Endocrine (hydrocortisone,prednisone,levothyroxine,vasopressin) Flashcards
Topical Corticosteroid
HYDROCORTISONE
MOA:
INDIC:
CONTRAINDIC:
AE:
NURSING:
MOA: decrease local inflammation
INDIC:inflammatory and pruritic skin conditions
CONTRAINDIC
:hypersensitivity
AE:
1.skin fragility
2.burning sensation
3.dryness
**skin fragility
**thinning
**hypo pigmentation
**oppurtunistic infection
NURSING:
1. use gloves to apply and wash hands
2.teach pt ae more likely with long term overuse , low risk systemic effects
Systemic Corticosteroids
PREDNISONE
MOA
INDIC
CONTRAIND
AE
MOA: anti inflammatory and immunosuprressive effects
INDIC:
1. acute infection
2.DM
3.acute peptic ulcers
4.CHF (older adult)
SATA***AE both short term and long term can happen
ST: gastric irritation, immunosuppression, edema (htn) , weight gain, insomia , appetite increase
LT: cushing syndrome , hypernatremia m hypokalemia , growth syndrome , adrenal suppresion
Thyroid Agents
LEVOTHYROXINE
MOA
INDIC
AE
BBW
NURSING
MOA synthetic (replaces hormones)
INDIC hypothyroidism
AE rt too much of levothyroxine
BBW
1.cm of hyperthyroidism
a.nervousness
b.insomia
c.tremors
d.tachy
e.palpitations
f.angina
g.arrthytmias
h.diaphoresis
i.heat tolerance
BBW: contraindicated for weight loss
NURSING
CM; listed above
-assess and monitor bp and pulse
-monitor tsh levels to evaluate therapy
Synthetic ADH
VASOPRESSIN
MOA
INDIC
AE
NURSING
MOA increase water permeability in renal tubular cells resulting in decrease urine volume and increased urine osmolarity (increase water reabsorption)
INDIC neurogenic , DI, severe hypotension
AE
1. rt too much of thismeds
2.SIADH (water intoxication , cerebral edema , hyponatremia, htn, seizure , coma)
NURSING
1. monitor bp ,hr, urine specific gravity
2.plasma /urine osmolarity
3.serum electrolytes
4.s/s of hyponatremia
A patient, newly diagnosed with hypothyroidism, receives a prescription for a thyroid hormone replacement drug. The nurse assesses for which potential contraindication to this drug?
a. Infection
b. Diabetes mellitus
c. Liver disease
d. Recent myocardial infarction
d. Recent myocardial infarction
Contraindications to thyroid preparations include known drug allergy to a given drug product,
1. recent myocardial infarction,
2.adrenal insufficiency, and 3. hyperthyroidism.
A patient with hypothyroidism is given a prescription for levothyroxine (Synthroid). When the nurse explains that this is a synthetic form of the thyroid hormone, he states that he prefers to receive more “natural” forms of drugs. What will the nurse explain to him about the advantages of levothyroxine?
a. It has a stronger effect than the natural forms.
b. Levothyroxine is less expensive than the natural forms.
c. The synthetic form has fewer adverse effects on the gastrointestinal tract.
d. The half-life of levothyroxine is long enough to permit once-daily dosing.
d. The half-life of levothyroxine is long enough to permit once-daily dosing.
One advantage of levothyroxine over the natural forms is that it can be administered only once a day because of its long half-life.
During a teaching session for a patient on antithyroid drugs, the nurse will discuss which dietary instructions?
a. Using iodized salt when cooking
b. Avoiding foods containing iodine
c. Restricting fluid intake to 2500 mL/day
d. Increasing intake of sodium- and potassium-containing foods
b. Avoiding foods containing iodine
Patients on antithyroid therapy need to avoid iodine-containing foods. These foods may interfere with the effectiveness of the antithyroid drug.
