lOMoA RcP S D|516 483 32
lO MoARcPS D|51648332
NSG318 / NSG 318 EXAM 4
STUDY GUIDE BLUEPRINT
Introduction to Pharmacology - GCU
100% Guarantee Pass
### Exam #4 Blueprint Cheat sheet
**Focus:** Specialized Drug Therapies and Integration
**Content Areas:**
- Endocrine drugs (insulin, oral hypoglycemics, thyroid supplements)
- Immune system agents (immunosuppressants, vaccines, chemotherapy)
- Pain management and opioid stewardship
- Nursing considerations for special populations
(pediatrics, geriatrics, pregnancy)
- Polypharmacy and strategies to avoid adverse effects
, lOMoA RcP S D|516 483 32
Blueprint for NSG 318 Exam #4 (Final)
NSG-318 EXAM 4 (Final) Student Blueprint Percent of
Level of Bloom’s taxonomy exam/
# of
Insulin YouTube video: Pharmacology for Nursing - Diabetic drugs Insulin Types & Memory Tricks (Peak, questions
Onset, & Duration) RN - YouTube
Topic 1: Introduction to Nursing Pharmacology, Terminology, and Medication Calculation 7%
1.4 Apply principles of dimensional analysis to calculate medication dosages 3
1.5 Discuss the measures followed by the nurse to ensure medications are administered safely 2
Nurse Responsibilites:
● 6 rights (right drug, right patient, right time, right dose, right route, right documentation)
● Right patient- 2 identifiers first & last name, date of birth
● Check vital signs (blood pressure, pulse, respiratory rate, oxygen saturation, pain & anxiety level)
o Normal vital signs for adult are:
BP 120/80
HR 60-100 beats per minute
RR 12-20 breaths per minute
temperature 97.8 – 99 F
oxygen sat 95-100%
● Perform focused assessment (related to the patients complaint/reason for being there)
● Verify and double check medication prescription (are all components of prescription/order there?)
o The components of a drug order are as follows:
• Patient name and birth date
• Date the order is written
• Provider signature or name if an electronic order, T/O, or V/O
• Signature of licensed staff who took the T/O or V/O, if applicable
• HCPs who wish to prescribe controlled drugs must register with the US Federal Drug
Enforcement Agency (DEA); when prescribing controlled substances, the HCP’s DEA
number must be on the prescription
*Example of a drug order.
• Drug name and strength
• Drug frequency or dose (e.g., once daily)
• Route of administration
• Duration of administration (e.g., ×7 days, ×3 doses, when applicable)
• Number of patient refills
• Number of pills to be dispensed
• Any special instructions for withholding or adjusting dosage based on nursing
assessment, drug effectiveness, or laboratory results
● Clarify prescription (if missing any components or possibly unsafe for patient).
● Consider patients most recent labwork, vital signs, physical condition before administering meds
● Keep environment clean and clear, no distractions when getting meds
● Use of scanning system/barcode
● Check medications at bedside (check meds 3 times… when getting from cart, when putting together dose,
at patients bedside). To avoid drug errors, the drug label should be read three times: (1) when the nurse
picks up the drug and removes it from the automatic dispensing cabinet (ADC), (2) as the nurse prepares
the drug for administration, and (3) when the nurse administers the drug.
, lOMoA RcP S D|516 483 32
Blueprint for NSG 318 Exam #4 (Final)
NSG-318 EXAM 4 (Final) Student Blueprint Level Percent of
of Bloom’s taxonomy exam/
# of
Insulin YouTube video: Pharmacology for Nursing - Diabetic drugs Insulin Types & Memory Tricks (Peak, questions
Onset, & Duration) RN - YouTube
Topic 2: Drugs and the Body: Pharmacodynamics, Pharmacokinetics, and Pharmacogenetics 3%
2.1 Differentiate among pharmacokinetics, pharmacodynamics, and pharmacogenetics 2
● Pharmacokinetics is the movement of drugs through the body (how medications get from point of entry to the
site of action). What the body does to the drug
o Factors affecting Pharmacokinetics: blood circulation, pain/stress, food texture, food fat content,
temp, pH, route of administration
o The processes of Pharmacokinetics are:
▪ Absorption-drug moving into the bloodstream from administration site (80% are oral so
from GI tract into bloodstream) 100% of IV drugs go into bloodsteam
● Disintegration: breakdown of oral drug into small particles
● Dissolution: process of combining small drug particles with liquid to form a
solution
▪ Distribution- drug moves from circulation (bloodstream) to the body tissues
● Protein-binding= drugs will bind with plasma proteins which are albumin,
lipoprotein, and AGP (alpha-1-acid-glycoprotein)
● The portion of the drug bound to protein is inactive because it is not available to
interact with tissue receptors and therefore is unable to exert a pharmacologic effect.
