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NUR 231 Exam 5
Terms in this set (79)
A report on the risks of medication administration revealed disturbing quality issues across all heath care settings in the United States. Approximately, how many preventable adverse drug events occur in the health care system each year?
To safely and accurately administer medications to a particular patient, nurses are accountable for which of the following? (Select all that apply)
-a particular patients medication regimen
-the 6 rights of medication administration
-willingness to report errors and near misses
-what is involved in administering drugs for a particular patient
all the above
What is an organization that requires all personnel to report near misses and breakdowns in care called?
Just Culture Organization
What is the first step the nurse takes to address medication safety?
obtain knowledge of the medication, including evidence-based standards for administration
What is the purpose of the six competencies that are integrated into the national curriculum standards for nursing?
so that all nurses are accountable for integrating safety and quality responsibilities into their daily work
Basing care decisions on knowledge of patient values and preferences is the definition of which of the follow?
What characteristic do nurses have if they tend to reflect before they act, reflect during action, and reflect on action and ask questions that lead to best current evidence and best practices?
spirit of inquiry
What does the "E" in QSEN stand for?
Which of the following guidelines is inherent to safe medication administration?
preventing the need for drug therapy, when possible by promoting health
Serious of life-threatening adverse effect identified by the FDA as being associated with a drug are identified in this text as which of the following:
black box warnings
As part of a class discussion, a nursing instructor describes which agency as being responsible for the approval of new drugs in the United States?
food and drug administration
After administering a medication to a client, the client reports an upset stomach. The nurse interprets this as a negative effect of the drug and identifies it as a(n):
Which term is used to describe the study of drugs and their action on living organisms?
A nurse is teaching a patient about medications referred to as "antihypertensives." To what is the term "antihypertensive" referring?
A client with an upper respiratory tract infection has been prescribed an antibiotic that the nurse is not familiar with. What should the nurse caring for the client do if not familiar with the new medication?
collect information about the new medication
Having drugs available OTC has potential advantages and disadvantages for consumers. What is one of the advantages?
faster and more convenient access to effective treatment
A nurse is teaching a patient about drug therapy for a disease process. What is the appropriate terminology for this therapy?
A nurse is administering a Schedule II drug to a patient. What most concerns the nurse about this medication therapy?
schedule II drugs have a high potential to become addictive and be abused
How can drug therapy or pharmacotherapy be best explained to a client?
it is the use of drugs to prevent, diagnose, or treat symptoms and disease processes
Drugs are classified according to what standard?
their effects on particular body systems, therapeutic uses, and chemical characteristics
What plays the largest role in drug excretion?
A post-surgical client rates the pain at 10/10. The nurse confirms that there are standing orders for the administration of opioid analgesics as needed. What route of administration should the nurse choose to achieve the fastest effect?
The nurse understands that it is important to educate the pregnant woman about the importance of taking medication only as prescribed by a health care provider while breast feeding. Why is this important for the client to do?
many drugs can be passed through the breast milk, causing ill effects to the infant
A nurse notes new drug orders for a client who is already getting several medications. Which is the most important consideration when preparing to administer the new drugs?
possible drug to drug interactions that might occur
When assessing a client who has developed an anaphylactic reaction, what would the nurse expect to find?
The nurse is caring for a client in the intensive care unit. This client took an overdose of acetaminophen 3 days previously and now has jaundice. Laboratory results show elevated liver enzymes. The nurse understands that the client:
is experiencing hepatotoxicity and may have permanent liver damage
The nurse is caring for a client who appears to be developing anaphylactic shock. What drug does the nurse anticipate the health care practitioner will order to treat this condition?
A parent brings a child to the clinic for an earache. The child receives a prescription for amoxicillin. The parent calls the clinic the next day and says the child has been taking the medicine and now has a rash. The nurse should give the parent instructions about which type of response?
