Podcast
Questions and Answers
A patient with severe hypothyroidism might present with which of the following conditions?
A patient with severe hypothyroidism might present with which of the following conditions?
- Hyperthyroidism
- Myxedema (correct)
- Euthyroid goiters
- Thyroid cancer
Which of the following physiological responses would be expected with an increase in thyroid hormones?
Which of the following physiological responses would be expected with an increase in thyroid hormones?
- Decreased cardiac output
- Decreased heart rate
- Decreased body temperature
- Increased oxygen consumption (correct)
A patient taking levothyroxine begins to experience a rapid heart rate, weight loss, and insomnia. Which of the following adverse effects is the patient MOST likely experiencing?
A patient taking levothyroxine begins to experience a rapid heart rate, weight loss, and insomnia. Which of the following adverse effects is the patient MOST likely experiencing?
- Symptoms of hyperthyroidism (correct)
- Hypersensitivity reaction
- Adrenal insufficiency
- Symptoms of hypothyroidism
Why is it generally recommended to avoid switching brands or types of levothyroxine?
Why is it generally recommended to avoid switching brands or types of levothyroxine?
Which of the following conditions is a contraindication for thyroid hormone replacement therapy?
Which of the following conditions is a contraindication for thyroid hormone replacement therapy?
What is an important instruction to provide to a patient who has diabetes and is starting thyroid hormone replacement therapy?
What is an important instruction to provide to a patient who has diabetes and is starting thyroid hormone replacement therapy?
When should vital signs and weight be assessed in relation to a patient starting on thyroid replacement therapy?
When should vital signs and weight be assessed in relation to a patient starting on thyroid replacement therapy?
A patient on thyroid hormone replacement therapy reports weight loss, increased appetite and pulse rate, and decreased puffiness in their face and hands. What does this indicate?
A patient on thyroid hormone replacement therapy reports weight loss, increased appetite and pulse rate, and decreased puffiness in their face and hands. What does this indicate?
Which instruction should be emphasized when educating clients about taking thyroid hormones to promote an optimal response to therapy?
Which instruction should be emphasized when educating clients about taking thyroid hormones to promote an optimal response to therapy?
A client has been prescribed thyroid hormone replacement. What education should the nurse provide regarding adjustments to the medication?
A client has been prescribed thyroid hormone replacement. What education should the nurse provide regarding adjustments to the medication?
Methimazole and propylthiouracil (PTU) are primarily used for the medical management of which endocrine disorder?
Methimazole and propylthiouracil (PTU) are primarily used for the medical management of which endocrine disorder?
What is an important instruction to give to a patient undergoing treatment with radioactive iodine for hyperthyroidism?
What is an important instruction to give to a patient undergoing treatment with radioactive iodine for hyperthyroidism?
After receiving radioactive iodine, what is an important action a patient should do to help with precautions?
After receiving radioactive iodine, what is an important action a patient should do to help with precautions?
What allergy history should be carefully obtained before administering iodine procedures or medications?
What allergy history should be carefully obtained before administering iodine procedures or medications?
If a patient on methimazole develops a rash, what is the MOST important nursing action?
If a patient on methimazole develops a rash, what is the MOST important nursing action?
Why is thyroid hormone replacement therapy necessary when hypothyroidism develops?
Why is thyroid hormone replacement therapy necessary when hypothyroidism develops?
Which of the following is a corticosteroid?
Which of the following is a corticosteroid?
A patient taking corticosteroids for an extended period is MOST at risk for developing which of the following conditions?
A patient taking corticosteroids for an extended period is MOST at risk for developing which of the following conditions?
Which of the following conditions is a common side effect associated with long-term corticosteroid use?
Which of the following conditions is a common side effect associated with long-term corticosteroid use?
What dietary modification is typically recommended for patients taking corticosteroids?
What dietary modification is typically recommended for patients taking corticosteroids?
What is a key monitoring parameter for a diabetic patient who is prescribed corticosteroids?
What is a key monitoring parameter for a diabetic patient who is prescribed corticosteroids?
Why should topical corticosteroids not be covered with occlusive dressings unless specifically directed by a healthcare provider?
Why should topical corticosteroids not be covered with occlusive dressings unless specifically directed by a healthcare provider?
A patient's medication list includes Betamethasone, Cortisone, and Dexamethasone. What class of medications is the patient taking?
A patient's medication list includes Betamethasone, Cortisone, and Dexamethasone. What class of medications is the patient taking?
What are the three primary properties that describe the action of insulin?
What are the three primary properties that describe the action of insulin?
A patient is experiencing tremors, tachycardia, and is diaphoretic. What condition should these signs and symptoms indicate to the nurse?
A patient is experiencing tremors, tachycardia, and is diaphoretic. What condition should these signs and symptoms indicate to the nurse?
A patient presents with hot, flushed skin along with fruity breath and polyuria. Thinking about DKA, what condition should these signs and symptoms indicate to the nurse?
A patient presents with hot, flushed skin along with fruity breath and polyuria. Thinking about DKA, what condition should these signs and symptoms indicate to the nurse?
It is most important to assess what before the administration of insulin?
It is most important to assess what before the administration of insulin?
Under what circumstances can Regular insulin be administered intravenously?
Under what circumstances can Regular insulin be administered intravenously?
Why should insulin glargine NEVER be mixed with other insulins?
Why should insulin glargine NEVER be mixed with other insulins?
When planning the rotation of insulin injection sites, what consideration is MOST important?
