NCM 106

PHARMACOLOGY
MODULE NO: 1
MODULE TITLE: INTRODUCTION TO NURSING PHARMACOLOGY
WRITER: MA. CRISTINA BENITO, RN

OPENING PRAYER

St. Thomas Aquinas: Prayer

before Study
Creator of all things,
true Source of light and wisdom,
lofty origin of all being,
graciously let a ray of Your brilliance
penetrate into the darkness of my understanding
and take from me the double darkness
in which I have been born,
an obscurity of both sin and ignorance.
Give me a sharp sense of understanding,
a retentive memory,
and the ability to grasp things correctly and
fundamentally.
Grant me the talent of being exact in my
explanations,
and the ability to express myself with thoroughness
and charm.
Point out the beginning,
direct the progress,
and help in completion;
through Christ our Lord.

Amen.

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MODULE INTRODUCTION AND FOCUS QUESTIONS:

Nowadays, there is an increasing dependence on drug or medication therapy to help manage

illnesses and diseases, as well as improving the general well-being of the patient. Consequently,
nurses are becoming more and more integral in providing safe and accurate medication
administration.

As nursing students, how are you going to fulfill your oath to do no harm and prolong the lives of
your patient through drug administration?

Online Class:
1. Enroll in the Google classroom.
2. Follow the instruction for each activity uploaded in
the Google classroom.
3. Access the learning materials uploaded in the
Google classroom.
4. Submit the requirements posted in the Google
classroom.

Off-site:
1. Modules will be sent through courier for those
students without internet access.
2. Follow the instructions as provided in the material.
3. Take note of the schedule and place of submission
as provide

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MODULE LESSONS AND COVERAGE:

Lesson Subtopics Learning Outcomes Estimated

1 Introduction to Drugs
Drugs and the Body
Toxic Effects of Drugs
Nursing Management
Dosage Calculations
Time
“ I SHOULD BE ABLE TO”...
Describe the scope of the science of 30 mins.
Pharmacology
Discuss the factors that can affect optimal 30 mins.
therapeutic response, drug therapy, and
clinical patient care
Outline the important factors to consider 30 mins.
when applying the nursing process to
selected situations of drug toxicity
Explainwhat is involved in each step of 30 mins.
the nursing process as it relates to drug
therapy
Apply correctdrug calculations when 1 hr.
given drug orders and available forms of
the drugs ordered

To do well in this module, you need to REMEMBER and DO the following:

1. Open the indicated website. Explore.

2. Read and go through the module in your own time and pace.
3. Open the suggested references and video links. It will help you in understanding the whole module.
4. Honestly answer the activities and the answers will be provided for you either online or at the end of
this module.
5. Go beyond the proceduregiven in the net. Explore more.
6. Before starting this module, it is best to start with a prayer to enlighten you and give you the wisdom
to understand the lesson.

HOOK ACTIVITY:
Instructions: Drugs and the body
Test your knowledge by playing the
Game below on the Effects of Drugs in
our Body.

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Click the link below:

https://www.purposegames.com/game/drug-pharmacology-game

Multiple Choice: Encircle the letter that best describes your

answer. Please answer all items. After taking this exam, you will
be able to check your answers. Take note of the items that you
were not able to correctly answer and look for the right answer
as you go through this module.

1. It is important for a nurse to be aware of the four sequential processes of the pharmacokinetic
phase. What are these processes?

A. Distribution, metabolism, excretion, absorption

B. Biotransformation, excretion, absorption, metabolism
C. Absorption, distribution, metabolism, excretion
D. Metabolism, distribution, absorption, excretion

2. Which agency regulates the development and sale of drugs in the United States?

A. United States Department of Health and Human Services

B. The Food and Drug Administration (FDA)
C. Drug Enforcement Administration (DEA)
D. Centers for Disease Control and Prevention

3. Drug labels are a source of information. What information might a drug label provide?

A. The manufactured date

B. The expiration date
C. When the patent expires
D. The binding properties of the drug

4. Two patients are receiving injections of penicillin G. One patient is a35-year-old male,
weighing 165 pounds.
The other patient is an 18-year-old female, weighing 125 pounds. You know that you will see the
effects of the drug first in the male patient. What is the rationale for this?

A. Women have fewer fat cells than men.

B. Men have more vascular muscles than women.
C. Women have a smaller circulatory system than men.

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D. Drugs are generally tested on healthy males.

5. Which of the following needs to be included in a physician’s order for a patient, so that the
nurse can use the “rights of safe administration” when administering medication?