What would the nurse include in the discharge teaching for a patient who is social drinker and has been given a prescription for a narcotic analgesic?
alcohol will potentiate the effect of the narcotic analgesic and can have a dangerous effect
A method that describes the process of absorption, distribution, and elimination of a drug in the body is known as:
How many pounds are in 1 kilogram?
The health care provider has asked a nurse to administer a drug intravenously to a client who is unresponsive. How can the nurse ensure that the drug is administered to the right client?
by checking the clients wristband
What statement, made by the nurse to a client prescribed a sublingual medication, demonstrates an understanding of the appropriate method of administration for this specific route?
hold the medication under your tongue until it is dissolved
A nurse is gathering information about a client. The nurse is participating in which step of the nursing process?
The route of medication administration can change dependent on client factors. Therefore, the route of medication administration is:
always included in the five rights of medication administration
Medication orders are written with very specific criteria and coincide with the rights of medication administration. What critical piece of information is missing from the following medication order? Cephalexin 250 mg every 8 hours.
A nurse is to administer 150 mg of a drug intramuscularly. The label on the multidose vials reads 100 mg/mL. How much would the nurse give?
A nurse gives a client 0.25 mg of digoxin instead of the prescribed dose of 0.125 mg. What should the nurse do next?
assess the client and notify the clients health care provider
The nursing process consists of the following five major steps:
assessment, diagnosis, planning, implementation, evaluations
A mother asks why she cannot use adult dosages of over-the-counter (OTC) medication for her 11-year-old child. Which explanation best demonstrates the nurse's understanding of the importance of the mother's question?
drug therapy in children requires special considerations because of the child's size, developmental level, and organ function
A 70-year-old female preparing for discharge from the hospital tells the nurse that she must take bisacodyl (Dulcolax) or she will not have her daily bowel movement. What would the nurse include in the discharge teaching?
educate the client on natural ways to stimulate bowel evacuation, such as increasing the fiber in her diet
A nurse who is working with an older adult who takes eight medications a day wants to promote medication adherence. Which nursing intervention would best promote medication adherence?
place pills in a daily or weekly pillbox organized according to hours of the day or mealtimes
A nurse is teaching an older adult about polypharmacy. Which statement best describe this term?
taking several drugs simultaneously
An elderly client comes to the clinic and shows the nurse the medications the client is taking. The nurse observes that there are three medications prescribed that are not with the medications. The client says that she cannot afford all the medications. What intervention by the nurse will assist the client with this issue?
assist the client in gaining access to reduced-price medications
An older adult client intends to supplement a prescribed anti-inflammatory with a herbal remedy that a neighbor strongly recommended. What action should the nurse encourage the client to take before initiating that plan?
checking with the physician before taking the supplement
The nurse is aware that almost a third of all hospital admissions in older adults are as a result of what problem?
An elderly client is being admitted to the hospital for surgery. The nurse is reconciling the client's medications. The client is prescribed digoxin 0.125 mg daily, furosemide 40 mg two times a day, Lanoxin 0.125 mg daily, metoprolol XL 25 mg once a day, and pravastatin (Pravachol) 40 mg at hours of sleep daily. The nurse recognizes a problem when the nurse notes:
digoxin and Lanoxin are the same medications
A 76-year-old client with congestive heart failure is being admitted to the hospital. The client states only taking medications that the health care provider prescribes, but when the nurse assesses the medications, three over-the-counter laxatives are in the client's bag of medications. What concerns does the nurse have about this omission?
the laxatives can interact with and complicate prescribed drug therapy
A nurse who works in an acute care for elders (ACE) unit recognizes the unique pharmacokinetics and pharmacodynamics that often occur in older adults. Which factor should the nurse take into account when administering medications to older adults on the unit?
as a result of age-related changes, older adults face an increased risk of adverse medication effects
A nurse is aware that older adults tend to have a significantly decreased rate of hepatic blood flow compared with younger adults. What effect is this likely to have on pharmacokinetics and pharmacodynamics in an older adult?
