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NURS 1060: EXAM #2 QUESTIONS AND VERIFIED ANSWERS LATEST UPDATE

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NURS 1060: EXAM #2 QUESTIONS AND VERIFIED ANSWERS LATEST UPDATE Pharmacokinetics: Four basic processes Absorption, distribution, metabolism, excretion Clinical Decision Making A process used to examine and determine the best actions to meet desired goals; requires anticipating, recognizing and ...

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  • November 18, 2024
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NURS 1060: EXAM #2 QUESTIONS AND VERIFIED

ANSWERS LATEST UPDATE

Pharmacokinetics: Four basic processes

Absorption, distribution, metabolism, excretion

Clinical Decision Making

A process used to examine and determine the best actions to meet desired goals;

requires anticipating, recognizing and organizing patient problems to respond with

urgency and/or importance in a preferential order to avoid or minimize adverse changes

in a patients condition

Acid-Base Balance

The physiological mechanisms that maintain blood pH critical to homeostasis and

optimal cell function

Distribution

Movement of the drug from the blood to the site of action or storage area

Drug distribution is determined by three factors

Blood flow to tissues, exiting the vascular system, & entering cells

Blood flow to tissues

Drugs are carried by the blood to tissues and organs of the body, blood flow determines

the rate of delivery, & abscesses and tumors

Abscesses and Tumors

-Low regional blood flow impacts therapy

-Pus-filled pockets, not internal blood vessels

,-Solid tumors have limited blood supply

(This is one reason treatment of abscesses and tumors can be difficult- the amount of

drug to the site is reduced)

Blood flow to Tissues: High blood flow regions-

Heart, liver, kidney, brain

Blood flow to Tissues: Slower blood flow regions-

Muscle, bone, skin

Exiting the Vascular System

Capillary walls: ionized drugs pass between capillary cells.

-Non-ionized or lipid soluble drugs pass between and also directly through the lipid

membrane of cells of the capillary wall

Protein Binding

Drugs can form reversible bonds with protein, plasma albumin is the most important

protein drugs bind with, albumin is a LARGE molecule that always remains in the

bloodstream

Protein Binding (Pt. 2)

Protein binding maintains a consistent level of drug in the blood and prolongs drug

action and constantly maintains drug levels

Protein Binding: Bound Drug

Drugs attached to protein/albumin in the blood

Protein Binding: Free Drug

Drug not attached to protein/albumin in the blood

Protein Binding (Pt. 3)

, -Only free drug can travel to the site of action or a cell

-Bound drug stays in the blood stream

-Competing for protein binding sites will occur when the client is taking two drugs that

are protein bound. Both drugs have an increase in the amount of free drug and a

decrease in the amount of bound drug. Adverse reaction of toxicity can occur

Protein Binding (Pt. 4)

-Albumin is the most prevalent protein in plasma and the most important of the proteins

to which drugs bind

-Only unbound (free) drug molecules can leave the vascular system. Bound molecules

are too large to fit through the pores in the capillary wall

Drugs can enter cells to:

-Reach the site of action

-Undergo metabolism and excretion

Many drugs produce their effects by:

Binding with receptors on the external surface of the cell membrane

-Key and Lock fit

-Do not need to cross the cell membrane to act

Plasma Drug Levels: Clinical Significance

Promote patient safety of maximum benefit with minimum harm

-Individualize dosage for this patient

Two Plasma Drug Levels

Minimum effective concentration (MEC) and Toxic concentration

Minimum Effective Concentration (MEC)

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