When planning the rotation of insulin injection sites, what consideration is MOST important?
What information about insulin administration should be documented on a patient's Medication Administration Record (MAR)?
What information about insulin administration should be documented on a patient's Medication Administration Record (MAR)?
What is the PRIMARY reason for rotating insulin injection sites?
What is the PRIMARY reason for rotating insulin injection sites?
If a patient is hypoglycemic, what would you NOT do?
If a patient is hypoglycemic, what would you NOT do?
Which type of insulin has the fastest onset of action and is often used in insulin pumps?
Which type of insulin has the fastest onset of action and is often used in insulin pumps?
Why can intermediate acting insulin ONLY be administered subcutaneously?
Why can intermediate acting insulin ONLY be administered subcutaneously?
Which of the following instructions is important for a patient who has been prescribed Glucophage (metformin)?
Which of the following instructions is important for a patient who has been prescribed Glucophage (metformin)?
Which of the following side effects should a patient report for drugs ending in 'ide'?
Which of the following side effects should a patient report for drugs ending in 'ide'?
When should the medication Precose (acarbose) be taken in relation to meals?
When should the medication Precose (acarbose) be taken in relation to meals?
What instruction regarding the timing of medication is important for a patient newly prescribed Prandin (repaglinide)?
What instruction regarding the timing of medication is important for a patient newly prescribed Prandin (repaglinide)?
A patient with Parkinson's disease is experiencing increased hand tremor, dizziness, and difficulty in swallowing. How are these classified?
A patient with Parkinson's disease is experiencing increased hand tremor, dizziness, and difficulty in swallowing. How are these classified?
What is the mechanism of action of levodopa/carbidopa in treating Parkinson's disease?
What is the mechanism of action of levodopa/carbidopa in treating Parkinson's disease?
What is one of the most common side effects of Symmetrel (amantadine)?
What is one of the most common side effects of Symmetrel (amantadine)?
What recommendation should be given to someone who has dry mouth in relation to medications for parkinsonism?
What recommendation should be given to someone who has dry mouth in relation to medications for parkinsonism?
Which of the following is a potential use for thyroid hormones?
Which of the following is a potential use for thyroid hormones?
What physiological change occurs with the increase in thyroid hormone levels?
What physiological change occurs with the increase in thyroid hormone levels?
A patient with cardiac disease needs thyroid hormone replacement. What should the healthcare provider consider when initiating therapy?
A patient with cardiac disease needs thyroid hormone replacement. What should the healthcare provider consider when initiating therapy?
What indicates a therapeutic response to thyroid hormone replacement therapy?
What indicates a therapeutic response to thyroid hormone replacement therapy?
After thyroid hormone therapy starts, a diabetic patient may require closer monitoring for:
After thyroid hormone therapy starts, a diabetic patient may require closer monitoring for:
When a patient is prescribed methimazole for hyperthyroidism, what instructions should be provided?
When a patient is prescribed methimazole for hyperthyroidism, what instructions should be provided?
What is the correct procedure if a suspected iodine allergy is present before administering radioactive iodine?
What is the correct procedure if a suspected iodine allergy is present before administering radioactive iodine?
After receiving radioactive iodine, patients should maintain a distance of how many feet from others?
After receiving radioactive iodine, patients should maintain a distance of how many feet from others?
Why is thyroid hormone replacement typically continued lifelong for individuals with hypothyroidism?
Why is thyroid hormone replacement typically continued lifelong for individuals with hypothyroidism?
What therapeutic use is commonly associated with corticosteroids?
What therapeutic use is commonly associated with corticosteroids?
What condition is a long-term risk with corticosteroid use?
What condition is a long-term risk with corticosteroid use?
Why is it important not to discontinue corticosteroids abruptly?
Why is it important not to discontinue corticosteroids abruptly?
A patient is prescribed corticosteroids. What dietary advice is most appropriate?
A patient is prescribed corticosteroids. What dietary advice is most appropriate?
What should a patient taking corticosteroids for more than five days do while discontinuing their therapy?
What should a patient taking corticosteroids for more than five days do while discontinuing their therapy?
What should the nurse tell a patient about applying topical corticosteroids?
What should the nurse tell a patient about applying topical corticosteroids?
A patient is ordered to receive Florinef for medication. Which condition does this medication treat?
A patient is ordered to receive Florinef for medication. Which condition does this medication treat?
What aspect of diabetes does assessing HgBA1C as part of a pre-administration assessment for insulin relate to?
What aspect of diabetes does assessing HgBA1C as part of a pre-administration assessment for insulin relate to?
Why is insulin glargine typically administered at bedtime?
Why is insulin glargine typically administered at bedtime?
Why is it important to plan the injection site when administering insulin?
Why is it important to plan the injection site when administering insulin?
Why is it not safe to administer oral medications to those going through a hypoglycemic reaction?
Why is it not safe to administer oral medications to those going through a hypoglycemic reaction?
Which intervention is needed when a patient is ordered to receive Humalog Mix 75/25 insulin suspension?
Which intervention is needed when a patient is ordered to receive Humalog Mix 75/25 insulin suspension?
What patient education should be included with a prescription for Glucophage (metformin)?
What patient education should be included with a prescription for Glucophage (metformin)?
Drugs that end in 'ide' such as Glimepiride, Glyburide, and Glipizide are important to educate patients report which side effect?
Drugs that end in 'ide' such as Glimepiride, Glyburide, and Glipizide are important to educate patients report which side effect?
Precose (acarbose) lowers blood sugar, but how?
