Endocrine

Question 1

Levothyroxine (PO)

Answer 1

Indication: Thyroid supplement for hypothyroidism, euthyroid goiters

Contraindications: Hypersensitivity, Hyperthyroidism

Side Effects: Sweating, Headache

Adverse Reactions: Tachycardia, arrhythmias, chest pain

Nursing Considerations: Assess apical pulse and BP periodically throughout therapy, Monitor thyroid function prior to and during therapy (TSH levels)
Assess for tachycardia/ chest pain

Patient Teachings: Explain that this is a lifelong therapy, Take medication at the same time each day

Question 2

Prednisone (PO)

Answer 2

Indication: Inflammation, Immunosuppression, endocrine disorder

Contraindications: Active untreated infections, Osteoporosis or other degenerative bone diseases, Uncontrolled hyperglycemia

Side Effects: Nausea, vomiting, Acne, depression, increased hunger, weight gain

Adverse Reactions: Peptic ulceration, Thromboembolism, Hypertension

Nursing Considerations: Assess for S/S of adrenal insufficiency before and periodically throughout therapy, Monitor intake/output, observe for peripheral edema

Patient Teachings: Take medication as directed, Don’t stop taking suddenly or adrenal insufficiency may occur, Contact HCP if abdominal pain or melena occurs

Question 3

Cyanocobalamin (IM)

Answer 3

Indication: Vitamin B12 deficiency, Pernicious anemia

Contraindications: Hypersensitivity

Side Effects: Itching, swelling of body

Adverse Reactions: Anaphylaxis, HF, pulmonary edema, hypokalemia

Nursing Considerations: Assess for S/S of Vitamin B12 deficiency before and periodically throughout therapy

Patient Teachings: Consume foods high in Vitamin B12 (meat, seafood, eggs), Encourage compliance with diet, Emphasize importance of follow up and evaluate progress

Question 4

Metformin (PO)

Answer 4

Indication: Type II Diabetes

Contraindications: Hypersensitivity, Diabetic ketoacidosis, Severe renal impairment

Side Effects: Nausea, vomiting

Adverse Reactions: Hypoglycemia, Lactic acidosis

Nursing Considerations: Monitor for S/S of hypoglycemia, Patients with severe renal impairment are at risk for lactic acidosis

Patient Teachings: Take at the same time everyday, Usually long-term therapy, Take with prescribed diet and exercise

Question 5

Insulin short-acting (Novalog - SQ)

Insulin long-acting (Levimir - SQ)

Answer 5

Indication: Diabetes

Contraindications: Hypersensitivity, Hypoglycemia

Side Effects: Swelling and itching at injection site

Adverse Reactions: Hypersensitivity reactions, Hypoglycemia

Nursing Considerations: Assess periodically for S/S of hypo/hyperglycemia, Monitor body weight periodically

Patient Teachings: Explain that it is a long-term therapy, Emphasize importance of nutritional/ exercise guidelines, Teach proper administration technique

Question 6

Ferrous Sulfate (PO)

Answer 6

Indication: Iron deficiency anemia

Contraindications: Hypersensitivity, Hemochromatosis (iron overload w/ organ damage), hemosiderosis (iron overload w/o organ damage)

Side Effects: Nausea, vomiting, dark stools

Adverse Reactions: GI bleeding, syncope

Nursing Considerations: Monitor Hb levels, hematocrit/ reticulocyte count during therapy

Patient Teachings: Explain purpose of iron therapy. Stools may appear dark green/black. Educate importance of implementation of high-iron foods.