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Exam One Review - nursing of foundations
Fundamentals (NUR155)
Galen College of Nursing
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Pharmacology exam 1
review
Thursday, July 27
th
Unit 1 – 12 questions Unit 2 – 19 questions Unit 3 – 19 questions Medication Safety – 3 questions o High-alert medications Can cause harm if given in error Need two nurses. o Administration of medications prepared by others. Do not do it. o Documentation timing Only AFTER you give the medication. o Medication orders – identify an appropriate order – table 9 page 77 Client name (last and first) Medication name Strength of medication (if required) Dosage of medication Route of administration Specific directions for use, including frequency of administration Reason for administration if the medication is ordered PRN or as needed Most commonly violated Provider signature Do not use commonly mistaken abbreviations (QD, U, MSO4), always use a leading zero, and never use a trailing zero Medication Administration – 2 questions o Administration of Antacids Not indicated for all patients because can interfere with the absorption of other meds o Nasal Spray procedure Blow your nose first Tip does not touch the inside of the nose Pharmacokinetics – 2 questions
o Protein binding Unbound is more available for use – free drug floating around High protein binding = high competition o Absorption, distribution, metabolism, excretion Pharmacodynamics – 2 questions o Interactions: antagonistic, additive, synergistic, potentiation – page 29 Antagonistic – one drug reduces or blocks the effect of the other Additive – when two drugs are administered in combination and the response is increased beyond what either could produce alone – the sum of effects of two drugs Synergistic – effect is much greater than the effect of either drug alone Potentiation – one drug acts to potentiate the therapeutic effect of the other drug o Peak/trough – when to draw Peak – at the half-life – highest therapeutic level Trough – before the next dose – on its way out Geriatric Considerations – 3 questions o Aging changes that affect the pharmacokinetics Absorption – slowing of the GI tract Distribution – decreased available protein – lower fluid status Metabolism – decreased liver function Excretion – decreased kidney function o Assessment of medication compliance Polypharmacy Cost Compliance o Initial signs of drug toxicity Confusion Change from baseline behavior Anti-migraine – Sumatriptan – 2 questions o Adverse reaction Auditory deficits o Assessment of effectiveness Decrease in migraine pain Anesthetics – 3 questions o Local anesthetic – the onset of action Lidocaine Short onset Rapid onset at the injection site o Spinal anesthesia – adverse effect Hypotension Respiratory o Midazolam – contraindication
Respiratory depression o Signs of overdose Respiratory depression Sedation Pinpoint pupils Benzodiazepines – 2 questions o Indications Anxiety, insomnia, alcohol withdrawal o Adverse reactions Respiratory depression Antiseizure – 6 questions o Phenytoin Patient teaching Monitor glucose levels Oral care – gingival hyperplasia Avoid aspirin Use other forms of birth control Indication Seizures o Valproic acid Labs to monitor ALT, AST – liver enzymes Pregnancy Teratogenic Will cause defects o Barbiturates – phenobarbital – monitoring is required with higher doses Vital signs – respiratory depression o Status epileptics – medications Lorazepam and Diazepam – immediate Phenobarbital – long-acting CNS stimulants o Indications ADHD and narcolepsy o Dietary considerations Avoid caffeine – may increase the effects of medication Antidepressants – 5 questions o Desvenlafaxine – patient teaching for adverse reactions Hypertension Suicidal ideations NMS – neuroleptic malignant syndrome Report high fevers immediately o Medication history – use of other antidepressants o MAOIs
Interactions Tyramine-contain foods – an extensive list Pseudoephedrine Drug of last resort o Tricyclics – patient teaching for common side effects Orthostatic hypotension Change positions slowly Antipsychotics - 3 questions o EPS signs/symptoms Hand tremors Facial grimacing Involuntary upward eye movement Restlessness, pacing, rocking movement Chewing motion o Aripiprazole Time to effectiveness Doesn’t work immediately – 4-6 weeks Classifications Atypical Mood stabilizer – 1 question o Adverse reactions Adverse reactions GI upset Increased urination Hyponatremia Dry mouth Metallic taste Excreted unchanged in urine – urinary symptoms
Exam One Review - nursing of foundations
Course: Fundamentals (NUR155)
University: Galen College of Nursing
