Download RNSG 1301 Pharmacology Midterm Exam Latest 2025 Complete Full-Length Exam with Accurate An and more Exams Pharmacology in PDF only on Docsity!
RNSG 1301 Pharmacology Midterm Exam Latest 2025
Complete Full-Length Exam with Accurate Answers Lone Star
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Pharmacology the study of drugs and their interactions with living systems Pharmacotherapy the application of drugs for the purpose of disease prevention and treatment of suffering Pharmacokinetics Drug movement in the body. The process by which drugs are absorbed, distributed within the body, metabolized, and excreted. Pharmacodynamics The study of what the drug does to the body and the mechanism of action. Medications drugs given for therapeutic purposes local effect when drug activity is at the site of administration systemic effect A generalized response to a drug by the body. The drug has a widespread influence on the body because it is absorbed into the bloodstream.
Drug Schedules the five categories that drugs are classified into based upon the drug's accepted medical use and its potential for abuse Schedule 1 drugs the highest potential for abuse; no accepted medical use, heroin, LSD, MDMA Schedule 2 drugs
- High abuse potential
- Accepted medical use
- Severe physical and/or psychological dependence Oxycodone, morphine, CNS Stimulants, barbiturate sedatives Schedule 3 drugs
- Less abuse potential than schedule 1 & 2 drugs
- Accepted medical uses
- Moderate or low physical dependence
- High psychological dependence Codeine Schedule 4 drugs
- Lower abuse potential than schedule 3 drugs
- Accepted medical uses
- Limited physical or psychological dependence Benzodiazepines-lorazepam, phentermine, hypnotics Schedule 5 drugs Limited potential for abuse, Ex: cough syrup w/codeine. Drug Enforcement Administration (DEA) The federal agency responsible for enforcing the nation's laws and regulations regarding narcotics and other controlled substances. Established 1973.
- wearing of a sash or vest to signal others to avoid interruptions of the nurse during medication administration Error reduction strategies
- improved communication between professionals
- unit-base RPh rounding with team
- computerized prescriber order entry Sources of Drug Information
- Pharmacology and textbooks
- Drug Reference books
- Journal Articles
- Internet sites High Alert Medications The Institute for Safe Medication Practices (ISMP) identifies drugs that when used in error have a heightened risk of causing significant patient harm. High Alert Medications THEY NEED A DOUBLE CHECK WITH SECOND RN protein binding drugs allows part of the drug to be stored and part released as needed. Drugs that are highly bound to plasma proteins or stored extensively in other tissues have a long duration of action. Protein binding does not increase the speed of action or increase metabolism. Protein binding does decrease the speed of action by storing the drug to be released when needed. Protein binding drugs drugs that are bound to plasma proteins are characterized by a longer duration of action. A drug that is highly protein bound takes longer to begin working therefore longer duration of action. A drug that is NOT highly protein bound will have a shorter duration of action.
Plasma protein binding Medications compete for protein binding sites within the bloodstream, primarily albumin. The ability of a medication to bind to a protein can affect how much of the medication will leave and travel to target tissues. Two medications can compete for the same binding sites, resulting in toxicity. Effects of Age The effects of age on drug action are especially important in neonates, infants, and older adults. In children, drug action depends largely on age and development stage. During pregnancy Drugs cross the placenta and may harm the fetus. Fetuses have no effective way to eliminate the drugs due to immature kidney and liver function. In older adults physiologic changes may alter all pharmacokinetic processes. A nurse is looking up information about the effects of a drug on different receptors. Characteristics of receptors include which of the following? A. They are carbohydrates located in cell membranes or inside cells. B. They are constantly synthesized and degraded in the body. C. They bind with molecules of any drug circulating in the bloodstream. D. They regulate the actions of all drugs. They regulate the actions of all drugs A patient with an overdose of an oral drug usually receives which of the following? Activated Charcoal How does a nurse know a client is experiencing an allergic reaction or an adverse reaction?
What factors affect absorption of an oral medication? Acidity of stomach, Length of time in stomach, blood flow to GI tract, presence of interacting food and drugs Pregnancy Category A: No risk for fetus Pregnancy category B: Insufficient data to use in pregnancy Pregnancy category C: Benefits of medication could outweigh the risks Pregnancy category D: There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks. Pregnancy Category X: Avoid use in pregnancy or those who could become pregnant Risk to fetus outweighs potential benefits of drug What is the purpose of the scopolamine patch? It is used to help motion sickness and to help prevent stomach upset and throwing up from surgery and may be given for other reasons How is scopolamine administered?
