Chapter 8: Drug Administration Throughout the Life Spam

Question 1 of 28

1

Drug therapy in pregnant women is discontinued unless a serious condition is present.

Select one of the following:

  • True
  • False

Explanation

Question 2 of 28

1

Select the drugs that are less likely to cross the placenta in pregnant women..

Select one or more of the following:

  • Water soluble

  • Ionized

  • Bound to plasma proteins

  • Lipid soluble

  • Non-ionized.

  • Not bound to plasma proteins

Explanation

Question 3 of 28

1

Which of the following is NOT a bodily change in pregnant women that can affect the success of drug therapy?

Select one of the following:

  • Increased progesterone levels.

  • Increased blood volume.

  • Increased blood flow to the kidneys

  • Alterations in lipid levels.

  • Decreased blood blow to the skin.

Explanation

Question 4 of 28

1

Fat soluble drugs are distributed into breast milk, so it may be passed to the lactating infant,

Select one of the following:

  • True
  • False

Explanation

Question 5 of 28

1

Some drugs, such as thalidomide, are absolute teratogens.

Select one of the following:

  • True
  • False

Explanation

Question 6 of 28

15

The following are stages of pregnancy, as they relate to pharmacology. Note that these are out of order.

: This occurs during weeks of the . The embryo has not yet established a physical connection to the mother. This is also called the period because exposure to a teratogen either causes death or has no effect. Drugs are much to cause malformations because the baby's organ systems have not yet begun to form, but certain drugs (such as ) can cause growth delays.

: Occurs in weeks post-conception. During this time, the fetus' organs systems are growing and developing. Blood flow to the placenta and placental vascular membranes become . This maximizes the transfer of substances from mother to child. The fetus may receive doses of medications and other substances from the mother, which has a prolonged duration of action in the unborn child due to a lack of mature metabolic enzymes and efficient excretion mechanisms.. Exposure to teratogens is to produce slowed growth or impaired organ function rather than gross structural malformations.

: This occurs in weeks postconception. There is rapid development of internal structures. This is the period of to teratogens. Teratogenic agents can lead to structural abnormalities and spontaneous abortion. The abnormality depends on which organ is forming.

Drag and drop to complete the text.

    Preimplantation phase
    1-2
    first trimester
    second trimester
    third trimester
    all or none
    something or nothing
    less likely
    nicotine
    atorvastatin
    metoprolol
    Fetal period
    9-40
    increases
    decreases
    thinner
    thicker
    larger
    smaller
    more likely
    3-8
    maximum sensitivity
    minimal sensitivity
    Embryonic period

Explanation

Question 7 of 28

1

Select from the dropdown lists to complete the text.

The following is the current FDA pregnancy category ratings with examples. I made them out of order to make sure that we know the answers.

( A, B, C, D, X )- Adequate, well -controlled studies in pregnant women have shown no increased risk of fetal abnormalities in any trimester of pregnancy.

( C, B, A, D, X )- Animal studies have shown an adverse effect and there are no adequate and well-controlled studies in women. OR no animal studies have been conducted and there are no adequate and well controlled studies on women (basically, we don't know what this will do to your baby.)

( X, D, A, B, C )- Adequate, well controlled observational studies in animals or pregnant women have demonstrated evidence of fetal abnormalities or risks.

( D, C, B, A, X )- Adequate, well controlled or observational studies in pregnant women have demonstrated a risk to the fetus.

( B, C, A, D, X )- Animal studies have revealed no evidence of harm to the fetus, but there aren't any adequate and well-controlled studies in pregnant women. OR animal studies have shown an averse effect, but adequate and well-controlled studies in pregnant women have failed to yield a similar response.

Explanation

Question 8 of 28

1

Select the drugs that are a FDA pregnancy risk category A.

(Here's a hint: 4 of these are correct)

Select one or more of the following:

  • Prenatal vitamins

  • Insulin

  • Thyroxine

  • Folic acid

  • Penicillins

  • Selective serotonin reuptake inhibitors

  • ACE inhibitors

  • Statins

Explanation

Question 9 of 28

1

Select the drugs that are an FDA pregnancy risk category B.