A. Patient’s weight
B. Patient’s drug history
C. Patient’s name
D. Patient’s address

6. What is the most accurate calculation for drug dosage in a child?

A. Fried’s rule
B. Young’s rule
C. Clark’s rule
D. Surface area calculation

7. A client reports to a cardiac rehabilitation session complaining of not feeling well. The nurse
questions what is wrong and is told, “I’ve been having angina for several days.” During further
assessment, the client reports that no nitrate has been used because it causes a terrible headache.
Which of these nursing diagnoses is most appropriate?

A. Knowledge deficit related to the side effects of nitroglycerin

B. Knowledge deficit related to the need for nitrates
C. Alteration in comfort: headache related to the side effects of the vasodilator
D. Noncompliance related to the side effects of nitroglycerin

8. The client’s ability to take oral medications will be hindered by:

A. Age
B. Dental caries
C. Dysphagia
D. Lifestyle

9. The nurse is asked to give an investigational drug to a client. Upon entering the room, the
nurse asked if the study and the use of the drug has been explained to the client. If the client
answers “no”, the nurse should:

A. Proceed to administer the drug anyway

B. Give a brief explanation about the drug and proceed to administer it
C. Explain the study, secure a consent, and administer the drug
D. Refuse to administer the drug and notify the investigational physician

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10. A nurse applies a medication in the form of an ointment to a client’s rash. Shortly after
applying the ointment, the nurse begins to feel a burning sensation on the hand and notices that it
has reddened. The nurse then sees some ointment next to the reddened area and realizes that this
drug reaction is a (an):

A. Systemic effect
B. Local effect
C. Idiosyncratic effect
D. Synergistic effect

11.The name selected by the original manufacturer based on the chemical structure of the drug is
the:

A. Chemical name
B. Drug name
C. Generic name
D. Trade name

12. Which of the following routes have the highest bioavailability?

A. IM
B. Oral
C. Subcutaneous
D. IV

13. When a drug binds to a receptor to produce a pharmacologic effect, the drug may be called
a(n):

A. Agonist
B. Antagonist
C. Blocker
D. Accelerator

14. A client has had most of the small intestine removed. The nurse would be most concerned
about drug:

A. Excretion
B. Absorption
C. Metabolism
D. Distribution

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15. A client who has received an initial dose of an antibiotic has severe wheezing within minutes.
Which is the most appropriate documentation to describe the situation?

A. Idiosyncratic reaction
B. Anaphylactic reaction
C. Serum sickness
D. Cumulative effect

16. What describes the action of a drug on the body?

A. Pharmacodynamics
B. Pharmacokinetics
C. Microbiology
D. Pharmacology

17. As a knowledgeable nurse, you know that the following are part of the 8 Medication rights
except:

A. Right dose
B. Right route
C. Right drug
D. Right room

18. A client with abdominal pain reports to the emergency department. A brief history reveals an
allergy to the analgesic morphine sulfate. The nurse should follow through by first asking which
of these questions?

1. What other analgesic are you allergic to?

2. Have you had this allergy long?
3. Exactly what does the morphine do to you?
4. Does the morphine make you nauseated?

19. Which of the following will determine nursing interventions for a client on medication?

A. Assessment
B. Diagnoses
C. Implementation
D. Evaluation

20. What is bioavailability?

A. The amount of blood that is available for transfusion

B. The amount of medication in your blood that is available to produce an effect

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C. The amount of drug that is biometrically excreted in your blood
D. The amount of available drug to be used for biological testing

ACTIVITY 1: Anticipation Reaction Guide

Instruction: Respond to each statement twice. Once before the lesson and again after reading the
discussion of the lesson
 Write YES if you agree with the statement
 Write NO if you disagree with the statement

Response Before Statement Response After

the Lesson the Lesson
YES 1. Pharmacotherapeutics is the branch of pharmacology that YES
uses drugs to treat, prevent, and diagnose disease.
NO 2. Phase I clinical studies study the effect of a drug on patients NO
with the disease.
YES 3. The liver plays a key role in the excretion of drugs from the YES
body.
YES 4. Pharmacodynamics is the term used to describe how a drug YES
affects the body.
NO 5. Adverse effects of drugs are considered to be the same as a NO
drug allergy.
YES 6. Administering an antibiotic to a patient is an example of a YES
nursing intervention.
NO 7. Fried’s rule is used to calculate drug dosages for children NO
less than 1 year of age.
YES 8. Parenteral drugs must be administered in a powder form. YES
YES 9. A patient who develops spontaneous bleeding while taking YES
an anticoagulant is demonstrating a primary action.
YES 10. Critical concentration is the amount of a drug that is needed YES
to create a therapeutic effect.

At the end of this lesson go back to this ARG and answer

the third column. Compare your answer to your previous
answer

Activity 2: Watch these videos.

