NR 293 Quiz 1

Name

Chamberlain University

NR-293: Pharmacology for Nursing Practice

Prof. Name

Date

Quiz One

Rights of Medication Administration

The five essential rights of medication administration are critical for ensuring patient safety. These include administering the medication to the right patient, giving the right dose, through the right route, and respecting the patient’s right to refuse. It is essential that the final check before administering the medication is done at the patient’s bedside, rather than at the nurse’s station, to ensure the medication is being given to the correct individual.

First Pass Effect

The first pass effect pertains to the way certain medications are metabolized by the liver. When oral medications pass through the liver, the amount of the drug available for use in the body decreases. This necessitates administering a higher dose for medications that undergo the first pass effect, such as oral morphine. Because of this process, less of the medication is absorbed into the bloodstream, making higher doses necessary to achieve therapeutic effects.

Nursing Considerations When Administering Medications

Nurses must follow specific protocols when administering medications. They should always verify the patient’s identity using two methods and never leave unused medication at the patient’s bedside. If a patient refuses medication, the nurse should dispose of it properly and document the refusal. The nurse should also stay with the patient until the medication is fully administered. Additionally, the nurse should be cautious of certain liquids, such as milk, which may impact medication absorption.

Routes of Medication Administration

Medications can be administered through various routes such as oral, subcutaneous, or transfer methods. When receiving an order that includes multiple routes, nurses should not assume the route but must verify with the healthcare provider and discontinue the other routes not used.

Ethical Considerations in Medication Administration

Patients have the right to refuse medication. There may be instances where a patient requests additional pain medication due to discomfort. While it is important to provide comfort, nurses must adhere to the code of ethics and follow appropriate guidelines for specific medications.

STAT and PRN Medications

Stat medications must be administered within 30 to 60 minutes, while PRN (as needed) medications are given only when necessary based on the patient’s condition.

Oral Medication Routes

Oral medications come in different forms, each with specific considerations. Capsules have a coating that breaks down to release the medication. Enteric-coated tablets prevent breakdown in the stomach and reduce gastrointestinal distress; crushing these tablets compromises the protective coating. Extended-release tablets should not be crushed, as this will release the medication all at once, potentially leading to adverse effects. Liquids, solutions, and suspensions are absorbed more quickly compared to tablets or capsules.

Pregnancy Categories

Medications are categorized according to their potential risks to the fetus:

Category A: No risk to fetus or breastfeeding mothers.
Category B: No risk to animal fetuses, but insufficient human data.
Category C: No human studies available, but some animal research has been conducted.
Category D: Potential fetal risk in humans has been reported.
Category X: The risks outweigh the benefits.

Administration in Adults and Children

Infants have a higher concentration of water in their bodies compared to adults, which can affect how medications are distributed and metabolized.

Quiz Two

Antidote for Opioids

Naloxone is the antidote used for someone withdrawing from opioids.

Vasopressin for Diabetes Insipidus

In patients with diabetes insipidus, vasopressin impacts urine output. The common symptoms include polyuria (excessive urine), polydipsia (excessive thirst), and polyphagia (excessive hunger).

Patient Teaching: Levothyroxine

Levothyroxine is prescribed for hypothyroidism. It is important to swallow capsules whole without chewing or crushing them. The medication should be taken on an empty stomach, with a full glass of water, and at least 30 minutes before breakfast. Common side effects include heat intolerance, a fast heart rate, and diarrhea. More serious side effects include tremors and mood changes.

Propylthiouracil (PTU)

Propylthiouracil (PTU) can cause severe liver damage. Side effects include hair loss, difficulty tasting food, numbness or tingling of the hands or feet, joint or muscle pain, dizziness, and swelling of the neck.

Metformin for Diabetes

Metformin should be taken with meals to reduce gastrointestinal side effects. The extended-release tablets should not be crushed or chewed. Metformin must be stopped 48 hours before any procedures that involve contrast dye, to avoid the risk of lactic acidosis.

Regular Insulin and Meal Timing

Patients should eat within 30 to 60 minutes after taking regular insulin to avoid hypoglycemia. For those on NPH insulin, it is important to time exercise appropriately to avoid low blood sugar.

Prednisone – Steroids

Side effects of prednisone include dizziness, insomnia, mood swings, and increased appetite. To counteract bone density loss, patients should increase their intake of calcium and vitamin D.

Glaucoma Medications

When administering Timolol or Pilocarpine for glaucoma, it is important to follow proper eye drop techniques to ensure the medication is absorbed effectively.

Quiz Three

Antihistamines

Antihistamines can cause side effects such as blurry vision, dizziness, and drowsiness. They are often prescribed for colds due to their anticholinergic effects, which dry up secretions.

Respiratory Medications

Oral respiratory medications have a longer systemic effect, while nasal sprays provide immediate relief but may cause rebound congestion with overuse.

Antitussive and Expectorant Medications

Antitussives suppress the cough reflex, while expectorants thin mucus, making it easier to clear from the airway.

Albuterol

Common side effects of albuterol include feeling shaky, headaches, and nasal irritation. Inhaled steroids may cause thrush, so patients should rinse their mouths after use.

Decongestants and Theophylline

Decongestants help with breathing, while theophylline is used for COPD patients. Side effects of theophylline include palpitations and tachycardia.