NRNP_6665_Week_4_Assignment_Assessing__Diagnosing__and_Treating_Adults_With_Mood_Disorders_INSTRUCTI.pdf

1 – nursing process and drug therapy  Correct nursing dx – anxiety related to new drug therapy as evidenced by statements such as “I’m upset about having to test my blood sugars” 3 step process.  Right dose, right time, right route, right medication, right patient  Nursing process – ADPIE  Outcome criterion for patient recently diagnosed with type 1 diabetes: “Demonstrating correct blood glucose testing technique” is a specific and measurable outcome criterion.  Contact prescriber to confirm all rights of med administration. Even route. Doses are not interchangeable with different routes.  meals may need to be considered when timing medications.  Subjective data is what the patient SAYS. Objective is what you OBSERVE. 2 – Pharmacologic Principles  Bioequivalent – two drugs absorbed into the circulation in the same amount of time.  IV route allows for quicker action of the medication.  Parenteral drugs bypass the first-pass effect. Sublingual, transdermal also bypass it. PO medications that are metabolized by the liver are effected by it.  A pharmacologic reaction is an extension of a drug’s normal effects in the body. i.e. low BP in pt taking drug to lower BP… lethargy, difficult to awaken.  Half-life - The time it takes for one half of the original amount of a drug to be removed from the body.  Duration of action - The time period at which a drug’s concentration is sufficient to cause a therapeutic response.  With selective enzyme interaction, the drug attracts the enzymes to bind with the drug instead of allowing the enzymes to bind with their normal target cells  Drugs that are bound to plasma proteins are characterized by longer duration of action.  Route of administration – sublingual is under the tongue. Subcutaneous is into the fatty tissue of abdomen.  Pt with renal failure will have problems with excretion of drugs.  Palliative care is therapy to keep patients comfortable such as pt with advanced cancer receiving around the clock opioid meds.  Which OTC route works the fastest? Powder. Then in order tablet, capsule, enteric-coated tablet 3 - Lifespan Considerations  Drug transfer is more likely during last trimester because of enhanced blood flow to the fetus.  Pregnancy drug categories – Category D, pose a possible fetal risk but the potential benefits may warrant use.  Pediatric doses are weight based. Mg/kg. consider organ maturity when dosing as well. Neonates liver is not fully developed and cannot detoxify many drugs.  Polypharmacy – use of multiple medications simultaneously.  Confusion, forgetfulness, increased fall risk is common response for elderly pt taking sedatives  Elderly patient may have reduction in stomachs ability to produce hydrochloric acid resulting in altered absorption of weakly acidic drugs Pharmacology Final Exam Study Guide – January 2021 Cumulative Chapters 1-7, 10-28, 30-41, 44, 47, 48, 50-52, 54, 56, 58  An elderly woman is taking thiazide diuretic to tx mild HF. Watch for electrolyte imbalance, legs cramps, fatigue, and dehydration.  “start low and go slow” for elderly patient dosing.  For giving liquid PO meds with strong taste to peds patient, give with spoonful of ice cream.  For giving an injection to 4 yr old, offer a short but concrete explanation of the procedure at the patient’s level and with parent present.  True regarding pediatric patients and pharmacokinetics. o a. The levels of microsomal enzymes are decreased. o b. Perfusion to the kidneys may be decreased and may result in reduced renal function. o d. First-pass elimination is reduced because of the immaturity of the liver. o f. Gastric emptying is slowed because of slow or irregular peristalsis.  True regarding elderly patients and pharmacokinetics o a. The levels of microsomal enzymes are decreased. o b. Fat content is increased because of decreased lean body mass. o e. The number of intact nephrons is decreased. o f. Gastric pH is less acidic. 4 – Cultural, legal, and ethical Considerations  placebo is included in research to prevent bias or unrealistic expectations.  Phase I studies involve small numbers of healthy volunteers to determine optimal dosage range and the pharmacokinetics of the drug.  Schedule