s) Principles of Drug Administration
f f f f
1)fAfclientflooksfupfthefdrugftheyfareftakingfinfafdrugfguide.fThefclientfasksfafnursefwhyfthefhe
althcarefproviderfprescribedfafmedicationfthatfhasfaflethalfdosefmeasure.fWhatfisfthefbestfre
sponsefbyfthefnurse?
1.f"Itfjustfrefersftofwhatfisfdonefinfresearch;fitfisfnotfusedfbyfhealthcarefprovidersfprescribingfd
rugs."
2.f"Itfisfafvaluefdeterminedfduringfresearch,fwhichfhelpsftofdeterminefthefsafefdoseftofgive."
3.f"Allfthatfmeansfisfthatfthefdrugfcouldfbeflethal,fbutfIfwillfwatchfyoufforfsidefeffects."
4.f"Don'tfworryfaboutfthat,fI'llfhavefyourfhealthcarefproviderfexplainfitftofyou."f-f2
Explanation:f
1.fTheflethalfdosefmeasurefisfusedfbyfhealthcarefprovidersfprescribingfdrugs.
2.fThefdifferencefbetweenfafmedianfeffectivefdosefandfafmedianflethalfdosefisfafmeasurefoff
afdrug'sfsafetyfmargin,fwhichfhelpsfdeterminefthefsafestfdoseftofgive.
3.fTellingfafclientfthatfthefdrugfcouldfbeflethal,fbutfthatftheyfwillfbefobservedfforfsidefeffects,fwi
llffrightenfthefclientfandfmostflikelyfresultfinfthefrefusalfoffthefmedication.
4.fTellingfafclientfnotftofworryfisfnontherapeutic;fthisfisfafcondescendingfresponse.
PagefRef:f50
CognitivefLevel:fApplying
ClientfNeed/Sub:fPhysiologicalfIntegrity:fPharmacologicalfandfParenteralfTherapies
Standards:fQSENfCompetencies:fIII.A.1fDemonstratefknowledgefoffbasicfscientificfmethod
sfandfprocesses.f|fAACNfEssentialfCompetencies:fII.7fPromoteffactorsfthatfcreatefafculturef
offsafetyfandfcaring.f|fNLNfCompetencies:fKnowledgefandfScience:fRelationshipsfbetweenf
knowledge/sciencefandfqualityfandfsafefpatientfcare.f|fNursing/IntegratedfConcepts:fNursin
gfProcess:fImplementation
LearningfOutcome:f5-
4fComparefandfcontrastfmedianflethalfdosef(LD50)fandfmedianftoxicityfdosef(TD50).
MNLfLearningfOutcome:f5.1fRelateftheflevelfoffafdrug'sfdosingftofitsfsafety.
1)fAfnursefisfconductingfmedicationfeducationfforfpatientsfwithfhypertension.fTheffocusfoffth
efeducationfisfonfenhancingfthefabsorptionfofftheirfmedications.fThefnursefdeterminesfthatfl
earningfhasfoccurredfwhenfthefpatientsfmakefwhichfstatement?
1.f"Wefcanfsafelyftakefthefdrugfforfatfleastf6fmonthsfbeyondfthefexpirationfdate."
2.f"Wefdon'tfneedftofworryfaboutfstoragefoffthefdrug,fitfwon'tflosefpotency."
3.f"Wefshouldfnotftakefourfmedicationsfwithfmilkforfdairyfproducts."
4.f"Wefneedftofbefcarefulfaboutftakingfthefmedicationfwithfcertainffoods."f-f4
Explanation:f
1.fPatientsfshouldfbeftaughtftofavoidftakingfmedicationsfbeyondfthefexpirationfdate.
,2.fStoragefcanfaffectfthefmedication'sfstrengthfandfmayfaffectfhowfitfrespondsfinfthefbody.
3.fTherefarefmanyfmoreffoodsfthatfwillfalterfthefabsorptionfoffmedicationsfotherfthanfmilkfandf
dairyfproducts.
