Download Pharmacology Review Guide and Cheat Sheet and more Cheat Sheet Pharmacology in PDF only on Docsity!
7/
SAINT BARNABAS HEALTH CARE SYSTEM
Preparation for Nursing Pharmacology Test
PHARMACOLOGY REVIEW GUIDE
In order to successfully pass the 50 item pharmacology exam, nurses must achieve an overall score of 80%. However, nurses are only allowed to get 2 calculation questions wrong from the Drug Calculation section of the exam (3 errors in calculation questions means an automatic failure and the nurse must re-take the exam). For the calculation questions on the exam, the nurse must show all work that led to arriving at the answer. Only ONE retake is permitted. Time allotted for exam: 1 1/2 hour (90 min.). I. Categories of Medications Know the actions, use, serious side effects and specific nursing measures for administration of the following frequently ordered medications or categories of medications
Cardiovascular/Antiarrhythmics Beta Blockers eg. metoprolol (Lopressor); atenolol (Tenormin) ACE inhibitors – eg. enalapril (Vasotec) Digoxin (Lanoxin) Nitroglycerine: transdermal patch & paste Adrenergics – dopamine infusion (Intropin) Verapamil (Veracaps SR)
Antidiabetic Agents Insulins: Regular, & NPH Humalog, Humulin, Lantus Metformin (Glucophage) Glyburide (Diabeta) Insulin Pen use
Analgesics/Narcotics Hydromorphone (Dilaudid) Morphine sulfate & MS Contin Oxycodone-acetaminophen. (Percocet)
Diuretics Hydrochlorothiazide (Esidrix) Spironolactone (Aldactone) Furosemide (Lasix )
Hormones – levothyroxine (Synthroid) Agents for Depression/Sedation Fluoxetine (Prozac) Lorazepam (Ativan)
Anti-infectives/Anti-fungals Ampicillin Cefazolin (Ancef/Kefzol) Gentamicin sulfate (Garamycin) Vancomycin
Anti-inflammatory Agents Prednisone/methylprednisolone Dexamethasone (Decadron) NSAIDS – eg.Ibuprophen, Aleve Cox-2 Inhibitors- eg Celebrex
Anticoagulants/Hematologic Agents Heparin sodium Warfarin sodium (Coumadin) Enoxaparin sodium (Lovenox) Dalteparin sodium (Fragmin)
Antiulcer/Antiemetics Famotidine (Pepcid) Omeprazole (Prilosec) Ondansetron (Zofran) Flumazenil (Romazicon)
7/
Antiseizure Phenytoin sodium (Dilantin)
Antidotes Protamine Sulfate Naloxone HCl (Narcan) Vitamin K (Aquamephyton)
High Alert Medications: Identified by TJC (The Joint Commission) -- concentrated KCL, concentrated NaCl,, insulin, heparin
Herbal Interactions: anticoagulants and ginko biloba
II. Important to Know:
- Medication administration based on RN standards of practice.
- How to administer intramuscular injections – variations by weight, size, age.
- Nursing responsibilities for first-dose of any medication.
- Nursing documentation for PRN medications.
- How to draw up and administer insulin subcutaneously and how to use an insulin pen.
- Heparin/Lovenox/Fragmin injection techniques and sites
- Specific lab values to be monitored for patients on Lovenox/Fragmin, Heparin, Coumadin, Vancomycin
- How to apply topical/ transdermal medication/patches
- IV push medications
- How to administer eye and ear drops – adults and pediatric
- How to administer sustained release (SR, LX, LA etc.) tablets/capsules
- Distinguish S/S of hypoglycemia & the interventions for treating it.
- Measures for effective pain management – dosing schedule, documentation, use of appropriate pain scale eg. FLACC, BPS, CPOT, Wong-Baker, Numeric.