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Have you ever wondered or been baffled by how a drug is made? Where does it come from and why are
they used to treat illnesses and diseases?

The videos centers on how a newly discovered drug undergoes through the 4 phases of drug development
and approval.
*Do not only watch the video, but read the article as well.

https://healthblog.uofmhealth.org/health-management/different-phases-of-
clinical-trials-and-what-they-mean
Let’s now check your understanding, answer the following questions:
https://lakecharlesclinicaltrials.com/about-clinical-trials/
1. Briefly describe the phases involved in each step of developing and approving a new drug in the
United States.

Clinical Trials is the process of testing a new drug or treatment before it can be marketed
to the masses to ensure its safety and effectiveness. According to Food and Drug Administration (FDA)
clinical trials can take as long as 9 years. There are four phases in clinical trials but before undergoing to
these phases the new drug/treatment will begin its testing on Animal to help predict how it possible affect
humans, it’s called Pre-clinical phase and it usually takes 18 months to complete. Clinical trials is also
known as is also known as clinical research, it’s the drug development process. The pre-clinical trial
must submit full reports to the Department of Health and Human Services about the details of the drug’s
composition, preparation, manufacturing and conditions use, along with animal test results (Therapeutic
and Toxicity effects). Once it’s approved the human testing can begin.

Phase 1 will start on small number of volunteers are chosen from anywhere from 20 to 100
people. The qualifications to be a volunteers must be young, healthy, mentally stable and consenting
adults that can accurately describes their experiences. Phase 1 will lasts for several months and the main
purpose is to determine the safety and side effects of the new drug to human.

Phase 2 is about the drug’s effectiveness on a certain disease or disorder. Volunteers will increase
up to hundred people. This phase is randomized because the patient will be randomly assigned to a
treatment group. The double blind means the patient and the doctor don’t know what treatment the patient
will be getting. The 2 main goal of this phase (1) determining if the drug is effective when given for a
certain time at a certain dose, (2) Finding out of the drug is better than the drugs already on the market.

Phase 3 is open on testing population to thousands of patient. It’s main purpose is to gather safety
data on a large number of people. It helps to identify the drug’s effectiveness, possible side effects and
dose regimen. It’s also the longest phase of drug development, lasting for several years. It’s open label
which mean the patient and doctor know the patient is on what kind of study drug, or single blind which
means the treatment group is not concealed from the doctor. If the Phase 3 have successfully completed
the drug company can submit New Drug Application (NDA) to the FDA for approval to market the drug.

Phase 4 is Post Marketing Surveillance Trials and it’s also FDA approved. They also identify the
name suggest. The main purpose of this phase is to continue monitoring the new drug for long term safety
and effectiveness. Coast analysis and drug comparison are also investigated in this phase. The new drug
can be taken off to the market/ restricted based on the findings on Phase 4.

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2. A drug company is beginning a new drug trial for a medication that is used to treat rheumatoid
arthritis (RA). Stella is a 22-year-old female who has had RA for 2 years and does not feel that she
has full relief of pain from the medications she has taken. She states she has fallen on hard times
since she became ill and the money for the study will also be beneficial. She wants to participate in
the study.
a. Discuss the reason she should not participate in the study. Do you feel this patient should be
allowed to participate?
She should not participate because there’s a high chance that she can be infertile or can
have a problem on their menstrual cycle. Honestly no because first of all she’s a female and the
common volunteer is male because they produce sperm cell every single day while female only
produce once a month because they undergo on Menstrual Cycle. According to Phase 2 the study
is about “drug’s effectiveness on a certain disease or disorder”, she had a RA before and the new
drug trial is about medication that is used to treat rheumatoid arthritis (RA). Yes it’s beneficial for
her because it can help it about her illness and the money that she will get that’s why she wants to
participate to the study but the down side is there’s a chance that she can be infertile for life.

b. Discuss the role of the Food and Drug Administration (FDA) in clinical drug testing.

The role of Food and Drug Administration (FDA) in Clinical drug testing is to protect the
participants (volunteers) by ensuring that people have reliable information before deciding to join
a clinical trial. New drug/treatment should be FDA approved before it can be brought to the
market. In short the main role of FDA is to assure that the current and new medical products are
safe and effective.

END OF EXPLORE:
Your grasp of the lesson will further be enhanced as you go through the next phase. Try to
incorporate everything that you’ve learned from everyday experience especially as you
start your clinical practice.

RESEARCH
Activity 3: Enhance your knowledge

ONLINE: Download the PowerPoint presentation uploaded in google classroom.

OFFLINE:A copy of the PowerPointpresentationisenclosed at the end of this module.