Precose (acarbose) lowers blood sugar, but how?
Increased dosing of Prandin may influence what?
Increased dosing of Prandin may influence what?
What causes Parkinson's disease?
What causes Parkinson's disease?
While working with the patient that has parkinsonism, you hear the doctor has ordered Tolcapone (Tasmar). This medication can be toxic to what?
While working with the patient that has parkinsonism, you hear the doctor has ordered Tolcapone (Tasmar). This medication can be toxic to what?
The patient states they have been experiencing dry mouth from their parkinsonism medications. What is the nurse's best response?
The patient states they have been experiencing dry mouth from their parkinsonism medications. What is the nurse's best response?
You are taking care of a Parkinson's disease patient in which the provider has prescribed selegiline. What would you educate to your patient in relation to food?
You are taking care of a Parkinson's disease patient in which the provider has prescribed selegiline. What would you educate to your patient in relation to food?
A patient with parkinsonism that has a tremor, what medication would be ordered?
A patient with parkinsonism that has a tremor, what medication would be ordered?
What intervention is most important when providing medications to a patient with memory loss and reduced cognition?
What intervention is most important when providing medications to a patient with memory loss and reduced cognition?
A patient with Alzheimer's disease has an adverse reactions to their medications that includes anorexia, n/v, and dizziness. What can you educated the patient in relation to this?
A patient with Alzheimer's disease has an adverse reactions to their medications that includes anorexia, n/v, and dizziness. What can you educated the patient in relation to this?
Myasthenia gravis reduces the production of what naturally in the body?
Myasthenia gravis reduces the production of what naturally in the body?
You remember from clinicals that cholinergic medications can be used for which conditions?
You remember from clinicals that cholinergic medications can be used for which conditions?
A patient with a cholinergic order is reporting salivation and muscle weakness, what would be your next step and what condition are you worried about?
A patient with a cholinergic order is reporting salivation and muscle weakness, what would be your next step and what condition are you worried about?
A patient has an adverse affect and are experiencing a urinary retention from their medication. What could the provider order?
A patient has an adverse affect and are experiencing a urinary retention from their medication. What could the provider order?
A patient takes Benadryl for allergies and Urecholine, a cholinergic for urinary retention. Can these be taken together?
A patient takes Benadryl for allergies and Urecholine, a cholinergic for urinary retention. Can these be taken together?
What is an expected side-effect if a cholinergic gets into your eyes?
What is an expected side-effect if a cholinergic gets into your eyes?
What class of medications are you most concerned with while assessing for an allergy to Sulfa?
What class of medications are you most concerned with while assessing for an allergy to Sulfa?
What would you educate your diabetic patient about to expect regarding their illness, if they are also taking a diuretic?
What would you educate your diabetic patient about to expect regarding their illness, if they are also taking a diuretic?
A nurse has an order for a patient that needs to take a few diuretics. They need to give it but notes that the BUN and Creatinine are 3x the normal value. What should they do?
A nurse has an order for a patient that needs to take a few diuretics. They need to give it but notes that the BUN and Creatinine are 3x the normal value. What should they do?
A patient being treated for hypothyroidism with levothyroxine reports persistent constipation and increased fatigue. Which action is the MOST appropriate?
A patient being treated for hypothyroidism with levothyroxine reports persistent constipation and increased fatigue. Which action is the MOST appropriate?
A patient is prescribed methimazole for hyperthyroidism. What potential side effect should the patient be taught to immediately report to their healthcare provider?
A patient is prescribed methimazole for hyperthyroidism. What potential side effect should the patient be taught to immediately report to their healthcare provider?
A patient with iodine allergy is being prepared for a thyroid scan using radioactive iodine. Which intervention is MOST important?
A patient with iodine allergy is being prepared for a thyroid scan using radioactive iodine. Which intervention is MOST important?
A patient on long-term corticosteroid therapy is scheduled for surgery. What adjustment to their medication regimen is MOST likely needed?
A patient on long-term corticosteroid therapy is scheduled for surgery. What adjustment to their medication regimen is MOST likely needed?
A patient prescribed prednisone reports insomnia. What instruction should the nurse provide?
A patient prescribed prednisone reports insomnia. What instruction should the nurse provide?
A patient with diabetes who is prescribed corticosteroids should receive which of the following instructions regarding blood glucose monitoring?
A patient with diabetes who is prescribed corticosteroids should receive which of the following instructions regarding blood glucose monitoring?
A patient is prescribed fludrocortisone for adrenocortical insufficiency. Which of the following should the nurse monitor to determine the effectiveness of the medication?
A patient is prescribed fludrocortisone for adrenocortical insufficiency. Which of the following should the nurse monitor to determine the effectiveness of the medication?
A patient taking insulin reports consistently high blood sugar levels in the morning. Which action is MOST appropriate?
A patient taking insulin reports consistently high blood sugar levels in the morning. Which action is MOST appropriate?
A patient is prescribed insulin glargine. What information should the nurse offer to the patient to help the patient understand the nature of this medication?
A patient is prescribed insulin glargine. What information should the nurse offer to the patient to help the patient understand the nature of this medication?
A patient who takes insulin reports that they are planning to start a new exercise program. Which adjustment to their insulin regimen should be anticipated?
A patient who takes insulin reports that they are planning to start a new exercise program. Which adjustment to their insulin regimen should be anticipated?
A patient receiving Glucophage (metformin) is scheduled for a CT scan with contrast dye. Which action is MOST appropriate?
