NR 293 Week 8 Final Exam Collection (2023/2024)

Exam 1 You go to the MAR, you’re going to give meds. First action you’re going to do in med administration: comparing labels on the meds, calculating med dosing, verify patient identity, or compare med administration order with original orders. How do you know ensure the right med dose is given = med calc How to ensure right time is being used to give med = PRN meds are given under special times and special circumstances Fastest absorption order = IV and then oral suspension (liquid) First pass effect = Know all parenteral routes = everything that is not GI (enteral) Intraarticular = joint. That is not parenteral route Intrathecal = spine. That is parenteral Transdermal = patches or adhesives You give a drug and it has narrow therapeutic index = higher risk of toxicity You’re assessing a newly admitted old patient, which statement nurse’s concern = patient takes multiple meds for different illnesses (polypharmacy) Drug transferred to the fetus is likely to happen during = last trimester because enhanced placenta blood flow Know categories for FDA = A,B,C,D,X Possible risk to fetus = Category D Reduced albumin and protein level in relation to medication = possible drug toxicity Which statement is true regarding administration errors = med errors can occur during any time of process Check meds = at least 3 times Highest priority when administering meds = patient safety Which description is correct order of med reconciliation process = collection of meds, professional review, analysis, and documentation Consequences of med errors = incident report, stress and anxiety (emotional toll) Healthcare provider writes an order for STAT, wrong drug ordered from pharmacy, right drug arrives an hour later, what do you do next = administer medication Patient education Potential barriers Discharge teaching Understanding instructions Over the counter meds = adverse drug reactions My herbal drugs are safe and natural there’s no harm, nurses therapeutic response = discuss with your healthcare provider. Just because it's natural, doesn't mean it's safe Patient takes too much Advil, it affects = KIDNEY Antidote to Tylenol = acetylcysteine NARCAN Does FDA regulate herbal remedies? = No Patient’s med is due same time as… = call the surgeon Order for Benadryl 50mg, give b4 vancomycin = find the route, Call the physician Digoxin = cardiac glycoside; it’s a positive inotropic. Slows down heart rate Check heart rate before administering If heart rate is less than 60, you do not give drug. 0.5-2 range Safety in older patients = lower drug dosing because of liver and kidney metabolism Bioavailability Pharmacokinetics Synergistic Antagonistic Nurse is taking care of a patient who is taking antagonistic drugs at same time, what is the best next action = Change the frequency, spread it out Best way to find out pharmacokinetics = read package insert Patient given meds thru IV and asks why am I getting this IV? Best answer = fastest absorption Garlic good for = heart, cholesterol, BP You’re on the phone … = repeat the order back to them Kid in ER who has fever, first culture = antibiotics then Tylenol Common HAI UTI’s from = Foley Mechanism of broad spectrum of antibiotic = preventing bacteria from synthesizing folic acid Penicillin’s = cell membrane rupture; cell wall Penicillin’s kill both Gram positive and gram negative Which statement is true about cephalosporin = broad spectrum can destroy anaerobic bacteria Sulfonamides interact w/ sulfonylureas – UTI, kidney stones Which statement is accurate about cephalosporin administration = cephalosporin can be administered to patients with nonlife threatening conditions Tetracycline is good for = skin, soft tissue Macrolides = erythromycin Macrolides can have positive interaction with Digoxin Multidrug resistant bacteria Handwashing Nephrotoxicity