1. Any ingested drugs go through a four-step process in the body: absorption, distribution, metabolism,
and excretion
Answer: FACT
2. Absorption can be affected by several factors: surface area available, drug formulation, route of
administration, availability of circulating blood, circulation to a specific site, pain, stress, drug
solubility, drug interactions, and pH level of the body.

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Answer: FACT
3. Metabolism of all substances and drugs is primarily done in the liver, where they are broken down into
either of two forms: harmless substances or substances that are capable of further drug activity.
Answer: FACT
4. Excretion of drugs is primarily by the kidneys. The pH of the urine and the presence of kidney disease
affect excretion. The half-life of a drug is maintained by normal kidney function.
Answer: FACT
5. The therapeutic response obtained by the administration of a drug can be affected by the body size of
the individual, age, presence of disease, immunologic state, psychological belief in the drug,
environment, gender and genetic factors.
Answer: FACT
6. Medication should always be checked for the “five rights” (5R’s): right drug, right dose, right route,
right time, and right client.
Answer: FACT
7. Routes of administration include enteral, parenteral, topical, inhalation, and absorption through the
mucous membranes
Answer: FACT
8. The common forms of preparations are as follows: oral (solids and liquids), topical, injected, vaginal,
rectal, ophthalmic, otic, and other nonspecific methods such as implants, insulin pumps, venous access
devices, etc.
Answer: FACT
9. Handwashing before the preparation of drugs and between clients is essential.
Answer: FACT
10.All drugs have a primary effect, which is intended, and are capable of secondary effects, or side
effects.
Answer: FACT

Activity 4: Watch and understand well the following videos below:

DRUGS AND THE BODY:

The effective use of drugs in clinical practice requires a thorough
understanding of both the foundational principles of pharmacology
and the specific pharmacological characteristics of the major drug
classes currently used in healthcare practice. To fully understand the
molecular basis of drug action, the complex interactions between a
GUIDE QUESTIONS:
drug and the body must be examined, including the consequences
these interactions have on the drugs therapeutic or desired effects.
1. What is the process of pharmacodynamics?
2. What are the four ways wherein the drugs work within the body?
3. What is pharmacokinetics?
4. How are the mechanisms of pharmacokinetics used in clinical practice – critical concentration, loading
dose and dynamic equilibrium?
5. What are the factors that affect the dynamic equilibrium: absorption, distribution, biotransformation,
and excretion.?
6. How are medications absorbed?
7. What are the factors affecting absorption?
8. How does a drug undergo biotransformation process once it is in the body?
9. What is half-life?
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10. What is the procedure for calculating the half-life?
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END OF RESEARCH:

Looks like you’ve acquired loads of information and knowledge on Pharmacology. Now it’s
time for you to apply your understanding on the topic.

ANALYSIS

Activity 5: Fun with Drug Application

Drug analysis and calculation is essential part of every nurse to be skilled in since giving medication can
be harmful and risky to patients. Providing safe care is one of the nursing objectives and medication error
is considered as a threatening factor for patient safety. Now, Let’s check how you value the lives of your
patient in medication administration.

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A. Conduct an Internet search on reasons for medication errors or read your textbook on Nursing
Pharmacology on Medication error.
a. Find an error that occurred related to miscalculation of a drug dose.
b. Explain how this error could have been prevented.

B. Dosage Analysis and Calculations: Show your Formula and Solution

A. Conduct an Internet search on reasons for medication errors or read your textbook on
Nursing Pharmacology on Medication error.

a. Find an error that occurred related to miscalculation of a drug dose.

ANSWER:

Medication errors can occur at many steps in patient care. It can be during ordering, prescribing,
documenting, transcribing, dispensing, administering and monitoring. Medication errors are most
common at the ordering or prescribing stage. Luckily, these problems are preventable. Causes for
errors are common such as heavily engaged, overloaded, too many patients, lack of
concentration, staff shortage, similar drug name, illegible prescription and misinterpreted
prescription. An example of medication error related to miscalculation of a drug dose is, wrong
calculation of daily dose for an ‘as required’ drug. This will lead to poisoning or unnecessary
treatment.

b. Explain how this error could have been prevented.

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ANSWER:

This error is memory based. The error is preventable such that the nurse or the prescriber should
have double checked the calculation in order to be sure and accurate. Use a calculator if it was
not used when obtaining the wrong dose. Double checking the numbers and answer will help
prevent such errors most importantly.