The portion that remains unbound is free, active drug. Free drugs are able to exit
blood vessels and reach their site of action, causing a pharmacologic response.
● Two highly protein-bound drugs administered together compete for protein-
binding sites and highest % wins.
Example: warfarin (99%) and furosemide (95%) administered together warfarin
could displace furosemide so that more furosemide is “free/active” which can lead
to toxicity.
● Patients with liver or kidney disease have low serum albumin levels so less protein-
binding sites so more of the “free drug” available and possible toxicity.
● Blood Brain Barrier (BBB)- blood vessels in brain have special endothelial lining
where cells are pressed together (called tight junctions) that protects brain and
keeps 98% of all drugs out.
o Highly lipid soluble and low molecular weight drugs cross the BBB by
diffusion. (example, benzodiazepines).
o Water soluble drugs, and free drugs, cant cross the BBB (example
alcohol, and penicillin).
● Placenta- drugs can cross the placenta like they do other cell membranes.
o Breastfeeding- drugs can pass through breast milk
o Metabolism (biotransformation)- the body chemically changes the drug into a form that can be
excreted
▪ First-pass effect: (oral route only) after absorption of oral drugs from the GI tract they pass
to the liver via the portal vein. In the liver, some drugs are metabolized to an inactive form
and excreted which reduces the amount of active drug available to exert a pharmacologic
effect. This is the first-pass effect.
▪ Drugs that are delivered by other routes (intravenous [IV], intramuscular [IM],
lO MoARcPS D|51648332
NSG318 / NSG 318 EXAM 4
STUDY GUIDE BLUEPRINT
Introduction to Pharmacology - GCU
100% Guarantee Pass
### Exam #4 Blueprint Cheat sheet
**Focus:** Specialized Drug Therapies and Integration
**Content Areas:**
- Endocrine drugs (insulin, oral hypoglycemics, thyroid supplements)
- Immune system agents (immunosuppressants, vaccines, chemotherapy)
- Pain management and opioid stewardship
- Nursing considerations for special populations
(pediatrics, geriatrics, pregnancy)
- Polypharmacy and strategies to avoid adverse effects
, lOMoA RcP S D|516 483 32
Blueprint for NSG 318 Exam #4 (Final)
NSG-318 EXAM 4 (Final) Student Blueprint Percent of
Level of Bloom’s taxonomy exam/
# of
Insulin YouTube video: Pharmacology for Nursing - Diabetic drugs Insulin Types & Memory Tricks (Peak, questions
Onset, & Duration) RN - YouTube
Topic 1: Introduction to Nursing Pharmacology, Terminology, and Medication Calculation 7%
1.4 Apply principles of dimensional analysis to calculate medication dosages 3
1.5 Discuss the measures followed by the nurse to ensure medications are administered safely 2
Nurse Responsibilites:
● 6 rights (right drug, right patient, right time, right dose, right route, right documentation)
● Right patient- 2 identifiers first & last name, date of birth
● Check vital signs (blood pressure, pulse, respiratory rate, oxygen saturation, pain & anxiety level)
o Normal vital signs for adult are:
BP 120/80
HR 60-100 beats per minute
RR 12-20 breaths per minute
temperature 97.8 – 99 F
oxygen sat 95-100%
● Perform focused assessment (related to the patients complaint/reason for being there)
● Verify and double check medication prescription (are all components of prescription/order there?)
o The components of a drug order are as follows:
• Patient name and birth date
• Date the order is written
• Provider signature or name if an electronic order, T/O, or V/O
• Signature of licensed staff who took the T/O or V/O, if applicable
• HCPs who wish to prescribe controlled drugs must register with the US Federal Drug
Enforcement Agency (DEA); when prescribing controlled substances, the HCP’s DEA
number must be on the prescription
*Example of a drug order.
