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Study Guide 1

Terms in this set (163)

Adverse effects
drug effects, sometimes called side effects, that are not the desired therapeutic effects; may be unpleasant or even dangerous
brand name
name given to a drug by the pharmaceutical company that developed it
chemical name
name that reflects the chemical structure of a drug
drugs
chemicals that are introduced into the body to bring about change
Food and Drug Administration (FDA)
federal agency responsible for the regulation and enforcement of drug evaluation and distribution policies
generic drugs
drugs sold by their generic name; not brand name or trade name product
generic name
the original designation that a drug is given when the drug company that developed it applies for the approval process
Generic engineering
process of altering DNA, usually of bacteria, to produce a chemical to be used as a drug
Orphan drugs
drugs that have been discovered but would not be profitable for a drug company to develop; usually drugs that would treat only a small number of people; these can be adopted by drug companies to develop
over-the-counter (OTC) drugs
drugs that are available without a prescription for self-treatment of a variety of complaints; deemed to be safe when used as directed; often formerly only available by prescription
Pharmacology
the study of the biological effects of chemicals
pharmacotherapeutics
clinical pharmacology or the branch of pharmacology that deals with drugs; chemicals that are used in medicine for the treatment, prevention, and diagnosis of disease in humans
phase I study
a pilot study of a potential drug using a small number of selected, usually healthy human volunteers
phase II study
a clinical study of a proposed drug by selected physicians using actual patients who have the disorder the drug is designed to treat; patients must provide informed consent
phase III study
use of a proposed drug on a wide scale in the clinical setting with patients who have the disease the drug is thought to treat
phase IV study
continuous evaluation of a drug after it has been released for marketing
preclinical trials
initial trial of a chemical thought to have therapeutic potential; uses laboratory animals, not human subjects
teratogenic
having adverse effects on the fetus
absorption
what happens to a drug from the time it enters the body until it enters the circulating fluid; intravenous administration causes the drug to directly enter the circulating blood, bypassing many complications from other routes
active transport
the movement of substances across a cell membrane against the concentration gradient; this process requires the use of energy
chemotherapeutic agents
synthetic chemicals used to interfere with the functioning of foreign cell populations, causing cell death; this term is frequently used to refer to the drug therapy of neoplasms, but it also refers to drug therapy affecting any foreign cell
critical concentration
the concentration a drug must reach in the tissues that respond to the particular drug to cause the desired therapeutic effect
distribution
movement of a drug to body tissues; may depend on the drug's solubility, perfusion of the area, cardiac output, and binding of the drug to plasma proteins
enzyme induction
process by which the presence of a chemical that is biotransformed by a particular enzyme system in the liver causes increased activity of that enzyme system
excretion
removal of a drug from the body; primarily occurs in the kidneys, but can also occur through the skin, lungs, bile, or feces
first-pass effect
a phenomenon in which drugs given orally are carried directly to the liver after absorption, where they may be largely inactivated by liver enzymes before they can enter the general circulation; oral drugs frequently are given in higher doses than drugs given by other routes because of this early breakdown
glomerular filtration
the passage of water and water-soluble components from the plasma into the renal tubule
half-life
the time it takes for the amount of drug in the body to decrease to one half of the peak level it previously achieved
hepatic microsomal system
liver enzymes tightly packed together in the hepatic intracellular structure, responsible for the biotransformation of chemicals, including drugs
loading dose
use of a higher dose than what is usually used for treatment to allow the drug to reach the critical concentration sooner
passive diffusion
movement of substances across a semipermeable membrane with the concentration gradient; this process does not require energy
pharmacodynamics
the study of the interactions between the chemical components of living systems and the foreign chemicals, including drugs, that enter living organisms; the way a drug affects a body
pharmacogenomics
the study of genetically determined variations in the response to drugs
pharmacokinetics
the way the body deals with a drug, including absorption, distribution, biotransformation, and excretion
placebo effect
documented effect of the mind on drug therapy; if a person perceives that a drug will be effective, the drug is much more likely to actually be effective
receptor sites
specific areas on cell membranes that react with certain chemicals to cause an effect within the cell
selective toxicity
property of a chemotherapeutic agent that affects only systems found in foreign cells without affecting healthy human cells; specific antibiotics can affect certain proteins or enzyme systems used by bacteria but not by human cells
blood dyscrasia
bone marrow depression caused by drug effects on the rapidly multiplying cells of the bone marrow; lower-than-normal levels of blood components can be seen
dermatological reactions
skin reactions commonly seen as adverse effects of drugs; can range from simple rash to potentially fatal exfoliative dermatitis
drug allergy
formation of antibodies to a drug or drug protein; causes an immune response when the person is next exposed to that drug
hypersensitivity
excessive responsiveness to either the primary or the secondary effects of a drug; may be caused by a pathological condition or, in the absence of one, by a particular patient's individual response
poisoning
overdose of a drug that causes damage to multiple body systems and has the potential for fatal reactions
stomatitis
inflammation of the mucous membranes related to drug effects; can lead to alterations in nutrition and dental problems
superinfections
infections caused by the destruction of normal flora bacteria by certain drugs, which allow other bacteria to grow out of control and cause infection; may occur during the course of antibiotic therapy
assessment
information gathering regarding the current status of a particular patient, including evaluation of past history and physical examination; provides a baseline of information and clues to effectiveness of therapy
evaluation
part of the nursing process; determining the effects of the interventions that were instituted for the patient and leading to further assessment and intervention
implementation
actions undertaken to meet a patient's needs, such as administration of drugs, comfort measures, or patient teaching
nursing
the art of nurturing and administering to the sick, combined with the scientific application of chemistry, anatomy, physiology, biology, nutrition, psychology, and pharmacology to the particular clinical situation
nursing diagnosis
statement of an actual or potential problem, based on the assessment of a particular clinical situation, which directs needed nursing interventions
nursing process
the problem-solving process used to provide efficient nursing care; it involves gathering information, formulating a nursing diagnosis statement, prioritizing the diagnoses, developing goals and desired outcomes for the patient, carrying out interventions, and evaluating the process
planning
the process of prioritizing the information gathered in assessment and, using the established nursing diagnoses, to develop goals and desired outcomes for the patient
Pre-Clinical Trials
Determines whether the drug has the presumed effects in living tissues and evaluates any adverse effects.