- Safety measures for administration of TPN (total parenteral nutrition)
- How to administer meds via NG tube
- IV administration of diluted KCl only via central line or large vein
- Monitoring for IV infiltration of vesicants (e.g. Dopamine)
- Heparin Infusion weight-based dosages
III. Conversions 1 kg = 1000 gm 1 liter = 1000 ml 1 oz = 30 ml 1 gm = 1000 mg 1 kg = 2.2 lbs 1 tbsp = 3 tsp 1 mg = 1000 mcg 1 tsp = 5 ml 1 inch = 2.54 cm
7/
includes unacceptable abbreviations, or does not conform to the patient’s condition, the nurse must contact the physician to correct the problem or clarify the order before administering the medication.
Correct: 4mg Incorrect: 4.0 mg
c. Never use a range of doses or times. Correct: Percocet 1 tab. po q4h Incorrect: Percocet 1-2 tabs q 3- 4 hours.
MISSED MEDICATION DOSES
Whenever a medication dose has been missed, the nurse should contact the physician to clarify what is best for the patient.
When a medication dose is missed eg. the patient is off the unit, the nurse should not assume that the patient can wait until the next dose is due. The decision about the missed dose belongs to the physician.
DANGEROUS
ABBREVIA-
TIONS
Certain previously-acceptable abbreviations CAN NO LONGER BE USED in the medical record.
The TJC and hospital policy now prohibits their use.
If these abbreviations appear in a medication order, the order must be clarified with the physician and rewritten correctly.
WRONG
U
IU
ug
QD/OD
QOD
sc or sq
QID
MS/MSO
MgSO
OS/OD/OU AS/AD/AU
RIGHT
Units International Units
Micrograms, mcg
Daily
Every other day
Subcutaneously
Four times a day
Morphine sulfate (morphine)
Magnesium sulfate
Left/right/both eyes Left/right/both ears
V. Some Helpful Hints: Exam candidates may bring one nursing drug reference book and a calculator (extra batteries recommended) to use during the exam. Example: Mosby’s Nursing Drug Reference by Linda Skidmore-Roth; Cost: approx. $38.00. No cell phones may be brought into the exam area or used during the test.
VI. Sample Conversions and Calculations : The problems below represent the types of calculations that will be presented on the nursing pharmacology exam. The answers are found at the end of this review guide.
7/
Conversions:
a. 2 tsp = _____ mL f. 2 oz = _____ mL b. 450 mcg = _____ mg g. 150 lbs = _____ kg c. .048 gm = _____ mg h. 65 kg = _____ lbs d. 475 mg = _____ gm i. 4.1 mg = _____ mcg e. 3 tablespoons = _____ mL j. 2.5 inches = _____ cm
Calculations:
- A child is to receive amoxicillin 50 mg po. The medication in oral suspension is labeled 125 mg per 5 ml. How many mls should the child receive?
- The liquid medication label reads 100 mg per 2 ml. The order is for the patient to receive 200 mg of the medication. How many mls will be administered?
- The patient is to receive digoxin 0.25 mg IV. Digoxin is in prefilled syringes of 0.5 mg per 2 mls. How many mls will be administered by syringe?
- The physician orders dynapen 125 mg po stat. The bottle is labeled 25 mg per ml. How many mls should be given?
- Penicillin G sodium for injection contains 250,000 units per ml. How many units are there in 3.5 mls?
- The doctor orders 1000 ml of D 5 W every 6 hours. How many mls per hour should the patient receive?
- Calculate the drip rate for an IV of D 5 ½ NS to run at 20 ml per hour using a microdrip set (60 gtts per ml).
- The patient is to receive Keflex 1 gm P.O. On hand is Keflex 250 mg per tablet. How many tablets should be administered?
- Garamycin comes in a concentration of 80 mg per 2ml. How many mls would be needed for a dose of 40 mg?
- The physician orders 1 liter of NS every 8 hours. How many mls per hour should the patient receive? Using macrodrip tubing (15 gtts per ml) what is the flow rate in gtts per minute?
