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pharm; ch 30-35; 38; 39; 58 > test > Flashcards

test Flashcards

1
Q

What would the nurse assess when monitoring for the therapeutic effectiveness of vasopressin?

A

fluid balance

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2
Q

The nurse admitting a patient with acromegaly anticipates administering which medication?

A

octreotide (Sandostatin)

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3
Q

After administering somatropin (Serostim), the nurse would assess for adverse effects by monitoring which parameters?

A

serum glucose levels

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4
Q

when administering vasopressin, which is the priority vital sign for the nurse to monitor?

A

blood pressure

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5
Q

which nursing diagnosis is most appropriate for a patient who is receiving a pituitary drug?

A

disturbed body image

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6
Q

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?

A

clear the nasal passages before spraying the medication

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7
Q

what 2 drugs can be used to treat DI?

A

vasopressin or desmopressin

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8
Q

function of ADH

A

promotes renal conservation of H2O by increasing permeability of collecting ducts;

regulated by the hypothalamus

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9
Q

adverse effects of vasopressin

A

increased BP (r/t excess vasoconstriction); HA; dizziness; uterine cramping; H2O intoxication

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10
Q

growth hormone-kids

  1. deficiency?
  2. excess?
A
  1. short stature

2. gigantism

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11
Q

growth hormone- adults

  1. deficiency?
  2. excess?
A
  1. decreased muscle mass; reduced exercise tolerance

2. acromegaly

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12
Q

adverse effect of GH therapy

A

hyperglycemia; neutralizing that bind with GH; fatality in Prader Willi

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13
Q

adverse effects of Somatropin

A

hyperglycemia; hypothyroidism; antibodies against GH

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14
Q

use growth hormone cautiously in which patients?

A

migraine; asthma; epilepsy

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15
Q

thyroid hormone regulates what body processes?

A

basal metabolic rate;

lipid/carb metabolism (essential for normal growth and development)

heart regulation

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16
Q

hypothyroidism lab test

A

high TSH

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17
Q

hypothyroidism in pregnancy effects?

A

can cause neuropsych problems in child

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18
Q

hypothyroidism in adults (symptoms)

A

many not be noticed if mild

if moderate to severe: pale face; cold skin; lethargy; goiter

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19
Q

congenital hypothyroidism

A

failure of thyroid development in utero; part of newborn screen

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20
Q

most common cause of hyperthyroidism

A

Graves Disease

**affects women 6x more than men

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21
Q

symptoms of grave’s disease

A 
tachycardia
CNS stimulation
Increased metabolic rate
weight loss
exophthalmos (bulging eyes)
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22
Q

treatment for graves disease

A

surgery
destruction w/ iodine
suppression w/ antithyroid drugs

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23
Q

treatment for hypothyroidism (drug)

A

levothyroxine

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24
Q

treatment for hyperthyroidism

A

PTU (adjunct w/ surgery/radiation)

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25
Q

Which statement by the patient demonstrates an understanding of discharge instructions on the use of levothyroxine (Synthroid)?

A

“I will take this medication in the morning so as not to interfere with sleep.”

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26
Q

The nurse would suspect excessive thyroid replacement in a patient taking levothyroxine (Synthroid) when the patient is exhibiting which adverse effect?

A

irritability

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27
Q

Patients taking levothyroxine (Synthroid) and warfarin (Coumadin) concurrently would be monitored for which adverse effect?

A

increased risk of bleeding

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28
Q

A patient receiving propylthiouracil (PTU) asks the nurse how this medication will help relieve his symptoms. What is the nurse’s best response?

A

“Propylthiouracil inhibits the formation of new thyroid hormone, thus gradually returning your metabolism to normal.”

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29
Q

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?

A

seafood

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30
Q

Which patient statement demonstrates understanding of radioactive iodine (I-131) therapy?

A

“This drug will be taken up by the thyroid gland and destroy the cell to reduce my hyperthyroidism”

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31
Q

When assessing for potential toxicity to PTU, the nurse will monitor the patient for changes in which laboratory test?

A

CBC

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32
Q

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.)

A

liver and bone marrow toxicity

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33
Q

A patient who is beginning therapy with levothyroxine ask the nurse when the medication will start working. The best response is?

A

within a few weeks

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34
Q

A pt wants to switch brands of levothyroxine . What is the nurses best response?

A

“You should check with your provider before switching brands”

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35
Q

Pt teaching for a pt taking antithyroid medication will include the need to avoid which foods?

A

soy products and seafood

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36
Q

Which statement by the patient indicates a need for further teaching about thyroid replacement therapy?

