Final Quiz Review NUR2474 – Module 10 Quiz: Test writer strategy(ies): 1. Scenarios X3; 15 questions… 2. “Choose at least one correct answer” versus “Choose at least one correct answer (select all that apply)” 3. Double negative questions… 4. ALWAYS remember therapeutic communication… Review: 1. What is the most critical time for the development of major birth defects in developing fetuses? Embryonic period (weeks 3-8) during organogenesis, roughly the first trimester 2. Remember: The most the most reliable way to predict the potential of fetal harm is by referencing the FDA Pregnancy Risk Categories. 3. How does alcohol effect a developing baby. (Remember the double negative with this question). Teratogenic effects from alcohol require prolonged exposure in high doses-lower doses may only produce subtle abnormalities Teratogenic effects include fetal alcohol syndrome, stillbirth, spontaneous abortion, low birth weight, intellectual disabilities Regular use can result in the birth of a drug dependent infant. If the dependence is not supported with drugs following birth withdrawal will ensue. The baby should be weaned from dependence by giving smaller doses of the drug they are dependent on progressively. Neonatal withdrawal syndrome-shrill crying, vomiting, extreme irritability 4. Remember: Lipid soluble drugs are more likely to cause fetal damage. 5. Remember: The health of a baby depends on the health of the mother. 6. Remember: Drug doses must be reduced and is based on vulnerable populations age and weight (even with chemotherapy). 7. In general (based on the child’s age), how soon should you expect a child’s system to clear medications? Children metabolize drugs faster than adults, elevated until age 2 and then gradually declines 8. Side effects/adverse reaction of tetracyclines. Discoloration of teeth 9. If you have a family concerned with an older family member (the geriatric patient) with multiple comorbid dx’s and has a history of noncompliance, how do you promote patient compliance? (Hint: Select all that apply). Simplifying regimen so the number of drugs and doses per day is as small as possible Explaining treatment plan using clear, concise verbal and written instructions Choosing appropriate dosage form Requesting pharmacy label drug containers using large print size and provide easy to open containers Suggest use of calendar or pill counter Asking if they are able to afford medications Monitoring for therapeutic responses, adverse reactions and plasma drug levels 10. What risk factors might interfere with a geriatric pts (actually any pt) plan of care? (Consider: age; pre-existing conditions; hx of non-compliance/non-adherence). Polypharmacy, pre-existing conditions, confusion, dementia, multiple doses for each medications, low literacy, changes in regimen, inability to pay for drugs, presence of side effects, multiple prescribers, drug packaging that is difficult to open, living alone 11. Remember: Chronic laxative abuse does NOT cause drugs to be cleared from your system faster. 12. When assessing patients meds (in general) what is the best way to inquire about nonprescription drugs? (Therapeutic communication). Take a complete drug history at each visit, include not only how medications are prescribed but also how the patient is actually taking them, bring a home medication list 13. Ma huang (What it is/does; why would someone take this; side effects; remember therapeutic communication). What is it? Ephedra, contains Ephedrine. Side effects: HTN, stimulates the heart, stimulates the CNS, CVA, MI, dysrhythmias, sudden death