NR 293 Pharmacology Exam 1

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Chamberlain University

NR-293: Pharmacology for Nursing Practice

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Date

Pharmacology Exam 1

Medication Errors and the Six Rights of Medication Administration (Chapter 1)

Medication errors are preventable mistakes that can result in inappropriate drug use or patient harm. To minimize these errors, nurses follow the six rights of medication administration.

Right Drug – Verify that the medication given matches the provider’s order.
Right Dose – Ensure the prescribed dosage is safe and appropriate for the patient’s age, weight, and condition.
Right Time – Administer medications at the correct intervals, considering the last dose given and scheduled frequency.
Right Route – Confirm the prescribed route (oral, IV, IM, etc.) and check for any contraindications or allergies.
Right Patient – Use two identifiers, such as the patient’s full name and date of birth, to prevent errors.
Right Documentation – Record all details accurately, including the time, dose, route, and patient response.

Following these principles ensures safe practice and reduces risks related to drug administration.

Nursing Process (Chapter 1)

The nursing process serves as a structured framework for providing safe, patient-centered care. It involves five steps:

Assessment: Collecting data about the patient, including medical history, allergies, and current medication profile.
Diagnosis: Analyzing data to identify nursing problems and patient needs.
Planning: Establishing clear, measurable goals for treatment and patient recovery.
Implementation: Executing interventions, such as administering medications or providing education.
Evaluation: Continuously reassessing to determine whether goals are achieved and modifying care plans if necessary.

Objective and Subjective Data

When collecting patient information, nurses distinguish between:

Subjective Data – Information provided by the patient, such as pain, nausea, or dizziness.
Objective Data – Observable and measurable signs like blood pressure, temperature, or laboratory results.

Both forms of data are essential for accurate assessments and care planning.

Routes of Medication Administration: Advantages and Disadvantages (Chapter 2)

Route	Advantages	Disadvantages
Intravenous (IV)	Complete absorption, rapid onset, precise control	Irreversible once administered; risk of infection, embolism, and fluid overload
Intramuscular (IM)	Useful for depot drugs and poorly soluble medications	Painful, risk of nerve injury, variable absorption
Transdermal	Sustained drug release, convenient for long-term use	Local irritation possible; unsuitable for liquid drugs
Subcutaneous (SubQ)	Good for depot formulations, easy to administer	Discomfort, local tissue injury, slower absorption than IV
Oral	Safe, noninvasive, convenient for self-administration	Variable absorption due to GI factors; possible inactivation in stomach acid

Pharmacokinetics (Chapter 2)

Pharmacokinetics describes how drugs move through the body. The four processes are:

Absorption – Entry of the drug into the bloodstream from its site of administration.
Distribution – Transport of the drug to target tissues and organs.
Metabolism – Biotransformation, mainly in the liver, converting drugs into active or inactive forms.
Excretion – Removal of drugs via the kidneys (urine), intestines (feces), or bile.

Pediatric Considerations for Drug Administration (Chapter 3)

Children have unique physiological characteristics that affect drug therapy. Intramuscular absorption is unpredictable and often faster. Because children have higher body water content but less fat, drug distribution differs compared to adults. Additionally, immature liver and kidney function alter drug metabolism and excretion, increasing the risk of toxicity.

Drug Classifications: Schedule C-1 to C-5 (Chapter 4)

Controlled substances are categorized into five schedules:

C-1 – High abuse potential; no accepted medical use (e.g., heroin).
C-2 to C-5 – Progressively lower abuse potential with increasing medical benefits. Examples include morphine (C-2) and cough preparations with codeine (C-5).

Telephone Orders (Chapter 1)

Telephone or verbal orders are used in emergencies. To maintain safety:

The prescriber must sign the order within 24 hours.
Avoid abbreviations to prevent misinterpretation.
Nurses must repeat back the order to verify accuracy.

Erickson’s Stages of Development

Understanding Erikson’s psychosocial stages helps nurses provide age-appropriate care. For example, infants face “trust vs. mistrust,” while adolescents struggle with “identity vs. role confusion.” Applying this framework ensures holistic care.

Over-the-Counter (OTC) Medications: Advantages and Disadvantages (Chapter 7)

Advantages	Disadvantages
Affordable, easily accessible, no prescription needed	May delay treatment of serious conditions
Provides symptom relief and patient autonomy	Risk of overdose, drug interactions, and toxicity

Medication Use Terms (Chapters 2 & 38)

Empiric Therapy – Treatment started before lab results are available.
Definitive Therapy – Treatment tailored to specific diagnostic findings.
Prophylactic Therapy – Preventive treatment before potential exposure.
Palliative Therapy – Focuses on comfort and symptom relief.
Maintenance Therapy – Prevents progression of chronic illnesses.

Synergistic Effect (Chapter 2)

A synergistic effect occurs when two drugs combined produce a stronger effect than either drug alone. For example, combining antibiotics may improve bacterial eradication.

Vancomycin (Chapter 39)

Vancomycin is a powerful antibiotic used against resistant infections like MRSA. Due to poor oral absorption, it is typically given intravenously. Monitoring peak (18–50 mcg/mL) and trough (10–20 mcg/mL) levels helps prevent toxicity while ensuring effectiveness.

Antiviral Drugs (Chapter 40)

Antivirals inhibit viral replication or destroy virions. They are most effective in patients with intact immune systems and often require early initiation of therapy for optimal results.

Ciprofloxacin (Cipro) (Chapter 39)

Ciprofloxacin, a broad-spectrum quinolone, treats infections caused by bacteria such as Chlamydia, Mycoplasma, and anthrax. It has high bioavailability, making both oral and IV forms effective.

Ginkgo (Chapter 7)

Ginkgo is an herbal supplement often used to improve memory, treat dementia, and reduce fatigue. However, it can interact with anticoagulants, raising bleeding risk, and in large doses, may cause seizures.

Peak and Trough Levels (Chapter 2)

Peak Level – Highest concentration of a drug, usually measured 30 minutes after administration.
Trough Level – Lowest concentration, measured just before the next dose.

Monitoring these values ensures therapeutic effectiveness and minimizes toxicity.

Quinolones and Adverse Effects (Chapter 39)

Quinolones are bactericidal agents with excellent oral absorption, though absorption decreases with antacids. Adverse effects include headaches, gastrointestinal upset, and tendonitis, which can be severe in rare cases.

Zidovudine (Retrovir) (Chapter 40)

Zidovudine (AZT) is an antiretroviral used to treat HIV/AIDS. It is especially effective in preventing transmission from mother to child during pregnancy and delivery.

Oseltamivir (Tamiflu) (Chapter 40)

Oseltamivir is a neuraminidase inhibitor prescribed for influenza A and B. It is most effective when administered within 48 hours of symptom onset, reducing illness duration.

Aminoglycosides (Chapter 39)

Aminoglycosides are potent antibiotics effective against severe gram-negative infections. Despite their effectiveness, they carry risks of nephrotoxicity (kidney damage) and ototoxicity (hearing loss), making close monitoring essential.

References

Lehne, R. A. (2022). Pharmacology for Nursing Care (11th ed.). Elsevier.
Lilley, L. L., Collins, S. R., Snyder, J. S., & Savoca, K. E. (2020). Pharmacology and the Nursing Process (9th ed.). Elsevier.

NR 293 Pharmacology Exam 1

Hinkle, J. L., & Cheever, K. H. (2018). Brunner & Suddarth’s Textbook of Medical-Surgical Nursing (14th ed.). Wolters Kluwer.