Pharmacology Proctored ATI Study Guide
Chapter 1: Pharmacokinetics and Routes of Administration
• Absorption (depends on route)
§ Route of admin affects the rate and amount of absorption
o Oral:
§ GI pH and emptying time
§ Presence of food in the stomach or intestines
§ Form of meds (liquid/XR)
§ Sit upright or put your chin to your chest to aid in swallowing
o Sublingual/buccal
§ Quick absorption systemically through highly vascular mucous
membranes
§ Must make sure it is fully absorbed before you eat or drink
o Inhalation via mouth/nose
§ Rapid absorption through alveolar capillary networks
§ Metered-dose inhaler: shake and press, inhale for 3-5 seconds and
then hold for 10 seconds before exhaling
§ Dry powder: DO NOT SHAKE
o Intradermal, topical
§ Slow, gradual absorption
o SQ/IM
§ Highly soluble meds have rapid absorption (10-30min), poorly
soluble have slower absorption
§ Blood perfusion at site of injection affect absorption
o IV
§ Immediate and complete
§ 20 gauge – standard
• Distribution
o Transportation of meds to sites of action by body fluids
o Plasma binding protein: meds compete for protein binding sites within
bloodstream, primarily albumin. The ability of med to bind to protein can
affect how much med will leave and travel to target tissues.
• Metabolism
o Primarily occurs in the liver but can take place in the kidney
o Factors that influence metabolism:
§ Age (infants/older adults require smaller doses)
§ First pass effect: liver inactivates some meds on first pass through and
thus require sublingual or IV route (may need higher dose)
• Excretion
o Eliminated through the kidneys
o Kidney dysfunction can result in elevated levels of medications.
• Med Response
For More Nursing Materials Visit: WWW.qwivy.COM
WWW.qwivy.COM
1 / 4
o Maintain plasma levels between minimum effective concentration and the
toxic concentration:
• Therapeutic index (TI)
o High TI has a wide safety margin.
o Low TI requires monitoring of serum levels; higher risk of toxicity
o Tough levels: obtain immediately before next dose.
• Half-life
o Time it takes a medication level to drop in the body by 50%.
o Short vs long half-life: long half-life has greater risk for med accumulation in
body.
• Agonist: enhance/produces an action
• Antagonist: blocks the action
• Routes of admin:
o Oral/Enteral:
§ 90 degrees upright
§ do not mix with large amounts of food
§ lean chin in to help facilitate swallowing
o Sublingual/buccal
§ Keep med in place until completely dissolved
o Transdermal
§ Wash skin with soap and water then dry it thoroughly before placing
patch. Place patch on hairless area and rotate sites to prevent
irritation.
o Drops:
§ Place drop in center of sac.
§ Avoid placing directly on cornea.
§ If blink repeat process.
§ Apply gentle pressure with finger and a clean facial tissue on the
nasolacrimal duct for 30-60 seconds to prevent systemic absorption.
o Ears:
§ Have client lay on unaffected side.
§ Up and out for adults
§ Down and back for children
o Inhalation:
§ MDI
• Shake vigorously 5-6 times
• Take a deep breath and then exhale
• Slow deep breath for 3-5 seconds from MDI
• Hold breath for 10 seconds after
§ DPI
• DO NOT SHAKE DEVICE
• Place mouthpiece between lips and take a deep breath
• Hold breath for 5-10 seconds
For More Nursing Materials Visit: WWW.qwivy.COM
WWW.qwivy.COM
2 / 4
o NG/Gastrostomy tubes
§ To prevent clogging flush tube before and after each med with 15-
30ml of warm sterile water.
o Suppositories:
§ Left lateral sims position.
§ Remain flat or left lateral for 5 min after insertion.
o Intradermal:
§ Used for allergy testing
§ Used for tb testing
§ Small amount of solution (no more than 0.1ml)
§ 10-15-degree angle bevel up.
o Z-track: for iron
Chapter 2: Safe Med Admin and Error Reduction
• Types of Prescriptions:
o Routine/standard: regularly scheduled meds
o Single/one time: asap or a specific time
o Stat: once and immediately
o PRN: as needed
o Standing: specific circumstances or specific units: ex: heparin protocol
• Taking a phone prescription:
o Have 2nd nurse on line if possible
o Read-back prescription
o Verify and sign within 24 hours
• Med rec:
o Take place at admission, transfer of clients, and discharge.
• RIGHTS OF SAFE MED ADMIN:
o Right client
o Right med
o Right dose
o Right time
o Right route
o Right documentation
o Right client education
o Right to refuse
o Right assessment
o Right evaluation
• Evaluation
o Report all errors and implement corrective measures immediately
§ Complete incident report within time frame the facility specifies
(usually 24 hours) and it should include
• Client id, name and dose of med, time and place of incident,
accurate and objective account of event, who you notified,
what actions you took, your signature.
For More Nursing Materials Visit: WWW.qwivy.COM
WWW.qwivy.COM
3 / 4
Chapter 3: Dosage Calculation
• 1kg=1000mg
• 1oz=30mL
• 1L=1000mL
Chapter 4: IV Therapy
• Rapid and precise
• Circulatory overload is possible if too large or too rapid of an infusion
• Admin can irritate vein
• Can lead to sepsis if aseptic technique is broken
• Distal veins on nondominant hand first
• Write date/time, document size/site/appearance
• Flush every 8-12 hours when not in use
• Avoid tourniquets in older adults
• Hold hand below heart
• Change every 72 hours
• Change tubing every 24 hours
• Changes fluids every 24 hours
• Wipe all ports with alcohol before using or inserting a syringe
• Complications
o Infiltration
§ Findings: pallor, local swelling at site, decreased skin temp around
site, damp dressing
§ Treatment: stop infusion and remove catheter, elevate extremity,
encourage active range of motion, apply a cold or warm compress
depending on type of solution that infiltrated, check with provider to
determine whether the IV is still needed.
o Extravasation
§ Findings: pain, burning, redness, and swelling.
§ Treatment: stop infusion, place antidote before removing catheter if
there is one, notify provider.
o Hematoma
§ Elevate extremity, use warm compress
o Catheter embolus
§ Missing catheter tip after discontinuation. Place tourniquet high on
extremity, surgical removal.
o Phlebitis/thrombophlebitis
§ Red line up the arm with palpable band at vein site
§ Symptoms - edema, throbbing, paining, burning, increased skin temp
For More Nursing Materials Visit: WWW.qwivy.COM
WWW.qwivy.COM
Powered by qwivy(www.qwivy.org)
4 / 4
Pages | 44 |
Language | English |
Comments | 0 |
Sales | 0 |
{{ userMessage }}