chapter 7/Drug Administration Throughout the Life Span

63 terms by LRetterath 

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adolescence

period from 13 to 16 years of age

embryonic period

period of life from 3 to 8 weeks postconception

fetal period

period of life from 9 to 40 weeks post conception

infancy

child younger than 1 year

middle adulthood

person from 40 to 65 years of age

older adulthood

person older than age 65

polypharmacy

the taking of multiple drugs concurrently

preimplantation perion

period of life from 1 to 2 weeks postconception

preschool child

child from 3 to 5 years of age

school-age child

child from 6 to 12 years of age

teratogen

drug or other agent that causes birth defects

toddlerhood

term applied to children from 1 to 3 years of age

young adulthood

term applied to persons from 18 to 40 years of age

growth

term that characterizes the progressive increase in physical size

development

related to growth that refers to the functional changes in the physical, psychomotor, and cognitive capabilities of a person

What can effect the absorption in a pregnant woman?

hormonal changes as well as the pressure of the expanding uterus on the blood supply to the abdominal organs, gastric acidity, GI tract slowed by progesterone, changes in the respiratory system-increased tidal volum and pulmanory basodilation may cause inhaled drugs to be absorbed to a greater extent

What changes in the pregnant patient increase cardiac output, increase plasma volume and change regional blood flow?

hemodynamic changes

What does the increased blood volume in the mother do?

caused dilution of drugs and decreases plasma protein concentrations, affecting drug distribution

What alters drug transport and distribution during the third trimester?

alterations in lipid levels

How are fat-soluble drugs passed to the infant?

distributed into the lipid-rich breast milk

During the third trimester or pregnancy when bloods flow through the mothers kidneys increases 40% to 50%, what does this have an effect on?

this increase has a direct effect on renal plasma flow, glomerular filtration rate and rental tubular absorption (drug excretion rates increase affecting dosage timing and onset of action)

What period are drugs less likely to cause congenital malformations and why?

preimplanation period (weeks 1-2), the baby's organs have not yet begun to form

What period is the maximum sensitivity to teratogens?

embryonic period (weeks 3-8)

During the fetal period what is the effect of a teratogen?

more likely to produce slowed growth or impaired organ function

What category drugs should be avoided during pregnancy?

D and X drugs

What is the key factor in the effect of drugs during lactation that relates to the infant?

the infant's ability to metabolize small amount of drugs, seriously ill infants, permature, neonatal may be at greater risk because they lack drug metabolizing enzymes

What drugs should be selected if possible that are not secreted in the milk?

high protein-binding

Factors for the nurse to consider in children?

physiological variations, maturity of body system and greater fluid distribution in children

polypharmacy increases the risk of?

drug interactions and side effects

What age group experience more adverse effects from drug therapy?

geriatric patients

What are the principle complications of drug therapy in older adults?

due to degeneration of organ systems, multiple and severe illness, polypharmacy and unreliable compliance

Why is absorption of drugs slower in an older adult?

diminished gastric motility and decreased blood flow to digestive organs, tablets that require high levels of acid for absorption take longer to dissolve and therefore take longer to become available to the tissues

A 16 year old adolescent is 6 weeks pregnant. The pregnancy has exacerbated her acne. she asks the nurse if she can resume taking her isotretinoin (Accutane) prescription, a category X drug. The best response by the nurse is:

Accutane is know to cause birth defects and should never be taken in pregnancy.

To reduce the effect of a prescribed medication on the infance of a breast-feeding mother, the nurse should plan to administer the medication:

immediately after breast-feeding

A nurse is administering a liquid medication to a 15 month old child. The most appropriate approach by the nurse is to:

sit the child up, hold the medicine cup to her lips, and kindly instruct her to drink

The nurse is preparing to give an injection to an infant. What is the preferred site for injections for newborns and infants?

vastus lateralis muscle

To reduce the chance of polypharmacy in the older adult, the nurse should:

take an OTC, prescription and pharmacy history with each patient visit.

A term that characterizes the progressive increase in physical size is ______.

growth

The functional changes in the physical, psychomotor, and cognitive capabilities of a person is called________.

development

Considering the individual needs of the patient and caring for the whole person is called _________?

holistic

During pregnancy, weeks 1-2 are the _________ period, weeks e-8 are the ______ period and weeks 9-40 are the _______ period.

preimplantation, embryonic and fetal

By the third trimester of pregnancy, blood flow through the _____ is reduced by 40% to 50% which may affect drug _______.

maternal kidney, excretion

In older adults hepatic metabolism _____, which may require _____drug dosages for this age group.

decreases, lower

A substance that may produce permanent changes to an embryo or fetus is called a?

teratogen

The taking of multiple drugs, or _______ in older adults increases the risk for drug interactions and adverse effects.

polypharmacy

During the first trimester of pregnancy, what is the primary consideration from a medical, nursing and pharmacologic viewpoint?

safety of the patient and delivery of a healthy baby

The nurse determine that the fetus is at the greatest risk for developmental and structural anomalies during which period?

embryonic

During which period is there the greatest risk of a drug causing death of the growing embryo or fetus?

preimplantation

During a routine prenatal visit in her third trimester, a patient informs the nurse that she is smoking again because of a stressful situation at her job. The nurse counsels the patient on the increased risks to the fetus.why are risks increased at this time?

blood flow to the placenta increase and placental vascular membranes become thinner

The nurse correctly provides the following education to a breast-feeding patient?

no dietary supplement, herb or drug should be taken without approval of the health care provider

What is the preferred site for administering an IM injection to an infant?

Vastus lateralis

When determining the correct method for calculating drug amount for infants, what must the nurse consider?

age and size of infant

When assessing risk factors, which age group must the nurse evaluate for a high risk for accidental poisoning?

toddler

Before administering a drug to an older adult, the nurse should understand that the average dose may be affected by what normal consequence of aging?

older adults have reduced kidney function

During adolescence, the nurse assumes a key role in the patient's education in relationship to ?

use of tobacco and illicit drugs

During which period of adulthood would the nurse expect to offer counseling regarding positive lifestyle modifications?

middle adulthood

During which period of adulthood would the nurse expect to offer counseling regarding inccreased potential for adverse reactions to medications related to impaired physiologic and biochemcial processes?

older adulthood

The nurse knows that all of the following contribute to increased serum drug levels in the older adult

reduced total body water, decreased amounts of plasma proteins, reduced renal excretion

Which branch of medicine deals with the general treatment of suffering and disease?

therapeutics

What does the prototype approach to drug therapy consider?

representative drug for how other drugs in a particular class work

What is the most common type of drug formulation for eye and ear medication?

drops

The nurse places a drug tablet between the patient's cheeck and gum. What delivery route is being used for this patient?

buccal

The nurse is administering Tylenol to reduce the fever of a child. What past of the nursing process is the nurse using?

intervention

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