Vocab
Peak and trough level
Peak- highest level drawn at midpoint
Trough- lowest, drawn before next dose
contraindications for a transdermal medication?
excessive moisture, skin breakdown, etc.
subjective vs objective data
subjective= what the patient tells you
objective is what you or another nurse can observe through physical assessment and data collection
Flo will assess these general things before giving meds
allergies, rights of med admin, any specific med data (BP before BP meds), any route issues (compatibility)
organ maturity is not fully developed, breastfeeding (meds can get to baby). Minimize this through breast feeding right after medication
Half-life
time it takes for 1/2 of the drug to be excreted
First pass- what organ and which routes are affected?
Liver tax
Affected: enteral
Think: Is SL affected?
Key components to patient education
Ability, readiness, and then practice
Flo know this is the major concern with herbals and OTC meds
Interactions/safety; mask symptoms of a more severe problem
Pregnancy category C
Caution. Possible adverse effects in animals, not enough research in humans
Therapeutic window
drug must be in this concentration for it to be effective
Think: what do we do if it is narrow?
Excretion is affected by
GI motility, kidney health, fluid status (anything that affects filtration in the kidney)
Further assessment is needed if a patient reports an allergy
what were the symptoms of their reaction
Signs of an allergic reaction:difficulty breathing, wheezing, facial swelling, hives, feeling of doom
Flo know these 6 rights of med administration
patient, dose, route, time, med, documentation
Pregnancy category D
Evidence of risk in humans, only use for a compelling reason
the nurse is about to give pain medications. what should they do first?
Assess the patient (location of pain), VS, pain,
Absorption is affected by
route, GI pH, food in GI organs, lipid solubility, blood flow
Included in informed consent for meds
what, how it works and is made, side effects, and unknowns (if research)
Flo does this when taking a verbal or phone order
Repeat back, double check med and dose (spell if necessary), check indication
Reasons why patients may be nonadherent with medications
cost, fear, route, side effects, complicated to take, lack of education
Polypharmacy
So many meds at once, usually a concern in the elderly
IM vs SQ vs ID (=parenteral routes)
where do they go? which is slowest?
IM- muscle
SQ- Fat (slowest bc of blood flow)
ID- under skin
What is the difference between allergic reaction, adverse reaction, and idiosyncratic reaction?
allergic reaction activates the immune system with sx of inflammation (sx including difficulty breathing, wheezing, facial swelling, hives, feeling of doom)
adverse reaction: undesired known effects of a med (ex., dry cough with lisinopril). not life-threatening
idiosyncratic- opposite response of the desired effect (ex. Benedryl taken for sleep but makes patient more alert instead)
Flo know a RX must contain these to be complete
name, dose, timing and route
Changes in older adults related to absorption, distribution, metabolism and excretion (In general, individuals may vary)
absorption- decreased
distribution- decreased protein available, decreased body fat (lipid solubility)
metabolism- decreased liver function
excretion- slowed