NR 293 Quiz 1
Student Name
Chamberlain University
NR-293: Pharmacology for Nursing Practice
Prof. Name
Date
Quiz One
Rights of Medication Administration
The rights of medication administration serve as essential safety measures to ensure patient well-being and minimize errors. These include the right patient, right dose, right route, and the right to refuse. Nurses are expected to perform the final verification of medications at the patient’s bedside, rather than at the nurse’s station. This direct verification helps prevent administration errors by confirming the medication against the patient’s identification and the provider’s order in real time.
First Pass Effect
The first-pass effect refers to the initial metabolism of a drug within the liver before it enters systemic circulation. This process significantly reduces the bioavailability of some medications, particularly when taken orally. As a result, higher oral doses may be prescribed to ensure adequate therapeutic effects. For instance, oral morphine often requires a higher dose than parenteral morphine due to this effect. Understanding the first-pass effect is crucial for correct dosing and ensuring that the patient receives an effective drug concentration.
Nursing Considerations When Administering Medications
Nurses must adopt multiple precautionary measures when administering medications. These include verifying the patient’s identity through two identifiers, avoiding leaving medications at the bedside, disposing of unused or refused doses appropriately, documenting refusals, ensuring the patient fully ingests the medication, and administering medications with water (as certain beverages, such as milk, can interfere with absorption).
| Nursing Considerations | Details |
|---|---|
| Patient identity verification | Use at least two identifiers (e.g., name and date of birth) |
| Unused medications | Do not leave at bedside; dispose of according to protocol |
| Refusal handling | Document refusal and discard medication safely |
| Supervised administration | Stay with the patient until the medication is swallowed |
| Fluid for administration | Preferably water; avoid liquids that may alter absorption |
Routes of Medication Administration
Medications may be given orally, subcutaneously, intravenously, or via other routes as prescribed. Orders from providers sometimes list multiple possible routes; in such cases, nurses must confirm the intended route and discontinue unused routes to avoid confusion.
Ethics in Medication Administration
Patients have the right to refuse medication, and nurses must respect this while also balancing ethical obligations. For example, in cases of pain management, nurses should advocate for patient comfort within the boundaries of safe and lawful medication administration.
STAT and PRN Medications
- STAT medications: Must be administered immediately, typically within 30–60 minutes.
- PRN medications: Given as needed, based on patient request and assessment.
Oral Medication Types and Considerations
| Medication Type | Key Information | Special Instructions |
|---|---|---|
| Capsules | Coating dissolves to release medication | Swallow whole |
| Enteric-coated tablets | Prevent breakdown in the stomach; reduce GI irritation | Do not crush or chew |
| Extended-release tablets | Release medication slowly | Do not crush; may cut only if scored |
| Liquid solutions & suspensions | Absorbed faster than tablets/capsules | Shake suspensions before use |
Pregnancy Medication Categories
| Category | Description | Example |
|---|---|---|
| A | No risk to fetus/mother based on human studies | Safe vitamins |
| B | No risk in animal studies; no human data | Acetaminophen |
| C | Animal studies show adverse effects; no human studies | Certain antidepressants |
| D | Evidence of human fetal risk | ACE inhibitors |
| X | Risks outweigh benefits | Isotretinoin |
Administration in Adults vs. Children
Infants have a higher body water content than adults, which influences medication distribution and dosing considerations.
Quiz Two
Antidote for Opioids
Naloxone is the primary antidote used in opioid overdose or withdrawal situations, rapidly reversing respiratory depression.
Vasopressin for Diabetes Insipidus
Diabetes insipidus presents with polyuria (excessive urination), polydipsia (excessive thirst), and polyphagia (increased hunger). Vasopressin helps reduce urine output and restore fluid balance.
Patient Teaching: Levothyroxine
Levothyroxine, prescribed for hypothyroidism, should be taken on an empty stomach with water, at least 30–60 minutes before breakfast. Capsules should be swallowed whole and kept in their packaging until use. Common side effects include heat intolerance, tachycardia, and diarrhea, while serious effects may involve tremors and mood changes.
Propylthiouracil (PTU) Considerations
PTU, used for hyperthyroidism, can cause severe liver damage. Adverse effects may include hair loss, altered taste, numbness, joint pain, dizziness, and neck swelling.
Metformin for Diabetes
Metformin should be taken with meals to minimize gastrointestinal discomfort. It must be discontinued during contrast dye procedures and withheld for at least 48 hours afterward due to the risk of lactic acidosis.
Regular Insulin Timing
Regular insulin should be taken 30–60 minutes before meals to align peak action with food absorption. Exercising too soon after insulin administration can cause hypoglycemia.
Prednisone and Nutrient Considerations
Prednisone may cause weight gain, mood changes, and decreased immunity. Patients should increase dietary calcium and vitamin D to counteract bone loss.
NR 293 Quiz 1
| Nutrient | Food Sources |
|---|---|
| Calcium | Dairy, sardines, salmon, kale |
| Vitamin D | Salmon, tuna, egg yolks, sunlight |
Glaucoma Medication Administration
Timolol should be applied by placing one drop in the conjunctival sac and applying gentle pressure to the inner corner of the eye for 1–2 minutes. Pilocarpine requires pulling the lower eyelid to create a pocket for the drop. Combination therapies like timolol/latanoprost are generally preferred for intraocular pressure reduction.
Quiz Three
Antihistamines
Used to relieve allergic symptoms, antihistamines may cause blurred vision, dizziness, and drowsiness due to their anticholinergic properties.
Respiratory Medications
- Oral forms: Provide systemic effects with longer duration.
- Nasal sprays: Offer rapid relief but can cause rebound congestion with overuse.
Antitussives vs. Expectorants
| Type | Purpose |
|---|---|
| Antitussives | Suppress cough reflex |
| Expectorants | Thin mucus for easier clearance |
Albuterol
Commonly causes shakiness, headache, throat irritation, and muscle aches; these effects are generally mild and temporary.
Inhaled Steroids
May lead to oral thrush; patients should rinse their mouth after use.
Decongestants
Effectiveness is indicated by improved breathing and reduced congestion.
Theophylline
Prescribed for COPD; side effects may include palpitations and tachycardia.
References
U.S. Food & Drug Administration. (2023). Pregnancy and lactation labeling. https://www.fda.gov
Potter, P. A., Perry, A. G., Stockert, P., & Hall, A. (2021). Fundamentals of nursing (10th ed.). Elsevier Health Sciences.
NR 293 Quiz 1
Lilley, L. L., Collins, S. R., & Snyder, J. S. (2020). Pharmacology and the nursing process (9th ed.). Elsevier.