NUR 607 FINAL EXAM STUDY GUIDE
QUESTIONS AND CORRECT ANSWERS
Appropriate use/precautions/administration of acetaminophen in
children and adults: - correct answer- Due to 4% of the drug
converting to a toxic metabolite in the liver, taking more than the
recommended dose per day could cause fatal liver necrosis. In adults,
generally, the maximum daily dose is 4,000 mg. This should be lowered
in those who drink two or more alcoholic beverages per day or if liver
disease is present. In older adults, it is now suggested to lower the daily
dose to 3,000 mg daily. In children through 12 years of age, Tylenol
should be based on weight, may be taken every 4-6 hrs., not to exceed 5
doses in a 24 hour period (2.6 g) It is important to teach parents not to
administer any other medication that may contain acetaminophen at the
same time (cold meds, etc.)
Biphosphonate teaching and monitoring: - correct answer-
Biphosphonates are used for preventing and treating osteoporosis.
Examples are: Aredia, Nerixia, Olpadronate, Fosamax, Boniva, Actonel,
and Aclasta. Education: sit upright for 30 minutes after taking. Boniva is
given via IV infusion over 15-30 mins. Always take oral biphisphonates
with 8 ounces of water. Patients with esophageal issues and diarrhea
shouldn't take biphosphonates. Continue to monitor BMD while taking
them. Dexascans should be performed every 2 years. Treatment may be
lifelong, but some experts state that a holiday should be taken after 5
yrs.
, Body fat considerations for prescribing drugs: - correct answer-
According to our text, "drug distribution may be affected by obesity,
both immediately after absorption and after achieving an equilibrium or
steady state in the body. Lipid-soluble drugs readily distribute into the
fatty tissues, where they may be stored and even concentrated. Water-
soluble drugs, however, tend to remain in the highly vascularized spaces
of the skeletal muscle. Ideal body weight is usually considered the
standard for determining drug dosage, which is often adjusted for obese
or cachectic patients." Additionally, according to Drug Pharmokinetics in
the Obese" (Cheymol, et.al), with lipophilic drugs (e.g., barbiturates,
benzodiazepines), the drug distribution volume is significantly increased,
explaining the prolongation of the plasma elimination half ‐life.
Causes of poly-pharmacy in the elderly. - correct answer- Varied
symptoms and complaints associated with chronic illnesses; when a drug
doesn't work, another is prescribed (known as the prescribing cascade);
stockpiling discontinued medications due (primarily due to the cost);
placing prescriptions in different bottles; sharing of medications
between family members; seeing "polyproviders": seeing multiple
specialists for various chronic diseases; failure of providers to fully
review the patient's other medications before prescribing; lack of
primary care provider;
Colchicine patient teaching - correct answer- Colchicine may be
taken for the first 6 months of chronic gout therapy. Otherwise it should
be used for gouty flares. It prevents the activation and migration of
neutrophils to the area of attack, preventing inflammation. Give within
24 hrs. of onset of acute attack. A/Es of colchicine treatment are GI
effects (mainly diarrhea), pain, fatigue headache, blood dyscrasias. Teach
patient that onset of Colchicine's effects take between 18-24 hours. They
QUESTIONS AND CORRECT ANSWERS
Appropriate use/precautions/administration of acetaminophen in
children and adults: - correct answer- Due to 4% of the drug
converting to a toxic metabolite in the liver, taking more than the
recommended dose per day could cause fatal liver necrosis. In adults,
generally, the maximum daily dose is 4,000 mg. This should be lowered
in those who drink two or more alcoholic beverages per day or if liver
disease is present. In older adults, it is now suggested to lower the daily
dose to 3,000 mg daily. In children through 12 years of age, Tylenol
should be based on weight, may be taken every 4-6 hrs., not to exceed 5
doses in a 24 hour period (2.6 g) It is important to teach parents not to
administer any other medication that may contain acetaminophen at the
same time (cold meds, etc.)
Biphosphonate teaching and monitoring: - correct answer-
Biphosphonates are used for preventing and treating osteoporosis.
Examples are: Aredia, Nerixia, Olpadronate, Fosamax, Boniva, Actonel,
and Aclasta. Education: sit upright for 30 minutes after taking. Boniva is
given via IV infusion over 15-30 mins. Always take oral biphisphonates
with 8 ounces of water. Patients with esophageal issues and diarrhea
shouldn't take biphosphonates. Continue to monitor BMD while taking
them. Dexascans should be performed every 2 years. Treatment may be
lifelong, but some experts state that a holiday should be taken after 5
yrs.
, Body fat considerations for prescribing drugs: - correct answer-
According to our text, "drug distribution may be affected by obesity,
both immediately after absorption and after achieving an equilibrium or
steady state in the body. Lipid-soluble drugs readily distribute into the
fatty tissues, where they may be stored and even concentrated. Water-
soluble drugs, however, tend to remain in the highly vascularized spaces
of the skeletal muscle. Ideal body weight is usually considered the
standard for determining drug dosage, which is often adjusted for obese
or cachectic patients." Additionally, according to Drug Pharmokinetics in
the Obese" (Cheymol, et.al), with lipophilic drugs (e.g., barbiturates,
benzodiazepines), the drug distribution volume is significantly increased,
explaining the prolongation of the plasma elimination half ‐life.
Causes of poly-pharmacy in the elderly. - correct answer- Varied
symptoms and complaints associated with chronic illnesses; when a drug
doesn't work, another is prescribed (known as the prescribing cascade);
stockpiling discontinued medications due (primarily due to the cost);
placing prescriptions in different bottles; sharing of medications
between family members; seeing "polyproviders": seeing multiple
specialists for various chronic diseases; failure of providers to fully
review the patient's other medications before prescribing; lack of
primary care provider;
Colchicine patient teaching - correct answer- Colchicine may be
taken for the first 6 months of chronic gout therapy. Otherwise it should
be used for gouty flares. It prevents the activation and migration of
neutrophils to the area of attack, preventing inflammation. Give within
24 hrs. of onset of acute attack. A/Es of colchicine treatment are GI
effects (mainly diarrhea), pain, fatigue headache, blood dyscrasias. Teach
patient that onset of Colchicine's effects take between 18-24 hours. They
