Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/63

Click to flip

63 Cards in this Set

  • Front
  • Back
Glucocorticoids

1
sugar hormone from the adreanal cortex
potent anti-inflammatory agents
suppress immune system function
mimics body cortisol (sugar hormone)
Systemic Glucocotrticoids

2
short acting-low potency
Intermediate acting-medium potency
Long acting-high poetency
All compared to natural cortisol in body
Short Acting

3
low potency
Hydrocortisone (Cortef, Solu-Cortef)po/iv/IM
Intermediate acting

4
Medium potency
Methylprednisolone (solu-medrol) IV/IM, (medrol)-po
Prednisolone (prelone, pediapred)- PO/IV/IM
Long acting

5
High Potency
Dexamethasone (decadron)- PO/IM/IV
Nursing Implications related to Systemic Glucocorticoid Administration

6
Administered for more than 14 days can suppress the adrenal glands secretion of glucocorticoids and therefore must be weaned off to prevent adrenal insufficiency.
Nursing Implication Glucocorticoid Administration p2

7
Patient should be taught about the potential adverse effects of glucocorticoids and that they may need supplemental amounts when under stress situations.
Nursing Implication Glucocorticoid Administration p3

8
Administer the medication first thing in the morning with food will help minimize adverse effects
Nursing Implication Glucocorticoid Administration p4

9
Watch for thrush when patient is using oral or nasal forms. Teach patient to rinse mouth after using the oral and nasal forums to prevent thrush
Nursing Implications Glucocorticoid Administraton p5

10
Contraindicated for patients with a history of TB, or patients undergoing skin testing or vaccinations-no skin test
Adverse Effects related to Systemic Glucocorticoid Administration

11
Cushing syndrome- women facial hair, men lose hair
Cushing Syndrome

12
Abnormal fat distribution: moon face buffalo hump, truncal obesity
Cushing Syndrome p2

13
Protein catabolism: decreased muscle mass, slow wound healing, fragile skin, easy bruising-leave wounds sutures, prone to illness
Cushing Syndrome p3

14
Hyperglycemia
Increased susceptibility to infections and masking of signs and symptoms of infection
Cushing Syndrome p4

15
Osteoporosis
GI irritation/ulcers
Electrolyte imbalance (sodium retaing and potassium wasting) uf gas nuberkicirtuciud cinoibebt (eg, prednisone, hydrocortisone, prednisolone)
Personality changes/mood shifts
Drug Interactions Related Systemic Glucocorticoid Administration

16
Diminished response to vaccines and toxoids (can reactive TB)
Enhanced when combined with: ketoconazole(increase metabolism of drug) and oral contrceptives
Drug Interactions Glucocorticoid p2

17
Dimished with phyenytoin barbituates
Potassium wasting when glucocoticoids are administered with diuretics or medications that deplete potassium
superinfections when patient is on glucocorticoids and antibiotics
Mineralocorticoid Drugs variables related to fludrocortisone

18
Raise blood pressure more specific to mineral corticoid thats missing
Mineralococorticoid Planning and Intervention

19
Look for cushings
Mineralcocorticoid Drugs Minimizing effects

20
Obtain serum electrolyte levels as indicated, similar to glucocorticoids
Pharmacotherapeutics Mineralocorticoid Drugs

21
Fludrocortisone
Aldosterone-Increased
Flornet-Blood
Primary adrenocortical insufficency
Pharmacodynamics Mineralcocorticoid pharmacodynamics

22
Increased blood pressure secondary to above effects-Aldosterone
Contraindications and precautions Mineralcocorticoid

23
Contraindications
Hypersensitvity
Conditions not requiring intense mineralocorticoid activity
Systemic fungal infection
Adverse Effects Mineralococorticoid

24
Cardiovascular Effects
Edema, Hypertension, CHF, Cardiomegaly
Dematologic effects
Bruising, Diaphoresis, urticara, allergic skin rash.
Hypokalemic alkalosis
Glucocorticoid effects
Drug Interactions Minerolocorticoid

