NURS 209 EXAM QUESTIONS AND ACCURATE ANSWERS (A+)
Polypharmacy is
When a person is on more drugs and start to have some disadvantages or side effects
5 or more medications daily
Hyperpolypharmacy if 10 or more drugs
Risk factors for Polypharmacy and nursing interventions
What is it?
If person was brought to ER and medications are not reviewed
Comorbidities (more issues)
NonPrescribed drugs
Alcohol
Automatic refills
Patient on same meds for years with no review or blood tests
Nursing interventions?
Go through all meds the patient is on in the chart and the patients hard copy of meds
Go through one by one and document patient meds
Any concerning meds, send to the pharmacy or doctor for review.
,- Make sure doctors are doing 6 months of yearly review for patients, and yearly blood
tests.
Pharmacokinetics
effect from drug on body.
(ADME) - absorption,distribution, metabolism, elimination.
Absorption:
Mechanical issues
Gastrointestinal motility
Reduced acid secretion (if using antacids or using protien pump inhibitors) it will affect
absorption because of stomach PH
Blood flow and inflammation in stomach which may cause issues with absorbing meds
Distribution:
Decreased albumin or hemoglobin
Iron levels might be low
, If gaining a lot of fat it will take a lot of time for the drug to absorb, and the alternative is
being really frail and will elevate drug concentration in the body.
The water content changes as we get older by 10-15%. That is why older people need to
drink water for absorption and distribution of medication.
Metabolism:
Liver issues as getting older can have the perfusion. Amount of blood flow through the
liver will decrease as we get older.
Metabolism through the enzyme P-450 will help but it decreases with age which makes it
more difficult.
First-pass metabolism (metabolism that occurs before a drug reaches systemic
circulation) decreases by about 1%/yr after age 40 (this can cause issues because body
cannot metabolize meds)
Elimination:
Decreased renal mass and blood flow
Reduction of clearance of drugs through kidneys
Rate of glomeruli decreases as we get older.
Polypharmacy is
When a person is on more drugs and start to have some disadvantages or side effects
5 or more medications daily
Hyperpolypharmacy if 10 or more drugs
Risk factors for Polypharmacy and nursing interventions
What is it?
If person was brought to ER and medications are not reviewed
Comorbidities (more issues)
NonPrescribed drugs
Alcohol
Automatic refills
Patient on same meds for years with no review or blood tests
Nursing interventions?
Go through all meds the patient is on in the chart and the patients hard copy of meds
Go through one by one and document patient meds
Any concerning meds, send to the pharmacy or doctor for review.
,- Make sure doctors are doing 6 months of yearly review for patients, and yearly blood
tests.
Pharmacokinetics
effect from drug on body.
(ADME) - absorption,distribution, metabolism, elimination.
Absorption:
Mechanical issues
Gastrointestinal motility
Reduced acid secretion (if using antacids or using protien pump inhibitors) it will affect
absorption because of stomach PH
Blood flow and inflammation in stomach which may cause issues with absorbing meds
Distribution:
Decreased albumin or hemoglobin
Iron levels might be low
, If gaining a lot of fat it will take a lot of time for the drug to absorb, and the alternative is
being really frail and will elevate drug concentration in the body.
The water content changes as we get older by 10-15%. That is why older people need to
drink water for absorption and distribution of medication.
Metabolism:
Liver issues as getting older can have the perfusion. Amount of blood flow through the
liver will decrease as we get older.
Metabolism through the enzyme P-450 will help but it decreases with age which makes it
more difficult.
First-pass metabolism (metabolism that occurs before a drug reaches systemic
circulation) decreases by about 1%/yr after age 40 (this can cause issues because body
cannot metabolize meds)
Elimination:
Decreased renal mass and blood flow
Reduction of clearance of drugs through kidneys
Rate of glomeruli decreases as we get older.