B. Dosage Analysis and Calculations: Show your Formula and Solution

I. A 6-year-old child is to receive cefdinir (Omnicef). The usual adult dose of the medication is
300 mg. The mother requests an oral suspension of the medication because it is difficult for the
child to swallow capsules.

a. The nurse has to administer the oral suspension to the child. The bottle of cefdinir
(Omnicef) suspension reads 250 mg/5 mL. Using Young’s rule, how much would the
nurse give?

ANSWER:

Using Young’s rule,

Child’s dose (age<1 year) = (Infant’s age in years/child’s age in years + 12) x avg adult dose

Given:
Infant’s age in years = 6 years
Average adult dose = 300 mg

Hence,
Child’s dose = ( 6 / 6 + 12 ) x 300
= 100 mg

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Therefore, the nurse will give the child 100mg of cefdinir (Omnicef).

b. Why do children require different dosages of medications than adults?

ANSWER:
This is because of the age, body composition and functionality and maturity of organs of the
child are different from adults which are matured and are fully functioning. If the same dosage is
used to give to the children, the children’s body will response differently and adversely as the
dose of the drug might be too much or too little for the children.

II. A 75-year-old client is admitted to the hospital with lower GI bleeding. His hemoglobin on
admission to the emergency department is 7.3 g/dl. The physician prescribes 2 units of packed
red blood cells to infuse over 2 hours each. The blood administration set has a drip factor of 10
gtts/ml. What is the flow rate in drops per minute?

ANSWER:
Calculating IV DRIP,
(total volume x drip factor)/time in minutes = gtts/min

Given:
2 units of packed red blood cell = 200mL x 2 = 400mL
Time in minutes = 2 x 60 mins = 120 mins
Drip factor = 10 gtts/min

Hence,
( 400 x 10 ) / 120 = 33.3 gtts/min
= 33 gtts/min (rounded off to nearest whole no.)

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Therefore, the flow rate is 33 gtts/min.

III. A cardiologist prescribes digoxin (Lanoxin) 125 mcq by mouth every morning for a client
diagnosed with heart failure. The pharmacy dispenses tablets that contain 0.25 mg. each. How
many tablets should the nurse administer in each dose?

ANSWER:

Calculating no. of tablets to administer,

(amount of drug avail/1 tablet) = (amount of drug prescribed/no. of tablet to give)

Given:
Amount of drug available = 0.25 mg
Amount of drug prescribed = 125 mcg = 0.125 mg
Hence,
Let the no. of tablets be X,
0.25 / 1 = 0.125 / X
X = ( 1 / 0.25 ) x 0.125
X = 0.5 tablet

Therefore, the nurse should administer, HALF of the tablet in each dose every morning.

IV. A 53-year-old client returns to his room from the post anesthesia care unit after undergoing
right hemicolectomy. The physician orders 1 L of dextrose 5% in half- normal saline solution to
infuse IV at 125 ml/hour. The drip factor of the available IV tubing is 15 gtts/ml. What iss the
drip rate in drops per minute?

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ANSWERS:

Calculating IV DRIP,
(total volume x drip factor)/time in minutes = gtts/min

Given:
Total volume = 1 liter = 1000mL
Drip factor = 15 gtts/ml
Since, physician wants 125 ml/hour to finish 1 L of dextrose, total no. of hours = 8 hours = 480
mins

Hence,
( 1000 x 15 ) / 480 = 31.25 gtts/min
= 31 gtts/min (rounded off to nearest whole no.)

Therefore, the drip rate is 31 gtts/min.

END OF ANALYSIS

How was your experience? Was learning interesting and were you able to do well in all the
activity?
>Good job if you did well
> if not go through the part that you don’t understand.

ACTION
The Nursing Process is a systematic, rational, and continuous method of planning, providing, and
evaluating individualized nursing care to optimize the administration of medications.

The nursing process involves critical thinking throughout each of its five steps: Assessment,
Nursing diagnosis, planning and establishing goals or outcomes, intervention and evaluation.

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Exercise 1: Create a Plan

Instruction: Create a comprehensive Nursing Care Plan on patient Bea. Refer to your NANDA book in
formulating your nursing diagnosis. Final output should be in tabular form.

Scenario:

Patient Bea Maristelais a 16 years old, single student who is admitted to the hospital for an allergic
reaction to antibiotic, manifested the following symptoms, skin rash, swelling of the lips and wheezing.
Her physician’s orders are as follows: cetirizine oral, albuterol for wheezing and corticosteroid ointment
for skin rash. From the following data make your own nursing care plan in tabular form with independent,
dependent and collaborative management of care. As a student nurse present your output to your
classmate and clinical instructor.

