Battery

Principle of pharmacology about what the body does to the medications that are taken.

Pharmacokinetics

Where is the target site or destination of absorption in Pharmacokinetics?

Blood stream

Defined as the percentage of a medication that reaches the systemic circulation?

Bioavailability

• Also called biotransformation

• This is where the liver converts the form of a medication to another

Metabolism

What is SHATT of Pharmacodynamics?

• Side effects

• Hypersensitivity

• Allergic Reaction / Anaphylactic Shock

• Tolerance

• Toxicity

What are the 10 Rights of Medication?

• Right Medication

• Right Education

• Right Dosage

• Right Ideal Documentation

• Right Client

• Right Assessment

• Right Time

• Right Ideal Route

• Right Oath (To refuse)

• Right Need of Evaluation

What are the original rights of medication according to JCAHO?

• Right Medication

• Right Dosage

• Right Client

• Right Time

• Right Route

Is the measure of how much fluid (like a drug solution) moves through a system per unit of time.

Flow Rate

Adjustment of the IV medication dosage within prescribed parameters to achieve a desired effects.

Titration

What are macrodrip drop factors?

• 10 gtts/min

• 15 gtts/min (Most Ideal)

• 20 gtts/min

What is the microdrip drop factor?

60 gtts/min

In cases where there is no specific age group for a drip factor, what do you assume as the patient’s drop factor?

Macrodrip (10-20 gtts/min)

Where is the most ideal site of intradermal injection?

Ventral mid-forearm

Sites of Intradermal Injection?

• Anterior forearm

• Upper Chest

• Scapular Area

When is the different angles of subcutaneous injections used?

• 45 degrees (Ideally)

• 90 degrees (Obese-patients)

• Given abdominally most ideally mainly because of its fastest absorption

What is the formula for body surface area?

If there is a meter squared (m²) find the body surface area.

What is the correct volume of medication for intradermal injection?

0.1 - 0.5 mL

What is the correct volume of medication for subcutaneous injection?

0.5 - 1.0 mL

What is the correct volume of medication for intramuscular injection?

2.5 - 3.0 mL

What is the correct volume of medication for intravenous push injection?

1 - 60 mL

What is international standard for intravenous push administration?

• 1 mL per minute

  • To reduce the risk for infiltration

  • Never kink the tubing when doing IVP

Reasons why Intravenous Therapy is prescribed;

• Fluid and electrolyte imbalance

• Route for medicine and blood administration

• Laboratory Diagnostic Procedure (CBC)

How to determine whether a intravenous solution is a hypotonic solution?

• <1% concentration

  • .225% NS

  • .33% NS

  • .45% NS

What is primary mechanism of hypotonic solutions?

Swells the cells

How to determine whether a intravenous solution is a hypertonic solution?

• >1% concentration

  • D10W

  • D5LR

  • D5 NSS

  • D5 3% NS

  • D5 5% NS

What is primary mechanism of hypertonic solutions?

Shrink the cell

Nursing Considerations for Intravenous Therapy;

• Avoid kinking or pitching

• Assess the patency 

  • Lower the bag and check for the blood flow

• Assess every 8 hours

  • Infiltration (Cold to touch)

  • Phlebitis (Warm to touch)

  • Change the IV dress (Every 2 to 3 hours)

  • Maintain sterile procedure

Is a substance administered for the diagnosis, cure, treatment, or relief of a symptom or for prevention of disease.

Medication

 Is the art of preparing, compounding, and dispensing drugs.

Pharmacy

Also referred to as the desired effect, is the primary effect intended.

Therapeutic Effect

Secondary effect is one that is unintended and are usually predictable and may be either harmless or potentially harmful

Side Effect

Deleterious effects of a drug on an organism or tissue and resulted from overdosage and build-up of the drug in the blood; most drug toxicity is avoidable.

Drug Toxicity

Is the increasing response to repeated doses of a drug that occurs when the rate of administration exceeds the rate of metabolism or excretion

Cumulative Effect

Is the one side effect that is unexpected and may differ individually to a client; examples are under response and over response.

Idiosyncratic Effect

Disease caused unintentionally by medical therapy.

Iatrogenic Disease

• It is a process involving the movement of a substance from its site of administration across body membranes, to circulating fluids

• Length of time

• Common sites: Skin, Mucous Membrane, GI Lining, Respiratory Tract

Absorption

• The transport of pharmacologic agents throughout the body

• The simplest factor determining distribution is the amount of blood flow to body tissues.

Distribution

• It is also called biotransformation

• It is the process of chemical converting a drug to a form that is usually more easily removed from the body.

Metabolism

• It is the process of removing a drug and its metabolites from the body

• This usually happens in the kidneys via urine produced in them

• Other possible routes includes bile, saliva, sweat, tears and feces.

Excretion

The time after administration when the body initially response to the drug

Onset of Action

The highest plasma level achieved by a single dose when the elimination rate of a drug equals the absorption rate.

Peak Plasma Level

The time required for the elimination process to reduce the concentration of the drug to one-half of what it was at initial administration

Drug Half-life

A maintained concentration of a drug in the plasma during a series of schedule dose

Plateau

Factors Affecting Medication Action

• Developmental Factors

• Gender

• Cultural, Ethnic, and Genetic Factor

• Diet

• Environment

• Psychological Factors

• Illness and Disease

• Time of Administration

Indicates that medication is to be given immediately

Stat Order

For medication to be given once at a specified time

Single Order

May be carried out indefinitely until an order is written to cancel it or may be carried out for a specified number of days

Standing Order

Permits the nurse to give a medications when, in the nurses judgement, the client requires it.

