test Flashcards
What would the nurse assess when monitoring for the therapeutic effectiveness of vasopressin?
fluid balance
The nurse admitting a patient with acromegaly anticipates administering which medication?
octreotide (Sandostatin)
After administering somatropin (Serostim), the nurse would assess for adverse effects by monitoring which parameters?
serum glucose levels
when administering vasopressin, which is the priority vital sign for the nurse to monitor?
blood pressure
which nursing diagnosis is most appropriate for a patient who is receiving a pituitary drug?
disturbed body image
the nurse will instruct a patient taking desmopressin as a nasal spray for the treatment of DI to preform which action to obtain maximum benefit of the drug?
clear the nasal passages before spraying the medication
what 2 drugs can be used to treat DI?
vasopressin or desmopressin
function of ADH
promotes renal conservation of H2O by increasing permeability of collecting ducts;
regulated by the hypothalamus
adverse effects of vasopressin
increased BP (r/t excess vasoconstriction); HA; dizziness; uterine cramping; H2O intoxication
growth hormone-kids
- deficiency?
- excess?
- short stature
2. gigantism
growth hormone- adults
- deficiency?
- excess?
- decreased muscle mass; reduced exercise tolerance
2. acromegaly
adverse effect of GH therapy
hyperglycemia; neutralizing that bind with GH; fatality in Prader Willi
adverse effects of Somatropin
hyperglycemia; hypothyroidism; antibodies against GH
use growth hormone cautiously in which patients?
migraine; asthma; epilepsy
thyroid hormone regulates what body processes?
basal metabolic rate;
lipid/carb metabolism (essential for normal growth and development)
heart regulation
hypothyroidism lab test
high TSH
hypothyroidism in pregnancy effects?
can cause neuropsych problems in child
hypothyroidism in adults (symptoms)
many not be noticed if mild
if moderate to severe: pale face; cold skin; lethargy; goiter
congenital hypothyroidism
failure of thyroid development in utero; part of newborn screen
most common cause of hyperthyroidism
Graves Disease
**affects women 6x more than men
symptoms of grave’s disease
tachycardia CNS stimulation Increased metabolic rate weight loss exophthalmos (bulging eyes)
treatment for graves disease
surgery
destruction w/ iodine
suppression w/ antithyroid drugs
treatment for hypothyroidism (drug)
levothyroxine
treatment for hyperthyroidism
PTU (adjunct w/ surgery/radiation)
Which statement by the patient demonstrates an understanding of discharge instructions on the use of levothyroxine (Synthroid)?
“I will take this medication in the morning so as not to interfere with sleep.”
The nurse would suspect excessive thyroid replacement in a patient taking levothyroxine (Synthroid) when the patient is exhibiting which adverse effect?
irritability
Patients taking levothyroxine (Synthroid) and warfarin (Coumadin) concurrently would be monitored for which adverse effect?
increased risk of bleeding
A patient receiving propylthiouracil (PTU) asks the nurse how this medication will help relieve his symptoms. What is the nurse’s best response?
“Propylthiouracil inhibits the formation of new thyroid hormone, thus gradually returning your metabolism to normal.”
The nurse is teaching the patient taking an antithyroid medication to avoid foods high in iodine. Which food will the nurse advise the patient against?
seafood
Which patient statement demonstrates understanding of radioactive iodine (I-131) therapy?
“This drug will be taken up by the thyroid gland and destroy the cell to reduce my hyperthyroidism”
When assessing for potential toxicity to PTU, the nurse will monitor the patient for changes in which laboratory test?
CBC
The nurse is reviewing adverse effects of antithyroid medications with a patient who has been taking PTU. What adverse effects does the nurse include in the teaching? (Select all that apply.)
liver and bone marrow toxicity
A patient who is beginning therapy with levothyroxine ask the nurse when the medication will start working. The best response is?
within a few weeks
A pt wants to switch brands of levothyroxine . What is the nurses best response?
“You should check with your provider before switching brands”
Pt teaching for a pt taking antithyroid medication will include the need to avoid which foods?
soy products and seafood
Which statement by the patient indicates a need for further teaching about thyroid replacement therapy?
“Sometimes this medication can make my heart skip beats, but that’s a normal side effect”
diabetes mellitus blood sugar level
above 126 (fasting blood glucose)
signs and symptoms of DM (7)
polyuria polydipsia polyphagia glucosuria unexplained wt loss fatigue hyperglycemia
treatment for DM
- type 1
- type 2
- insulin
2. lifestyle change, oral drug therapy; insulin as last resort
Insulin lispro (Humalog)
similar to endogenous insulin
- *Rapid acting (5 - 15 minutes)
- *given subQ or subQ insulin pump