During a teaching session for a patient on antithyroid drugs, the nurse will discuss which dietary instructions?
a. Using iodized salt when cooking
b. Avoiding foods containing iodine
c. Restricting fluid intake to 2500 mL/day
d. Increasing intake of sodium- and potassium-containing foods
b. Avoiding foods containing iodine
Patients on antithyroid therapy need to avoid iodine-containing foods. These foods may interfere with the effectiveness of the antithyroid drug.
A 19-year-old student was diagnosed with hypothyroidism and has started thyroid replacement therapy with levothyroxine (Synthroid). After 1 week, she called the clinic to report that she does not feel better. Which response from the nurse is correct?
a. “It will probably require surgery for a cure to happen.”
b. “The full therapeutic effects may not occur for several weeks.”
c. “Is it possible that you did not take your medication as instructed?”
d. “Let’s review your diet; it may be causing absorption problems.”
b. “The full therapeutic effects may not occur for several weeks.”
A patient, newly diagnosed with hypothyroidism, has received a prescription for thyroid replacement therapy. The nurse will instruct the patient to take this medication at which time of day?
a. In the morning
b. With the noon meal
c. With the evening meal
d. At bedtime
a. In the morning
If possible, it is best to administer thyroid drugs taken once daily in the morning so as to decrease the likelihood of insomnia that may result from evening dosing.
When reviewing the laboratory values of a patient who is taking antithyroid drugs, the nurse will monitor for which adverse effect?
a. Decreased glucose levels
b. Decreased white blood cell count
c. Increased red blood cell count
d. Increased platelet count
b. Decreased white blood cell count
Antithyroid drugs may cause bone marrow suppression, resulting in agranulocytosis, leukopenia, thrombocytopenia, and other problems.
When reviewing the laboratory values of a patient who is taking antithyroid drugs, the nurse will monitor for which adverse effect?
a. Decreased glucose levels
b. Decreased white blood cell count
c. Increased red blood cell count
d. Increased platelet count
b. Decreased white blood cell count
Antithyroid drugs may cause bone marrow suppression, resulting in agranulocytosis, leukopenia, thrombocytopenia, and other problems.
A patient has been taking levothyroxine (Synthroid) for more than one decade for primary hypothyroidism. Today she calls because she has a cousin who can get her the same medication in a generic form from a pharmaceutical supply company. Which is the nurse’s best advice?
a. “This would be a great way to save money.”
b. “There’s no difference in brands of this medication.”
c. “This should never be done; once you start with a certain brand, you must stay
with it.”
d. “It’s better not to switch brands unless we check with your doctor.”
d. “It’s better not to switch brands unless we check with your doctor.”
A patient has a diagnosis of primary hypothyroidism. Which statement accurately describes this problem?
a. The hypothalamus is not secreting thyrotropin-releasing hormone (TRH);
therefore, thyroid-stimulating hormone (TSH) is not released from the pituitary
gland.
b. The pituitary gland is dysfunctional and is not secreting TSH.
c. The abnormality is in the thyroid gland itself.
d. The abnormality is caused by an insufficient intake of iodine.
c. The abnormality is in the thyroid gland itself.
Primary hypothyroidism stems from an abnormality in the thyroid gland itself and occurs when the thyroid gland is not able to perform one of its many functions.
A 19-year-old woman has been diagnosed with hypothyroidism and has started thyroid replacement therapy with levothyroxine (Synthroid). After 6 months, she calls the nurse to say that she feels better and wants to stop the medication. Which response by the nurse is correct?
a. “You can stop the medication if your symptoms have improved.”
b. “You need to stay on the medication for at least 1 year before a decision about stopping it can be made.”
c. “You need to stay on this medication until you become pregnant.”
d. “Medication therapy for hypothyroidism is usually lifelong, and you should not
stop taking the medication.”
d. “Medication therapy for hypothyroidism is usually lifelong, and you should not
stop taking the medication.”