A patient receiving Glucophage (metformin) is scheduled for a CT scan with contrast dye. Which action is MOST appropriate?
A patient taking medications from the sulfonylurea class of antidiabetic medications - Glimepiride, Glyburide, and Glipizide - reports feeling shaky, sweaty, and confused. What should be the next nursing action?
A patient taking medications from the sulfonylurea class of antidiabetic medications - Glimepiride, Glyburide, and Glipizide - reports feeling shaky, sweaty, and confused. What should be the next nursing action?
Which of the following actions is an important action a nurse should take when administering Acarbose?
Which of the following actions is an important action a nurse should take when administering Acarbose?
What education should be offered to a patient that is taking Prandin (repaglinide)?
What education should be offered to a patient that is taking Prandin (repaglinide)?
What is understood about the disease process of Parkinson's?
What is understood about the disease process of Parkinson's?
The doctor orders Tolcapone (Tasmar). The nurse understands that this medication can be toxic to which organ?
The doctor orders Tolcapone (Tasmar). The nurse understands that this medication can be toxic to which organ?
The patient is prescribed selegiline. What food interaction education is most important for the nurse to offer the patient?
The patient is prescribed selegiline. What food interaction education is most important for the nurse to offer the patient?
A patient demonstrates an understanding of carbidopa/levodopa when they state:
A patient demonstrates an understanding of carbidopa/levodopa when they state:
The patient has been prescribed a medication for Alzheimer's disease. The patient has been having anorexia, nausea/ vomiting, and dizziness. What would be the most correct response?
The patient has been prescribed a medication for Alzheimer's disease. The patient has been having anorexia, nausea/ vomiting, and dizziness. What would be the most correct response?
How do cholinergic medications assist with patients with glaucoma?
How do cholinergic medications assist with patients with glaucoma?
What parameter is MOST important to monitor when administering selegiline to a patient with parkinsonism?
What parameter is MOST important to monitor when administering selegiline to a patient with parkinsonism?
Which of the following best describes the effect of cholinergic drugs on bladder function?
Which of the following best describes the effect of cholinergic drugs on bladder function?
A patient with a known history of glaucoma is prescribed a cholinergic medication. What anticipated therapeutic effect should the nurse expect regarding intraocular pressure?
A patient with a known history of glaucoma is prescribed a cholinergic medication. What anticipated therapeutic effect should the nurse expect regarding intraocular pressure?
A patient is prescribed a cholinergic medication. Which assessment finding would warrant immediate intervention due to the risk of cholinergic crisis?
A patient is prescribed a cholinergic medication. Which assessment finding would warrant immediate intervention due to the risk of cholinergic crisis?
A patient is taking a cholinergic medication for urinary retention and is now prescribed an antihistamine for seasonal allergies. What could be the MOST significant concern?
A patient is taking a cholinergic medication for urinary retention and is now prescribed an antihistamine for seasonal allergies. What could be the MOST significant concern?
A patient is prescribed a cholinergic eye drop medication. What potential side-effect should the nurse include in the patient education?
A patient is prescribed a cholinergic eye drop medication. What potential side-effect should the nurse include in the patient education?
The nurse correlates which data as a contraindication in the administration of Urecholine for urinary retention?
The nurse correlates which data as a contraindication in the administration of Urecholine for urinary retention?
Which concurrent medication would be concerning with a cholinergic due to toxicity?
Which concurrent medication would be concerning with a cholinergic due to toxicity?
What is the priority intervention when a patient displays signs of cholinergic crisis?
What is the priority intervention when a patient displays signs of cholinergic crisis?
When educating a patient about benztropine, a cholinergic-blocking agent prescribed for parkinsonism, what would be a priority?
When educating a patient about benztropine, a cholinergic-blocking agent prescribed for parkinsonism, what would be a priority?
What intervention is MOST appropriate for the nurse to recommend to a patient experiencing constipation as an adverse effect of cholinergic-blocking medications?
What intervention is MOST appropriate for the nurse to recommend to a patient experiencing constipation as an adverse effect of cholinergic-blocking medications?
Which statement made by the patient demonstrates an understanding of the effects of benztropine (Cogentin)?
Which statement made by the patient demonstrates an understanding of the effects of benztropine (Cogentin)?
Parkinson's Disease affects levels of what in the brain?
Parkinson's Disease affects levels of what in the brain?
A diagnosis of Parkinson's Disease is made. What statement would offer insight as to the disease affecting them?
A diagnosis of Parkinson's Disease is made. What statement would offer insight as to the disease affecting them?
Due to the adverse side effects due to levadopa/ carbidopa, what assessment findings would you look for?
Due to the adverse side effects due to levadopa/ carbidopa, what assessment findings would you look for?
Carbidopa is ordered for your patient. Knowing the affects of it, you know:
Carbidopa is ordered for your patient. Knowing the affects of it, you know:
What symptoms require consultation?
What symptoms require consultation?
You have a patient that reports dry mouth. What can the nurse do to help?
You have a patient that reports dry mouth. What can the nurse do to help?
What are some considerations to tell your clients when working with Lamatrogine while they are taking it for parkinsonism?
What are some considerations to tell your clients when working with Lamatrogine while they are taking it for parkinsonism?
What is not safe to administer?
What is not safe to administer?
What is a priority nursing intervention when administering Humalog Mix 75/25?
What is a priority nursing intervention when administering Humalog Mix 75/25?
What needs to be included with each dose?
What needs to be included with each dose?
What education is required when giving Glucophage (metformin)?
