Exam 7- MSK and Endocrine Flashcards
A)The onset of Acromegaly is usually between the ages of 9-21 years old.
B)The person with Gigantism is typically very tall, sometimes up to 7ft.
C)The person with Acromegaly will need to buy a bigger shoe size.
D)The person with Gigantism will not show the symptoms until they are in their older adult years.
E)The person with Acromegaly will commonly have cardiomegaly.
B, C, E
Growth hormone replacement therapy has been prescribed for the child with a growth hormone deficiency. Somatropin (Humatrope), a synthetic growth hormone, is administered by which route?
sub cutaneously
How frequently should the child on Growth Hormone replacement have bone-age (epiphyseal plate) assessed with an X-Ray?
monthly
Prolonged synthetic growth hormone replacement therapy may lead to which one of the following health problems?
A. Hyperthyroidism
B. Asthma
C. Diabetes Mellitus
D. Cushings Syndrome
Diabetes Mellitus
T/F Diabetes Insipidus is a disease in which the person has excessive secretion of the ADH.
False
A nurse can expect that the person with untreated D.I. will have which of the following symptoms?
A. polyuria
B. decreased urine output
C. Dry mucous membranes
D. pulmonary edema
E. urine specific gravity less than 1.010
A, C, E
What is DDAVP? What is another name for this drug?
Desmopressin Acetate, a synthetic form of vasopressin hormone
Vasopressin: a hormone regulates the water balance.
T/F: Diabetes Insipidus is treated with drugs such as DDAVP or Vasopressin
true
T/F: Both DDAVP and Vasopressin can lead to an adverse effect of vasoconstriction.
True , but there is more in Vasopressin
The drug of choice for Diabetes Insipidus, b/c of les severe side effects and can be administered intranasally is ->
DDAVP
What are symptoms of hyponatremia? Why would someone with SIADH have hyponatremia?
cognitive changes, EKG changes, seizure that can lead to coma
// because all the water retention dilutes the sodium
What are common side effects of DDVAP and Vasopressin, in the treatment of Diabetes Insipidus?
hypertension, water intoxication, tachypnea
What is Myxedema? what are some signs and symptoms
What do they need?
the result of undiagnosed or untreated hypothyroidism -
they need thyroid hormone every morning without food
everything is sluggish
HR is low
hypothermia
hypotension
hypoventilation
loss of consciousness
weight gain
Which med will someone with Myxedema Coma be treated with
IV Levothyroxine
What are signs and symptoms of Graves Disease
Tachycardi
excessive perspiration
heat intolerance
nervousness & irritability
exophthalmos
weight loss
What are medications to be taken for hyperthyroidism
Propranolol – to decrease the heart rate
Methimazole (Tapazole) –
The patient is being treated with Methimazole for hyperthyroidism (grave’s disease). If the pt is not receiving enough medication, which of the following symptoms might you expect?
A) Constipation
B) Diarrhea
C) Bradycardia
D. Tachycardia
E. Perspiration
F. Dry skin
G. Weight gain
H. Weight loss
Diarrhea, tachycardia, perspiration, weight loss
The pt is receiving for the treatment of hyperthyroidism and calls the health clinic and reports a sore throat and fever. The nurse instructs the patient to…
A. Please come to the clinic to have your WBC count checked.
B. You may take acetaminophen for the pain and fever.
C. This is a common adverse effect of Methimazole. Nothing to be concerned
D. Please monitor the fever for the next few days. If you continue to have a fever.
A– check the WBC count
Agranulocytosis: low neutrophils and high risk for infection.
What medication might someone with hypothyroidism be prescribed? What will it do to the oxygen demand of the heart?
Levothyroxine
Increase oxygen demand of the heart
What are some nurse education points for Levothyroxine?
-you can expect to take med for lifetime
-narrow therapeutic window
-take med in the morning on an empty stomach with glass of water
-will take a month for drug to reach therapeutic level
-report any chest pain or SOB
What are some symptoms for someone with Adrenal Insufficiency. What does this mean and what are some signs and symptoms
inadequate release of glucocorticoid (cortisol) and mineralcorticoid (aldosterone)
weakness and fatigue
hypotension
hyponatremia
hyperkalemia
What drugs for Addisons Disease?
Adrenal insufficiency
Hydrocortisone
A pt with Addison’s Disease has been treated with Hydrocortisone. The provider determines the pt is not receiving adequate mineralocorticoid. What is a Mineral-corticoid agent that can be given to this patient?
