Pharmacokinetics & Pharmacodynamics
What is the difference between pharmacokinetics and pharmacodynamics, in one line each?
Pharmacokinetics is what the body does to the drug (absorption, distribution, metabolism, excretion); pharmacodynamics is what the drug does to the body's cells
What are the five rights?
Right medication, dose, patient and time right route
What does the ASA Physical Status Classification actually measure?
A patient's risk for anaesthesia, scored from a normal healthy patient (ASA 1) up to a moribund patient not expected to survive without operation
What is the core difference in focus between the scrub nurse and the anaesthetic nurse during surgery?
The scrub nurse manages the sterile field, instruments, and the surgical count; the anaesthetic nurse prepares the patient's airway, IV access, and equipment for the anaesthetist
Which pain scale is used for infants up to age 7, and what five things does it assess?
The FLACC scale, assessing Face, Legs, Activity, Cry, and Consolability
A patient's amoxicillin dose isn't reduced despite poor liver function. Why might this be safe for this particular drug?
Amoxicillin is not extensively metabolised by the liver — most of it stays unchanged and is excreted through urine, so liver impairment matters less than it would for a heavily hepatic-metabolised drug
What makes a order valid?
Legible, written in ink, signed, write order, prescribed in the past 7-10 days
A patient is fasted before general anaesthesia. What specific complication is this trying to prevent?
Pulmonary aspiration — stomach contents being inhaled into the lungs while the patient's protective airway reflexes are suppressed under anaesthesia
Why does the anaesthetic nurse act as the patient's advocate specifically during the pre- and intraoperative period?
Once anaesthetised, the patient can't communicate their own needs, identify allergies, or consent to changes, so the anaesthetic nurse carries that responsibility on their behalf through this vulnerable window
Why is the Wong-Baker Faces scale chosen over a numerical 0–10 scale for young children?
Young children may not yet grasp abstract numbers, but they can point to a facial expression that matches how they feel, making it more developmentally appropriate
Why does understanding a drug's half-life matter when planning dosing intervals?
It tells you how quickly the active drug clears the body by 50%, which determines how often a dose needs to be repeated to keep levels therapeutic without accumulating toxicity
Why can a nurse change a medication's form but never its route?
The route is a clinical decision made by the prescriber based on how the drug needs to act in the body; the form (tablet vs. syrup, for example) is a practical delivery choice the nurse can adjust
Consent is described as needing four elements. Beyond capacity and being freely given, what are the other two, and why does missing either invalidate it?
Consent must be sufficiently specific to the proposed procedure and must be informed — without specificity a patient could be consenting to the wrong thing, and without being informed they can't truly weigh the risks and benefits
On arrival to PACU, why is attaching monitoring done before anything else, even before the full handover is finished?
The patient is still recovering from anaesthesia and at highest risk of airway or haemodynamic compromise immediately post-op, so continuous monitoring needs to start straight away rather than waiting for handover to complete
A PACU patient on opioids becomes bradycardic and sedated. Why are these side effects expected rather than alarming on their own?
Opioids commonly cause sedation, bradycardia and hypotension as part of their normal effect profile, so mild versions of these are anticipated and monitored for rather than immediately signalling an emergency
Explain the difference between a toxic effect and an allergic reaction as adverse drug reactions.
A toxic effect is predictable and results from overdose or build-up due to impaired metabolism/excretion; an allergic reaction is unpredictable and involves the immune system reacting to the drug itself
A patient is due their morning tablets but has vomited twice in the last hour. Walk through the reasoning for withholding the dose.
Vomiting is one of the situations where medication should not be administered, since the drug may not be absorbed and could increase aspiration or further vomiting risk — the dose should be withheld and reported, not just skipped silently
Compare implied and written consent — why would a clinical team choose one over the other for different procedures?
Implied consent is inferred from a patient's actions (e.g. rolling up a sleeve for a blood test) and suits low-risk routine care; written consent is required for higher-risk procedures like surgery because it creates a documented, specific record of an informed decision
A PACU nurse performs a rapid airway assessment using jaw thrust and chin lift. What is this step trying to catch, and what comes next once the airway is confirmed stable?
It's checking for airway obstruction or difficulty breathing as the patient wakes from anaesthesia; once stable, the nurse moves to monitoring every 10 minutes for the remainder of the PACU stay
Why might a non-opioid combination like paracetamol and an NSAID be preferred over opioids alone for some PACU patients?
Non-opioids such as paracetamol, NSAIDs (parecoxib) or ketamine manage pain effectively without the risk of over-sedation that comes with opioids, useful when avoiding respiratory depression or excess drowsiness matters
A drug antagonises another when taken together, reducing its effect. Contrast this with a general medication interaction — what's the key distinction?
A medication interaction is any modification of a drug's action by food, herb, or another medication (could increase or decrease effect); antagonism is specifically when the effect is decreased by that combination
Explain why enteric-coated tablets should never be crushed, connecting it to how the coating works pharmacokinetically.
The coating is designed to resist dissolving in the stomach and only dissolve in the intestine, protecting either the stomach lining or the drug itself; crushing destroys this timed-release/protective mechanism and can cause the drug to be absorbed too early or damage the stomach
An ASA 4 patient with an "E" suffix is going for surgery. Explain what both parts of that classification tell the surgical team.
ASA 4 means the patient has severe systemic disease that is a constant threat to life; the E suffix indicates the surgery is an emergency — together this tells the team the patient is high-risk and there is no time for the usual optimisation before proceeding
A PACU patient is unsettled and the nurse suspects pain, but reasons it might not be surgical. What non-surgical causes should be ruled out first, and why does this matter for treatment?
A full bladder, restrictive dressings, or intraoperative positioning can all cause pain that mimics surgical pain; ruling these out matters because treating them (repositioning, loosening a dressing) resolves the issue directly rather than masking it with unnecessary analgesia
A patient needs high concentrations of oxygen but also has thick secretions and risk of mucosal damage. Which device suits both needs, and why do the alternatives fall short?
High flow nasal prongs, because they humidify the mucosa to prevent damage while still keeping the airway open and delivering oxygen at high concentrations; a non-rebreather mask reaches similarly high concentrations but doesn't provide humidification, and nasal prongs or a Hudson mask can't reach the same concentration range