Ch.4- Nursing process in drug therapy and patient safety
Name (6) components of a medical order.
Client name
medication name
strength (if required)
route of administration
dosage
specific directions, including frequency
reason for administration
provider signature
Why is it important to properly dispose of expired and unused medications? Give at least two reasons.
-Proper disposal of unused or expired medications can
help to protect the environment and may decrease
drug-searching behaviors in some situations.
-Medications in drinking water: Patients flushing meds,
throwing them in garbage
True or False
The cell membrane is a lipoprotein structure
True
Explanation:
Plasma membrane or Cell Membrane is a lipoprotein structure that
separates the interior of a cell from the external environment.
Function: Regulates what can enter and leave a cell.
A client has begun taking an antidepressant that causes the client to be drowsy. What nursing diagnosis should the nurse prioritize related to drug therapy?
A.) Risk for injury
B.) Risk for imbalanced fluid volume
C.) Impaired memory
D.) Impaired physical mobility
A.) Risk for injury
Explanation:
Drowsiness and fatigue can interfere with the client's ability to function, placing the client at risk for injury. Ability to function may be affected by the drowsiness and fatigue but safety would be the priority. Mobility may be affected by the client's issues, but safety would be the priority. Drowsiness is unlikely to affect the client’s memory.
True or false
Some prescription drug instructions allow patients to flush medications down the toilet.
True
Explanation:
check packaging information to see whether drug can be flushed down the toilet.
What are six roles nurses have when administering a drug?
Hint: "Rights"
Right drug
right patient
right time
right dosage
right storage
right route
right documentation
right preparation
right reason
A client asks a nurse about using the Internet to obtain drugs at a cheaper price. The nurse should recommend the client access what site for additional information regarding this practice?
A.) Food and Drug Administration
B.) Drug Facts and Comparisons
C.) Centers for Disease Control and Prevention
D.) National Center for Complimentary and Alternative Medicine
A.) Food and Drug Administration
Explanation:
The FDA website contains important information and guidelines for people who elect to use the Internet to purchase cheaper drugs. Drug Facts and Comparisons provides a cost comparison of drugs in each class. The Centers for Disease Control would be appropriate for obtaining information related to infectious disease and biologic agents. The National Center for Complementary and Alternative Medicine is a good source for information on alternative therapies.
Which cells have the most mitochondria?
heart muscle cells or cardiac cells
The nurse teaches a parent the importance of administering appropriate dosages of acetaminophen when the client’s infant has a fever. What information should the nurse provide to this client? (Select all that apply.)
A.) "Children's dosages will change with time as they grow."
B.) An infant's dose of acetaminophen is about 1/2 of an adult dose."
C.) "It is important to give the right dose to prevent toxic effects of the medication."
D.)"Infant’s and children’s doses should be based on their weight or age."
E.) "In most cases, infants cannot be given medications because of their immature organs."
Answer: A,C,D
Explanation: A child's dose is never based on an adult's dose. A child's dosage is based on weight and age and will change with age as they grow. Larger than directed dosages can result in toxic effects of this medication. Infants can safely receive medication, but caution must be exercised with regard to dose.
A 7-year-old child fell off a wood pile while playing and has been admitted to the ICU with multiple broken bones and internal bleeding. What factor related to drug therapy will be altered in this client?
A.) Adverse effects may be decreased.
B.) Therapeutic effects may be increased.
C.) Pharmacodynamics may be altered.
D.) Pharmacokinetics remain the same.
C.) Pharmacodynamics may be altered.
Explanation:
The child's developmental age will also influence pharmacokinetics and pharmacodynamics, the immature liver may not metabolize drugs in the same way, and the kidneys may not be as efficient as these of an adult. Adverse effects might be increased and therapeutic effects may be decreased.
Which assessment should be made by the nurse before administering a new medication?
A.) Determining the client's past medication history
B.) Evaluating the client's health beliefs
C.) Instructing the client on the effect of the medication
D.) Teaching the client about the desired outcomes of drug therapy
A.) Determining the client's past medication history
Explanation:
Assessment involves collecting data on client characteristics known to affect drug therapy. This process includes observing and interviewing the client, interviewing family members, completing a physical assessment, reviewing medical records for pertinent laboratory and diagnostic reports, and other methods. Initially (before drug therapy is started or on first contact), the client should be assessed for age, weight, vital signs, health status, pathologic conditions, and ability to function in usual activities. It is not necessarily important to evaluate the client's health beliefs at this point. Education is considered to be an intervention, not an assessment.
Name at least two ways to properly dispose of medications.
Take unused, unneeded, or expired prescription drugs out of their original
containers.
• Mix the prescription drugs with an undesirable substance, such as used coffee grounds or kitty litter, and put them in impermeable, nondescript containers, such as empty cans or sealable bags, further ensuring that the drugs are not diverted or accidentally ingested by children or pets.
