NURSING MSN 571 Pharm Midterm and Final Exam,
Featuring Questions and Answers for the Latest
Academic Year | Already Graded A+
What intervention does the provider take to decrease risk to the patient
when prescribing drugs with a narrow therapeutic index? -ANS-- drugs
with narrow therapeutic range are more dangerous, provider who is aware
of this fact can focus additional attention on monitoring these patients for
signs and symptoms of toxicity
definition of onset of action -ANS-- Onset of Action: the time it takes a drug
to reach the minimum effective concentration after a drug is administered.
definition of bioavailability -ANS-- Bioavailability: the amount of an active
drug that reaches the systemic circulation from its site of administration.
Disintegration time, extended release, capsule coatings, can all effect this.
Greatest concern is with drugs that have a narrow therapeutic index. IV
administration results in the highest bioavailability.
definition of protein binding -ANS-- Plasma protein binding refers to the
degree to which medications attach to proteins within the blood. A drug's
efficiency may be affected by the degree to which it binds. The less bound a
drug is, the more efficiently it can traverse cell membranes or diffuse.
definition of loading dose -ANS-- Loading dose: a large initial dose of the
drug is given to achieve a rapid minimum effect concentration in the
plasma.
,how to write out a prescription -ANS-- Good to know brand name and
generic name (generic is most important), route, dose, frequency. If it is an
as needed drug, what is it being prescribed for?
A patient is prescribed digoxin. Which screening will the provider order to
monitor for potential adverse effects from this drug? -ANS-- digoxin: treats
HF and supraventricular dysrhythmias. Heart rate and rhythm should be
monitored with periodic ECGs to assess desired effects and signs of toxicity.
Baseline and periodic serum creatinine. Periodically monitor electrolytes
(potassium, magnesium, calcium) especially if on diuretics. Because this
drug has a narrow therapeutic range (0.5-0.8). Monitor plasma drug levels
in patients with unchanged symptoms
,of heart failure after initiation or patient with signs of toxicity- altered
heart rate or rhythm, visual or GI disturbances). Patient should be taught to
monitor their pulse and know signs of toxicity.
What is pharmacodynamic tolerance? -ANS-- Pharmacodynamic tolerance:
a state in which a particular dose elicits a smaller response than it did with
initial use, results from regular drug use. -intrinsic responsivity of the
receptor system diminishes over time
What is a side effect of a nonselective b agonist medication? -ANS-- Beta 1:
tachycardia, dysrhythmias, angina
Beta 2: hyperglycemia, tremor
Which assessment finding would be of greatest concern for a provider who
is attempting to determine the appropriateness of prescribing the patient a
nonselective b agonist? -ANS-- Cardiac disease- any dysrhythmias or
previous MI, angina, tachycardia. Because it can cause dysrhythmias and
tachycardia.
For what purpose will a provider prescribe pilocarpine? -ANS--
Pilocarpine: Muscarinic agonist used mainly for the topical treatment of
glaucoma because it reduces intraocular pressure. Second-line drug for
open angle glaucoma. Can also treat dry mouth from Sjogren's syndrome.
What condition would be contraindicated in using Bethanechol? -ANS--
Bethanechol is a direct acting muscarinic agonist that is used to cause
bradycardia, and increases secretions, in GI tract and lungs it causes
constriction. Treats non obstructive urinary retention.
Contraindications: ASTHMA, because of activation of muscarinic receptors
in the lungs cause bronchoconstriction. Also, bowel obstruction.
The prescriber has ordered neostigmine for a patient with myasthenia
gravis. What physiological process would be assessed to best assure patient
safety and the long- term effectiveness of the medication therapy? -ANS--
ANSWER: the patient's current swallowing ability. Many patients
hospitalized for myasthenia gravis do not have the muscle strength to
swallow well and need a parenteral form of the medication, assessing
swallowing ability is an important initial safety measure.
