PHARMACOLOGY REVIEW GUIDE

1 7/2005 Rev. 1/2007, 1/2010, 5/2015, 11/2015 1 SAINT BARNABAS HEALTH CARE SYSTEM Preparation for Nursing PHARMACOLOGY Test PHARMACOLOGY REVIEW GUIDE In order to successfully pass the 50 item PHARMACOLOGY exam, nurses must achieve an overall score of 80%. However, nurses are only allowed to get 2 calculation questions wrong from the Drug Calculation section of the exam (3 errors in calculation questions means an automatic failure and the nurse must re-take the exam). For the calculation questions on the exam, the nurse must show all work that led to arriving at the answer.

2 Only ONE retake is permitted. Time allotted for exam: 1 1/2 hour (90 min.). I. Categories of Medications Know the actions, use, serious side effects and specific nursing measures for administration of the following frequently ordered medications or categories of medications Cardiovascular/Antiarrhythmics Beta Blockers eg. metoprolol (Lopressor); atenolol (Tenormin) ACE inhibitors eg. enalapril (Vasotec) Digoxin (Lanoxin) Nitroglycerine: transdermal patch & paste Adrenergics dopamine infusion (Intropin) Verapamil (Veracaps SR) Antidiabetic Agents Insulins.

3 Regular, & NPH Humalog, Humulin, Lantus Metformin (Glucophage) Glyburide (Diabeta) Insulin Pen use Analgesics/Narcotics Hydromorphone (Dilaudid) Morphine sulfate & MS Contin Oxycodone-acetaminophen. (Percocet) Diuretics Hydrochlorothiazide (Esidrix) Spironolactone (Aldactone) Furosemide (Lasix ) Hormones levothyroxine (Synthroid) Agents for Depression/Sedation Fluoxetine (Prozac) Lorazepam (Ativan) Anti-infectives/Anti-fungals Ampicillin Cefazolin (Ancef/Kefzol) Gentamicin sulfate (Garamycin) Vancomycin Anti-inflammatory Agents Prednisone/methylprednisolone Dexamethasone (Decadron)

4 NSAIDS , Aleve Cox-2 Inhibitors- eg Celebrex Anticoagulants/Hematologic Agents Heparin sodium Warfarin sodium (Coumadin) Enoxaparin sodium (Lovenox) Dalteparin sodium (Fragmin) Antiulcer/Antiemetics Famotidine (Pepcid) Omeprazole (Prilosec) Ondansetron (Zofran) Flumazenil (Romazicon) 7/2005 Rev. 1/2007, 1/2010, 5/2015, 11/2015 2 Antiseizure Phenytoin sodium (Dilantin) Antidotes Protamine Sulfate Naloxone HCl (Narcan) Vitamin K (Aquamephyton) High Alert Medications: Identified by TJC (The Joint Commission) -- concentrated KCL, concentrated NaCl,, insulin, heparin Herbal Interactions: anticoagulants and ginko biloba II.

5 Important to Know: 1. Medication administration based on RN standards of practice. 2. How to administer intramuscular injections variations by weight, size, age. 3. Nursing responsibilities for first-dose of any medication. 4. Nursing documentation for PRN medications. 5. How to draw up and administer insulin subcutaneously and how to use an insulin pen. 6. Heparin/Lovenox/Fragmin injection techniques and sites 7. Specific lab values to be monitored for patients on Lovenox/Fragmin, Heparin, Coumadin, Vancomycin 8. How to apply topical/ transdermal medication/patches 9.

6 IV push medications 10. How to administer eye and ear drops adults and pediatric 11. How to administer sustained release (SR, LX, LA etc.) tablets/capsules 12. Distinguish S/S of hypoglycemia & the interventions for treating it. 13. Measures for effective pain management dosing schedule, documentation, use of appropriate pain scale eg. FLACC, BPS, CPOT, Wong-Baker, Numeric. 14. Safety measures for administration of TPN (total parenteral nutrition) 15. How to administer meds via NG tube 16. IV administration of diluted KCl only via central line or large vein 17.

7 Monitoring for IV infiltration of vesicants ( Dopamine) 18. Heparin Infusion weight-based dosages III. Conversions 1 kg = 1000 gm 1 liter = 1000 ml 1 oz = 30 ml 1 gm = 1000 mg 1 kg = lbs 1 tbsp = 3 tsp 1 mg = 1000 mcg 1 tsp = 5 ml 1 inch = cm 7/2005 Rev. 1/2007, 1/2010, 5/2015, 11/2015 3 IV. Policies - The following SBHCS policies apply to the administration of medication and must be followed at all times. TOPIC GOLDEN RULES ADDITIONAL INFORMATION PAIN Patients must receive adequate pain control.

8 Pain assessment, interventions, and outcomes must be documented completely If the medications ordered are not controlling the patient s pain, a new order should be obtained from the physician. Don t let the patient suffer. Documentation includes: pain assessment, treatment, comfort level achieved (the pain goal for that patient), interventions when treatment is inadequate, and new outcomes from those interventions DOUBLE IDENTIFICA-TION To identify each patient receiving medication, the nurse must use 2 forms of identification.

9 Forms of identification include the patient s ID BAND (a must!); asking the patient his name, the MR number, date of birth, phone number, photo license, etc. TELEPHONE ORDERS All telephone orders must be completely read back and verified to the physician as soon as they are recorded on the medical record and BEFORE they are executed. The order read back and verification includes the patient s name, date and time of the order, the name of the med, the dose, the route, the frequency of administration, any parameters or criteria for administration.

10 VERBAL ORDERS Verbal orders can only be accepted in an emergency situation. For accuracy, all verbal orders must be read back and verified to the Physician completely as soon as they are written in the medical record. An emergency situation is one in which the health of the patient would be compromised if there were a delay in administering the medication. The order read-back and verification includes the patient s name, date and time of the order, the name of the med, the dose, the route, the frequency of administration, any parameters or criteria for administration.