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GI SYSTEM: STOMACH, SMALL INTESTINE The oral medication reaches the systemic circulation through the GI system. Asa re- sult, numerous factors can affect the absorp- tion of the pill. QUESTIONS 1. Which would be absorbed the fastest: pill, capsule, or liquid? 2. A client is experiencing diarrhea. How could this affect absorption ofan oral drug? 3. How does the presence of food in the stomach affect the rate of absorption? CARDIOVASCULAR SYSTEM Once the pill is absorbed into the blood- stream, it is carried or delivered to the sites of pharmacologic action where the drug produces its effects. QUESTION 1. How is distribution of the oral medication affected if a client has less than normal cardiac output (e.g., low BP, prolonged capillary refill)? PHYSIOLOGY RE LIVER Most biotransformation takes place in the liver. Any decrease in the ability of the liver to metabolize medication could lead to an accumulation of the active drug in the bloodstream. This could put the client at risk for toxic effects and adverse reactions. QUESTIONS 1. What are risk factors that can affect liver function? 2. A dient is suspected of having decreased liver function. What information would be essential for the nurse to know about the oral medication that is to be given? KIDNEYS Drug excretion occurs mainly through the kidneys into the urine-If there is any impair- ment in kidney function, medications may not be excreted at the anticipated speed. Subsequent medication administration may lead to accumulation and potential toxicity. QUESTIONS 1. Why would very young and very old clients need to be closely monitored by the nurse for signs and symptoms of drug toxicity? 2. How can the nurse assess kidney function? See student resource website for answers. 
