NUR 2474 Pharmacology for Professional Nursing

NUR2474 Pharmacology Module 1 Quiz Review

Tips:

1. 15 questions = 25min

2. Learn how to identify and answer negatively worded questions (positively

vs negatively worded questions)

3. Learn how to apply priorities test taking strategy (ABC, Maslow’s

Hierarchy of Needs, Nursing Process)

Topics review:

1. Characteristics of medications

a. Based on properties of the ideal drug:

i. Effectiveness: Why we take a certain drug to fix an issue in

the body. Does the drug work for what we need to correct?

ii. Safety: the drug cannot produce harmful adverse effects and

be safe to use and not kill us.

iii. Selectivity: The drug elicits the only response for what it is

given for. One thing only (i.e.: antihypertensive lowering BP

but also lowering amount of acid in the stomach).

iv. Reversible action: is there an antidote available if something

goes wrong. I.e.: naloxone given for opioid reversal.

v. Predictability: how it affects the body and exactly what

occurs.

vi. Ease of administration: whether its PO, IV, IM, SC is it easy

to make a mistake or hard to and causes extra pain, need of

supplies, etc.

vii. Freedom of drug interactions: does the drug interact with

other drugs or foods in certain ways that decrease its action

or make it unsafe to use. 

viii. Low cost: cheaper drugs will be easier for people to afford

and maintain.

ix. Chemical Stability: is it stable and easy to store.

x. Simple generic name: some can be complicated and hard to

pronounce. This is important so that people do not get

confused with certain drugs. Generic= given by the

government, Brand= company

b. NO DRUG IS IDEAL!!!!!

2. Properties of medicines to consider when prescribing to patients

a. Pharmacokinetics: how the drug moves its way through the body.

i. Absorption: movement of drug from site of administration to

various tissues

1. Ex: PO med- intestines- liver (broken down)- blood; IV

med: straight into blood stream, IM med: straight into

the muscle and then to bloodstream.

ii. Distribution: movement of the drug throughout the blood to

its site of action. If not enough blood or poor circulation, the

medication cannot move well or work efficiently.

1. Ex: The PO med travels in the blood stream to the site

of pain.

iii. Metabolism: the chemical change of the drug to a more or

less potent form to act on the tissue.

1. Intended med response occurs here

iv. Excretion: elimination of drug via kidneys, feces, sweat, air

v. Half-life: time it takes for a drug to decrease in amount by ½.

Shows us how fast or slow a drug is absorbed and what type

of dosing schedule we should initiate.

vi. 1st Pass Effect: amount of the drug that is inactivated at

metabolism that is decreased in what is taken

1. Why we may give a loading dose for first dose of a

medication.

vii. Bioavailability: amount of drug available after passing

through the liver.

viii. Onset: amount of time for first therapeutic effect to be seen

ix. Peak: time it takes for full therapeutic effect to been seen

x. Duration: how long the therapeutic effect lasts.

3. Patient specific variabilities affecting response to medications

a. Body weight and composition

b. Age: infants have immature organs while older adults have organ

degeneration and slower response and reaction times w/ increased

diseases and multiple drug treatments 

c. Diseases: kidney disease- makes it harder for excretion and for

increased drug levels in the body from retention; liver diseasereduced metabolism and increased toxicity occurs if the liver

cannot break down a med sufficiently; acid/base imbalance- ph.

change and alter the kinetics of a drug; dehydration or imbalance

electrolytes can cause impact on drug use.

d. Tolerance: how much of a med your body needs to become

therapeutic and work over time. Decreased responsiveness over

time.

4. Pharmacodynamics

a. The biochemical changes in the body from a drug.

b. Focused on the therapeutic, side and adverse effects on the body

and secondary effects

c. Agonist: are molecules that activate receptors. They increase a

response that can be good or bad.

d. Antagonist: they block receptor activation.

e. Partial antagonist: has some receptor activity but can also block

the activity.

5. Routes of medication administration and their qualities (benefits vs

dangers)

a. PO: easiest to give, but can be a danger for one with dysphagia,

longer time it takes for action, decreased bioavailability due to 1st

pass effect.

b. SC: goes directly into the tissues and blood stream, has some pain

associated with it and have to rotate sites.

c. IM: goes directly into the muscle. Have to know how to properly

give the injection and that it may cause mild pain in some people

d. IV: goes directly into the vein and acts the fastest due to skipping

absorption and distribution. Have to have a skill set to inset an IV

and to maintain it. Can cause mild pain to patients too.

e. Topical: easy to apply but you have to do so with gloves. May need

to dose multiple as it can wear off.

f. If it can be reversed= it can be safe to use!

6. TORB and VORB is and the 6 rights of medication administration

a. TORB: telephone order read back- very important to ensure you

have received all parts of the medication order and that no

mistakes or spelling errors are made when getting the medication

orders.

b. VORB: Verbal Order Read back- you should read back the order

multiple times to yourself or to the provider to ensure you have the

correct medication order and that it makes sense.

c. Parts of a medication order: drug name, patient name, dose with

measure, route, frequency, indication, and provider signature

i. If one part is missing- call the doctor for clarification.

d. 6 rights: right patient, drug, dose, time, route, documentation.

i. Need to always do thorough assessment and data collection

before giving a medication or to not give it (ie: if heart rate is

too low, do not give Beta Blocker)

7. Pre- and post- medication administration assessment and interventions

a. Assessment: what data you collect based on what you see or what

the patient reports (ex: they are in pain, they have a fever, etc)

b. Analysis: where you decide to give or not to give the medication

based on your assessment.

c. Planning: how you will be giving it (PO/IV/IM/SC)

d. Implementation: the process of you actually giving the medicationremember your 6 rights and 3 medication checks and how to

identify your patient with name and DOB

e. Evaluation: you will come back later to assess your patient and

ask them if the medication is working appropriately. If not,

reevaluate your options, use other no pharm stuff and call the

doctor.