Critical Care Pharmacy Flashcards

Question 1

What does the term critical care pharmacy describe in practice?

Accepted Answer

Critical care pharmacy is the practice area in which pharmacists support patients in intensive care units and similar settings where illness is life threatening or unstable. Pharmacists in this area review orders, prepare and check medications, monitor records, and advise the care team on safe use.

Question 2

What is a medication order, and why does it matter in critical care?

Accepted Answer

A medication order is a prescriber's written or electronic instruction directing that a specific medication be given to a specific patient. It usually names the drug, dose, route, frequency, and timing. In critical care, clear and complete orders reduce delays and prevent misunderstandings during fast-moving treatment decisions.

Question 3

What does the term pharmacokinetics describe in medication handling?

Accepted Answer

Pharmacokinetics describes how the body takes up, distributes, metabolizes, and eliminates a medication over time. Clinicians and pharmacists use this framework to understand how concentration changes after a dose is given. This is separate from pharmacodynamics, which describes what a medication does to the body.

Question 4

What does the term half-life mean in pharmacokinetics?

Accepted Answer

Half-life is the time it takes for the amount or concentration of a medication in the body to fall by half. It helps predict how long a drug stays active. Half-life is a time measure, so it changes with clearance and does not describe the dose itself.

Question 5

What does bioavailability describe when a medication enters the body?

Accepted Answer

Bioavailability is the fraction of an administered medication that reaches the systemic circulation in active form. Route of administration strongly affects it, because some routes bypass early breakdown while others pass through it first. Knowing this helps the team compare how the same amount of medication behaves when given differently.

Question 6

What does the term parenteral mean in medication administration?

Accepted Answer

Parenteral refers to any route of administration that bypasses the digestive tract, such as delivery directly into a vein, muscle, or under the skin. Parenteral routes are common in critical care because they allow reliable delivery when a patient cannot swallow or absorb medication from the gut.

Question 7

What does the term pharmacodynamics describe in medication science?

Accepted Answer

Pharmacodynamics describes what a medication does to the body, including the effects it produces and how those effects relate to its concentration. It is the counterpart to pharmacokinetics, which tracks what the body does to the medication. Together the two concepts help teams reason about expected effects and timing.

Question 8

What does the term formulary mean in a hospital setting?

Accepted Answer

A formulary is the approved list of medications a health system or hospital has chosen to stock and use. It usually includes guidance on preferred products, strengths, and therapeutic alternatives. Decisions are usually made through a review committee and aim for consistent, safe, and cost-aware prescribing.

Question 9

What is medication reconciliation and when is it performed?

Accepted Answer

Medication reconciliation is the process of comparing a patient's current medication list with orders at a transition of care, such as admission, transfer, or discharge. The goal is to identify and resolve discrepancies, including omissions, duplications, and unintended changes. Transitions are a common point where errors can be caught.

Question 10

What information should appear in a complete medication history?

Accepted Answer

A complete medication history records each medication the patient takes, including prescribed products, over-the-counter items, supplements, and any product taken on an as-needed basis. It also notes the dose, route, frequency, and time of last use when known. Sources include the patient, family, pharmacy fill records, and the prior clinical record.

Question 11

What is a medication discrepancy, and why does it matter for records?

Accepted Answer

A medication discrepancy is any difference between what a patient should be receiving and what the record or orders show. Discrepancies may be intentional, such as a documented change, or unintentional, such as an omitted home product. Each one needs review so that the record reflects a clear, justified plan.

Question 12

What does a medication administration record, often called a MAR, document?

Accepted Answer

A medication administration record documents each scheduled or as-needed dose that was given, held, or refused, along with the time and the staff member who acted. It serves as the official clinical record of what the patient actually received. Accurate entries let the team judge response and plan the next dose.

Question 13

Why is a standardized abbreviation list used in medication records?

Accepted Answer

A standardized abbreviation list defines which shorthand terms are approved and which are prohibited in orders and records. Many error-prone abbreviations look similar or can be misread, so a shared list reduces confusion between prescribers, pharmacists, and nurses. Spelling out terms in full is often the safest practice.

Question 14

What is the purpose of an allergy and intolerance field in a patient record?

Accepted Answer

The allergy and intolerance field lists substances a patient has reacted to, with a description of the reaction and its severity when known. Keeping this field current helps every person who reviews an order see potential conflicts before a dose is given. Entries should be verified with the patient or family whenever possible.

