UTA Pharmacology Exam 1 Prep With Complete Solutions.

START OF NOTES #1 Nursing Process (ADPIE) An organizational framework for the practice of nursing. It encompasses all steps taken by the nurse in caring for a patient: Assessment Nursing Diagnosis (problem or need identification) Planning (Desired Outcome Identification) Implementation (Nursing Action) Evaluation Quality and Safety Education for Nurses (QSEN) 2005 -Stands for Quality and Safety Education for Nurses -Knowledge, Skills, and Attitudes (KSAs) needed to continuously improve the quality and safety of patient care within the health care system. Six major initiatives of QSEN: 1. Patient-centered Care 2. Teamwork 3. Collaboration 4. Evidence-based Practice (EBP) 5. Quality Improvement (QI) 6. Informatics Assessment Data is collected, reviewed, and analyzed from the patient, family, or the medical record. Ex. A medication history including allergies and type of reaction, current prescribed medications, use of OTC medications, herbal remedies, dietary supplements. Current or past use of alcohol, tobacco products, and street (illicit drugs). Family history and ethnic origin (these can impact response to medications due to genetic variance) Nursing Diagnosis Three part statement example: PROBLEM STATEMENT- risk for injury RELATED TO alpha blocker and diuretic use as EVIDENCED BY orthostatic hypotension (BP drops when the patient arises too quickly) Different from medical diagnosis which focuses on the problem Orthostatic hypotension. Planning (desired Outcome Identification) These are what you and the patient together decide he or she wants to accomplish Implementation Requires all the previous steps. It requires constant communication with the patient, family members, other healthcare providers. many nursing interventions are independent. Evaluation evaluation of medication therapy occurs after administration and is a systematic and ongoing process to assess the therapeutic outcome of the medication and note any adverse events. The Big Three Proactivity Communication Patient Education These are just a way of combining the nursing process into three main areas. Proactivity Steps 1-3 & 5 of nursing process Communication with other health care team members (steps 1-5 of the nursing process. ISBAR Checklists- Team Steps Patient Education (*) Informing patients about their health, medicines, etc. Chapter 1 Vocabulary: Compliance Implementation or fulfillment of a prescriber's or caregiver's prescribed course of treatment or therapeutic plan by a patient. Use of compliance versus adherence in this textbook is supportive of the terms used in the current listing of NANDA-I nursing diagnosis. Medication error Any preventable adverse drug event involving inappropriate medication use by a patient or health care professional; it may or may not cause the patient harm. Noncompliance Any informed decision on the part of the patient not to adhere to or follow a therapeutic plan or suggestion. Use of noncompliance versus nonadherence in this textbook is supportive of the terms used in the current listing of NANDA-I nursing diagnosis. Outcomes Descriptions of specific patient behaviors or responses that demonstrate meeting of or achievement of behaviors related to each nursing diagnosis. These statements are specific while framed in behavioral terms and are measurable. Prescriber Any health care professional licensed by the appropriate regulatory board to prescribe medications. Chapter 2: vocabulary Additive effects Drug interactions in which the effect of a combination of two or more drugs with similar actions equivalent to the sum of the individual effects of the same drugs given alone. For example, 1+1=2 (compare with synergistic effects). Adverse drug event Any undesirable occurrence related to 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 (as opposed to an overdose). Adverse effects A general term for any undesirable effects that are a direct response to one or more drugs. Agonist A drug that binds to and stimulates the activity of one or more receptors in the body. Antagonist A drug that binds to and inhibits the activity of one or more receptors in the body Antagonistic effects Drug interactions in which the effect of a combination of two or more drugs is less than the sum of the individual effects of the same drug given alone ( 1+1 equals less than 2); it is usually caused by an antagonizing (blocking or reducing) effect of one drug on another. Bioavailability A measure of the extent of drug absorption for a given drug and route (from 0% to 100%) Biotransformation One or more biochemical reactions involving a parent drug; occurs mainly in the liver and produces a metabolite that is either inactive or active . Also known as metabolism. Blood-brain barrier (BBB) The barrier system that restricts the [passage of various chemicals and microscopic entities (e.g., bacteria, virus) between the bloodstream and the central nervous system. It allows for the passage of essential substances like oxygen. . Chemical name The name that describes the chemical composition and molecular structure of a drug. Contraindication Any condition, especially one related to a disease state or patient characteristic, including current or recent drug therapy, which renders a particular form of treatment improper or undesirable Cytochrome P-450 The general name for a large class of enzymes that play a significant role in drug metabolism and drug interactions. Dependence A state in which there is compulsive or chronic need, as for a drug. Dissolution The process by which solid forms of drugs disintegrate in the gastrointestinal tract and become soluble before being absorbed into the circulation Drug Any chemical that affects the physiologic processes of a living organism. Drug actions The process involved in the interaction Patient Education Steps 3, 4, 5 of Nursing process Who is legally and ethically responsible for maintaining patient safety? Nurses (us) ERR is Human 1999- study by the Institute Of Medicine that made a crude estimate of the number of medical errors and patient deaths in US hospitals. unfortunately, not much has changed since. How many adults in the US take medications daily? 4 out of 5 How many medical errors are there annually? 1.5 million What is the leading cause of death Medical errors. How much of the population takes 5 or more drugs daily? 1/3 Who is the last line of defense for patients? Nurses (us) 1906 Pure Food Drug Act weak law 1938 Food drug and Cosmetic Act stronger- required the drug to be SAFE (toxicity testing). Reason: 100 people died from a drug that had antifreeze added as a solubility agent. 1962 amended FDA legislation Drug had to be tested for EFFICACY (drugs needed to have activity in the disease for which they were prescribed). 1970 Controlled Substance Act Enacted to control drugs with varying degrees of addictive potential. Since then the schedule of several drugs has been changed due to the noted abuse with them (e.g. Vicodin Ulteam) 2007 Amended FDA Rules to give the agency power to monitor drug safety problems after marketing (Avandia). FDA was given further power to require extra testing of drugs after they are marketed, and can require a drug manufacturer to remove a drug from the market. Establishing safety and efficacy is the most important property of US law.