(Here's a hint: 5 of these are correct)

Select one or more of the following:

  • Penicillins

  • Cephalosporins

  • Azithromycin

  • Acetaminophen

  • Ibuprofin

  • Thyroxine

  • Clarithromycin

  • Gentamycin

  • Lithium carbonate

  • Warfarin

Explanation

Question 10 of 28

1

Select the drugs that are a FDA pregnancy risk category C.

(Hint: 6 of these are right).

Select one or more of the following:

  • Clarithromycin

  • Fluoroquinolones

  • Bactrim

  • Selective serotonin reuptake inhibitors

  • Corticosteroids

  • Antihypertensives

  • Carbamazepine

  • Cephalosporins

  • Valporic acid

  • Clomiphene

Explanation

Question 11 of 28

1

There were too many things that were pregnancy category D and X, so rather than making a "select all that apply" question, I made a "drag and drop" one. Match the drugs to their pregnancy category. To make things easier to place, I put the drugs in alphabetical order.

D: , , , , , , , , , , , , , , , .

X: , , , , , , , , , , , , , , , and ,

Drag and drop to complete the text.

    alcohol
    ACE inhibitors
    angiotensin receptor blockers
    carbamazepine
    cyclophosphamide
    gentamicin
    lithium carbonate
    methimazole
    mitomycin
    nicotine
    NSAIDs
    phenytoin
    propylthiouracil
    streptomycin
    tetracyclines
    valproic acid
    clomiphene
    flurouracil
    isotretinoin
    leuprolide
    menotropins
    methotrexate
    misoprostol
    nafarelin
    oral contraceptives
    raloxifene
    ribavirin
    statins
    temazepam
    testosterone
    thalidomide
    warfarin

Explanation

Question 12 of 28

1

A lot of the drugs secreted into breast milk cause injury to infants.

Select one of the following:

  • True
  • False

Explanation

Question 13 of 28

1

Which of the following is FALSE about drug administration in breast feeding women?

Select one of the following:

  • The guidelines that applied during pregnancy also apply during breast feeding.

  • The amount of drug that actually reaches the infant's tissues must be considered.

  • The infant's ability to metabolize a small amount of drugs matters.

  • Drugs that have a high water solubility are better drugs for breast feeding women

Explanation

Question 14 of 28

1

Which of the following is NOT a factor to consider when giving medications to pediatric patients?

Select one of the following:

  • Physiological variations

  • Maturity of body systems

  • Greater fluid distribution

  • Presence of metabolic enzymes

Explanation

Question 15 of 28

1

If a child is given a medication and vomits immediately after, you should NEVER reorder the medication,

Select one of the following:

  • True
  • False

Explanation

Question 16 of 28

1

Select the appropriate interventions when administering medication to infants.

Select one or more of the following:

  • Offer a pacifier if the infant is on fluid restrictions caused by vomiting or diarrhea.

  • Place oral medications under the tongue.

  • Hold the buttocks together for 10-15 minutes if giving a drug rectally

  • If giving a volume less than 1 mL via a parenteral route, a tuberculin syringe is an appropriate tool.

  • The vastus lateralis is the preferred IM injection site.

  • For IV medications, the feet and scalp veins should not be used.

Explanation

Question 17 of 28

1

You are teaching a parenting class to a group of young, new mothers. You are instructing them about how to take care of their children when their children are sick Select the accurate educational statements about handing medication administration to toddlers that could be made by the nurse.

Select one or more of the following:

  • "Carefully follow the instructions on the back of the medication bottle."

  • "Young children are unable to get caps off medications."

  • "Don't put drugs in empty food or drink containers."

  • "To encourage your toddler to take their medications, tell them it's candy."

  • "Make sure you keep the numbers for poison control on hand."

  • "Never try to correct suspected poisonings at home."

Explanation

Question 18 of 28

1

Which of the following should you tell parents to do when administering medications to their toddler?

Select one of the following:

  • Carefully explain why you're giving them the drug.

  • Give the child some time to process what you said before you administer the drug.

  • Physically comfort the child after medication administration.

  • Give oral medications that taste bad in things like milk, orange juice, and cereal.

Explanation

Question 19 of 28

1

IM and IV medication administration in a toddler is similar to IM and IV medication administration in an infant.

Select one of the following:

  • True
  • False

Explanation

Question 20 of 28

1

Select the options that may be helpful and/or necessary when giving medications in toddlers?

Select one or more of the following:

  • Keep the IV less secure

  • Inform the parents about the dangers of the toddler trying to pull away from the IV pump.

