Metabolism

Question 1

Classification of levothyroxine (Synthroid)?

Answer 1

Thyroid hormone replacement

Question 2

Contraindications of levothyroxine?

Answer 2

Severe CV conditions
Acute MI
Adrenal insufficiency

Question 3

Uses/action for levothyroxine?

Answer 3

T4 replacement
Uses: hypothyroidism

Question 4

Interactions with levothyroxine?

Answer 4

Cholestyramine
Colestipol
Epinephrine
Norepinephrine

Question 5

Side effects of levothyroxine?

Answer 5

Insomnia
Headache
Weight loss
Anxiety
Heat intolerance
Menstrual irregularities

Question 6

Nursing interventions of levothyroxine?

Answer 6

Monitor BP and HR - report tachycardia
Monitor for hyperthyroidism - BMR too high in older adults - angina, heart failure
Monitor thyroid function tests (T4, TSH)
Concurrent anticoagulant therapy - monitor INR/PT
Teach pt to take on empty stomach 30-60 minutes before breakfast

Question 7

The nurse tells Nettie to call the healthcare provider to report which side effects?

Answer 7

Insomnia
Palpitation
Fast heart rate
Chest pain

Question 8

What are some of the symptoms for being diagnosed with diabetes?

Answer 8

Fatigue
Excessive thirst (polydipsia)
excessive hunger (polyphagia)
Urinating more than normal (polyuria)
Blurred vision
A1C level is 7% (blood sugar levels)

Question 9

What drugs can be given together for diabetes if the pancreas is still secreting some insulin?

Answer 9

Oral anti-diabetic drugs and insulin

Question 10

Classification for Metformin?

Answer 10

Antidiabetic, biguinide

Question 11

Contraindications for metformin?

Answer 11

Hepatic or cardiopulmonary insufficiency
Acute MI
Metabolic or lactic acidosis
Renal disease
Alcoholism

Question 12

Uses/action for metformin?

Answer 12

> cell sensitivity to insulin
< hepatic production of glucose
Uses: type 2 diabetes

Question 13

Interactions with metformin?

Answer 13

Captopril
Furosemide
Nifedipine
Digoxin
Vancomycin
Anole antifungals

Question 14

Side effects of metformin?

Answer 14

Nausea
Vomiting
Abdominal pain
Bitter or metallic taste
Diarrhea
Bloated mess
Anorexia
Lactic acidosis

Question 15

Nursing interventions for metformin?

Answer 15

Monitor BS
Report S/S lactic acidosis: somnolence, malaise, myalgia, respiratory depression, abdominal distress
Monitor CV status
Monitor lab tests: kidney & liver function, A1C, fasting BS
Instruct pt to avoid alcohol

Question 16

What determines whether a patient is treated with an anti-diabetic drug or insulin?

Answer 16

Acute - how high the blood sugar is at the time
Chronic - oral anti-diabetic drugs: age 40 or older, diagnosis < 5 years, normal weight or over weight, FBS <200 mg/dl, takes < 40 units insulin/day, normal renal and hepatic function.

Question 17

Classification of dulaglutide (trulicity)?

Answer 17

Antidiabetic, incretin mimetic

Question 18

Contraindications for dulaglutide (trulicity)?

Answer 18

Pancreatitis, thyroid cancer (hex or family hx)

Question 19

Uses/action for dulaglutide (trulicity)?

Answer 19

Type 2 diabetes
Action: mimics function of incretin; incretin secreted by intestinal mucosa after meal; signal pancreas to secrete insulin & liver to stop making glucagon.

Question 20

Interactions with dulaglutide (trulicity)?

Answer 20

Insulin

Question 21

Side effects of dulaglutide?

Answer 21

Hypoglycemia
GI distress
Anorexia
Weight loss

Question 22

Nursing interventions for dulaglutide?

Answer 22

Monitor BS, GI distress, pancreatitis, kidney function
Monitor/report injection site reactions
Monitor for thyroid tumors

Question 23

Insulin name, short/intermediate/long acting?

Answer 23

Short acting
—— Lispro, regular
Intermediate acting
—— Isophane
Long acting
—— Glargine, Detemir

Question 24

What insulin can be combined in what order?

Answer 24

Do not mix long acting insulin with any other insulin.
Intermediate acting insulin (isophane) can mix with short acting - draw up short acting first.
Draw up clear insulin before cloudy.

Question 25

Nursing considerations for insulin?

Answer 25

Lispro - Monitor glucose closely
Regular - Monitor glucose closely; only insulin that can be given IV

Isophane - Can mix w/ short-acting insulins in same syringe; draw up short-acting first.

Glargine - Do not mix with other insulin
Detemir - Do not mix with other insulin, give at bedtime