• Drug name and strength
• Drug frequency or dose (e.g., once daily)
• Route of administration
• Duration of administration (e.g., ×7 days, ×3 doses, when applicable)
• Number of patient refills
• Number of pills to be dispensed
• Any special instructions for withholding or adjusting dosage based on nursing
assessment, drug effectiveness, or laboratory results
● Clarify prescription (if missing any components or possibly unsafe for patient).
● Consider patients most recent labwork, vital signs, physical condition before administering meds
● Keep environment clean and clear, no distractions when getting meds
● Use of scanning system/barcode
● Check medications at bedside (check meds 3 times… when getting from cart, when putting together dose,
at patients bedside). To avoid drug errors, the drug label should be read three times: (1) when the nurse
picks up the drug and removes it from the automatic dispensing cabinet (ADC), (2) as the nurse prepares
the drug for administration, and (3) when the nurse administers the drug.
, lOMoA RcP S D|516 483 32
Blueprint for NSG 318 Exam #4 (Final)
NSG-318 EXAM 4 (Final) Student Blueprint Level Percent of
of Bloom’s taxonomy exam/
# of
Insulin YouTube video: Pharmacology for Nursing - Diabetic drugs Insulin Types & Memory Tricks (Peak, questions
Onset, & Duration) RN - YouTube
Topic 2: Drugs and the Body: Pharmacodynamics, Pharmacokinetics, and Pharmacogenetics 3%
2.1 Differentiate among pharmacokinetics, pharmacodynamics, and pharmacogenetics 2
● Pharmacokinetics is the movement of drugs through the body (how medications get from point of entry to the
site of action). What the body does to the drug
o Factors affecting Pharmacokinetics: blood circulation, pain/stress, food texture, food fat content,
temp, pH, route of administration
o The processes of Pharmacokinetics are:
▪ Absorption-drug moving into the bloodstream from administration site (80% are oral so
from GI tract into bloodstream) 100% of IV drugs go into bloodsteam
● Disintegration: breakdown of oral drug into small particles
● Dissolution: process of combining small drug particles with liquid to form a
solution
▪ Distribution- drug moves from circulation (bloodstream) to the body tissues
● Protein-binding= drugs will bind with plasma proteins which are albumin,
lipoprotein, and AGP (alpha-1-acid-glycoprotein)
● The portion of the drug bound to protein is inactive because it is not available to
interact with tissue receptors and therefore is unable to exert a pharmacologic effect.
The portion that remains unbound is free, active drug. Free drugs are able to exit
blood vessels and reach their site of action, causing a pharmacologic response.
● Two highly protein-bound drugs administered together compete for protein-
binding sites and highest % wins.
Example: warfarin (99%) and furosemide (95%) administered together warfarin
could displace furosemide so that more furosemide is “free/active” which can lead
to toxicity.
● Patients with liver or kidney disease have low serum albumin levels so less protein-
binding sites so more of the “free drug” available and possible toxicity.
● Blood Brain Barrier (BBB)- blood vessels in brain have special endothelial lining
where cells are pressed together (called tight junctions) that protects brain and
keeps 98% of all drugs out.
o Highly lipid soluble and low molecular weight drugs cross the BBB by
diffusion. (example, benzodiazepines).
o Water soluble drugs, and free drugs, cant cross the BBB (example
alcohol, and penicillin).
● Placenta- drugs can cross the placenta like they do other cell membranes.
o Breastfeeding- drugs can pass through breast milk
o Metabolism (biotransformation)- the body chemically changes the drug into a form that can be
excreted
▪ First-pass effect: (oral route only) after absorption of oral drugs from the GI tract they pass
to the liver via the portal vein. In the liver, some drugs are metabolized to an inactive form
and excreted which reduces the amount of active drug available to exert a pharmacologic
effect. This is the first-pass effect.
▪ Drugs that are delivered by other routes (intravenous [IV], intramuscular [IM],