A

“Sometimes this medication can make my heart skip beats, but that’s a normal side effect”

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37
Q

diabetes mellitus blood sugar level

A

above 126 (fasting blood glucose)

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38
Q

signs and symptoms of DM (7)

A 
polyuria
polydipsia
polyphagia 
glucosuria 
unexplained wt loss
fatigue 
hyperglycemia
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39
Q

treatment for DM

  1. type 1
  2. type 2
A
  1. insulin

2. lifestyle change, oral drug therapy; insulin as last resort

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40
Q

Insulin lispro (Humalog)

A

similar to endogenous insulin

  • *Rapid acting (5 - 15 minutes)
  • *given subQ or subQ insulin pump
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41
Q

Regular Insulin (Humanlin R)

A

onset 30-60 minutes; clear

**the only insulin that may be given IV infusion or drip or IM

42
Q

Isophane insulin suspension (NPH)

A
  • cloudy

* *slower onset and more prolonged duration than endogenous insulin

43
Q

glargine (Lantus), detemir (Levemir)

A
  • long-acting

* *referred to as basal insulin

44
Q

Which is a rapid-acting insulin with an onset of action of less than 15 minutes?

A

insulin aspart (Novolog)

45
Q

Which long-acting insulin mimics natural, basal insulin with no peak action and a duration of 24 hours?

A

insulin glargine (Lantus)

46
Q

Which insulin can be administered by continuous intravenous infusion?

A

regular insulin (Humalin R)

47
Q

The nurse is caring for a patient scheduled to undergo a cardiac catheterization procedure utilizing iodine-based contrast material. The nurse would question an order for which medication to be given to this patient the day before the scheduled procedure?

A

metformin (Glucophage)

48
Q

The patient is prescribed 30 units regular insulin and 70 units NPH insulin subcutaneously every morning. The nurse will provide which instruction to the patient?

A

“Draw up regular insulin into the syringe first, followed by the cloudy NPH insulin”

49
Q

The nurse is providing education to a patient about the time to take glipizide (Glucotrol). For maximum benefit, the nurse will tell the patient to administer glipizide at which time?

A

30 minutes before a meal

50
Q

The nurse will advise the patient to treat hypoglycemia with which drug?

A

glucagon

51
Q

Which information should be included in a teaching plan for patients taking oral hypoglycemic drugs?

A
  • limit your alcohol consumption
  • report symptoms of anorexia and fatigue
  • notify your physician if blood glucose levels rise above the level set for you
52
Q

when administering insulin, the nurse must keep in mind that which is the most immediate and serious adverse effect?

A

hypoglycemia

53
Q

a dose of long-acting insulin has been ordered for bedtime for a diabetic pt. the nurse expects to administer which insulin?

A

Glargine

54
Q

signs of hypoglycemia

A

irritability, sweating, and confusion

55
Q

oral anti-diabetic drugs

A

used to treat type 2 diabetes

**only effective w/ lifestyle/diet changes

56
Q

metformin

A

oral anti-diabetic drug

**does not decrease insulin production so can’t cause hypoglycemia

***lactic acidosis rare but fatal

57
Q

adrenal medulla

A

secretes catecholamines

epi and norepi

58
Q

adrenal cortex

A 
secretes corticosteroids 
(glucocorticoids and mineralcorticoids [primarily aldosterone])
59
Q

“moon face”

A

Cushing’s syndrome

**increased secretion of adrenal corticoid hormone

60
Q

Addison’s disease

A

under secretion

  • *decreased Na and glucose
  • *increased K+, dehydration and wt loss
61
Q

glucocorticoids inhalation used for?

A

bronchospasms

62
Q

glucocorticoids nasally used for?

A

rhinitis

63
Q

glucocorticoids topically used for?

A

inflammation of eye, ear, skin

64
Q

a patient is taking an inhaled corticosteroid for asthma. After the pt takes a dose, the nurse’s priority should be to:

A

instruct the pt to rinse his mouth with warm water

65
Q

what lab values may change with glucocorticoids

A

blood glucose and electrolytes

66
Q

patients taking glucocorticoids should be told to avoid?

A

sick people; it can be an immunosuppressant

67
Q

what can happen with sudden discontinuation of glucocorticoids?

A

adrenal crisis r/t sudden drop in cortisone levels

68
Q

a patient taking glucocorticoids needs to avoid what drugs?

A

alcohol, NSAIDs, and aspirin

69
Q

A patient will be receiving somatropin. The nurse expects that the patient has which disorder?

A

hypopituitary dwarfism

70
Q

A women who has hypothyroidism will have to stop her thyroid replacement therapy now that she is pregnant.

True or false?

A

False

Fetal growth may be retarded if maternal hypothyroidism is untreated during preg.

71
Q

A patient who is taking thyroid replacement medication begins to experience cold intolerance, depression, constipation and dry skin. What is the concern?

A

Inadequate doses of the medication

72
Q

what effect can corticosteroids have on insulin?

A

antagonistic–resulting in elevated blood glucose levels

73
Q

The nurse has just administered the morning dose of a patient’s lispro insulin. Just after the injection, the dietary department calls to inform the patient care unit that breakfast trays will be 45 minutes late. What should the nurse do next?

