NUR 153 Pharmacology ATI Exam COMPLETE with ANSWERS |St Louis Community College

Pharmacology ATI Exam Chapter 1: Pharmacokinetics and Routes of Administration • Absorption – how quickly or how well it is absorbed; DEPENDS ON THE ROUTE o Oral – takes a while, must pass through the GI tract  Food can SLOW this down  pH juices play a role  Liquids vs extended release tablets o Sublingual – quick, under the tongue o Intradermal/topical – slow, gradual o Intravenous (IV) – the FASTEST route; immediate absorption • Distribution – requires binding proteins of medication o Albumin is a common binding protein • Metabolism – medication is inactivated o Occurs primarily in the LIVER o Factors that Influence Metabolism:  Age – dysfunction of liver  Children – metabolism is not mature yet o First-pass effect – medications are inactivated through their first pass of the liver; THEREFORE, you may need a HIGHER DOSE of the medication to reach therapeutic effects • Excretion – primarily done by the KIDNEYS • Therapeutic Index o HIGH TI = wide safety margin, no need for routine monitoring o LOW TI = small safety margin; NEEDS MONITORING; HIGH risk of toxicity  Ex: vancomycin; need to draw peak/trough blood levels • Half-life – the amount of time it takes for the medication in the body to drop by 50% o Short half-life – leaves the body quickly o Long half-life – lingers in the body for long periods; HIGH risk of toxicity • Agonist – medication designed to produce an action • Antagonist – opposes the action • Nursing Considerations for Routes of Administration o Oral:  May need to mix with apple sauce  Want patient to sit up/Fowler’s position  “Chin to chest” to help with swallowing  REMEMBER! NEVER chew enteric-coated capsules  REMEMBER! Never break/chew extended-release capsules o Sublingual/buccal:  Keep medication in place until it is completely dissolved  DO NOT eat/drink until it is completely dissolved o Transdermal:  Wash and dry thoroughly  Place patch on a hairless area  Rotate patch sites o Eyes:  Put into conjunctival sac  Apply pressure to the nasolacrimal duct  Wait 5 minutes between different drops  Never touch the eye with the dropper (1-2 cm away) o Ears:  Lay on unaffected side  Pull up and out if they are an ADULT  Pull down and back if they are a CHILD o NG/Nose:  Flush before and after with 15 ml  One last flush of 15 ml-30 ml o Suppository:  Place just beyond the external sphincter  Left lateral sims’ position o Inhalation:  MDI (meter dose inhaler) • SHAKE 5-6 TIMES • TAKE DEEP BREATH 3-5 secs • HOLD BREATH 10 secs  DPI (dry powder inhaler) • AVOID SHAKING INHALER • HOLD BREATH 10 secs o Intramuscular:  REMEMBER! VASTUS LATERALIS for children under 2 years-old  REMEMBER! DELTOID site MAX 1 mL of fluid  REMEMBER! Z-TRACK prevents medication from walking back into subcutaneous tissue