerations Oral Med = pt sitting upright (Fowler’s position) may need to mix in applesauce to facilitate swallowing - never chew enteric coated meds - avoid grapefruit juice - administer on empty stomach - liquid form of meds may facilitate swallowing Sublingual = make sure med is fully absorbed before pt eats or drinks, do not swallow Transdermal = assure skin is hairless, clean & thoroughly dry; also rotate sites (prevents irritation) Eye Med = use surgical aseptic technique; drop med in center conjunctival sac w/ gentle pressure for 30-60 sec @ nasolacrimal duct [Show More]

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