- Transdermally as a small patch placed behind ear
What are mydriatics? drugs that dilate the pupil (anticholingeric) Who are mydriatics used on? Any cultural/ethnic groups require different dosages? Why or why not? Used preoperatively for eye surgery. Are much less effective on african americans than in general populations. Increased dose may be needed, and there may be a prolonged time to peak effect. Also seen in individuals with dark pigmented eyes What are anticholinergics? Drugs that oppose the effects of acetycholine at acetycholine receptor sites. What are side effects or anticholinergics? "dries you up" ( can't see, can't pee, can't talk, can't sh*t) What are the common adverse effects of gentamicin? Sinusitis, dizziness, rash fever, risk of nephrotoxicity, ototoxicity, tinitis, seizure Describe the side effects, labs, and organs affected for a patient on cephalpsporins Side effects: Nausea, vomiting, diarrhea, anorexia, abdominal pain, and flatulence. **Pseudomembranous collitis also reported Labs: Culture and sensitivity test. Check renal and hepatic function. (Creatinine BUN) Patient teaching: Finish all antibiotics, use caution while pregnant or lactating, Use with caution in patients with renal or kidney impairment Organs affected: Skin, genitals, bones, throat What patient education should be included when administering tetracycline? (antibiotic) Take this drug on an empty stomach 1 hour before or 2-3 hours after a meal with a full glass of water. You may develop other infections in your mouth or vagina. Do not take this drug with food, dairy products , iron preparations, or antacids. causes photosensitivity (wear sunscreen)
Known allergies to antibiotics could interfere with drug metabolism and excretion leading to higher toxicity How does insulin work at the cellular level? Insulin reacts with specific receptor sites on the cell to promote storage of body's fuels. Stimulates synthesis of glycogen from glucose, fats from lipids, and proteins from amino acids. List the labs affected by acetaminophen CBC, Liver ALT AST AOP and renal function test, urinalysis, stool, and serum electrolytes Anti-inflammatory medications that are contraindicated in elderly clients gold salts, Naproxen, ketorolac, and ketoprofen Education and Administration of etanercept Tumor necrosis factor blocker, works to treat signs and symptoms of rheumatoid arthritis, does not cure it but helps live with it, administered by SQ injection Influenza vaccinations for children and elderly clients for everyone 6 months of age & up. Elderly get higher dose children get smaller When is the administration of Gardasil appropriate and innapropriate? Used in patients male and female from ages 9-26 to protect in the prevention of HPV not to be used in patients with immune deficiency or during pregnancy & if you already have HPV, optimally used before sexually active Contraindications for tramadol any known allergy to any narcotic agonist antagonist to avoid hypersensitivity reactions, limit use in patients with history of addiction, presence of diarrhea, post billiary surgery or surgical anastomoses
assessments and interventions for clients on fentanyl Assessments: for contraindications or cautions (allergies, respiratory dysfunction) history of heart disease, perform pain assessment, orientation, affect, reflexes, CNS, monitor, pulse, Blood pressure, cardiac output, palpate abdomen for distension, monitor lab results, liver/test to determine if dose needs to be adjusted. Interventions: Pain assessment, monitor injection sites, additional measures to relieve pain, caution when injecting drug into body that is chilled or has poor perfusion, provide patient teaching, reassure patient addiction to this drug is not common. naloxone for overdose Keep opioid antagonist and facilities for assisted or controlled respiration readily available during parenteral administration. Contraindications for pentazocine hypersensitivity to pentazocine or any other component, respiratory depression or acute/severe asthma, pregnancy category c, CNS depressants Assessments for clients receiving morphine PCA Vital signs, urinary output, pain assessment what are the indications for naloxone? Suspected narcotic overdose, short acting wears off in 20 minutes, continued medical support needed. safety measures Peak time for alprazolam onset: 30 min peak: 1-2hours Potential complications a pregnant client might experience when taking benzodiazepine (pregnancy category D) near time of delivery baby may have withdrawal symptoms, early pregnancy associated with risk of spontaneous abortion, prolonged use throughout pregnancy raised concern that there may be altered transmitter synthesis and function leading to neurobehavioral problems in the children, microcephaly, cleft palate
Muscle stiffness/pain/tenderness/weakness Severe tiredness Severe confusion Sweating Fast/irregular heartbeat Dark urine Signs of kidney problems Medications used to treat status epilepticus Diazepam, Lorazepam, phenytoin, fosphenytoin, Midazolam, pentobarbital, phenobarbital how to assess if phenytoin levels are therapeutic therapeutic serum levels range from 10-20mcg/mL The serum levels peak about 10-20 minutes after infusion, look for decrease in seizures, monitor changes in affect (CNS) and adverse effects Lab levels of ethotoin and nursing interventions 8.0-20ug/mL interventions: monitor for blood dyscrasia, rash, fever, discontinue drug slowly, offer support, provide teaching
- The physician has ordered levothyroxine 100 mcg po daily. You have 0.05 mg tablets available. How many tablets will you administer? 2 tabs We have an expert-written solution to this problem!