What education is required when giving Glucophage (metformin)?
What is important report with Sulfonylureas?
What is important report with Sulfonylureas?
What is the method of action with Precose (acarbose)?
What is the method of action with Precose (acarbose)?
What should happen if the patient skips a meal while ordering prandin?
What should happen if the patient skips a meal while ordering prandin?
Patient teaching for long term corticosteroid therapy should include
Patient teaching for long term corticosteroid therapy should include
If a diabetic patient has been prescribed corticosteroids it is important to tell them:
If a diabetic patient has been prescribed corticosteroids it is important to tell them:
When on corticosteroid therapy, it is important NOT to d/c abruptly because
When on corticosteroid therapy, it is important NOT to d/c abruptly because
What diet is best for corticosteroid therapy?
What diet is best for corticosteroid therapy?
Name a way to monitor and manage care when someone has increased fluid volume?
Name a way to monitor and manage care when someone has increased fluid volume?
A goal of synthroid is?
A goal of synthroid is?
Known hypersensitivity is to which disorder that correlates synthroid medications?
Known hypersensitivity is to which disorder that correlates synthroid medications?
Taking synthroid can have an adverse affect of?
Taking synthroid can have an adverse affect of?
What action would you take if you recognize upper respiratory reactions?
What action would you take if you recognize upper respiratory reactions?
What distance should the radioactive iodine patient maintain in relation to others
What distance should the radioactive iodine patient maintain in relation to others
Which finding would determine that the treatment is at a therapeutic range?
Which finding would determine that the treatment is at a therapeutic range?
Which finding would be concerning when receiving Methimazole while pregnant or not?
Which finding would be concerning when receiving Methimazole while pregnant or not?
What action is needed with methimazole in relation to a rash?
What action is needed with methimazole in relation to a rash?
Why is it important to take allergy hx with a thyroid scan?
Why is it important to take allergy hx with a thyroid scan?
Why is Thyroid medication needed for the rest of their lives?
Why is Thyroid medication needed for the rest of their lives?
When is the best time to weight and take vital signs for someone that has hypothyroidism
When is the best time to weight and take vital signs for someone that has hypothyroidism
A patients diabetes becomes what in terms of blood glucose while receiving thyroid replacement therapy?
A patients diabetes becomes what in terms of blood glucose while receiving thyroid replacement therapy?
Flashcards
Uses of Levothyroxine
Uses of Levothyroxine
Treats hypothyroidism, myxedema, cretinism, and euthyroid goiters; may prevent thyroid cancer
Thyroid hormone effects
Thyroid hormone effects
Metabolic rate, heart/respiratory rate, body temperature, cardiac output, and oxygen consumption.
Adverse reactions to Levothyroxine
Adverse reactions to Levothyroxine
Signs of overdose and hyperthyroidism during titration.
Levothyroxine contraindications
Levothyroxine contraindications
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Levothyroxine precautions
Levothyroxine precautions
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Monitor for with anti-thyroid meds
Monitor for with anti-thyroid meds
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Instructions for taking thyroid medication
Instructions for taking thyroid medication
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Important medication rule to note
Important medication rule to note
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Propylthiouracil/Methimazole uses
Propylthiouracil/Methimazole uses
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Adverse reactions of antithyroid meds
Adverse reactions of antithyroid meds
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Serious adverse reactions of anti-thyroid meds
Serious adverse reactions of anti-thyroid meds
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Allergies as a precaution for thyroid meds
Allergies as a precaution for thyroid meds
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Coritcosteroids
Coritcosteroids
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Corticosteroids treat?
Corticosteroids treat?
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Corticosteroids treat?
Corticosteroids treat?
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Corticosteroids function?
Corticosteroids function?
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Cushy Carl lab changes
Cushy Carl lab changes
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Important lab reminders for meds
Important lab reminders for meds
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Corticosteroid Instructions
Corticosteroid Instructions
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Corticosteroid S/S to report
Corticosteroid S/S to report
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Corticosteroid drugs
Corticosteroid drugs
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Insulin's Onset
Insulin's Onset
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Insulin's Peak
Insulin's Peak
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Insulin's Duration
Insulin's Duration
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Low blood sugar symptoms
Low blood sugar symptoms
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High blood sugar reminders
High blood sugar reminders
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Rules regarding regular insulin
Rules regarding regular insulin
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Other insulin instructions
Other insulin instructions
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Injection site rules
Injection site rules
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Administration rules with hypo's
Administration rules with hypo's
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Insulin Humalog/Novalog characteristics
Insulin Humalog/Novalog characteristics
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Intermediate insulins characteristics
Intermediate insulins characteristics
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Long lasting insulin characteristics
Long lasting insulin characteristics
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Anti-convulsants treat
Anti-convulsants treat
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Side effects of Anti-convulsants
Side effects of Anti-convulsants
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Important instruction considerations for drug
Important instruction considerations for drug
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Anti-convulsant contraindications
Anti-convulsant contraindications
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Nursing considerations
Nursing considerations
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Health teaching considerations
Health teaching considerations
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Phenytoin can cause
Phenytoin can cause
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What the adverse reactions
What the adverse reactions
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When Disease progresses
When Disease progresses
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Dopamine Symmetrel
Dopamine Symmetrel
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What does it treat
What does it treat
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Blood flow
Blood flow
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Actolyne
Actolyne
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Blood helps
Blood helps
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Hypertension Crisis
Hypertension Crisis
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Slow heart
Slow heart
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Euthyroid goiters
Euthyroid goiters
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Levothyroxine
Levothyroxine
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Hypothyroidism therapeutic response
Hypothyroidism therapeutic response
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Thyroid hormone administration
Thyroid hormone administration
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Sodium Iodide
Sodium Iodide
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Documenting skin/rash affected areas
Documenting skin/rash affected areas
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Slowing the breakdown
Slowing the breakdown
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Closely monitor blood sugar
Closely monitor blood sugar
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Precautions for taking sodium?