Drug may be dropped if:
*Chemical lacks therapeutic activity when used with living animals
*too toxic to living animals to be worth the risk of developing it into a drug
*is highly teratogenic
*safety margins are too small
Phase I Study
Uses healthy human volunteers to test drugs.

Drug may be dropped if:
*Causes unacceptable adverse effects
*Highly teratogenic
*Too toxic
*Lacks evidence of potential therapeutic effect in humans
Phase II Study
Allows drug use in patients who have the disease the drug is intended to treat.

Drug may be dropped if:
*Less effective than anticipated
*Too toxic
*Unacceptable adverse effects
*Low benefit to risk ratio
*No more effective than other drugs already on the market
Phase III Studies
Use of drug in vast clinical market

Drug may be dropped if:
*produces unacceptable adverse effects
*produces unexpected responses
Phase IV Studies
Ongoing evaluation on a marketed drug
Category A
Adequate studies have not demonstrated risk to fetus in first trimester and no evidence of risk in later trimesters
Category B
Animal studies have not demonstrated risk but no adequate studies in pregnant women

OR

Animal studies have shown an adverse effect but adequate studies in pregnant women have not demonstrated risk to fetus in first trimester and no evidence of risk in later trimesters
Category C
Animal studies have shown adverse effects on fetus but no adequate studies in humans; the benefits from the drug may be acceptable despite its current risks

