NR 293 STUDY EXAMS GUIDE LATEST QUESTIONS
AND ANSWERS SURE A+
✔✔Drug Therapy During Breastfeeding - ✔✔Breastfed infants are at risk for exposure to
drugs consumed by the mother. Consider the risk-to-benefit ratio. It is possible to
readjust the schedule, and only breastfeed when the concentration of the medicine is
low.
✔✔Premature or Preterm Infant Age Range - ✔✔Younger than 38 weeks gestation
✔✔Neonate or Newborn Infant Age Range - ✔✔Younger than 1 month
✔✔Infant Age Range - ✔✔1 month - 1 year
✔✔Child Age Range - ✔✔1 year to 12 years
✔✔Absorption of Drugs in Neonatal and Pediatric - ✔✔-Gastric pH less acidic
-Gastric emptying slowed
-Intramuscular absorption faster and irregular
✔✔Distribution of Drugs in Neonatal and Pediatric - ✔✔-Greater total body water means
lower fat content
-Decreased level of protein binding
-Immature blood-brain barrier, more drugs enter the brain
✔✔Metabolism of Drugs in Neonatal and Pediatric - ✔✔-Liver immature, doesn't
produce enough microsomal enzymes
-Older children may have increased metabolism, requiring higher doses than infants
✔✔Excretion of Drugs in Neonatal and Pediatric - ✔✔-Kidney immaturity affects
glomerular filtration rate and tubular secretion
-Decreased perfusion rate of the kidneys may reduce excretion of drugs
, ✔✔Factors Affecting Pediatric Drug Dosages - ✔✔-Skin is thin and permeable
-Stomach lacks acid to kill bacteria
-Lungs have weaker mucus barriers
-Body temp less well regulated, and dehydration occurs easily
-Liver and kidneys are immature, impairing drug metabolism and excretion
✔✔Methods of Dosage Calculation for Pediatric Patients - ✔✔-Body surface area
method: uses West nomogram, most accurate
-Always use weight in kg, not pounds
-Body weight dosage calculations use mg/kg
✔✔Considerations for Elderly Patients r/t Drugs - ✔✔-High use of medications
-Polypharmacy
-Noncompliance, non-adherence (don't change their mind easily, like about smoking for
ex)
-Increased incidence of chronic illnesses
-Sensory and motor deficits
✔✔Physiological Changes in Elderly Patients - ✔✔-↓ cardiac output = ↓ absorption and
distribution
-↓ blood flow = ↓ abs & dis
-↑ pH = altered absorptions
-↓ peristalsis = delayed gastric emptying
-↓ hepatic enzyme production = ↓ metabolism
-↓ hepatic blood flow = ↓ metabolism
-↓ renal blood flow = ↓ excretion
-↓ renal function = ↓ excretion
- ↓ GFR = ↓ excretion
✔✔Drug Absorption in Elderly - ✔✔-Gastric pH less acidic
-Gastric emptying slowed
-Movement through GI tract slowed
-Blood flow to GI tract reduced
-Use of laxatives may accelerate GI motility
✔✔Drug Distribution in Elderly - ✔✔-Lower total body water percentage
-Increased fat content
-Decreased production of proteins by liver, resulting in decreased protein binding of
drugs (and increased circulation of free drugs)
✔✔Drug Metabolism in Elderly - ✔✔-Aging liver produces fewer microsomal enzymes,
affecting drug metabolism
-Reduced blood flow to the liver
AND ANSWERS SURE A+
✔✔Drug Therapy During Breastfeeding - ✔✔Breastfed infants are at risk for exposure to
drugs consumed by the mother. Consider the risk-to-benefit ratio. It is possible to
readjust the schedule, and only breastfeed when the concentration of the medicine is
low.
✔✔Premature or Preterm Infant Age Range - ✔✔Younger than 38 weeks gestation
✔✔Neonate or Newborn Infant Age Range - ✔✔Younger than 1 month
✔✔Infant Age Range - ✔✔1 month - 1 year
✔✔Child Age Range - ✔✔1 year to 12 years
✔✔Absorption of Drugs in Neonatal and Pediatric - ✔✔-Gastric pH less acidic
-Gastric emptying slowed
-Intramuscular absorption faster and irregular
✔✔Distribution of Drugs in Neonatal and Pediatric - ✔✔-Greater total body water means
lower fat content
-Decreased level of protein binding
-Immature blood-brain barrier, more drugs enter the brain
✔✔Metabolism of Drugs in Neonatal and Pediatric - ✔✔-Liver immature, doesn't
produce enough microsomal enzymes
-Older children may have increased metabolism, requiring higher doses than infants
✔✔Excretion of Drugs in Neonatal and Pediatric - ✔✔-Kidney immaturity affects
glomerular filtration rate and tubular secretion
-Decreased perfusion rate of the kidneys may reduce excretion of drugs
, ✔✔Factors Affecting Pediatric Drug Dosages - ✔✔-Skin is thin and permeable
-Stomach lacks acid to kill bacteria
-Lungs have weaker mucus barriers
-Body temp less well regulated, and dehydration occurs easily
-Liver and kidneys are immature, impairing drug metabolism and excretion
✔✔Methods of Dosage Calculation for Pediatric Patients - ✔✔-Body surface area
method: uses West nomogram, most accurate
-Always use weight in kg, not pounds
-Body weight dosage calculations use mg/kg
✔✔Considerations for Elderly Patients r/t Drugs - ✔✔-High use of medications
-Polypharmacy
-Noncompliance, non-adherence (don't change their mind easily, like about smoking for
ex)
-Increased incidence of chronic illnesses
-Sensory and motor deficits
✔✔Physiological Changes in Elderly Patients - ✔✔-↓ cardiac output = ↓ absorption and
distribution
-↓ blood flow = ↓ abs & dis
-↑ pH = altered absorptions
-↓ peristalsis = delayed gastric emptying
-↓ hepatic enzyme production = ↓ metabolism
-↓ hepatic blood flow = ↓ metabolism
-↓ renal blood flow = ↓ excretion
-↓ renal function = ↓ excretion
- ↓ GFR = ↓ excretion
✔✔Drug Absorption in Elderly - ✔✔-Gastric pH less acidic
-Gastric emptying slowed
-Movement through GI tract slowed
-Blood flow to GI tract reduced
-Use of laxatives may accelerate GI motility
✔✔Drug Distribution in Elderly - ✔✔-Lower total body water percentage
-Increased fat content
-Decreased production of proteins by liver, resulting in decreased protein binding of
drugs (and increased circulation of free drugs)
✔✔Drug Metabolism in Elderly - ✔✔-Aging liver produces fewer microsomal enzymes,
affecting drug metabolism
-Reduced blood flow to the liver