Precautions for taking sodium?
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Administration of metformin
Administration of metformin
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What do you have to monitor?
What do you have to monitor?
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Metformin considerations
Metformin considerations
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Starlix considerations
Starlix considerations
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Anti-seizure meds during pregnancy
Anti-seizure meds during pregnancy
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D/C for seizures
D/C for seizures
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Drug changes?
Drug changes?
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Parkinson's is thought to be with?
Parkinson's is thought to be with?
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Symmetrel (amantadine)
Symmetrel (amantadine)
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Therapy used?
Therapy used?
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Atropine helps and helps decreases what
Atropine helps and helps decreases what
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What dosage may need to be decreases and why?
What dosage may need to be decreases and why?
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Take meds in what?
Take meds in what?
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Used with what
Used with what
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What inhibitor used what?
What inhibitor used what?
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Actlycone is important to do what
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Anti Myg gra
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Cholenergic crisis signs and symptoms
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Study Notes
Thyroid Hormones
- Used to treat hypothyroidism, myxedema (severe hypothyroidism in adults), and cretinism (congenital hypothyroidism)
- Also used for euthyroid goiters (enlargement of normal thyroid gland) and thyroid cancer
- Cause an increase in metabolic rate of tissues, heart and respiratory rate, body temperature, and cardiac output
- Increase oxygen consumption, metabolism of fats/proteins/carbohydrates, and mental activity
- The drug of choice is Levothyroxine (Synthroid), and brands/types should not be changed
- Most common adverse reactions are signs of overdose and hyperthyroidism, along with titration of drug
- Overdose symptoms are V/D, diarrhea, wt loss, tachycardia, palpitations, angina, nervousness, tremors, irritability, insomnia, menstrual irregularities, sweating, and heat intolerance
- Adverse reactions other that hypothyroidism symptoms are rare
- Contraindicated in patients with hypersensitivity to drug, uncorrected adrenal cortical insufficiency (Addison’s), and thyrotoxicosis (thyroid storm)
- Should be used cautiously in patients with cardiac/renal disease, hypertension, or diabetes
- A diagnosis of hypothyroidism should be obtained and therapy started after initial vital signs and weight are taken
- Monitor vital signs and weight, with signs of hyperthyroidism signalling excessive drug dosage
- Some results can be seen in 3-4 days, with full effects taking several weeks (6-8 wks)
- Therapeutic responses include weight loss, mild diuresis, increased appetite/pulse, and decreased puffiness of face/hands/feet
- Administer thyroid hormones once a day, initially at low dose (may increase over weeks), early in the morning preferably before breakfast (30-60 min)
- Closely monitor clients with diabetes on thyroid hormone replacement therapy, taking into account signs of hyperglycemia and notifying if a problem occurs
- Weigh weekly and report significant weight gain or loss, and consult provider before altering or discontinuing the dose
- Replacement therapy is for life, with periodic thyroid function tests needed (T4 & TSH) (q 6-8 wks)
- Replacement therapy is necessary if hypothyroidism develops, and follow up evaluations are necessary to review the thyroid gland and treatment effectiveness
- Levothyroxine sodium, sold as Levothroid and Synthroid, are thyroid replacements
- Methimazole (Tapizole) and propylthiouracil (PTU) are used for the medical management of hyperthyroidism
- Sodium iodide (131I) may be administered orally with methimazole/propylthiouracil to prepare for thyroid surgery
- Radioactive iodine treats hyperthyroidism and selected cases of cancer of thyroid - This radioactive isotope accumulates in thyroid gland cells, which causes destruction of the cells without damaging cells throughout the body
- Generalized system reactions to antithyroid drugs include sore throat (headache) and nausea (vomiting, paresthesias)
- Severe system reactions include agranulocytosis (decreased WBC) and thrombocytopenia
- A careful allergy history should be performed, particularly for iodine/seafood given prescription of an iodine procedure
- Document affected areas and note size, texture, extent of rash, and report it to primary healthcare provider if rash is experienced while taking methimazole (Tapazole) or propylthiouracil (PTU)
- For radioactive iodine, follow department of nuclear medicine directions regarding precautions - Maintain 6 feet distance from others - Do not share utensils or cook for others - Limit contact with others (30 min/day/person) - Increase fluid intake (2-3L/day)
Corticosteroids
- Properties include anti-inflammatory, regulation of blood pressure (increases), metabolism or carbohydrates/protein/fat, and immunosuppressant
- Also provide protection (released) during stress, as well as CNS responses that increase mood
- Treats adrenocortical insufficiency, allergic reactions, collagen diseases (lupus), dermatologic conditions, and rheumatic disorders
- Also treats shock (bp increases), such as with Florinef
- Side effects include Buffalo hump, moon face, oily skin/acne, osteoporosis, and excess fat deposits on trunk
- Other side effects include wasting of legs/arms, altered skin pigmentation, weight gain, and increased Na+ levels (decreasing K+), increased glucose, and decreased Ca+
- Medications should never be omitted, and if unable to take orally, get order for parentally
- Should watch electrolytes, examine EKG & TB skin test results
- For diabetics, monitor blood glucose levels and take with food or milk early in morning
- Never discontinue if given > 5 days
- Can result in adrenal insufficiency if discontinued without tapering
- Make sure to eat a diet low in sodium, high in vitamin D, protein, and potassium
- Should monitor pt. for risk of infections and acute pain, as well as reporting any signs/symptoms of each
- Monitor for excess fluid volume, as well as fluid intake & output records and daily weights
- If topical, do not cover and avoid sunlight on the treated area
- Many of the drugs end in “one”
- Medications include Betamethasone (Celestone), Cortisone, Dexamethasone (Decadron), Hydrocortisone (Solu-cortef), Methylprednisolone (Medrol), Prednisolone (Prelone), and Fludrocortisone (Florinef)
Antidiabetic Drugs
- Properties of insulin include: onset (when it starts), peak (max strength), duration (how long it lasts)
- If hypoglycemia occurs, a patient will experience tremors/tachycardia, irritability, restlessness, excessive hunger, and diaphoresis/depression
- Hypoglycemia is referred as "TIRED", as well as "Cool and clammy", a candy
- Signs of hyperglycemia, such as hot/flushed skin, fruity breath, polyuria, loss of appetite, tiredness, and thirst
- Hyperglycemia is referred as "Hot and Dry", with "Sugar to HIGH!”