Output should be in short bond paper, Font: Calibri and size 12. Upload in google classroom

ASSESSMENT NURSING GOAL/OUTCOM INTERVENTION RATIONALE EVALUATION

DIAGNOSIS E
Subjective: Ineffective After 1 day of INDEPENDENT After 1 week of
- Skin rash Airway nursing 1. Assess rate and 1. Tachypnea, Nursing intervention
- Swelling of Clearance r/t intervention the depth of respirations shallow respirations, the client was able
the lips Allergic client will be able: and chest movement. and asymmetric to:
- Wheezing Reaction as - Maintain chest movement are
Evidenced by airway frequently present - Maintain airway
Abnormal clearance because of clearance
Breath patency discomfort of patency
Sounds moving chest wall or
- Sustain fluid in lung. - Client’s
Respiratory respiratory rate is
rate within 2. Auscultate lung Crackles, rhonchi, within normal
normal range: fields, noting areas and wheezes are range: RR
RR – 12 – 20 of decreased or heard on inspiration 18bpm.
cpm. absent airflow and and expiration in
adventitious breath response to fluid - identify and
- identify and sounds, such as accumulation, thick avoid specific
avoid specific crackles and secretions, and factors that
factors that wheezes. airway spasm or inhibit effective
inhibit obstruction. airway clearance
effective

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airway Keeping the head - demonstrate
clearance 3. Elevate head of elevated lowers increased air
bed; change position diaphragm, exchange.
- demonstrate frequently promoting chest
increased air expansion, aeration
exchange. of lung segments,
and mobilization and
expectoration of
secretions to keep
the airway clear.

Deep breathing
facilitates maximum
4. Assist client with expansion of the
frequent deep- lungs and smaller
breathing exercises. airways. Coughing is
Demonstrate and a natural self-
help client, as cleaning mechanism,
needed; learn to assisting the cilia to
perform activity, maintain patent
such as splinting airways. Splinting
chest and effective reduces chest
coughing while in discomfort, and an
upright position. upright position
favors deeper, more
forceful cough effort.

Fluids, especially
warm liquids, aid in
mobilization and
expectoration of
5. Force fluids to at secretions.
least 2500 mL per
day, unless
contraindicated, as in
HF. Offer warm,
rather than cold,
fluids. 1. Elevation the head
of the bed facilitates
respiratory function
DEPENDENT by used of gravity.
1. Maintain leaning
on over bed table. 2. Provides the
patient with some
means to cope with
or control dyspnea
and reduce air-

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2. Exercised pursed- trapping.
lip breathing.

1. Aids in reduction
of bronchospasm and
mobilization of
secretions.
COLLABORATIV Analgesics are given
E to improve cough
1. Administer effort by reducing
medications, as discomfort but
indicated, for should be used
example, mucolytics, cautiously because
expectorants, they can decrease
bronchodilators, and cough effort and
analgesics. depress respirations

Fluids are required to

replace losses,
including insensible
losses, and aid in
mobilization of
secretions. Note:
Some studies
2. Provide indicate that room
supplemental fluids humidification has
such as IV, been found to
humidified oxygen, provide minimal
and room benefit and is
humidification. thought to increase
the risk of
transmitting
infection.

Follows progress and

effects of disease
process and
therapeutic regimen
and facilitates
necessary alterations
in therapy.

3. Monitor serial
chest x-rays, ABGs,
and pulse oximetry
readings. (Refer to

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ND: impaired Gas
Exchange,
following.)

Output of this activity can be submitted in the following portals:

1. Google classroom
2. Messenger
3. Email

RUBRIC:

INCOMPLETE POOR FAIR GOOD

5 pts 10 pts 15 pts 20 pts
Assessment Assessment Does not include Includes all Includes all
portion is all pertinent data pertinent data pertinent data
incomplete. related to nursing related to nursing related to nursing
Includes subjective, diagnosis. May diagnosis, but also diagnosis and does
objective and also include data includes data not not include data
historical data that that does not relate related to nursing that is not related
support actual or to nursing diagnosis. to nursing
risk for nursing diagnosis. diagnosis.
diagnosis.
Diagnosis Diagnosis portion Diagnosis is not Diagnosis is Diagnosis is
is incomplete. appropriate for appropriate for appropriate for
patient and ordinal patient and ordinal patient and ordinal
Includes the most level (first level, and level, and
appropriate diagnosis, second diagnosis is diagnosis is
diagnosis for diagnosis, etc). NANDA NANDA
patient and ordinal May also not be approved, but does approved.
number that NANDA and may not include all Diagnosis also
includes all not include all parts or includes all parts
appropriate parts parts. information is and information is
(stem, related to or listed in wrong listed in correct
R/T, and as part of diagnosis. part of diagnosis.
evidenced by AEB
for actual

