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NR293 Pharm Exam 1-3 Study GuNR293 Pharm Exam 1-3 Study Guideide
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Pharm 293 Exam 1 Study GuideChapt.1
1.Nursing process and medication administration. pg.7
Assessment – get data, review & analysis; know all drugs, vitamins, herbs & supplements taken
Diagnosis – 3 step processes; response to illness, “related to”, ”as evidenced by”
Planning (goals & outcome) – measurable & realistic goals w/ set time of achievement
Implementation (education) – starting and completing nursing actions
Evaluation – check if goals have been met if not change the goal
2. Six rights for med administration pg.11
Right drug
Right dose
Right time
Right route
Right patient
Right documentation
3. Pharmacokinetics and absorption pg.22
Pharmacokinetics – study of what the body does to the drug from beginning to end;
Absorb
Distribution
Metabolism
Excretion
Absorption – movement from the drug administered site into circulatory system
4. Terminology: First pass effect pg.22, bioavailability pg.22, synergistic pg.33, antagonistic
pg.33, pharmacokinetics pg.22, superinfection pg.613
First pass effect – First time your body is affected by the medication. A PO dose would be higher
because it has to be metabolizes through the liver, therefore having a smaller firt time effect.
Bioavailability – amount of time it takes the drug to fully absorb
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, Synergistic – 2 drugs given at the same time; effect is stronger than taking each drug separately
Antagonistic – 2 drugs given at the same time, effects are weaker then each given separately;
they cancel each other out.
Pharmacokinetics – the study of what the body does to the drug from beginning to end.
Superinfection – when antibiotics are given and it kills or reduces our normal flora causing an
infection.
5. Parenteral pg.23 and transdermal routes pg.25
Parenteral route – fastest absorption; straight into circulatory system by injection; advantage of
bypassing first-pass effect of the liver; alternative route for PO
Transdermal – adhesive patch of medicine on skin; commonly used for systemic effect
6. G6PD deficiency pg.35, liver dysfunction as it relates to medication metabolism ???
Glucose-6-phosphate dehydrogenase – enzyme found in large amounts in tissues of most
people; reduces risk of killing RBC (hemolysis) when in contact w/ oxidizing drugs (aspirin); in
African-Americans 13% of men & 20% of women carry a gene that results in G6PD deficiency.
Chapt.3
7. Drugs and pregnancy, Categories as per the FDA. Chp. 3 PPS 3
Category A – no risk to human fetus
Category B – no risk for animal fetus; info on humans not available
Category C – adverse effects on animal fetus; info on human not available
Category D – possible fetal risk for humans; consideration on potential benefit versus risk may
be used on pregnant women.
Category X – fetal abnormalities; positive fetal risk for humans from studies on animals and/or
humans; not to be used on pregnant women.
8. Medication errors and prevention, consequences. Chpt.5 PPS 9-15; Pg. 72
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, Multiple systems of checks & balancing
Legible & correct orders
Appropriate consult
Check med order 3 times
“Six rights”
Minimize verbal or phone orders (repeat order to prescriber, spell drug name loud,
speak slow & clear)
List indications next to each other
Avoid medical shorthand (abbrev. & acronyms)
Never assume anything on item not specified in drug order (route)
Don’t hesitate to question med order when in doubt
Do not decipher illegible written orders (clarify w/ prescriber)
Never use “trailing 0” w/ orders (1.0g bad, 1g good)
Always use “leading 0” for decimal (.25mg bad, 0.25mg good)
Learn administration techniques of certain dosage forms
Always verify new med record
Always listen & honor concerns from pts regarding meds
Check pt allergies & ID
Consequence vary from every institution; may need to do CEU’s; can be suspended or fired; can
be punished by state nursing board w/ suspension or revoking license;
9. Medication reconciliation process pg.71 chpt 5 PPS 20-21
3 steps –
Verification – collection of the pts meds info; (prescription, OTC & supplements)
Clarification – professional review of info to make sure that meds & dosages are
appropriate for pt
Reconciliation – further investigation of discrepancies & documentation of relevant
communications & changes in med orders
Should be done at all stages
Admission
Status change
Pt transfer within or between facilities/provider teams
Discharge
10. Patient medication education pg.92
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, Give verbal & written info about choosing right OTC drug, herb or supplement
Info on correct dose, common adverse effects & possible interaction w/ other meds; they
think there is no risk if herbal & natural, teach advantages & disadvantages of use
Instruct how to read OTC, herbal & supplement labels & directions
Instruct pt that all healthcare providers need to know OTC, herbs and supplements taking
Journal any improvement of symptoms w/ specific uses; for info on what they are taking
teach to use proper resources
Keep out of reach of kids & pets; teach how to properly administer dosage forms
11. OTC medication and toxicities pg. 86
OTC – non prescribed meds; short term; more than 30,000;
Toxicities – when there is too much medication causing adverse effects; it happens in the liver;
OTC’s have more than one ingredient; too much acetaminophen causes hepatic toxicity leading
to liver failure.
12. Herbal medicine and supplements, educating patients. Pg.92
Inform about safe use; frequency of dosing & dose
Specifics of how to take meds (w/ food or at bedtime)
Strategies to prevent adverse effects, drug interactions & toxicity; teach proper use &
application of transdermal patches
Make patient aware that the FDA doesn’t regulate these products unless there is enough
data to support recall.
13. Medication administration and proper orders, clarification of orders. Pg.69
Clarification – professional review of info to make sure that meds & dosages are appropriate for
patient
CONTACT PRESCRIBER IF YOU CAN’T UNDERSTAND HAND WRITING ON ORDER!
14. Medication administration to the older adult. Pg.77
Identify if they need aids at home for safe administration of meds (pill reminder stickers, med
container w/ alarm, weekly pill containers w/ separate compartments for dosage times,
document dosage when taken.
Chapter 38: Antibiotics
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