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63 terms

chapter 7/Drug Administration Throughout the Life Span

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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