Fludrocortisone
Who would get Cushings Syndrome?
A) The patient treated with Hydrocortisone for Addison’s Disease
B) The pt treated with a corticosteroid medication long term for treatment of rheumatoid arthritis
C) The patient treated with Levothyroxine for hypothyroidism.
D. The patient treated with propranolol to control HR with hyperthyroidism.
A & B
The patient treated with Hydrocortisone for Addison’s Disease
The pt treated with a corticosteroid medication long term for treatment of rheumatoid arthritis
*anytime someone is on systemic prolonged glucocorticoid meds *
What is Ketoconazole (Nizoral) used for?
Cushings Syndrome
What is Somatropin (Humatrope) used for?
Growth Hormone Deficit
What is Propylthiouracil (PTU) used for? What would you use if you couldn’t find this drug?
Hyperthyroidism
Methylmizole
what does it mean if something inhibits osteoclast activity?
it will decrease bone resorption (the break down of bone)
what does osteopenia mean? What will the team recommend for this pt?
precursor for osteoporosis
*vitamin D, weight bearing exercises, calcium pills
S/S of hypercalcemia
kidney stone
When do Chvostek and Trousseau signs show up?
hypocalcemia
What is a medication that promote bone formation?
Teriparatide (forteo)
How does Alendronate (Fosamax) work?
decrease bone resorption
The nurse is preparing Alendronate (Fosamax).
Which of the following are True?
A. Drug increases osteoclast activity
B. Drug has a narrow therapeutic range and high toxicity risk
C. drug must be given with food to decrease the GI effects
D. The pt must be upright for 30 min after administration
D. The pt must be upright for 30 min after administration
ADRS of Bisphosphonates
administration details
-dronate
empty stomach
-any food will decrease absorption
-full water glass to decrease
-sitting up
ADRs: esophagitis lead to ulcer, cancer
atypical femur fracture
necrosis of the jaw
What is the drug category of Raloxifene?
What is the MOA
What are the ADRS
drug category is SERM
it works by binding to estrogen receptors in the bones
Adrs: thromboembolism and stroke
Ibandronate MOA is
inhibits bone resorption by decreasing osteoclast activity
Calcitonin
hormone that moves calcium from blood stream to the bone
Teriparatide
what is it and what is the black box warning?
increases bone deposition by osteoblasts
Calcitriol
vitamin D supplement
Denosumab
Monoclonal antibody that decreases formation and function of osteoclast
Tum
calcium supplement
treatment of rheumatoid arthritis -
NSAID and Glucocorticoid at first, and the DMARD but that takes longer to come into effect
NSAIDs for RA b/c –>
anti-inflammatory and analgesic effects
Which of the lab tests should be monitored for DMARD, methotrexate?
A) potassium and sodium
B) AST and ALT
C. CBC
D. T4 and TSH
e. Vitamin D
AST and ALT liver function
CBC
What is innacurate about Methotrexate?
A. drug is sometimes used to treat cancer
B. blood checks need to happen on the reg
C. call doctor if experience yellowing of eyes or skin
D. i should start to feel better within a few days
D - doesnt work right away
What is an ADR of the DMARD Etanercept Enbrel)?
systemic infections due to immunosuppressant activity
b/c it blocks one of the inflammatory mediators
ADRS of TNF (tumor necrosis factor)
Allopurinol what does it do
prevention of future gout attacks
Inhibits uric acid formation
Naproxem
treat acute symptoms during gout attack (it is NSAID)
Probenecid
prevent future gout attacks
increases uric acid excretion
Prednisone
treat acute symptoms during gout attack
Indomethacin
treat actute symptoms during gout attack
Colchicine
antiinflammatory
What is the difference between muscle spasm and spasticity?
spasm: caused by injury or overuse, involuntary contractions
spasticity: caused by damage to upper motor neurons in theCNS, muscles are in constant state of contraction
Pt is prescribed Baclofen for muscle ________. Where will work? What are ADRS
spasticity, within the CNS as a depressant
ADRS are drowsiness, fatigue, hypoventilation, dizziness
Which of the following drugs used to treat muscle spasticity works directly on the skeletal muscles?
dantrolene
A pt experiences muscle spasms . Prescribed Cyclobenzaprine (flexeril). What is a pt teaching regarding this drug?
dont drive your car while taking this medication
(anything that requires alertness)
