How medications travel through the body

Transmission of medications from the location of the administration to the bloodstream

Routes of administration and effects on absorption include

Medication must pass through the tissue lining of the GI tract

Absorbed over long period, sustained/extended release

NOT CRUSHED OR CHEWED!

What happens when you swallow sublingual/buccal medication before it is dissolved?

 No significant barrier due to capillary
networks
 Solubility of medication can affect rate of
absorption
 Perfusion at site also greatly affects rate

NO barriers to absorption, absorption is complete and immediate

*medication lasts shorter

Transportation of medications to the side of action

Factors that affect distribution include

Enzymes change the medication into a less active or inactive form

The first-pass effect is described as

A nurse educator is reviewing medication metabolism at an in-service presentation.
Which of the following factors should the educator include as a reason to
administer lower medication dosages? Select all that apply

Elimination of medications from the body

Therapeutic index...

_____ therapeutic index increases need for monitoring

______ therapeutic index indicates a wide safety margin

Amount of time for medication to reduce in the body by half.

_______ = quickly leaves the body, does given more frequently

_____ = drug can accumulate, making toxicity more likely. Doses given less frequently

A provider prescribes phenobarbital for a client who has a seizure disorder. The
medication has a long half-life of 4 days. How many times per day should the nurse
expect to administer this medication?

______ describes what the medication does to the body

Describes how medication will produce its effect and work in the body

_______: binds to receptors

_______: blocks receptors

_________: does both

Treatment of diseases and medical conditions with pharmaceutical drugs

Which right of medication administration is wrong?

1. 1. Right person

2. 2. Right medication

3. 3. Right dose

4. 4. Right time

5. 5. Right route

6. 6. Right mechanism of action

7. 7. Right documentation

Which right of medication administration is missing?

Right person, right medication, right time, right route, right reason, right documentation

Expected and intended effect of the medication

Wanted/unwanted secondary effects, nausea, diarrhea, itching, rash

Undesirable and harmful effect of medication, orthostatic hypotension, altered mental status, toxicity

Conditions that make giving medication risky or completely unsafe

Examples of contraindications include

Medications can interact with other medications but not with food.

A nurse is reviewing a client’s prescribed medications. Which of the following
situations represents a contraindication to medication administration?
a) The client drank grapefruit juice, which could reduce a medication’s
effectiveness.
b) The medication has orthostatic hypotension as an adverse effect.
c) A medication is approved for ages 12 and older, and the client is 8 years old.
d) An anxiolytic medication has an adverse effect of drowsiness and is prescribed
as a preoperative sedative

Important nursing implications include

The use of multiple medications by one person describes

_____ and ______ result in commonly used medications being contraindicated

Forced exerted against arterial walls by blood pumped from the heart

Factors influencing arterial blood pressure:

Traits of Primary "Essential" Hypertension

Traits of secondary hypertension

A client who exercises for 30 minutes every day and maintains a normal
body weight develops primary hypertension. The client asks how this could
have happened. Which finding in the client's health history should the
nurse include in the response to the client? Select all that apply.
a) Age: 62 years
b) Insulin resistance
c) Working as an air traffic controller
d) Family history of hypertension
e) High magnesium intake

BP >180/120, immediate treatment necessary, decrease BP gradually.

-possible symptoms blurred vision, headache, chest pain

Clinical manifestations of high BP include:

What is done first to treat hypertension?

If diagnosed with secondary hypertension, the underlying cause of secondary HTN is treated first.

Lifestyle modifications to improve BP include

decreases sodium and water reabsorption in distal tubules

*monitor electrolytes!

*educate on orthostatic hypotension

Blocks angiotensin II at receptor site (blocks aldosterone)

*monitor electrolytes

*slow position changes

*Do not take with ACEi

*Teratogenic~ fetal toxicity

Inhibits angiotensin I conversion conversion to angiotensin II (blocks aldosterone)

*first dose complications

*cough

*angioedema

*do not use with ARB

Prevents calcium from entering channels of vascular smooth muscle, causing vasodilation

*Avoid grapefruit!

*careful use with heart failure patients

*Don't abruptly stop!

Used for HTN when other conditions make them first-line (HF, migraines)

-olol medications

Cause water and sodium retention

Anti-HTN medication can be stopped as soon as lifestyle modifications are made and maintained

_______ is important when measuring BP in children

The nurse is following up with a client after a diagnosis of prehypertension. Which
statement by the client indicates healthy coping? Select all that apply.
a) "I have reduced my grain intake to 6-8 servings per week."
b) "I take brisk walks with my dog 6 days a week."
c) "I have stopped smoking."
d) "I get 4-5 servings of fruit every day."
e) “I have cut back how often I eat fast food."