Adrenal Drugs

Question 1

What is the action of a glucocorticoid?

Answer 1

Promotes the preservation of energy thru increased glucose levels, protein breakdown & fat formation

Question 2

How do glucocorticoids reduce inflammation & suppress the immune system? What does glucocorticoids activate?

Answer 2

Lymphocytes they also inhibit the spread of phagocytes to the bloodstream and injured tissues

Question 3

Because hypernatremia is of concern, a client on aldosterone can eat all the following except. Select the best answer.
1.egg and vegetable toast
2. bagels, salad and cottage cheese
3. dried peas and beans
4. white bean and roasted bell pepper hummus

Answer 3

2.

Question 4

What is the prototype for the class Adrenal hormone replacement?

Answer 4

Hydrocortisone-
other meds are Glucocorticoids, Prednisone, Dexamethasone, Mineralocorticoid, Fludrocortisone

Question 5

What is the action of hydrocortisone?

Answer 5

Mimic effect of natural steroid hormones

Question 6

What is the therapeutic use for an Adrenal hormone replacement?

Answer 6

Acute and chronic replacement for adrenocortical insufficiency (Addison’s Disease, adrenal crisis

Question 7

What is the route of administration for an Adrenal hormone replacement?

Answer 7

Oral & IV

Question 8

What are complications for an Adrenal hormone replacement rx?

Answer 8

Hyperglycemia, glycosuria, osteoporosis, Adrenal suppression, Peptic ulcer, GI discomfort, infections (because immunosuppression can mask an infection)

Question 9

What is the disease and risk from chronic use of Glucocorticoids?

Answer 9

Cushing’s syndrome

Question 10

Contraindications of an Adrenal hormone replacement?

Answer 10

Pregnancy, patients with an active infection not controlled by antibiotics, Use with caution in clients who have has a recent MI, gastric ulcer, HTN, kidney disorder, osteoporosis, DM, cirrhosis, hypothyroidism, myasthenia gravis, glaucoma, seizure disorder

Question 11

Drug interactions and Adrenal hormone replacements, for example taking hydrocortisone with an NSAID, Tylenol or ETOH can cause an increased what?

Answer 11

Increased gastric distress or bleed

Question 12

Concurrent use with potassium depleting agents can cause what?

Answer 12

Hypokalemia

Question 13

Concurrent use with vaccines and toxoids can reduce what effect?

Answer 13

It can reduce the antibody response

Question 14

What are nursing administrations tasks to remember about administering an Adrenal hormone replacement?

Answer 14

Give with food to reduce gastric distress, monitor glucose levels in patients who have DM or prediabetes, monitor weight, blood pressure & electrolytes. DO NOT STOP RX SUDDENLY, TAPER DOSAGE IF DISCONTINUING

Question 15

Teaching points for client or patient education, for an Adrenal hormone replacement?

Answer 15

1) Observe for manifestations of peptic ulcer (coffee-ground emesis), bloody or tarry stools, ABD. Pain, 2) Also if there is fever, muscle and joint pain, weakness or fatigue are signs of acute adrenal insuff.
3) Dosages need to be increased during times of stress (infection, surgery or trauma). 4) Replacement therapy for Addison’s Disease must continue for life**, 5) Carry an extra supply of glucocorticoids for emergencies and wear a medical identification at all times.

Question 16

How to assess or evaluate the medication effectiveness of an Adrenal hormone replacement?

Answer 16

Relief of effects of adrenocortical deficiency (weakness, hypoglycemia, hyperkalemia, fatigue

Question 17

What are the symptoms for Diabetes insipidus?

Answer 17

1) Extra thirst, Dilute & excessive straw-colored urine & output 15L per day

Question 18

Diabetes insipidus is a disorder of what?

Answer 18

Posterior Pituitary gland

Question 19

Diabetes insipidus is caused by two reasons, what are they?

Answer 19

An antidiuretic hormone (ADH) deficiency or an inability of the kidneys to respond to ADH-Hence the result is the excretion of large volumes of urine

Question 20

What assessment would the nurse expect to support an admitting diagnosis of Graves disease (hyperthyroidism)?

Answer 20

Exophthalmos- which is abnormal protrusion of the eyes

Question 21

Periorbital edema, bradycardia & a horse voice are characteristics of what?

Answer 21

Hypothyroidism

Question 22

A nurse is caring for a client who is post-operative day 2 for a thyroidectomy. Which lab value requires close monitoring?
1. Sodium level
2. Calcium level
3. Potassium level
4. WBC

Answer 22

2. • Because the parathyroids are located on the back of the thyroid, and are important for calcium and phosphorus balance.