OR

There are no adequate studies in animals or humans
Category D
There is evidence of human fetal risk but potential benefits from the use of the drug may be acceptable despite the potential risks
Category X
Studies in animals or humans demonstrate fetal abnormalities or adverse reactions; reports indicative of fetal risk. Risk of use in pregnant women clearly outweighs any possible benefits.
Schedule I (C-I)
High abuse potential and no accepted medical use (heroin, marijuana, LSD)
Schedule II (C-II)
High abuse potential with severe dependence liability (narcotics, amphetamines, and barbiturates)
Schedule III (C-III)
Less abuse potential than schedule II drugs and moderate dependence liability (nonbarbiturate sedatives, nonamphetamine stimulants, limited amounts of certain narcotics)
Schedule IV (C-IV)
Less abuse potential than schedule III and limited dependence liability (some sedatives, antianxiety agents, and nonnarcotic analgesics)
Schedule V (C-V)
Limited abuse potential. Primarily small amounts of narcotics (codeine) used as antitussives or antidiarrheals.

Under federal law, limited quantities of these drugs may be purchased without a prescription directly from a pharmacist.

The purchaser must be at least 18 years of age and must furnish suitable identification. All such transactions must be recorded by the dispensing pharmacist.
OTC drugs
_____________ are products that are available without prescription for self-treatment of a variety of complaints. Some of these agents were approved as prescription drugs but later were found to be very safe and useful for patients without the need of a prescription. Some were not rigorously screened and tested by the current drug evaluation protocols because they were developed and marketed before the current laws were put into effect.
FDA

OTC drugs

Taking these drugs could mask the signs and symptoms of underlying disease, making diagnosis difficult.

Taking these drugs with prescription medications could result in drug interactions and interfere with drug therapy.

Not taking these drugs as directed could result in serious overdoses.
Many of these drugs were "grandfathered" into use because they had been used for so long. The ________ is currently testing the effectiveness of many of these products and, in time, will evaluate all of them. Although ___________ have been found to be safe when taken as directed, nurses should consider several problems related to OTC drug use: ____________, _____________, ______________
1. Category A
2. Category B
3. Category C
4. Category D
5. Category X
Explain each of the 5 pregnancy categories
1. Schedule I (C-I)
2. Schedule II (C-II)
3. Schedule III (C-III)
4. Schedule IV (C-IV)
5. Schedule V (C-V)
How are the 5 controlled substances categorized?
1. Preclinical trials
2. phase 1
3. phase 2
4. phase 3
5. phase 4
What is the 5 step process towards FDA approval?
pregnancy
Regardless of the designated category or presumed safety, no drug should be administered during _________ unless it is clearly needed.
DEA
Prescribing physicians and dispensing pharmacists must be registered with the _______________, which also provides forms for the transfer of schedule I and II substances and establishes criteria for the inventory and prescribing of controlled substances. State and local laws are often more stringent than federal law. In any given situation, the more stringent law applies.
FDA
The ________ regulates the development and sale of drugs. Local laws further regulate the distribution and administration of drugs. In most cases, the strictest law is the one that prevails. Nurses should become familiar with the rules and regulations in the area in which they practice. These regulations can vary from state to state and even within a state.
FDA (Food and Drug Administration)