Question 15

What does it mean to document a medication as held rather than omitted?

Accepted Answer

Held means a scheduled dose was intentionally not given at that time, with a documented reason and an expected plan for resuming or stopping. Omitted suggests the dose was missed without a clear decision, which weakens accountability and review. Clear wording lets the team trace each decision.

Question 16

Why do pharmacists verify orders before a medication is dispensed?

Accepted Answer

Pharmacist order verification is a check that an order is complete, appropriate for the patient, and consistent with the record before the medication is prepared or released. The review looks at allergies, interactions, dosing logic, and clarity of instructions. It acts as an independent safety step between prescribing and administration.

Question 17

What is a high-alert medication, in general terms?

Accepted Answer

A high-alert medication is one that carries a greater risk of significant harm when used in error. Such medications are flagged in systems so that extra checks, labeling, or independent double verification can be applied. Lists of these products are set by each organization based on its own experience and guidance.

Question 18

What is a root cause analysis in medication safety?

Accepted Answer

A root cause analysis is a structured review of an event that looks past the individual who made an error to find the system factors that allowed it. Teams then propose system changes, such as clearer labels or simpler workflows. The purpose is to prevent recurrence rather than assign blame.

Question 19

What is the purpose of a medication error reporting system?

Accepted Answer

A medication error reporting system collects confidential, nonpunitive reports of errors and near misses so that patterns can be found and addressed. Near misses are events caught before reaching the patient, and they often reveal weaknesses that have not yet caused harm. Reporting is valuable only when feedback and system changes follow.

Question 20

What does the term standard operating procedure mean in a pharmacy?

Accepted Answer

A standard operating procedure is a written, step-by-step description of how a routine task must be performed so that it is done the same way each time. In pharmacy it may cover compounding, labeling, storage, or waste handling. Staff are trained on the procedure, and it is reviewed regularly.

Question 21

What is the purpose of a barcode check at the bedside?

Accepted Answer

A bedside barcode check confirms that the right patient, medication, dose, route, and time match the order before administration. The nurse scans the patient identifier and the product, and the system flags any mismatch. This step adds an independent check at the bedside, though it depends on accurate data entry upstream.

Question 22

What does the term near miss mean in quality reporting?

Accepted Answer

A near miss is an error that was intercepted before it reached the patient. Quality teams track near misses because they reveal risks without the cost of actual harm. Learning from them is a core principle of safety programs. They are sometimes called close calls in everyday practice.

Question 23

What is the difference between a sentinel event and an adverse event?

Accepted Answer

An adverse event is any unintended harm that results from care, whether or not it was preventable. A sentinel event is a more serious subset, usually involving death or severe permanent harm, that triggers a formal, prompt review. Definitions vary by agency and organization, so teams should follow their own local policy.

Question 24

What does a plan-do-study-act cycle describe in quality improvement work?

Accepted Answer

A plan-do-study-act cycle is a repeating method for testing a change on a small scale before adopting it widely. Teams plan the change, carry it out, study the results against expectations, and then act by adopting, adjusting, or abandoning it. Each pass builds knowledge and supports steady improvement in pharmacy processes.

Question 25

What does the term continuous infusion mean in medication administration?

Accepted Answer

A continuous infusion is the steady delivery of a fluid or medication over an extended period, usually through a pump. It differs from an intermittent dose, which is given as a single amount at defined times. Continuous delivery keeps concentration more even but requires regular checks of rate and remaining volume.

Question 26

What does the term bolus mean when describing a medication dose?

Accepted Answer

A bolus is a single, relatively large amount of a medication or fluid given over a short period. It is often used to reach a target level quickly, in contrast to a slower continuous infusion. Because the effect of a bolus can be rapid and intense, the order should specify its rate and monitoring.

Question 27

What is a smart pump drug library, and what is its main purpose?

Accepted Answer

A smart pump drug library is a stored set of medication entries with preset safe dose limits and concentrations. When a clinician programs a pump, the software can warn if an entry falls outside those limits. It supports safety, but it works only when entries are kept current and clinicians respond to alerts.

Question 28

What is titration in the context of medication administration?

Accepted Answer

Titration is the process of adjusting a medication dose or infusion rate in steps, guided by a defined target and by the patient's measured response. Changes are made according to a written order or protocol, with limits on how far and how quickly a rate may move.