4.fFoodfcanfalterfthefabsorptionfoffmanyfmedications.
PagefRef:f38
CognitivefLevel:fAnalyzing
ClientfNeed/Sub:fPhysiologicalfIntegrity:fPharmacologicalfandfParenteralfTherapies
Standards:fQSENfCompetencies:fIII.A.1fDemonstratefknowledgefoffbasicfscientificfmethod
sfandfprocesses.f|fAACNfEssentialfCompetencies:fII.1fExplainfthefinterrelationshipsfamongf
theory,fpractice,fandfresearch.f|fNLNfCompetencies:fKnowledgefandfScience:fIntegrationfof
f knowledgeffromf nursingf andfotherf disciplines.f |fNursing/Integratedf Concepts:f NursingfProc
ess:fEvaluation
LearningfOutcome:f4-4fDiscussffactorsfaffectingfdrugfabsorption.
MNLfLearningfOutcome:f4.1fRecognizefhowfdrugsfcrossfplasmafmembranesftofreachftheirft
argetfcells.
1)fAfnursefisfpreparingftofadministerfseveralfmedicationsfforfafclient.fThefnursefisfresponsibl
efforfunderstandingfwhichfofftheffollowingfregardingfmedicationfadministration?
Note:fCreditfwillfbefgivenfonlyfiffallfcorrectfchoicesfandfnofincorrectfchoicesfarefselected.fSel
ectfallfthatfapply.
1.fCostfoffthefmedication
2.fReasonfthefmedicationfwasfprescribed
3.fRoutefoffadministration
4.fHowfthefmedicationfisfsuppliedfbyfthefpharmacy
5.fNamefoffthefmedicationf-f2,f3,f4,f5
Explanation:f
1.fAlthoughfthefcostfoffafmedicationfmayfleadftofnoncompliancefatfhome,fitfisfnotfaffactorfwhe
nfadministeringfmedicationsfinfafhealthcareffacility.
2.fKnowingfthefreasonfthefmedicationfwasfprescribedfforfthefpatientfisfthefresponsibilityfoffth
efnursefregardingfmedicationfadministration.
3.fKnowingfhowfthefmedicationfisftofbefadministeredfisfthefresponsibilityfoffthefnursefregardi
ngfmedicationfadministration.
4.fKnowingfhowfthefmedicationfisfsuppliedfbyfthefpharmacyfisfthefresponsibilityfoffthefnursefr
egardingfmedicationfadministration.
5.fKnowingfthefnamefoffthefmedicationfisfthefresponsibilityfoffthefnursefregardingfmedication
fadministration.
PagefRef:f20
CognitivefLevel:fApplying
ClientfNeed/Sub:fPhysiologicalfIntegrity:fPharmacologicalfandfParenteralfTherapies
Standards:fQSENfCompetencies:fV.B.1fDemonstratefeffectivefusefofftechnologyfandfstand
ardizedfpracticesfthatfsupportfsafetyfandfquality.f|fAACNfEssentialfCompetencies:fIX.3fImpl
ementfholistic,fpatient-
centeredfcarefthatfreflectsfanfunderstandingfoffhumanfgrowthfandfdevelopment,fpathophysi
ology,fpharmacology,fmedicalfmanagement,fandfnursingfmanagementfacrossfthefhealth-
illnessfcontinuum,facrossflifespan,fandfinfallfhealthcarefsettings.f|fNLNfCompetencies:fQuali
,tyfandfSafety:fCurrentfbestfpractices.f|fNursing/IntegratedfConcepts:fNursingfProcess:fPlan
ning
LearningfOutcome:f3-
2fDescribefthefrolesfandfresponsibilitiesfoffnursesfregardingfsafefdrugfadministration.
MNLfLearningfOutcome:f3.1fRecognizefthefnurse'sfrole,fresponsibilities,fandfsafefpracticesf
whenfprovidingfcareftofpatientsfreceivingfpharmacotherapy.