- The 44-pound child you are caring for is to receive Chloral Hydrate 25 mg/kg. It is available in 250 mg per 5 ml. How many ml will you give? 10 mL
- Your patient has an order to receive metoprolol 150 mg po twice daily for hypertension. You have 100 mg scored tablets. How many tablets will you administer at each dose? 1.5tabs
Hepatatoxicity liver toxcicity Nephrotoxicity damage to the kidneys by a toxic substance Liver enzyme tests
- Lactate Dehydrogenase (LDH)
- Aspartate Aminotransferase (AST)
- Alkaline Phosphatase (ALP) Kidney test lab results BUN: 10-20 mg/dL Creatinine:
- male: 0.6-1.2mg/dL
- female: 0.5-1.1 mg/dL contraindications for morphine PCA hypersensitivity, asthma, respiratory depression Nursing Assessment systematic and continuous collection and analysis of information about the client Nursing Diagnosis describes a health problem that can be treated by nursing measures; a step in the nursing process Nursing Planning
NANDA
North American Nursing Diagnosis Association, purpose is to define, refine, and promote a taxonomy of nursing diagnostic terminology of general use to professional nurses. Anticholinergics Atropine GI - Slows motility, spasm Eyes - Dilates pupils DO NOT GIVE TO GLAUCOME PTS Heart - Increase HR Resp - bronchodilator (Atrovent) Gentamicin aminoglycoside antibiotic Cephalosporins MOA B-lactam drugs that inhibit cell wall synthesis but less suspectible to penicillins Levothyroxine (Synthroid) Hypothyroidism Benzodiazepines MOA bind to BZD receptor, facilitate GABA Benzodiazepines The most common group of antianxiety drugs, which includes Valium and Xanax. used to treat seizures most common adverse effects of NSAIDS
The most common adverse reactions of nonsteroidal anti-inflammatory agents are nausea, dyspepsia, GI pain, constipation, diarrhea, or flatulence caused by direct GI effects of the drug. The potential for GI bleeding often is a cause of discontinuation of the drug. Headache, dizziness, somnolence, and fatigue also occur frequently and could be related to prostaglandin activity in the CNS. Bleeding, platelet inhibition, and even bone marrow depression have been reported with chronic use and probably are related to the blocking of prostaglandin activity. Rash and mouth sores may occur, and anaphylactoid reactions ranging up to fatal anaphylactic shock have been reported in cases of severe hypersensitivity. What are the key considerations in using antiinflammatory agents with older adults? Older patients may be more susceptible to the CNS and GI effects of some of these drugs. Dosage adjustment is not needed for many of these agents. Geriatric warnings have been associated with naproxen, ketorolac, and ketoprofen because of reports of increased toxicity when they are used by older patients. These NSAIDs should be avoided if possible. Gold salts, used to treat arthritis, which is more common in older patients, are particularly toxic for geriatric patients. salicytate (aspirin) MOA: Inhibit the synthesis of prostaglandin (an important mediator of inflammatory response) Indication: Treatment of moderate to sever pain, fever, used for arthritis osteoarthritis Metabolized: absorbed in stomach and metabolized in liver excreted in urine NSAIDS Metabolized: absorbed from GI tract, metabolized in liver, excreted in urine MOA: inhibition of prostaglandin synthesis Treatment of moderate to severe pain fever arthritis Acetominophen Reversibly inhibits COX1 and 2 in the CNS-->decreased PGE2 in CNS-->decreased pain and temp
