NR 293 Pharmacology for Nursing Content Areas to Review for Exam 1 (Latest 2021)

 NR 293 Pharmacology for Nursing

Content Areas to Review for Exam 1

1/18/2021

All Reading Assignments, (ATI), Lecture Materials, handouts are all testable material. Be prepared for

math question such as dosage calculations.

Apply Nursing Considerations (to the drugs/drug classes listed below)

 Assessments to include vital signs, physical assessment, labs

 Drug administration: safety, route considerations

 Drug toxicity (signs/symptoms) and antidote if applicable

 Patient teaching (ex. nutrition, adverse effects, infusion considerations, laboratory reviews)

 Health care collaboration

 Nursing process

Things to Consider:

 - Know the GENERIC names - Grapefruit juice is usually a good bet

 - Common Side Effect = HEADACHE/ GI UPSET

 - herbal supplements that start with G (ex. garlic, ginger, gingko biloba)  risk of bleeding

 - most meds are contraindicated for pregnancy

 - pt should not stop meds suddenly & if dose is missed don’t double dose

 - alcohol should not be consumed w/ most meds - gram + = staph & strep

Chapter 1: The Nursing Process and Drug Therapy

**5-9 Rights of Medication Administration with ability to determine which “right” was not followed.

 Right Client (uses 2 patient identifiers ex. name, DOB, MR number)

 Right Medication Right Route Right Dose Right Time Right Documentation (after admin)

 Right to Refuse

Chapter 2: Pharmacological Principles and Chapter 5: Medication Errors

*4 Phases of Pharmacokinetics:

1. Absorption - depends on route of administration

 EX. Oral meds (takes a while) considerations = food in stomach, pH of GI, liquid form vs

enteric-coated aka extended release

& *first pass effect (oral meds are inactivated on their 1st pass through liver, may

need to give pt higher dose

Sublingual absorbs very quickly, pt should wait until its completely absorbed

Inhalation absorbed very quickly, travels through alveoli

 Intradermal/Topical slow & gradual rate of absorption

IM absorption depends on solubility of the med IV is immediate absorption

2. Distribution (med travels to site of action) - binding proteins are req. [ex. albumin]

3. Metabolism (med is activated or broken down) - due to enzymes; primarily happens in liver &

kidneys, lungs, bowel, blood

Infants - organs are immatures so metab. doesn’t happen effectively = high risk of

toxicity

Older adults’ liver/kidneys dysfunction impacts metab. & slows it down also higher

risk for toxicity

4. Excretion - primarily happens through kidneys

Minimum Effective Concentration (MEC) /Therapeutic Index

- we want to attempt to keep plasma levels between the minimum effective concentration & toxic

concentration

- certain meds have a high therapeutic index (TI) aka big range between MEC & toxic concentration

-other meds have low TI making therapeutic level & toxic level very close together (ex. vancomycin)

there’s a  risk for toxicity so blood draws are req. to check trough & peak levels

assuring you’re not getting into toxic range

1/2 Life = period of time needed for med to be reduced by 50%

 if med has longer ½ life (stays in body longer) have  risk of toxicity

*Agonists vs. Antagonist Meds

Agonist = helps produce an action [ex. morphine binds w/ opioid receptors]

Antagonist = blocks normal receptor, opposing action

Routes of Administration & Nursing Considerations

 Oral Med = pt sitting upright (Fowler’s position) may need to mix in applesauce to facilitate swallowing

- never chew enteric coated meds - avoid grapefruit juice - administer on empty stomach

- liquid form of meds may facilitate swallowing

 Sublingual = make sure med is fully absorbed before pt eats or drinks, do not swallow

 Transdermal = assure skin is hairless, clean & thoroughly dry; also rotate sites (prevents irritation)

 Eye Med = use surgical aseptic technique; drop med in center conjunctival sac w/ gentle pressure for

30-60 sec @ nasolacrimal duct