Question 29

Why do teams often double check dose and rate calculations for infusions?

Accepted Answer

Independent double checks reduce the chance that an arithmetic or unit error reaches the patient. Two qualified people separately confirm the concentration, units, and resulting rate before the infusion starts. Because small unit slips can produce large differences in delivered amount, this step is common for higher-risk products.

Question 30

What does the term compatibility mean when two medications are given through one line?

Accepted Answer

Compatibility describes whether two substances can be mixed or run through the same line without physical or chemical change, such as precipitation, cloudiness, or loss of potency. Pharmacists check compatibility using approved references and institutional guidance before co-administration. Incompatible combinations require separate lines, flushing, or a different plan.

Question 31

What is a flush, and why is it documented?

Accepted Answer

A flush is a small volume of compatible fluid pushed through a line to clear medication remaining in it and to confirm the line is open. Flushing helps ensure the intended dose reaches the patient and prevents unintended mixing. It is documented because it affects the volume delivered.

Question 32

What is an infusion set, and what does it include?

Accepted Answer

An infusion set is the tubing assembly that connects a medication or fluid container to the patient's access point, often including a drip chamber, clamp, and filter where needed. The set must match the medication type and the pump in use. Selecting the correct set is part of routine preparation and checking.

Question 33

What is enteral nutrition, and how is it defined?

Accepted Answer

Enteral nutrition is feeding delivered through the gastrointestinal tract, usually by a tube placed into the stomach or small intestine when oral intake is not adequate. It is a general term that covers formulas designed for tube feeding. Enteral nutrition is generally preferred over parenteral nutrition when the gut can be used safely.

Question 34

What does parenteral nutrition deliver to a patient who cannot use the gut?

Accepted Answer

Parenteral nutrition is a nutrient solution delivered directly into a vein, bypassing the digestive tract. It supplies components such as dextrose, amino acids, lipids, electrolytes, and vitamins in a sterile, prepared formulation. Because it avoids the gut, it requires careful compounding, line management, and monitoring by the care team.

Question 35

What is a caloric requirement, and what does it describe?

Accepted Answer

A caloric requirement is the estimated amount of energy a person needs over a period, usually expressed in kilocalories per day. Estimates depend on body size, activity, and the clinical situation, so they are calculated by a dietitian or prescriber. The figure is a starting estimate that the team reviews and adjusts.

Question 36

What is the refeeding concept in nutrition support?

Accepted Answer

Refeeding describes the shifts in fluids, electrolytes, and metabolism that can occur when nutrition is restarted after a period of little or no intake. Because these shifts can be significant, teams monitor closely and often advance intake gradually. Early identification of risk is a key part of safe nutrition support.

Question 37

What does antimicrobial stewardship mean as a program concept?

Accepted Answer

Antimicrobial stewardship is a coordinated program that promotes the right choice, dose, route, and duration of antimicrobial therapy to improve patient outcomes. It also aims to limit unnecessary use that can drive resistance and harm. Pharmacists often lead or support these programs by reviewing use, providing feedback, and educating staff.

Question 38

What is the difference between incidence and prevalence?

Accepted Answer

Incidence counts new cases of a condition that arise during a defined period in a population, while prevalence counts all existing cases at a given point or within a period. Incidence describes the rate of new onset, and prevalence describes the overall burden. Both measures help public health teams plan prevention and resources.

Question 39

What is a medication use evaluation in quality programs?

Accepted Answer

A medication use evaluation is a structured review of how a medication is selected, ordered, prepared, and given across a defined group of patients. Its purpose is to compare actual practice with an agreed standard and identify gaps. Findings guide education, policy, or process changes rather than judging individual clinicians.

Question 40

What is a drug-drug interaction screen, and what does it check?

Accepted Answer

A drug-drug interaction screen is a review that compares a medication against others in the patient's profile to flag possible interactions. It checks for combinations that may change effect, increase risk, or alter how a medication is handled by the body. Alerts are a starting point, so pharmacists judge their clinical relevance.

Critical Care Pharmacy Flashcards

1Core Pharmacy Terminology

2Medication Records and Reconciliation

3Safety and Quality Systems

4Infusion and Administration Concepts

5Nutrition Support and Stewardship

Learning Resources