• Throw these closed containers in the trash.
• Flush prescription drugs down the toilet only if the accompanying patient information specifically instructs that this is safe to do.
• The safest route is to return unused, unneeded, or expired prescription drugs to pharmaceutical take-back locations that allow the public to bring unused drugs to a central location for safe disposal. Many hospitals have these locations. Many local governments have regular take-back days or drop-off sites. Check with your local hospital, health department, or police department.
What is the similarity of human plasma to isotonic solution?
plasma is an isotonic solution; helps to maintain homestasis
same concentration
isotonic solution is stable and will have the cell remain in shape
An 80-year-old with internal bleeding is admitted through the emergency room after a motor vehicle accident. The health care provider has ordered 2 units of packed red blood cells (1 unit is 250 mL) to infuse over 1 hour each. The drip rate on the blood administration set is10 gtt/mL. What would be the flow rate in drops per minute?
42
How are the nursing diagnoses developed by the North American Nursing Diagnosis Association (NANDA) most useful?
A.) identifying problems related to drug therapy
B.) classifying clients as per their age groups.
C.) classifying drugs as per their actions
D.) describing the expected outcome of treatments given
A.) identifying problems related to drug therapy
Explanation:
Some of the nursing diagnoses developed by NANDA are useful in identifying client problems related to drug therapy and are more commonly used when administering drugs. The nursing diagnoses developed by NANDA do not classify the clients as per their age groups or the drugs as per their actions. The NANDA nursing diagnoses do not describe the expected outcome of treatments given. Outcomes, however, may be chosen to address the problems described by the nursing diagnoses.
A nurse is, preparing to administer a client's scheduled beta-adrenergic blocker. The nurse, is aware that the client is receiving this medication for the treatment of hypertension. The nurse has addressed which right of safe medication administration?
A.) right indication
B.) right diagnosis
C.) right reason
D.) right history
C.) right reason
Explanation:
“Right reason” is one of the universally recognized rights of safe drug administration. The other listed “rights” are not used in practice.
OTC drugs have been deemed safe when used as directed and do not require a prescription or advice from a healthcare provider. Are there negatives to "grandfathered in" drugs? If so, name two.
Can mask the signs and symptoms of disease
Can interact with prescription drugs
A patient comes into the ER and is dehydrated, lost lots of fluids, and sweating profusely. What kind of fluids/solutions would be administered to this patient?
Hypotonic solution
Explanation:
Cells placed in a hypotonic solution would swell and burst. The key is the patient's loss of fluids, in order to regain fluids the cells must be hydrated. Isotonic cannot be used in this case because of the fluid loss, if there was no fluid loss then we would use isotonic solution.
The nurse is caring for a client who is to receive an IV antibiotic by a macroinfusion set (10 gtts/mL). The order reads 1 gm of antibiotic in 100 mL of D5W to be run in over 30 minutes. What drip rate should the nurse use?
33 gtts/min
Explain what is involved in each step of the nursing process as it relates to drug therapy.
A- assess the patient for subjective and objective data. looking for chronic conditions, past history/medications,allergies.
D- based on data collected, use nursing diagnosis.What the nurse think is going on with the patient without the dr's approval from data collected from and on the patient
P- Goal, time and outcome the nurse expect to happen while in the
nurses care
I- Actions the nurse do to justify the effects thats going on with the patient(rechecking vital signs, give meds, comfort measures, etc) .
E- Checking to see if plans and interventions worked for the patient
(rechecking the patient vital signs, rechecking temperature, seeing if patient pain rate went from a 9 to a 6)
Which information should supplement the overall nursing assessment of the patient?
Social, intellectual, financial, environmental, and other factors.
Which office established specific guidelines for proper disposal of prescription drugs?
Office of National Drug Control
Chemotherapeutic Agents with cellular physiology have what effects
on the body? Name three.
- cause cell death or alteration
- damages the genes inside the nucleus of cells
- fatigue, loss of appetite, nausea, bowel issues such as constipation or diarrhea, hair loss, mouth sores, skin
and nail problems
- Chemotherapy process of Hematocrit, so you might have side effects from having too few blood cells
When assessing a client before starting a drug regimen, how should the nurse best assess the client’s ability to excrete medications?
A.) Assess the client’s nutritional and hydration status
B.) Weight the client and measure the client’s abdominal girth
C.) Review laboratory values indicative of kidney function
D.) Review the client’s AST, ALT, bilirubin and albumin levels
C.) Review laboratory values indicative of kidney function
Explanation:
The client's renal status will indicate the ability to excrete the drug. Liver function is needed to assess metabolism. Weight, hydration and fluid balance are less significant than renal function in determining the client’s ability to excrete drugs.
what is the clark rule Clark Rule? what is the age range of this population? How is it done?
Used for infants under 1 year
Accounts for weight in dose formula
Weight divided by 150lb, assumes adult dose is based on 150 lb person