- A patient’s compliance with prescribed therapeutic regimen should be evaluated via health care provider with HgbA1C (2.5-6.0 % = good, > 10% = bad)
- Regular insulin is only preparation given via IV
- Regular insulin should be given 15-30 minutes before meals for optimal results
- Novolog is given immediately (5-15 minutes) before meal, while Humalogg is given 15 minutes before meal or immediately after meal
-
- Do not mix or dilute insulin glargine with any other insulin or solution - this will lose glucose control and render the drug ineffective
- Administer insulin glargine SC once daily at bedtime (HS)
- Check insulin dose with two nurses
- Be sure to know how to mix insulins
- Rotation site should be carefully planned, with 1-1 ½ inches apart and a write in the patient’s chart
- The abdomen is the fastest absorption rate, then upper arm, then thigh
- Be sure to record the site on the MAR
- Avoid lipodystrophy (atrophy of SQ fat) through rotation, which interferes with absorption by slightly dimpling or pitting SQ fat
- Never give oral fluids/substances unless swallowing and gag reflexes are present, and monitor/report signs of hypoglycemic reaction
- Rapid Acting includes Humalog and Novalog), given clear and can be given IV/SC to anticipate hypoglycemia mid morning and have peaks of 1-3 hours for durations of 3-5 hours
- Short Acting (Regular) such as Humulin R or Novolin R are given clear and can be given IV/SC, primarily to check for hypoglycemia before lunch
Antihypoglycemic Agents (Oral)
- Glucagon, which is administered, Subcut, IM, and IV is used for hypoglycemia in the diabetic client and is more effective once glycogen stores are present
- Common side effects include nausea and vomiting, while patients on Warfrin may potentiate anticoagulant effects of coumadin if used for extended amounts of time
- Administration techniques involves following up with oral glucose once the client is awake and able to swallow
- Glucophage (metformin) should be administered with meals to counter the risks of NV, anorexia, hypoglycemia (rare), diarrhea, and flatulence from the Biguinides
- Monitor BUN, creatinine, and liver function, as well as reporting hypoglycemia, hepatotoxicity, and blood dyscrasias
- Some Sulfonylureas are Diabinese (chlorpropamide), Amaryl – Glimepiride (elderly), DiaBeta (Glyburide ), and Glucotrol (Glipizide elderly)
- Meglitinides such as Prandin and Starlix are drugs given ~30min before a meal
- Precose (acarbose) is administered with the first bite each meal (3 x day), mainly in Type II if unresponsive for diet/exercise or adjunct therapy with metformin/sulfonylureas
- Side effects for Precose includes if hypoglycemia in conjunction with other agents or hepatotoxicity, a well as reporting if seen.
- Thiazolidinediones for diabetes can alter oral contraceptives needs to be observed so that an adequate dose is given
- These drugs needs to be taken with meals and always ingested after administering
- Medications include Actos and Avandia
- The three DPP-4 pill inhibitors (Januvia, Onglyza, Tradjenta) are for type 2 diabetes
- taken once a day
- do not promote weight gain
- often combined with metformin
- have very little side effects
- Be aware which of the side effect to report to the provider
GLP-1 Receptor Agonists
- Exenatide is injected once per week with action matching Byetta given above
- Liraglutide (Victoza) is injected at the same time each day
- Dulaglutide and semaglutide are injected each week and given if stimulated to release insulin
Anticonvulsants
- Treats seizures of all types
- Treats neuropathic pain, such as with Pregabalin (Lyrica)
- Treats bipolar disorders such as with Carbamazepine (Tegretol)
- Treats anxiety disorders and mania such as with Valproic Acid, (Depakote)
- Treats status epilepticus with Diazepam (Valium)
- An association between anticonvulsant use in pregnant women and birth defects has been found
- Adverse Reactions include CNS (drowsiness, headache/somnolence, nystagmus, ataxia, and slurred speech) and GI (NV/D, anorexia, constipation, and gingival hyperplasia)
- Adverse reactions also include cardiovascular dysrthmias and others, such as skin rashes, stevens johnson syndrome, urinary frequency, and hematologic changes (pancytopenia, leukopenia, aplastic anemiia, and thrombocytopenia)
- Barbiturates
- Phenobarbital
- Phenobarbital sodium - Luminal Sodium
- Benzodiazepines
- Clonazapam - Klonopin
- Clorazepate - Tranxene
- Diazepam - Valium
- Lorazepam - Ativan
- Hydantoins
- Phenytoin sodium - Dilantin
- Succinimides
- Ethosuximide - Zarontin
- Sodium Channel Inactivator Drugs:
- Lacosamide-Vimpat (Schedule V subs.)