FDA
After a chemical that might have therapeutic value is identified, it must undergo a series of scientific tests to evaluate its actual therapeutic and toxic effects. This process is tightly controlled by the ____________, an agency of the U.S. Department of Health and Human Services that regulates the development and sale of drugs. __________ regulated tests are designed to ensure the safety and reliability of any drug approved in this country.
phase III studies
Drugs that finish __________ are evaluated by the FDA, which relies on committees of experts familiar with the specialty area in which the drugs will be used.
phase IV study
After a drug is approved for marketing, it enters a phase of continual evaluation, or ____________.
Pharmacodynamics
___________ is the study of the interactions between the chemical components of living systems and the foreign chemicals, including drugs, that enter those systems. All living organisms function by a series of complicated, continuous chemical reactions.
therapeutic use
When a new chemical enters the system, multiple changes and interferences with cell functioning may occur. To avoid such problems, drug development works to provide the most effective and least toxic chemicals for ______________.
1. To replace or act as substitutes for missing chemicals
2. To increase or stimulate certain cellular activities
3. To depress or slow cellular activities
4. To interfere with the functioning of foreign cells, such as invading microorganisms or neoplasms leading to cell death
List four ways drugs work
chemotherapeutic agents
To interfere with the functioning of foreign cells, such as invading microorganisms or neoplasms leading to cell death, drugs that act in this way are called ____________
receptor sites
Many drugs are thought to act at specific areas on cell membranes called ____________. They react with certain chemicals to cause an effect within the cell. In many situations, nearby enzymes break down the reacting chemicals and open them for further stimulation.
agonists
Some drugs interact directly with receptor sites to cause the same activity that natural chemicals would cause at that site. These drugs are called _____________.
competitive antagonist
Some drugs react with receptor sites to block normal stimulation, producing no effect. This is said to be a ____________________.
noncompetitive antagonists
Still other drugs react with specific receptor sites on a cell and, by reacting there, prevent the reaction of another chemical with a different receptor site on that cell. Such drugs are called _________________.
Drug-Enzyme Interactions
Drugs also can cause their effects by interfering with the enzyme systems that act as catalysts for various chemical reactions. Enzyme systems work in a cascade fashion, with one enzyme activating another, and then that enzyme activating another, until a cellular reaction eventually occurs. If a single step in one of the many enzyme systems is blocked, normal cell function is disrupted. This is called _______________.
selective toxicity.
Ideally, all chemotherapeutic agents would act only on enzyme systems that are essential for the life of a pathogen or neoplastic cell and would not affect healthy cells. The ability of a drug to attack only those systems found in foreign cells is known as ______________.
critical concentration
The amount of a drug that is needed to cause a therapeutic effect is called the ______________.
loading dose
use of a higher dose than what is usually used for treatment to allow the drug to reach the critical concentration sooner
1. drug's lipid solubility and ionization
2. perfusion of the reactive tissue'
3. Protein Binding
4. Blood-Brain Barrier
5. Placenta and Breast Milk
What 5 factors affect distribution of a drug?
Protein Binding
Most drugs are bound to some extent to proteins in the blood to be carried into circulation. The more bound to the protein, the more difficult it can be for the medication to be released and able to cross membranes to get to the tissue cells. The drug must be freed from the protein's binding site to act on the tissues. This is called ______________.
blood-brain barrier

blood-brain barrier
The _______________ is a protective system of cellular activity that keeps many things away from the CNS. Drugs that are highly lipid-soluble are more likely to pass through and reach the CNS. Drugs that are not lipid-soluble are not able to pass. This is clinically significant in treating a brain infection with antibiotics. Almost all antibiotics are not lipid-soluble and cannot cross. Effective antibiotic treatment can occur only when the infection is severe enough to alter the ____________ and allow antibiotics to cross.
placenta

breast milk

breast milk

breast milk
Many drugs readily pass through the _________ and affect the developing fetus in pregnant women. Drugs should be given only when the benefit clearly outweighs any risk. Many other drugs are secreted into __________ and therefore have the potential to affect the neonate. Because of this possibility, the nurse must always check the ability of a drug to pass into __________ when giving a drug to a breastfeeding mother. With the new regulations, prescribing information now states the level of risk of drugs passing into _____________.
Liver
What organ is the most important site for metabolism of drugs?
first-pass effect
_________ a phenomenon in which drugs given orally are carried directly to the liver after absorption, where they may be largely inactivated by liver enzymes before they can enter the general circulation; oral drugs frequently are given in higher doses than drugs given by other routes because of this early breakdown
First pass effect
Why must an oral drug be given at a higher dosage than parenteral drugs?
Kidney

