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Summary NURB 3150 Final Exam Review
- Course
- Nurb 3150
- Institution
- Northwestern State University Of Louisiana
This is a comprehensive and detailed final exam review for NURB 3150. *An Essential Study Resource!! Here for YOU!!
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3150 Final ReviewChapter 1: Pharmacokinetics and Routes of Administration
- Routes: oral or enteral (sublingual and buccal), topical (transdermal, eye, ear, nose,
rectal suppositories, vaginal), inhalation (MDI, DPI, nasogastric and gastrostomy tubes),
parenteral (intradermal, subcutaneous, intramuscular, intravenous, and epidural)
- Agonists: medications that bind to or mimic the receptor activity that endogenous
compounds regulate
- Antagonists: medications that can block the usual receptor activity that endogenous
compounds regulate or the receptor activity of other medications
- Partial Agonists: act as agonists and antagonists, with limited affinity to receptor sites
Chapter 2: Safe Medication Administration and Error Reduction
- Uncontrolled Substances: require monitoring by a provider, but do not generally pose
risks of misuse and addiction (Ex: antibiotics)
- Controlled Substances: have potential for misuse and dependence and have a
“schedule” classification
- Types of medication prescriptions: routine or standing prescriptions, single or one-time
prescriptions, stat prescriptions, and PRN prescriptions
- Components of medication prescriptions: client’s full name, date and time of
prescription, name of the medication (generic or brand), strength and dosage of the
medication, route of administration, time and frequency of administration (exact times
or number of times per day), quantity to dispense and the number of refills, and
signature of the prescribing provider
- Medication reconciliation: Nurses compile a list of each client’s current medications,
including all medications with their dosages and frequency. They compare the list with
new medication prescriptions and reconcile it with the provider to resolve any
discrepancies. This process should take place at admission, when transferring clients
between units or facilities, and at discharge.
- Knowledge required prior to medication administration: medication category/class,
mechanism of action, therapeutic effect, adverse effects, toxic effects, medication
interactions, precautions/contraindications, preparation, dosage, administration, and
nursing implications
, - Rights of safe medication administration: right client, right medication, right dose, right
time, right route, right documentation, right client education, right to refuse, right
assessment, and right evaluation
- Use the nursing process to prevent medication errors: assessment, planning,
implementation, and evaluation
Chapter 3: Dosage Calculation
- Types of calculations: solid oral medication, liquid oral medication, injectable
medication, correct doses by weight, and IV infusion rates
- Standard conversion factors:
- 1 mg = 1,000 mcg
- 1 g = 1,000 mg
- 1 kg = 1,000 g
- 1 oz = 30 mL
- 1 L = 1,000 mL
- 1 tsp = 5 mL
- 1 tbsp = 15 mL
- 1 kg = 2.2 lb
Chapter 4: Intravenous Therapy
- Intravenous therapy: administering fluids via an IV catheter to administer medications,
supplement fluid intake, or give fluid replacement, electrolytes, or nutrients
- Advantages of intravenous therapy: rapid effects, precise amounts, less discomfort after
initial insertion, constant therapeutic blood levels, less irritation to subcutaneous and
muscle tissue, permits the use of large volumes of fluid for medications that are poorly
soluble and need larger amounts of fluid to dissolve, and permits the use of medications
that contain irritant properties (Ex: chemotherapy)
- Disadvantages of intravenous therapy: circulatory fluid overload is possible if the
infusion is large or too rapid, immediate absorption leaves little time to correct errors, IV
fluid administration can irritate the lining of the vein, failure to maintain surgical asepsis
can lead to local and systemic infection
- Types of IV access: peripheral or central venous access device
,Chapter 5: Adverse Effects, Interactions, and Contraindications
- Adverse Medication Effects:
o Central nervous system: can result from central nervous system (CNS) stimulation
(excitement) or CNS depression
Nursing Actions:
If CNS stimulation is expected, clients can be at risk for seizures,
and precautions should be taken.
If CNS depression is likely, advise clients not to drive, operate
heavy machinery, or participate in other activities that can be
dangerous.
o Anticholinergic: effects that are a result of muscarinic receptor blockade, most
are seen in eyes, smooth muscle, exocrine glands, and the heart
Client Education:
Manage these effects to minimize danger and discomfort.
Avoid activities that could lead to overheating, because there is a
decreased ability to produce sweat to cool the body.
o Cardiovascular: can involve blood vessels and the heart, antihypertensives can
cause orthostatic hypotension
Client Education:
Monitor for indications of postural hypotension (lightheadedness,
dizziness). If these occur, sit or lie down. Postural hypotension can
be minimized by getting up and changing positions slowly.
o Gastrointestinal (GI): can result from local irritation of the GI tract, stimulation of
vomiting center also results in adverse effects
Client Education:
NSAIDs can cause GI upset. Take these medications with food.
Opioid analgesics slow peristalsis and can cause nausea and
sedation. Perform methods to avoid constipation and GI irritation,
and promote safety.
o Hematologic: relatively common and potentially life-threatening with some
groups of medications
Nursing Actions:
Bone marrow depression/suppression is generally associated with
anticancer medications and hemorrhagic disorders with
anticoagulants and thrombolytics.
Client Education:
Monitor for bleeding (bruising, discolored urine/stool, petechiae,
bleeding gums). Notify the provider if these effects occur.
, o Toxicity: an adverse medication effect that is considered severe and can be life-
threatening, it can be caused by an excessive dose, but it also can occur at the
therapeutic dose levels
Nursing Actions:
Liver damage will occur with an acetaminophen overdose. There is
a greater risk of liver damage with chronic alcohol use. The
antidote, acetylcysteine, can be used to minimize liver damage.
o Hepatotoxicity: can occur with many medications, because most medications are
metabolized in the liver, the liver is particularly vulnerable to drug-induced injury,
damage to liver cells can impair metabolism of many medications, causing
medication accumulation in the body and producing adverse effects, many
medications can alter normal values of liver function tests with no obvious
clinical indications of liver dysfunction
Nursing Actions:
When two or more medications the are hepatotoxic are
combined, the risk for liver damage is increased.
Liver function tests are indicated when clients start a medication
known to be hepatotoxic and periodically thereafter.
Monitor clients for manifestations of hepatotoxicity (nausea,
vomiting, jaundice, dark urine, abdominal discomfort, and
anorexia). Advise clients to monitor for these manifestations.
o Nephrotoxicity: can occur with a number of medications, but it is primarily the
result of certain antimicrobial agents and NSAIDs, damage to the kidneys can
interfere with medication excretion, leading to medication accumulation and
adverse effects
Nursing Actions:
Aminoglycosides can injure cells in the renal tubules of the
kidneys. Monitor blood creatinine and BUN, as well as peak and
trough medication levels for clients taking medication that is
nephrotoxic (acyclovir, aminoglycosides, cyclosporine, NSAIDs,
amphotericin B)
o Hypersensitivity/Allergies: these words are used interchangeably, occurs when an
individual develops and immune response to a medication, the individual has
been previously exposed to the medication and has developed antibodies,
hypersensitivity or allergies can result in a mild reaction (itching, rash, watery
eyes, sneezing, rhinosinusitis) or a severe reaction resulting in anaphylaxis
o Angioedema: a severe allergic reaction that affects deep tissues (blood vessels,
skin, subcutaneous tissue, mucous membranes), generally involves the lips, face
oropharyngeal cavity, and neck but can also affect the intestinal system and other
parts of the body, NSAIDs and angiotensin-converting enzyme inhibitors (ACE
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