- Miscellaneous Preparations
- Carbamazepine - Tegretol
- Gabapentin - Neurontin
- Magnesium sulfate
- Pregabalin - Lyrica
- Topiramate - Topamax
- Valproic acid - Depakote, Depekene
- Lamotrigine - Lamictal
- Levetiracetam- Keppra
- Pregabalin (Lyrica) is also used for neuropathic pain, and postherpetic neuralgia
- Lorazepam (Ativan) is also a preanesthetic
- Carbamazepine (Tegretol) is also for bipolar disorder and neuralgia
- Gabapentin (Neurontin) also treats neuralgia
- Watch for electrolyte activity if you have taken TB skin test results
- Mag sulfate is for seizures associated with eclampsia and acute nephritis in children
- Topiramate (Topamax) and valproic acid (Depakote) help with migraine headaches
- Valproic acid (Depakote) also helps with mania
- Medications may require frequent adjustments in the beginning of therapy, and Plasma levels are checked to monitor for therapeutic level and toxicity The drug must never be stopped abruptly, since this may result in return of seizures or status epilepticus
- Drowsiness is common when administering drugs, where it's encouraged to rise slowly from bed
- Severe and potentially fatal rash can occur in clients taking lamotrigine (Lamactil) • Check blood levels regularly. • Don’t put anything in the mouth of a convulsing person. • Avoid alcohol
Antiparkinsonism
- Parkinson's disease
- Parkinson-like symptoms (extrapyramidal) as a result of injury, drug therapy, or encephalitis
- Restless leg syndrome
- Viral infections (amantadine)
- Adverse Reactions: as the disease progresses, the response to the drug may become less and the period of time that each dose is effective begins to decrease, leading to more frequent doses, and more adverse reactions
- Choreiform movements, dystonic movements, mental changes, anorexia, n/v, abdominal pain, constipation, dry mouth, difficulty in swallowing, increased hand tremor, ha, and dizziness can occur, so use caution
- Carbidopa has no effect when given alone
- Symmetrel (amantadine) is indicated in the treatment of parkinsonism
- The drug is also used for Parkinson’s disease (Paralysis Agitans), postencephalitic parkinsonism, and symptomatic parkinsonism with Amantadine s/e to including: orthostatic, hypotension, depression, CHF, psychosis, urinary retention, convulsion, leukopenia, and neutropenia confusion, and anorexia.
- Use is used an adjunctive therapy to tx. all from of antiparisnkomism and for extrapyramindal disorder control
- Increase fluid intake for constipation, sips of water for dry mouth, keep fluids readily available, ice chips
Other types of AntiCholingenic meds:
- Atropine reduction of secretions, vagal induced, bradycardia, ureteral and biliary colic
- Dicyclomine Irritable bowel syndrome
- Trimethobenzamide: Used for motion sickess, anti anesthesia Parkinson’s is caused by a deficiency in dopamine and excess of acetylcholine w that has No cure. Drigs are only use to manage, that will be changed For used in treatments is adjunts levodopa/carbidoca, which will have blood to the barrier May have have different used include : Mirpex: Requip for the Dopamine recotors Agonist Always asses the patients.
Nursing Alert :
observe patient if the have carbidopa
- Keep them out of of water, give them the water yourself in small bites
- The side effect of drug can cause GI Disturbance small and food with be prefered The use of small meals is to prevent difficulty in eating : dizzy.
Aterante for for treatment using parkincon's drugs, it can be for long time depending of drug holiday
Dopaminic Drugs can effect low dose: if you have them for high or serve
- Use drugs (5 to 18 times)
- Nursing Education*
- Take a small part of these drug do not get of it
- Avoid vitamin B6 If have 6, for diabetic,may interfere check
Anti partkisin drug are broken into two.
- Anti visual : Amantade for synmple
- *Complications, to the blood Hypertensive crisis with foods containing tyramine and merperidine, fluoxetine, MAOI, antidepressants, which you must watch out. You have to know parkinson in the drugs, be able to tell the drugs apart
- The dopamine, you must use promipole
- The one that make , mesyiolale
Cholinesterase Drugs
- For pt with Alzeiermers, for short time due too memin
Cholinerghic drugs for anti cholinester
Help for those with MG, this will promote the most contraction. Use for urninary reten
- Precautions:* Hypertension Epilepsy , it may promote the contracture. With other To help to keep the drug
Adverse Effect includes Topical skin and Flushing May cause and may have cardiac issues
-
Check it out in more detail:
-
For patients, that’s if you keep you out of water.
-
For fluid and what must you do in time
Antispasmodic Medications
-
Anti-muscarinic medications are a type of Anticholinergics
-
Tolterodine for overachieve bladder
IV Therapy, Nursing Intervention
Wash Hands
- Follow step for all patient before administering IV meds
- Follow the site for hour. and tubing. 24 hour
- Monitor for complications and fluid with
- Always ensure to provide electrolyte imbalance with
- Diuretic will to the work before.
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