PRN Order

Route of Administration;

• Most common and least expensive

• Most convenient route and drug is swallowed

• Disadvantages

  • Unpleasant taste of the drug

  • Irritation of the gastric mucosa

  • Irregular and slow absorption in the GI tract

  • Can be harmful to client’s teeth

Oral

• Drug is placed under the tongue where it dissolves

• In relatively short time, the drug is largely absorbed into the blood vessel

• The medication should not be shallowed

• More potent 

Sublingual

Types of drugs under Topical drugs;

• Dermatological

• Inhalation

• Otic Medication

• Ophthalmic Medication

If chemotherapeutic drugs cannot cross the blood brain barrier, what are the recommended intervention for patients with brain cancers;

Radiation and Surgery

Diabetic patients has an impairment of which part of Pharmacokinetics?

Distribution

If intramuscular injection exceeds 3mL, is deltoid muscle still used?

No, vastus lateralis muscle is more viable for this case

Angle for intravenous injection;

20-25 degrees

Which is more prone to toxicity? Drug with shorter or longer half-life?

Drugs with long half-lives are more prone to toxicity because they stay in the body longer, accumulate more easily, and take longer to clear—especially if not dosed carefully.

• It involves big picture moral dilemmas faced by the medical community

• Nursing ethics deal with individuals ethical dilemmas that arise from situations between a care provider and patient

Bioethics

Common Ethical Dilemmas;

1. Patient Autonomy vs. Medical Advice

2. Confidentiality vs. Patient and Public Safety

3. Resource Allocation and Fairness

4. Moral Distress and Personal Values Conflicts

What are the four main ethical principles;

• Autonomy

• Beneficence

• Non-maleficience

• Justice

Recognizes each individual’s right to self-determination and decision-making based values

Autonomy

Principle of benefiting others by preventing harm, removing harmful conditions, or affirmatively acting to benefit another or other, often going beyond what is required by law

Beneficience

Principle that specifies a duty to do no harm and balances avoidable harm with benefits of good achieved

Non-Maleficience

Moral obligation to act on the basis of equality and equity and a standard linked to fairness for all in society

Justice

It is defined as being responsible for providing competent nursing care

Fidelity

It means telling the truth

Veracity

How to determine the safe dose range of a medication?

To calculate the safe dose range for a child based on their weight, you simply multiply the child’s weight in kilograms by the lower and upper limits of the safe dosage range (in mg/kg/day).

• Is the utilization of the nursing process

• In terms of community health nursing problem, the nurse makes the family aware of the problem they are facing, therefore knowing what they need.

  • We prioritize the problems and needs identified by the family

Community Health Nursing

The awareness or perception of the family that they have a need or a problem

Salience

What do we first do in terms of nursing process?

Assessment

Which of the different level of clientele do we consider as the entry point of service?

Individuals

Which of the different level of clientele do we consider basic unit of services

Families

These are group of people with common health needs and common health problems.

Population Groups

Which of the different level of clientele do we consider as the final objective of service?

Community

What is the primary focus of a community health nurse?

Promotion of Health (Health Education)

What is the primary responsibility of a community health nurse?

Health Education

When is health education most needed?

When people are healthy

Who quoted “Public health enable every citizen to realize his birthright of health and longevity”?

Dr. Winslow (Winslongevity) - Birthright

Who quoted “Philosophy of CHN is based on the worth and dignity of man”?

Dr. Shetland (Shetlandignity)

Who quoted “CHN is a service rendered by a professional nurse”?

Freeman (No need MAN)

Who quoted “Ultimate goal of CHN is promotion of OLOF (Optimum level of function)”?

Jacobson (OLOF)

Who quoted ‘CHN is attainment of highest level of well-being and longevity”?

Hanlon (Hanlongevity)

What is the Philippine Health Care Delivery System?

System that the CHN utilized to distribute the health services

Is there such thing as free healthcare in the Philippines?

No, because it is prepaid using the taxes collected

Which among the pillars of primary health care is the most important?

Participation of people

What is most important principle of primary health care?

To develop self-reliance

What is the main strategy of the primary health care?

Partnership and empowerment

Who was the president when MDGs was checked in 2015 in the Philippines?

Ninoy Aquino

What was the health campaign during Duterte’s reign?

All for Health, towards health for all

Why is a person screened for disease?

Based on risk factors

Why is a person ordered a diagnostic test?

Based on side effects

Sectors of the Philippine Health Care Delivery System

• Public Health Sector (Prepaid) 

  • Taxes (Socialize)

  • Tax based system (Not entirely free)

    • Sin tax (Tax from contrabands (e.g. alcohol and cigarettes)

    • Highly sugared beverage tax (HSB)

• Private Health Sector (Market Oriented Services)

  • User’s fee 

Department of Health (Vision)

“Filipinos are among the healthiest people in Southeast Asia by 2022, and Asia by 2040”

Department of Health (Mission)

“To lead the country in the development of a productive, resilient, equitable and people-centered health system”

Which Republic Act states the functions and operations of the Department of Health?

EO 102

What are the remaining factors of the Department of Health? (LEAd)

• Leader / Policy Maker

• Enabler / Capacity Builder

• Administrator of National Health Services

In what year did the first International Conference on Primary Health Care take place, and what was it called?

1978 - Alma Ata Declaration

Primary Health Care in the Philippines was adopted through which Letter of Instruction (LOI) during the Marcos regime?

LOI 949

Which Republic Act promotes the use of generic medications as part of a government campaign?

RA 6675 of 1988

Also known as the Local Government Code of 1991.

RA 7160

Is a type decentralization of function, where the DOH partnered with the LGUs (Active Partners in Health).

Health Devolution