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diagnosis) and is
NANDA approved.
Planning (Goal Goal portion is Goal statement is Goal statement is Goal statement is
Setting) incomplete. not patient or patient or family patient or family
family oriented oriented, and oriented, and
and may not have contains at least contains two
Includes a patient measurable one measurable measurable
or family goal that criteria or a target criteria or a target criteria and a
is most appropriate date or time. date/time. target date or time.
for the
patient/family and
the nursing
diagnosis. Goal
should be
measurable by at
least two criteria
and have a target
date or time.
Implementation Interventions Interventions Interventions Interventions
(Interventions portion is portion does not portion contains portion contains
incomplete. include adequate adequate number adequate number
number of of interventions to of interventions to
Includes interventions to help patient/family help patient/family
interventions or help patient/family meet goal, but meet goal, and
nursing actions that meet goal. interventions may interventions are
directly relate to Interventions may not be specific, specific in action
the patient's goal, also not be labeled or listed and frequency,
that are specific in specific, labeled or with rationales. labeled with "I" or
action and listed with "C" and are listed
frequency, are rationales. with referenced
labeled "I" for rationales.
independent and
"C" for
collaborative, and
include a
referenced
rationale with page
number (if
applicable).
Number of
interventions
should be
appropriate to help
patient or family
meet their goal.
Evaluation Evaluations Evaluation portion Evaluation portion Evaluation portion
portion is does not contain does contain data does contain data

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incomplete. data that is listed that is listed as that is listed as
Includes data that as criteria in goal criteria in goal criteria in goal
is listed as criteria statement. May statement, but statement. Does
in goal statement. also not describe does not describe describe goal as
Based on this data, goal as met, goal as met, met, partially met,
goal is determined partially met, or partially met, or or not met. If goal
to be met, partially not met. May also not met. May also was partially met
met, or not met. If not include not include or not met,
goal was not met or revision or new revision or new includes revision
partially met, plan evaluation evaluation and/or new
of care is revised or date/time. date/time. evaluation
continued and a date/time.
new evaluation
date/time is set.

Multiple Choice: Encircle the letter that best describes your

answer. Please answer all items. After taking this exam, you will
be able to check your answers. Take note that this is already an
evaluation of your learning. If you score below the expected
level, its best to go through the module again.
1. What is bioavailability?

A. The amount of blood that is available for transfusion

B. The amount of medication in your blood that is available to produce an effect
C. The amount of drug that is biometrically excreted in your blood
D. The amount of available drug to be used for biological testing

2. It is important for the nurse to be aware of the four sequential processes of the
pharmacokinetic phase. What are these processes?

A. Distribution, metabolism, excretion, absorption

B. Biotransformation, excretion, absorption, metabolism
C. Absorption, distribution, metabolism, excretion
D. Metabolism, distribution, absorption, excretion

3. Which of the following will determine nursing interventions for a client on medication?

A. Assessment
B. Diagnoses
C. Implementation
D. Evaluation

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4. What of the following needs to be included in a physician’s order for a patient so the nurse can
use the “rights of safe administration” when administering medication?

A. Patient’s weight
B. Patient’s drug history
C. Patient’s name
D. Patient’s address

5. A client has had most of the small intestine removed. The nurse would be most concerned
about drug:

A. Excretion
B. Absorption
C. Metabolism
D. Distribution

6. The agency that regulates the development and sale of drugs in the United States?

A. United States Department of Health and Human Services

B. The Food and Drug Administration (FDA)
C. Drug Enforcement Administration (DEA)
D. Centers for Disease Control and Prevention

7. A nurse applies a medication in the form of an ointment to a client’s rash. Shortly after
applying the ointment, the nurse begins to feel a burning sensation on the hand and notices that it
has reddened. The nurse then sees some ointment next to the reddened area and realizes that this
drug reaction is a (an):

A. Systemic effect
B. Local effect
C. Idiosyncratic effect
D. Synergistic effect

8. A client reports to a cardiac rehabilitation session complaining of not feeling well. The nurse
questions what is wrong and is told, “I’ve been having angina for several days.” During further
assessment, the client reports that no nitrate has been used because it causes a terrible headache.
Which of these nursing diagnoses is most appropriate?

