RNSG 1301 Key Concepts Final Exam Top Mark

Key Concepts RNSG 1301 Final exam Fall 2019 (updated) When studying remember to know the indications, contraindications, common and severe adverse effects, special considerations regarding admini stra tion, teaching points and the nonpharmacologic treatment that can be implemented for the condition to improve drug effectiveness. There may be two or more questions on some of the high alert or frequently administered drugs to make sure you are knowledgeable of the adverse effects, management of overdosage and use of antidotes. Don’t forget the nursing process and remember to answer the question being asked, read items care fully. Ch 1 Routes of administration Controlled substances (2)  5 categories/schedules  Meds that have 0 risk for addiction are not scheduled o ex: insulin, bp & cholesterol med. , Propofol, Gabapentin Schedule I  NO currently accepted medical use & a high potential for abuse.  Ex: o heroin, lysergic acid diethylamide (LSD), marijuana (cannabis), 3,4- methylenedioxymethamphetamine (ecstasy), methaqualone, & peyote Schedule II  High potential for abuse, with use potentially leading to severe psychological/physical dependence.  considered dangerous.  Ex: o Narcotics, amphetamines, barbituates. Combination products with < than 15 mgs of hydrocodone per dosage unit (Vicodin), cocaine, opium, codeine, morphine, methamphetamine, methadone, hydromorphone (Dilaudid), meperidine (Demerol), oxycodone (OxyContin), fentanyl, Dexedrine, Adderall, & Ritalin Schedule III  moderate to low potential for physical & psychological dependence.  abuse potential is less than Schedule I & Schedule II drugs but more than Schedule IV. Ex: o Products containing < 90 mgs of codeine per dosage unit (Tylenol with codeine), ketamine, Vicodin, anabolic steroids, testosterone Schedule IV  LOW potential for abuse & low risk of dependence.  Ex: o Xanax, Soma, Darvon, Darvocet, Valium, Ativan, Talwin, Ambien, Tramadol Schedule V  drugs with lower potential for abuse than Schedule IV & consist of preparations containing limited quantities of certain narcotics. Schedule V drugs are generally used for antidiarrheal, antitussive, & analgesic purposes  Ex: o cough preparations with < than 200 mgs of codeine or per 100 milliliters (Robitussin AC), Lomotil, Motofen, Lyrica, Parepectolin, weed, pot (legal in some states) Regulatory agencies In response to the patient's question about how to know whether drugs are safe, the nurse explains that all medications undergo rigorous scientific testing controlled by what organization? Food and Drug Administration (FDA) Drug Enforcement Agency (DEA) Centers for Disease Control and Prevention (CDC) Joint Commission on Accreditation of Healthcare Organizations (JCAHO) A Feedback: The FDA is responsible for controlling and regulating the development and sale of drugs in the United States, allowing new drugs to enter the market only after being subjected to rigorous scientific testing. The DEA regulates and controls the use of controlled substances. The CDC monitors and responds to infectious diseases. The JCAHO is an accrediting body that inspects acute care facilities to ensure minimum standards are met. 20. The telephone triage nurse receives a call from a patient asking for a prescription for a narcotic to manage his surgical pain. The nurse explains that narcotic prescriptions must be written and cannot be called in to the pharmacy. The patient says, “Why are narcotics so difficult to get a prescription for?” What is the nurse's best response? D) “Controlled substances like narcotics are controlled by the FDA and the DEA.” Ans: D Feedback: Controlled substances are controlled by the FDA and the DEA: the DEA enforces control while the FDA determines abuse potential. Regulations related to controlled substances have remained strict and specific and have not been significantly impacted by substance abusers. The CDC is not involved in control of narcotics and other controlled substances. 21. The nurse explains the Drug Enforcement Agency's (DEA's) schedule of controlled substances to the nursing assistant who asks, “Do you ever get a prescription for Schedule I medications?” What is the nurse's best response? A) “Schedule I medications have no medical use so they are not prescribed.” Ans: A Feedback: Schedule I medications have no medical use and are never prescribed. Schedule V medications have the lowest risk for abuse and are found mostly in antitussives and antidiarrheals but they are not sold over the counter. Safety technologies in medication administration Black box warnings Toxicity - Ch 2 Pharmacokinetics - the way the body deals with a drug, including absorption, distribution, biotransformation, and excretion - Absorption, distribution, metabolism, excretion - Absorption: Drugs can be absorbed into cells through various processes, which include passive diffusion, active transport, and filtration. - distribution: movement of a drug to body tissues; the places where a drug may be distributed depend on the drug’s solubility, perfusion of the area, cardiac output, and binding of the drug to plasma proteins - Metabolism (Biotransformation) - Excretion- removal of a drug from the body. The skin, saliva, lungs, bile, and feces are some of the routes used to excrete drugs. The kidneys, however, play the most important role in drug excretio