Kidney dysfunction can lead to toxic levels of a drug in the body because the drug cannot be excreted. Acidity of urine can play an important role in drug excretion
What organ primarily affects excretion of drugs and explain how this organ's function could lead to drug toxicity.
half-life
What is the time called that it takes for the amount of a drug in the body to decrease to one half of the peak level?
Weight factor
The recommended dose of a drug is based on drug evaluation studies and is targeted at a 150-lb person. People who are much heavier may require larger doses to get a therapeutic effect from a drug because they have increased tissues to perfuse and increased receptor sites in some reactive tissue. People who weigh less than the norm may require smaller doses of a drug. Toxic effects may occur at the recommended dose if the person is very small.
Age factor
Age is a factor primarily in children and older adults. Children are not just little adults. Children metabolize many drugs differently than adults do, and they have immature systems for handling drugs. Many drugs come with recommended pediatric doses, and others without recommended doses can be converted to pediatric doses using one of several conversion formulas
Gender factor
Physiological differences between men and women can influence a drug's effect. When giving IM injections, for example, it is important to remember that men have more vascular muscles, so the effects of the drug will be seen sooner in men than in women. Women have more fat cells than men do, so drugs that deposit in fat may be slowly released and cause effects for a prolonged period.
Physiological factors
Physiological differences such as diurnal rhythm of the nervous and endocrine systems, acid-base balance, hydration, and electrolyte balance can affect the way that a drug works on the body and the way that the body handles the drug. If a drug does not produce the desired effect, one should review the patient's acid-base and electrolyte profiles and the timing of the drug.
pathological factors
Drugs are usually used to treat disease or pathology. However, the disease that the drug is intended to treat can change the functioning of the chemical reactions within the body and thus change the response to the drug.
Gentic factors
Genetic differences can sometimes explain patients' varied responses to a given drug. Some people lack certain enzyme systems necessary for metabolizing a drug, whereas others have overactive enzyme systems that cause drugs to be broken down more quickly. Still others have differing metabolisms or slightly different enzymatic makeups that alter their chemical reactions and the effects of a given drug.
psychological factors
The patient's attitude about a drug has been shown to have an effect on how that drug works. A drug is more likely to be effective if the patient thinks it will work than if the patient believes it will not work. This is called the placebo effect.
enviormental factors
The environment can affect the success of drug therapy. Some drug effects are enhanced by a quiet, cool, nonstimulating environment.
Tolerance Factors
The body may develop a tolerance to some drugs over time. Tolerance may arise because of increased biotransformation of the drug, increased resistance to its effects, or other pharmacokinetic factors. When tolerance occurs, the drug no longer causes the same reaction. Therefore, increasingly larger doses are needed to achieve a therapeutic effect.
Accumulation factors
If a drug is taken in successive doses at intervals that are shorter than recommended, or if the body is unable to eliminate a drug properly, the drug can accumulate in the body, leading to toxic levels and adverse effects.
Interaction factors
When two or more drugs or substances are taken together, there is a possibility that an interaction can occur, causing unanticipated effects in the body. Certain foods can interact with drugs in much the same way. Usually, this is an increase or decrease in the desired therapeutic effect of one or all of the drugs or an increase in adverse effects.
therapeutic effect
___________ is a consequence of the medical treatment of any kind, the results of which are judged to be desirable and beneficial. This is true whether the result was expected, unexpected, or even an unintended consequence of the treatment.
IV

inhalation
It is considered that ________ administration does not involve absorption, and there is no loss of drug. The fastest route of absorption is _______,
adverse effects
What is occurring in the description below?

*The drug may have other effects on the body besides the therapeutic effect.

*The patient may be sensitive to the drug being given.

*The drug's action on the body may cause other responses that are undesirable or unpleasant.

