NUR 607 FINAL EXAM STUDY GUIDE (Mods 1,2,8 only)
QUESTIONS WITH COMPLETE SOLUTIONS
Appropriate use/precautions/administration of acetaminophen in
children and adults: Correct Answers 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 Answers
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 Answers
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 Answers
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 Answers 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
QUESTIONS WITH COMPLETE SOLUTIONS
Appropriate use/precautions/administration of acetaminophen in
children and adults: Correct Answers 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 Answers
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 Answers
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 Answers
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 Answers 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