1)fAfpharmaceuticalfrepresentativefcomesftofthefphysician'sfofficefandfsaysfhisfcompany'sfp
harmaceuticalflaboratoryfisfmarketingfafdrugfthatfdoesfnotfneedfapprovalfbyfthefFoodfandfDr
ugfAdministrationf(FDA).fWhatfisfthefbestfresponsefbyfthefnurse?
1.f"AnyfpharmaceuticalflaboratoryfinfAmericafmustfhavefapprovalffromfthefFoodfandfDrugfA
dministrationf(FDA)fbeforefmarketingfafdrug."
2.f"Isfthisfanfover-the-
counterf(OTC)fdrug?fTheyfdofnotfneedfapprovalfbyfthefFoodfandfDrugfAdministrationf(FDA).
"
3.f"Isfyourfpharmaceuticalflaboratoryfprivate?fOnlyfpublicfpharmaceuticalflaboratoriesfneedf
approvalffromfthefFoodfandfDrugfAdministrationf(FDA)."
4.f"Yourfpharmaceuticalflaboratoryfmustfbefinvolvedfinfacademicfresearchfbecauseftheyfare
fexemptffromfapprovalf byf thefFoodfandfDrugf Administrationf (FDA)."f -f1
Explanation:f
1.fAnyfpharmaceuticalflaboratoryfmustfobtainfapprovalffromfthefFoodfandfDrugfAdministrati
onf(FDA)fbeforefmarketingfafdrug.
2.fPharmaceuticalflaboratoriesfthatfmanufacturefover-the-
counterf(OTC)fdrugsfmustfobtainfapprovalffromfthefFoodfandfDrugfAdministrationf(FDA)fbef
orefmarketingfthesefdrugs.
3.fPrivatefpharmaceuticalflaboratoriesfmustfobtainfapprovalffromfthefFoodfandfDrugfAdmini
strationf(FDA)fbeforefmarketingfafdrug.
4.fPharmaceuticalflaboratoriesfinvolvedfinfacademicfresearchfmustfobtainfapprovalffromfthe
f Foodfandf Drugf Administrationf (FDA)fbeforefmarketingfaf drug.
PagefRef:f12-13
CognitivefLevel:fApplying
ClientfNeed/Sub:fPhysiologicalfIntegrity:fPharmacologicalfandfParenteralfTherapies
Standards:fQSENfCompetencies:fV.B.1fDemonstratefeffectivefusefofftechnologyfandfstand
ardizedfpracticesfthatfsupportfsafetyfandfquality.f|fAACNfEssentialfCompetencies:fV.1fDem
onstratefbasicfknowledgefoffhealthcarefpolicy,ffinancefandfregulatoryfenvironments;fincludi
ngflocal,fstate,fnational,fandfglobalfhealthcareftrends.f|fNLNfCompetencies:fQualityfandfSaf
ety:fPoliciesfandfprocedures.f|fNursing/IntegratedfConcepts:fNursingfProcess:fAnalysis
LearningfOutcome:f2-
2fDiscussfthefrolefoffthefU.S.fFoodfandfDrugfAdministrationf(FDA)finfthefdrugfapprovalfproce
ss.
MNLfLearningfOutcome:f2.2fExaminefthefrolefoffthefU.S.fFoodfandfDrugfAdministrationfinfth
efprocessfoffdrugfapprovalfandfdrugfsafety.
1)fThefnurseffollowsfthefnursingfprocessfwhenfconductingfmedicationfeducationfaboutfinsuli
n.fWhatfwillfthefnursefaskfthefclientftofevaluatefthefclient'sfknowledgefoffinsulin?
1.f"Isfyourfabdomenfthefbestfplaceftofinjectfinsulin?"
, 2.f"Whatfquestionsfdofyoufhavefaboutfinsulin?"
3.f"Canfyoufrecognizefwhenfyoufarefexperiencingfhypoglycemia?"