  • Put longer tubing on the toddler's IV.

  • Keep the parent within close proximity when giving an invasive medication (i.e.: rectal medications)

  • Insist that the parent does not assist in invasive medication administration (i.e.: rectal medications)

  • Have at least 1 helper in the room during invasive medication administration (i.e.: rectal medications)

Explanation

Question 21 of 28

1

Select the similarities and differences between medication administration in preschool children and medication administration in toddlers.

Select one or more of the following:

  • Medications need to be kept out of reach of toddlers, but it not necessary to do that in preschool children

  • The ventrogluteal site can be used in preschool children, but not in toddlers.

  • The scalp veins can be used for IV medications in toddlers, but they can't be used in preschool children.

  • Just like toddlers, peripheral veins cannot be used in preschool children.

  • In both toddlers and preschool children, drugs may need to be crushed and mixed with food or drink

  • Longer explanations can be used in preschool children, but brief explanations immediately followed by medication administration is necessary in toddlers.

Explanation

Question 22 of 28

1

Play-acting troubling experiences with dolls may be beneficial in preschool children before and after medication procedures.

Select one of the following:

  • True
  • False

Explanation

Question 23 of 28

1

Because they are able to comprehend the difference between health and illness and recognize that medications are administered to make them feel better, school age children have a large concept of illness and the risks involved with ingesting a harmful substance.

Select one of the following:

  • True
  • False

Explanation

Question 24 of 28

1

School age children are unlikely to resist injections

Select one of the following:

  • True
  • False

Explanation

Question 25 of 28

1

Which of the following is important when administering medications to a school age child?

Select one of the following:

  • Allowing the child to play-act troubling experiencing will dolls.

  • Mixing bad-tasting oral medications with food or a flavored beverage.

  • Giving a more detailed explanation about the procedure

  • Making the children feel like willing participants

Explanation

Question 26 of 28

1

Select the appropriate interventions when approaching medication administration in adolescents.

Select one or more of the following:

  • Address safe and responsible sexual activity by discussing the use of condoms and contraceptives.

  • Discuss eating habits

  • Discuss use of over the counter appetite suppressants or laxatives.

  • Educate about the dangers of illegal drugs, alcohol, and tobacco.

  • Recognize that the teenager is not yet an adult and address them as such.

  • Recognize that adolescents have federally protected confidentiality and privacy.

  • Carefully explain important information regarding medications and expected side effects.

Explanation

Question 27 of 28

1

Select the differences between pharmacotherapy of young adults (18-40 years old) versus pharmacotherapy of middle adults (40-65 years old).

Select one or more of the following:

  • The use of antidepressants and antianxiety agents are more prominent in young adults than in middle adults

  • Substance abuse is an equal concern in both age groups.

  • Sexually active young adults with multiple partners are more likely to need medications for STIs than their middle adult counterparts.

  • Middle adults often take medications to control health alterations that could be fixed with lifestyle modifications; young adults do not do that as often.

  • There is minimal need for prescription drugs in both age groups.

  • Adult onset diabetes mellitus is more likely to emerge in young adulthood than in older adulthood.

Explanation

Question 28 of 28

1

Select the information that is FALSE about the normal physiological changes that affect medication administration in older adults.

Select one of the following:

  • Drug absorption is slowed due to diminished gastric motility and decreased blood flow to digestive organs.

  • Because of decreased absorption, oral tablets will take longer to become available to tissue.

  • Because of increased body fat, there is a larger storage compartment for lipid-soluble drugs and vitamins.

  • Plasma levels are reduce and the therapeutic response to drugs is increased.

  • A decline in body water makes dehydration more dramatic, and leads to an increased risk of drug toxicity and an increased concentration of water soluble drugs.

  • The liver produces less albumin and enzymes, and has less visceral blood flow, resulting in increased levels of free drug in the bloodstream and reduced hepatic drug metabolism.

  • Drug distribution is slowed because of decreased cardiac output and less efficient blood circulation

  • Because of reduced hepatic function, first-pass metabolism is decreased, so plasma levels are elevated and tissue concentrations of drug are increased

  • Excretion of drugs is decreased due to reduced renal function.

  • Serum drug levels and potential for toxicity increase due to decreased renal function causing reduced excretion.

Explanation

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