*The patient may be taking too much or too little of the drug
Adverse effects
________ are undesired effects that may be unpleasant or even dangerous
hypersensitivity
Some patients are excessively responsive to either the primary or the secondary effects of a drug. This is known as ____________, and it may result from a pathological or underlying condition.
drug allergy
A __________ occurs when the body forms antibodies to a particular drug, causing an immune response when the person is reexposed to the drug.
allergic
A patient cannot be ___________ to a drug that has never been taken, although patients can have cross-allergies to drugs within the same drug class as one formerly taken.
Dermatological reactions
____________ are adverse reactions involving the skin. These can range from a simple rash to potentially fatal exfoliative dermatitis. Many adverse reactions involve the skin because many drugs can deposit there or cause direct irritation to the tissue.
Stomatitis
____________, or inflammation of the mucous membranes, can occur because of a direct toxic reaction to the drug or because the drug deposits in the end capillaries in the mucous membranes, leading to inflammation.
superinfections
One of the body's protective mechanisms is provided by the wide variety of bacteria that live within or on the surface of the body and in the GI tract. This bacterial growth is called the normal flora. The normal flora protect the body from invasion by other bacteria, viruses, fungi, and so on. Several kinds of drugs (especially antibiotics) destroy the normal flora, leading to the development of _______________, or infections caused by organisms that are usually controlled by the normal flora.
Blood dyscrasia
_____________ is bone marrow suppression caused by drug effects. This occurs when drugs that can cause cell death are used. Bone marrow cells multiply rapidly; they are said to be rapidly turning over. Because they go through cell division and multiply so often, they are highly susceptible to any agent that disrupts cell function.
toxic effects
These effects are not acceptable adverse effects but are potentially serious reactions to a drug. The benefit of the drug to the patient must be weighed against the possibility of ____________ that may cause the patient harm.
Poisoning
______________ occurs when an overdose of a drug damages multiple body systems, leading to the potential for fatal reactions. Assessment parameters vary with the particular drug. Treatment also varies, depending on the drug. Emergency and life support measures often are needed in severe cases.
Hypoglycemia
Some drugs affect metabolism and the use of glucose, causing a low serum blood glucose concentration
Hyperglycemia
Some drugs stimulate the breakdown of glycogen or alter metabolism in such a way as to cause high serum glucose levels
Hypokalemia
Some drugs affecting the kidney can cause low serum potassium levels by altering the renal exchange system.
Hyperkalemia
Some drugs that affect the kidney, can lead to potassium retention. This results in an increase in serum potassium levels.
Liver Injury
Oral drugs are absorbed and passed directly into the liver in the first-pass effect. This exposes liver cells to the full impact of the drug before it is broken down for circulation throughout the body. Most drugs are metabolized in the liver, so any metabolites that are irritating or toxic will also affect liver integrity.
Renal Injury
The glomerulus in the kidney has a very small capillary network that filters the blood into the renal tubule. Some drug molecules are just the right size to get plugged into the capillary network, causing acute inflammation and severe renal problems. Some drugs are excreted from the kidney unchanged; they have the potential to directly irritate the renal tubule and alter normal absorption and secretion processes.
Ocular Damage
The blood vessels in the retina are very tiny and are called "end arteries," that is, they stop and do not interconnect with other arteries feeding the same cells. Some drugs are deposited into these tiny arteries, causing inflammation and tissue damage.
Auditory Damage
Tiny vessels and nerves in the eighth cranial nerve are easily irritated and damaged by certain drugs
General Central Nervous System Effects
Although the brain is fairly well protected from many drug effects by the blood-brain barrier, some drugs do affect neurological functioning, either directly or by altering electrolyte or glucose levels. Beta-blockers, which are used to treat hypertension, angina, and many other conditions, can cause feelings of anxiety, insomnia, and nightmares.
Atropine-like (Anticholinergic) Effects
Some drugs block the effects of the parasympathetic nervous system by directly or indirectly blocking cholinergic receptors. Atropine, a drug used preoperatively to dry up secretions and any other indications, is the prototype anticholinergic drug. Many cold remedies and antihistamines also cause anticholinergic effects.
Parkinson-like Syndrome
Drugs that directly or indirectly affect dopamine levels in the brain can cause a syndrome that resembles Parkinson disease. Many of the antipsychotic and neuroleptic drugs can cause this effect. In most cases, the effects go away when the drug is withdrawn.
Neuroleptic Malignant Syndrome
General anesthetics and other drugs that have direct CNS effects can cause __________ a generalized syndrome that includes high fever; if not treated quickly, it can be fatal.
Teratogenicity
Many drugs that reach the developing fetus or embryo can cause death or congenital defects, which can include skeletal and limb abnormalities, CNS alterations, and heart defects. The exact effects of a drug on the fetus may not be known.
1. Right patient