drug clearance is likely to be slower
therapeutic classification for aspirin
Nonopioid analgesic, nonsteroidal anti-inflammatory (NSAID), antipyretic, antiplatelet
pharmacological classification for aspirin
indications for aspirin
RA (rheumatoid arthritis), osteoarthritis, Mild pain or fever, Suspected acute MI, To reduce risk of MI, TIAs and stroke, Prevention of colorectal cancer
dosages for aspirin
1. Pain/fever 325mg - 1000mg every 4 hours prn maximum dose is 4000 mg in 24 hours
2. Transient ischemic attacks (TIAs) - 50-325mg/day
3. Acute MI - 160-325mg, non-enteric coated, chewed or crushed and swallowed immediately when MI is suspected
4. Prevention of MI: 75-325mg/day
contraindications in aspirin
GI bleeding, bleeding disorders, severe hepatic impairment, and peptic ulcers.
adverse reactions in aspirin
GI Bleed, pancreatitis, cerebral edema, seizures, intracranial hemorrhage, etc.
nursing considerations for aspirin
1. Especially that is should NOT be given to children or teens with flulike symptoms or chickenpox because Reye's syndrome may develop.
2. For inflammatory conditions give aspirin on a schedule rather than as needed.
3. Enteric-coated tables are slowly absorbed so they aren't suitable for rapid relief of acute pain, fever, or inflammation
4. Elderly patients need to be monitored closely because they may be more susceptible to toxic effects.
treatment for overdose with aspirin
Lavage, activated charcoal, monitor electrolytes, VS
action of antiinfectives
inhibit the growth and replication of susceptible bacterial organisms
contraindications of antinfectives
allergic reactions need to be identified; cross-sensitivity may occur
precautions with antiinfectives
used with caution in persons with renal/hepatic disease
adverse reactions with antiinfectives
nausea, vomiting, diarrhea
azithromycin: mild to moderate infections of the upper/lower respiratory tract, pharyngitis/tonsillitis, skin infections
cephalexin (Keflex): upper/lower respiratory tract, urinary tract, skin infections, otitis media, tonsillitis, endocarditis, surgical prophylaxis, septicemia
ciprofloxacin (Cipro):chronic bacterial prostatitis, acute sinusitis, postexposure inhalation anthrax, infectious diarrhea, typhoid fever, complicated intraabdominal infections, nosocomial pneumonia, UTIs
vancomycin - MRSA as well as many other microorganisms
amoxicillin/clavulanate (Augmentin): used for lower respiratory tract infections, sinus infections, pneumonia, otitis media, impetigo, skin infection, and UTI (as well as many others)
treat Syphilis, Chlamydia trachomatis, gonorrhea, lymphogranuloma venereum; uncommon gram-positive, gram-negative organisms; rickettsial infections)
action for NSAID
decrease prostaglandin synthesis by inhibiting an enzyme needed for biosynthesis
indications for NSAID
treat mild to moderate pain, osteoarthritis, rheumatoid arthritis, and dysmenorrhea
contraindications for NSAID
Persons with hypersensitivity, asthma, or severe renal/hepatic disease should not use these products
administration for NSAID
With food to decrease GI symptoms; however, best to take on empty stomach to facilitate absorption.
adverse reactions for NSAID
The most common side effects are nausea, abdominal pain, anorexia, dizziness, and drowsiness
therapeutic class for furosemide
indications for furosemide
Pulmonary edema; edema with CHF, hepatic disease, nephrotic syndrome, ascites, hypertension.
adverse reactions for furosemide
hypotension, hypokalemia, hypocalcemia, hyponatremia,
low potassium; weakness, fatigue, muscle cramps, constipations, heart palpitations, abnormal heart rhythms
low calcium; numbness/tingling of the hands feet or lips, muscle cramps and spasms, seizures, facial twitching, muscle weakness, lightheadedness, slow heartbeat
low sodium; nausea/vomiting, headache, confusion, loss of energy/fatigue, seizures, restlessness and irritability, muscle weakness spasms cramps, coma
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