A

Give the patient food.

rationale: Lispro onset of action is 15 minutes. It is essential that a diabetic pt eat a meal after the injection to avoid hypoglycemia

74
Q

T/F

Oral corticosteroids should be taken once daily in the morning to minimize adrenal suppression

A

True–

**take with milk or food to minimize GI upset

75
Q

A patient is receiving prednisone as part of treatment for severe arthritis. He is also receiving furosemide (a loop diuretic), levothyroxine (for hypothyroidism), and a proton pump inhibitor (for gastroesophageal reflux disease [GERD]). Which drug may be a concern during the therapy with prednisone?

A

The furosemide

rationale: loop diuretic with corticosteroids may result in hypokalemia b/c of K+ loss with both drugs

76
Q

The nurse will monitor which lab for a patient on aminoglutethimide?

A

Liver enzymes

**the drug may cause hepatotoxicity

77
Q

progestin

  1. produced by?
  2. effect?
A
  1. corpus luteum, placenta

2. suppresses uterine contractions

78
Q

anabolic steroids

A

increase tissue synthesis

**schedule III b/c highly abused by athletes

79
Q

use of androgen inhibitors

A

for prostate hyperplasia

80
Q

Which adverse effect can result if tetracycline is administered to children under 8 y/o?

A

permanent discoloration of teeth

81
Q

A patient who is allergic to penicillin is at increased risk for an allergy to which drug?

A

cefazolin (Ancef)

82
Q

When planning care for a patient receiving a sulfonamide antibiotic, it is important for the nurse to perform which action?

A

encourage fluid intake

83
Q

When administering a nonsteroidal antiinflammatory drug (NSAID) and penicillin concurrently, displacement of the penicillin antibiotic from the protein-binding sites results in

A

increased free drug in blood

84
Q

During antibiotic therapy, the nurse will assess the patient for a condition that may occur due to the disruption of normal flora. The nurse recognizes this as:

A

superinfection

85
Q

A patient prescribed azithromycin (Zithromax) expresses concern regarding gastrointestinal upset that he experienced when previously taking erythromycin. What is the nurse’s best response?

A

“This drug is like erythromycin with less severe GI side effects”

86
Q

n an effort to prevent superinfections of the gastrointestinal tract (e.g., from Clostridium difficile), the nurse will instruct patients to eat which foods?

A

cultured dairy products such as yogurt

87
Q

The nurse would monitor which laboratory values in a patient receiving intravenous gentamicin (Garamycin)?

A

BUN and creatinine

88
Q

Which is a complication of vancomycin infusions?

A

red man syndrome

89
Q

When teaching a patient being discharged on linezolid (Zyvox) to treat methicillin-resistant Staphylococcus aureus (MRSA), the nurse must emphasize the importance of

A

avoid ingestion of foods contains tyramine

90
Q

he nurse should assess a patient for nephrotoxicity and ototoxicity when administering which antimicrobial?

A

gentamicin

91
Q

When planning care for a patient receiving once-daily intravenous gentamicin therapy, the nurse schedules a trough drug level to be drawn

A

12 hours after completing the infusion

92
Q

The nurse would teach a patient receiving metronidazole (Flagyl) to avoid ingestion of which drink?

A

wine

93
Q

The patient’s culture has grown gram-positive cocci, and the patient is prescribed two different antibiotics, one of which is gentamicin. To treat this type of infection, which type of drug is typically prescribed with gentamicin?

A

a penicillin

94
Q

A patient is prescribed metronidazole (Flagyl) for a gynecologic infection, and she provides a list of medications she takes routinely to the nurse. Which medication would lead the nurse to question the order for Flagyl?

A

litium

95
Q

The nurse bases the plan of care regarding administration of eardrops on knowledge that

A

warming the eardrops to room temp

96
Q

A patient is complaining of excessive earwax, leading to diminished hearing ability. The nurse will expect to teach the patient regarding administration of which medication to correct this problem?

A

carbamide peroxide

97
Q

The nurse is providing education to a patient diagnosed with otitis externa (OE). Which statement by the patient indicates an understanding of the OE treatment plan?

A

“I will use the ear drops in the ear canal to treat this condition”

98
Q

The health care provider has ordered ciprofloxacin/dexamethasone (Ciprodex) otic drops for a patient with OE. The nurse knows the combination medication has both antibacterial medication and topical steroid medication. What is the purpose of the steroid in this medication?

A

reduce inflammation

99
Q

A mother of a young child asks what she can use to help keep her child’s ears clean from wax. What over-the-counter medication will the nurse suggest?

A

debrox

100
Q

The nurse is teaching the mother of a 1-year-old patient how to instill ear drops for OE. What instructions on instillation does the nurse provide to the mother?

A

“hold the pinna down and back”

101
Q

The nurse is evaluating the effectiveness of the otic medication used for OE. What will the nurse evaluate for to determine if the goals of therapy have been met?

A

improved hearing

102
Q

A 14-year-old patient is diagnosed with perforated tympanic membrane, OE, and otitis media. What does the nurse anticipate the provider will prescribe?

A

otic and oral antimicrobials

pharm; ch 30-35; 38; 39; 58 (1 decks)

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