4.f"Canfyouftellfmeffourfpointsfyoufrememberfaboutfhowftoftakefyourfinsulin?"f-f4
Explanation:f
1.fAskingfthefclientfifftheirfabdomenfisfthefbestfplaceftofinjectfinsulinfisfanfassessmentfquestio
n.
2.fAskingfthefclientfwhatfquestionsfheforfshefhasfaboutfinsulinfisfanfassessmentfquestion.
3.fAskingfthefclientfiffheforfshefcanfrecognizefwhenfheforfshefisfexperiencingfhypoglycemiafisf
anfassessmentfquestion.
4.fThefnursefisfevaluatingfthefeffectivenessfoffmedicationfeducationfbyfaskingfthefpatientfforf
feedbackffromfthefeducationfprovided.
PagefRef:f59
CognitivefLevel:fApplying
ClientfNeed/Sub:fPhysiologicalfIntegrity:fPharmacologicalfandfParenteralfTherapies
Standards:fQSENfCompetencies:fI.A.1fIntegratefunderstandingfoffmultiplefdimensionsfoffp
atient-
centeredfcare:fpatient/family/communityfpreferences,fvalues;fcoordinationfandfintegrationf
offcare;finformation,fcommunication,fandfeducation;fphysicalfcomfortfandfemotionalfsuppor
t;finvolvementfofffamilyfandffriends;fandftransitionfandfcontinuity.f|fAACNfEssentialfCompete
ncies:fIX.9fMonitorfclientfoutcomesftofevaluatefthefeffectivenessfoffpsychobiologicalfinterve
ntions.f|fNLNfCompetencies:fKnowledgefandfScience:fRelationshipsfbetweenfknowledge/s
ciencefandfqualityfandfsafefpatientfcare.f|fNursing/IntegratedfConcepts:fNursingfProcess:fE
valuation
LearningfOutcome:f6-1fComparefandfcontrastfthefdifferentfstepsfoffthefnursingfprocess.
MNLfLearningfOutcome:f6.4fRecognizefhowfthefevaluationfphasefoffthefnursingfprocessfisfu
sedftofmeasurefoutcomesfandfrevisefcare.
2)fAfclientfprescribedfafloadingfdoseftofbeffollowedfbyfaflowerfmaintenancefdosefasksfthefnur
sefwhyfthefmaintenancefdosefisflower.fWhichfresponsefshouldfthefnursefprovidefthefclient?
1.f"Thefinitialfdosefshortensfthefhalf-life,fsofthefmedicationfwouldfworkfmorefquickly."
2.f"Wefalwaysfgivefmedicationsfthisfway;fthefhealthcarefproviderfdidfnotfmakefafmistake."
3.f"Youfhadfaflargerfdosefinitiallyfsofthatfthefmedicationfwouldfworkfmorefquickly."
4.f"Givingfaflargerfdosefinitiallyfwillfreducefthefchancefoffsidefeffects."f-f3
Explanation:f
1.fLoadingfdosesfdofnotfshortenfthefhalf-lifefoffafdrug.
2.fNotfallfmedicationsfarefinitiatedfwithfafloadingfdose.
3.fLoadingfdosesfoffmedicationsfarefusedftofquicklyfinducefaftherapeuticfresponse.
4.fLoadingfdosesfdofnotfreducefthefoccurrencefoffsidefeffects.
PagefRef:f45
CognitivefLevel:fApplying
ClientfNeed/Sub:fPhysiologicalfIntegrity:fPharmacologicalfandfParenteralfTherapies
Standards:fQSENfCompetencies:fIII.A.1fDemonstratefknowledgefoffbasicfscientificfmethod
sfandfprocesses.f|fAACNfEssentialfCompetencies:fII.1fExplainfthefinterrelationshipsfamongf
theory,fpractice,fandfresearch.f|fNLNfCompetencies:fKnowledgefandfScience:fIntegrationfof
f knowledgeffromf nursingf andfotherf disciplines.f |fNursing/Integratedf Concepts:f NursingfProc
ess:fImplementation