A. Knowledge deficit related to the side effects of nitroglycerin

B. Knowledge deficit related to the need for nitrates
C. Alteration in comfort: headache related to the side effects of the vasodilator
D. Noncompliance related to the side effects of nitroglycerin

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 NCM 106
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9. The nurse is asked to give an investigational drug to a client. Upon entering the room, the
nurse asked if the study and the use of the drug has been explained to the client. If the client
answers “no”, the nurse should:

A. Proceed to administer the drug anyway

B. Give a brief explanation about the drug and proceed to administer it
C. Explain the study, secure a consent, and administer the drug
D. Refuse to administer the drug and notify the investigational physician

10. Drug labels are a source of information. What information might a drug label provide?

A. The manufactured date

B. The expiration date
C. When the patent expires
D. The binding properties of the drug

11. The client’s ability to take oral medications will be hindered by:

A. Age
B. Dental caries
C. Dysphagia
D. Lifestyle

12. A client with abdominal pain reports to the emergency department. A brief history reveals an
allergy to the analgesic morphine sulfate. The nurse should follow through by first asking which
of these questions?

1. What other analgesic are you allergic to?

2. Have you had this allergy long?
3. Exactly what does the morphine do to you?
4. Does the morphine make you nauseated?

13. What is the most accurate calculation for drug dosage in a child?

A. Fried’s rule
B. Young’s rule
C. Clark’s rule
D. Surface area calculation

14.The name selected by the original manufacturer based on the chemical structure of the drug is
the:

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 NCM 106
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A. Chemical name
B. Drug name
C. Generic name
D. Trade name

15. When a drug binds to a receptor to produce a pharmacologic effect, the drug may be called
a(n):

A. Agonist
B. Antagonist
C. Blocker
D. Accelerator

16. Two patients are receiving injections of penicillin G. One patient is a male, 35 years old,
weighing 165 pounds.
The other patient is female, 18 years old, weighing 125 pounds. You know that you will see the
effects of the drug first in the male patient. What is the rationale for this?

A. Women have less fat cells than men

B. Men have more vascular muscles than women
C. Women have a smaller circulatory system than men
D. Drugs are generally tested on healthy males

17.As a knowledgeable nurse, you know that the following are part of the 8 Medication rights
except:

A. Right dose
B. Right route
C. Right drug
D. Right room

18.What describes the action of a drug on the body?

A. Pharmacodynamics
B. Pharmacokinetics
C. Microbiology
D. Pharmacology

19. Which of the following routes have the highest bioavailability?

A. IM
B. Oral

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 NCM 106
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C. Subcutaneous
D. IV

20. A client who has received an initial dose of an antibiotic has severe wheezing within minutes.
Which is the most appropriate documentation to describe the situation?

A. Idiosyncratic reaction
B. Anaphylactic reaction
C. Serum sickness
D. Cumulative effect

END OF ACTION

You are almost done with Lesson 1 of your module, go back to the last column of your ARG
and answer the questions again. This time compare your previous answers to your latest
answers. Was there any improvement?

CLOSURE

SELF REFLECTION

Learning Skills

I’m an Expert I still need to Practice Oh no, I need help

1. I can describe the

different scope of science
of Pharmacology
x

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 NCM 106
PHARMACOLOGY
2. I can discuss the factors
that can affect optimal
therapeutic response, drug
x
therapy, and clinical patient
care
3. I can outline the
important factors to
consider when applying the
x
nursing process to selected
situations of drug toxicity
4. I can explain what is
involved in each step of the
nursing process as it relates
x
to drug therapy
5. I can apply correct
drug calculations when
given drug orders and
x
available forms of the
drugs ordered

REFERENCES

Textbook:

1. Smith, B.T., Pacitti, D., 2020. Pharmacology for Nurses, 2 nd Edition. Jones &Barlett Learning, LLC,
Burlington, Massachusette.
2. Karch, Amy M., 2017, Focus on Nursing Pharmacology, , 7th edition. Wolters Kluwer Health
3. Adams, M., Holland, N., Urban, C., 2020. Pharmacology for Nurses: A Pathophysiologic Approach, 6 th
Edition. Pearson
4. Lippincott William & Wilkins, 2015. Pharmacology A 2-in-1 Reference for Nurses, Lippincott William
& Wilkins

Links:

https://healthblog.uofmhealth.org/health-management/different-phases-of-clinical-trials-and-what-they-
mean

https://lakecharlesclinicaltrials.com/about-clinical-trials/

https://youtu.be/L1W0q1kEof4
https://youtu.be/NKV5iaUVBUI

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https://youtu.be/PGzT3cTPah8
https://youtu.be/VzrvklX5Wmw
https://youtu.be/eTqPsqnbwoc

CLOSING PRAYER

May God the Father bless us.

May God the son Heal us.

May God the Holy Spirit enlighten us, and give us eyes to see with,
ears to hear with, hands to do the work of God with, feet to walk
with, a mouth to preach the word of salvation with and the angel of
peace to watch over us and lead us at last, by our Lord’s gift to the
kingdom, AMEN.

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