When prescribing an anticholinergic drug, what would be a concerning
, preexisting conditions demonstrates the provider's understanding of
possible contraindications to this therapy? And what education would you
want to give the patient? -ANS--
Featuring Questions and Answers for the Latest
Academic Year | Already Graded A+
What intervention does the provider take to decrease risk to the patient
when prescribing drugs with a narrow therapeutic index? -ANS-- drugs
with narrow therapeutic range are more dangerous, provider who is aware
of this fact can focus additional attention on monitoring these patients for
signs and symptoms of toxicity
definition of onset of action -ANS-- Onset of Action: the time it takes a drug
to reach the minimum effective concentration after a drug is administered.
definition of bioavailability -ANS-- Bioavailability: the amount of an active
drug that reaches the systemic circulation from its site of administration.
Disintegration time, extended release, capsule coatings, can all effect this.
Greatest concern is with drugs that have a narrow therapeutic index. IV
administration results in the highest bioavailability.
definition of protein binding -ANS-- Plasma protein binding refers to the
degree to which medications attach to proteins within the blood. A drug's
efficiency may be affected by the degree to which it binds. The less bound a
drug is, the more efficiently it can traverse cell membranes or diffuse.
definition of loading dose -ANS-- Loading dose: a large initial dose of the
drug is given to achieve a rapid minimum effect concentration in the
plasma.
,how to write out a prescription -ANS-- Good to know brand name and
generic name (generic is most important), route, dose, frequency. If it is an
as needed drug, what is it being prescribed for?
A patient is prescribed digoxin. Which screening will the provider order to
monitor for potential adverse effects from this drug? -ANS-- digoxin: treats
HF and supraventricular dysrhythmias. Heart rate and rhythm should be
monitored with periodic ECGs to assess desired effects and signs of toxicity.
Baseline and periodic serum creatinine. Periodically monitor electrolytes
(potassium, magnesium, calcium) especially if on diuretics. Because this
drug has a narrow therapeutic range (0.5-0.8). Monitor plasma drug levels
in patients with unchanged symptoms
,of heart failure after initiation or patient with signs of toxicity- altered
heart rate or rhythm, visual or GI disturbances). Patient should be taught to
monitor their pulse and know signs of toxicity.
What is pharmacodynamic tolerance? -ANS-- Pharmacodynamic tolerance:
a state in which a particular dose elicits a smaller response than it did with
initial use, results from regular drug use. -intrinsic responsivity of the
receptor system diminishes over time
What is a side effect of a nonselective b agonist medication? -ANS-- Beta 1:
tachycardia, dysrhythmias, angina
Beta 2: hyperglycemia, tremor
Which assessment finding would be of greatest concern for a provider who
is attempting to determine the appropriateness of prescribing the patient a
nonselective b agonist? -ANS-- Cardiac disease- any dysrhythmias or
previous MI, angina, tachycardia. Because it can cause dysrhythmias and
tachycardia.
For what purpose will a provider prescribe pilocarpine? -ANS--
Pilocarpine: Muscarinic agonist used mainly for the topical treatment of
glaucoma because it reduces intraocular pressure. Second-line drug for
open angle glaucoma. Can also treat dry mouth from Sjogren's syndrome.
What condition would be contraindicated in using Bethanechol? -ANS--
Bethanechol is a direct acting muscarinic agonist that is used to cause
bradycardia, and increases secretions, in GI tract and lungs it causes
constriction. Treats non obstructive urinary retention.
Contraindications: ASTHMA, because of activation of muscarinic receptors
in the lungs cause bronchoconstriction. Also, bowel obstruction.
The prescriber has ordered neostigmine for a patient with myasthenia
gravis. What physiological process would be assessed to best assure patient
safety and the long- term effectiveness of the medication therapy? -ANS--
ANSWER: the patient's current swallowing ability. Many patients
hospitalized for myasthenia gravis do not have the muscle strength to
swallow well and need a parenteral form of the medication, assessing
swallowing ability is an important initial safety measure.
When prescribing an anticholinergic drug, what would be a concerning
, preexisting conditions demonstrates the provider's understanding of
possible contraindications to this therapy? And what education would you
want to give the patient? -ANS--