2. Right drug

3. Right storage

4. Right route

5. Right dose

6. Right preparation

7. Right time

8. Right recording
what are the 8 rights to ensure safe and effective drug administration?
physician or nurse practitioner

pharmacist

nurse
Who can be involved in a medication error?

These include the ____________ or __________ who prescribes a drug, the ___________ who dispenses the drug, and the ________ who administers the drug.
1. drug regimen process

2. Keep a written and/or electronic list of all medications you are taking, including prescription, OTC, and herbal medications

3. Know what each of your drugs is being used to treat

4. Read the labels, and follow the directions

5. Store drugs in a dry place, away from children and pets

6. Speak up
Identify 6 ways to prevent medication errors
1. Name, dose, and action of drug:

2. Timing of administration:

3. Special storage and preparation instructions:

4. Specific OTC drugs or alternative therapies to avoid:

5. Special comfort measures:

6. Safety measures:

7. Specific points about drug toxicity:

8. Specific warnings about drug discontinuation:
What are 8 key elements in any drug education?
1. therapeutic response,

2. the occurrence of adverse drug effects,

3. the occurrence of drug-drug, drug-food, drug-alternative therapy, or drug-laboratory test interactions.
What are 3 things that the nurse should evaluate in a patient after administering a medication?
1. Past History

2. physical examination

3. nursing diagnosis

4. planning

5. implementation
What are 5 assessments that could be pertinent to know about a patient prior to administration of a medication?
drug regimen process
The ______________, which includes prescribing, dispensing, and administering a drug to a patient, has a series of checks along the way to help to catch errors before they occur.
Evaluation
____________ is part of the continuing process of patient care that leads to changes in assessment, diagnosis, planning, and intervention.
nursing process
Some drug therapy requires evaluation of specific therapeutic drug levels. In addition, the efficacy of the nursing interventions and the education program also are evaluated. In some situations, the nurse evaluates the patient simply by reapplying the beginning steps of the _______________ and then analyzing for changes, either positive or negative. The process of evaluation may lead to changes in the nursing interventions being used to provide better and safer patient care.
Stevens-Johnson syndrome
Potentially fatal erythema multiforme exudative rash
Hepatotoxicity
Irritation or drug toxicity to the liver
Thrombocytopenia
A significant drop in platelets
Nephrotoxicity
Effect that could cause kidney damage
tinnitus
Symptom a client may have if hearing loss
optic neuritis
Adverse effect that could cause blindness
Anticholinergic
Drug effect that causes dry mouth, urinary retention and constipation
Paresthesias
Decreased feeling or numbness in extremity
Extrapyramidal symptoms
Rigidity of movements, involuntary movements, muscle tremors and gait changes
duration of action
Length of time that the drug concentration is adequate to cause a therapeutic response
Onset of action
Time required for a drug to cause a therapeutic response
Potential kidney damage
Nephrotoxic effects
Sedation
CNS depression effects
decreased WBC
leukopenia
pseudomembranous colitis
severe diarrhea and colon inflamation
carcinogenic
may cause cancer
Steven's Johnson syndrome
Severe rash affecting all mucous membranes
anaphylaxis
life threatening hypersensitivity reaction
sensitivity
usually effects more GI in origin
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