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pharm exam 1 pt 2 ch 5-9
Terms in this set (42)
what are adverse drug reactions? why do they occur even when the prescription is deemed safe?
unexpected, unintended, or excessive responses to medications given at therapeutic doses. two types of adverse drug reactions: allergic (predictable) and idiosyncratic (unpredictable)
what are the ways to prevent medication errors?
multiple systems of checks and balances should be implemented to prevent medication errors
-prescribers orders must be legible,
-authoritative resources, such as pharmacists or current drug reference literature must be consulted if there is a lack of clarity or concern (do not use faculty members)
- check the med order three times before giving the drug
- follow the basic 9 rights of administration
how should the nurse report a medication error?
must be reported regardless of whether the error was made by a nursing student or a professional nurse.
after pt has been assessed and urgent safety issues addressed, report error immediately to the appropriate prescriber and nursing management personnel.
when documenting the error only give factual information.
what is a medication error?
any preventable adverse drug event involving inappropriate medication use by a patient or health care professional, they may or may not cause the patient harm
what do you do if there is an abbreviation that son the "do not use" list on an order?
contact the prescriber for clarification
who are the groups prone to adverse drug reactions?
infants and children (immature organs)
elderly (deteriorating organs)
what are high alert medications, what is the biggest concern with these?
not necessarily more involved in more errors than other drugs, but the potential for patient harm is higher. these include meds for the central nervous system, anticoagulants, and chemotherapy drugs
what sources are best for a nurse who need to clarify information on a prescription?
reputable drug books and pharmacists, not google, peers or coworkers.
what is the priority action for a nurse if he or she makes a med error?
always make sure patient is okay first. patient is always FIRST PRIORITY
what are the 3 domains of learning and what type of education falls into which category?
-cognitive domain: the level at which basic knowledge is learned and stored
-affective domain: conduct that expresses feelings, needs, beliefs, values, and opinions. ex: if a pt stops taking a pain med bc she believes its bad, you teach her its not bad and is helpful in this situation
-psychomotor domain: involved the learning of a new procedure or skill and is often called the doing domain.ex: teaching a pt to give insulin injection
how is client education part of the implementation phase of the nursing process
this phase includes conveying specific information about the medication to the patient, family, or caregiver, teaching methods/session must always accommodate the priorities of the patient.
what are some obstacles to learning in patients regarding teaching them about medications?
mild levels of anxiety are motivating
moderate to severe levels of anxiety are obstacles to learning
if pt is in pain, vomiting, or other physical distresses, these need to be addressed prior to teaching
what should teaching of a new medication include?
-name of medication
-reason for taking medication
-prescribed dosage (including frequency)
-any potential side effect
-expected timeframe for medication to take effect
how to properly evaluate the effectiveness of client teaching?
ask specific questions related to patient outcomes
request that the patient repeat the information or give a return demonstration of skills
assess patients behavior such as adherence to the schedule
what can an excessive dose of acetaminophen lead to?
liver toxicity, this is the leading cause of liver failure
what do OTC medications do?
may relieve symptoms without necessarily addressing the cause of the disorder, this can cause delay in the effective management of chronic disease states or treatment of serious and/or life threatening disorders
what is a possible drug interaction with chamomile?
it can increase the risk for bleeding when taken with anticoagulants
what do cranberry and grapefruit juice do?
either decrease elimination or metabolism of certain drugs, which may lead to toxicity
describe the major different between legend drugs (prescription drugs) and OTC products and dietary supplements
DSHEA requires no proof of efficacy and set no standards for quality control for supplements. "natural: does not mean "healthy"
prioritize medication administration and assessment of multiple patients receiving therapy
ABC's or nursing
-always prioritize acute or new onset of symptoms over chronic. look for symptoms that are abnormal and should not be occurring
what doe aloe help with?
acceleration of wound healing, laxative effect
what does chamomile help with?
anti-inflammatory, calming agent
what is chondroitin used for?
used in combination with glucosamine to treat pain from oseoarthritis
what s echinacea used for?
stimulation of the immune system, antisepsis, treatment of viral infects, wound healing
what is garlic used for?
antispasmodic, antiseptic, antibacterial and antiviral, antihypertensive, anti platelet, lipid reducer
what is ginger root used for?
antiemetic (for nausea and vomiting)
what is valerian used for?
relief of anxiety, restlessness, sleep disorders
describe the first pass affect
the rapid hepatic inactivation or certain oral drugs. give stronger oral dose of medications because the liver metabolites a lot of the medication
what are the advantages and disadvantages of IV's
advantages: provides rapid, onset.
disadvantage: often higher cost, required intravenous access and not self administered, irreversibility of drugs in most cases, risk of fluid overload
what are the advantages and disadvantages PO (oral)
advantages: usually easier, more convenient, less expensive, safer then injection, dosing is more likely reversible
disadvantages: variable absorption and slower onset of action, inactivation of some drugs by stomach acid and or pH, problems with firs pass effect, some irritate GI mucosa
differentiate between adverse drug event and adverse drug reaction
adverse drug event: any undesirable occurrence related too administering or failing to administer a prescribed medication
adverse drug reaction: any unexpected unintended, undesired, or excessive response to a medication given at therapeutic dosages
describe the protein binding and albumin
-when the drug binds to albumin, the drug is bound and is not acting on the body
-when the drug breaks away from albumin, the drug is considered active
person with low protein is at risk for toxicity with protein binding drugs. having low albumin might make a person look puffy
what is the half life?
the time it takes for one half of the original amount of a drug to be removed from the body
-most drugs are considered to be effectively removed after about five half lives
what is the steady state?
when someone is taking a drug multiple times a day, it will eventually reach the steady state in which the amount of drug they take in and the amount of drug being excreted are the same
which foods and medication when combined can cause a hypertensive episode?
MAOI's (monoamine oxide inhibitors) and foods containing tyramine (aged meats, cheeses, wines, etc.. but not soft cheese such as cottage cheese or cream cheese)
what is gene therapy?
new therapeutic technologies that directly target human genes in the treatment and prevention of illness
what is genetic predisposition?
the presence of certain factors in a persons genetic makeup or genome that increase the individuals likelihood of developing one or more diseases
what is an inherited disease?
genetic disease tat result from defective alleles passes from parents to offspring
what is pharmacogenomics?
a branch of pharmacogenetics that involves the survey of the entire genome to detect multigenic determinants of drug exposure
what is of utmost importance during genetic testing and counseling?
maintaining privacy and confidentiality, the patient is the one who decides to include or exclude any family members from the discussion and from knowledge of the results of genetic testing
what can a person do to help offset his or her genetic predisposition?
make better lifestyle choices such as consuming a healthy diet and exercising to avoid development heart disease
what is the proper way to measure liquid medications?
if less than 5 mL, us a syringe to measure
do not use household tsp
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