25
Barbiturates
Hydantonins
Rifampin
Anticholinesterases
Salicylates
Drugs used to treat Hypothyroidism

26
slow moving, slaping, cold intolerant, weight gain, sleepy.
Levothyrozine (t4, Levothyroid, Synthroid, Levoxyl)
Levothyrozine Use

27
To normalize Thyroid Hormone level
Levothyroxine Contraindications

28
Recent heart attack, unstable angina, thyrotoxocosis
Levothyroxine Adverse Effects

29
tachycardia, irritablility, insomnia, nervousness angina-hyperthyroid
Levothyroxine drug interactions

30
Increase in diabetic agents
Nursing Implications levothyroxine

31
Thyroid function testing will be required to be monitored for as long as patient remains on the medication
Nursing Implications Levothyroxine p2

32
Monitor for signs and symptoms of toxicity (tachycardia, chestpain, nervousness, insomnia, diaphoresis, tremors, weight loss)
Nursing Implications Levothyroxine p3

33
hold dose if thier pulse is greater than 100 beats per minute
Nursing Implications Levothyroxine p4

34
Teach the patient to avoid OTC remedies without checking with their health care provider
Nursing Implications Levothyroxine p5

35
Diabetic patients should monitor thier blood sugar level more frequently until stabilized on their thyroid medication
Nursing Implications Levothyroxine p6

36
Teach the patient to avoid changing brands because potency can vary.
Teach the patient that may take several months for therapy to improve sypmtoms of hypothroidism
Levothyroxine other

37
Litothyronine (cytomel, T3 active form)
Liotrix (T3/T4(stored form), Tyrolar)
Thyrar, Thyroid Strong, Westhroid-Not precise dose as synthroid
Drugs used to treat Hyperthyroidism.

38
Loss of energy, heat intolerent, hyperactive.
Thioamides

39
Propylthiouracil (PTU); and Methimazole (Tapazole)
Thioamides action

40
Both inhibit thyroid and hormone synthesis, PTU also inhibits conversion of T$ to T3
Thioamides Use

41
To normalize thyroid hormone levels
Thioamides Adverse effects:

42
rash, agranulocytosis, leukopenia, hepatotoxicity (with PTU)
Thioamides Drug interactions

43
bone marrow suppression with other therapies that cause bone marrow suppression such as radiation therapy or antieoplastic drug therapy; additive antithyroid effect when given with lithium or iodines/iodides
Thioamides Nursing Implications

44
Caution patients to report signs and symptoms of agranulocytosis: sore throat, fever, chills, headache, malaise, weakness, easy bruising.
Signs and symptoms of hypothyroidism.
4-8 weeks for the drug to normalize hormone levels.
Iodides

45
Lugol's Solution, SSKI, Thyro-Block
Iodides Action

46
Inhibits synthesis and release of T3 & T4 into circulation; decreases size and vascularity of the thyroid gland, prior to surgery
Iodides Use

47
Thyroid suppressant used, treatment of thyrotoxicosis
Iodides Usual does

48
2-6 drops tid po for 10 days
Iodides adverse effects

49
iodism, nasal congestion
Iodides Drug interaction

50
can cause severe hypothyroidism
Iodides nursing implications

51
a bad taste, mix with a full glass of water, juice, milk or broth.
Stain teeth, use a straw to administer
No longer than 7-10 days
Preoperatively for hyperthyroid patient; in emergenicies (thyrotoxocosis); after radioactive iodine therapy
Beta blockers

52
reduce sympathetic nervous system symptoms, stage fright symptoms
Radioactive iodide (RAI)

53
Destroy hyperactive thyroid cells.
Orderless, colorless, tastelesss solution.
High doses (>30mCi) require hospitalization.
Low doses (<30 mCi) are safe to go home.
Radioactive iodide (RAI)
p2

54
All antithyroid, thyroid, or iodine-containing medications are stopped 5-7 days before and after treatment.
Take 6-8 weeks to normalize hormone levels.
Half of patients that recieve RAI will become hypothyroid after treatment.
Half of patients that recieve RAI will become hypothyroid after treatment.
After treatment thyroiditisi may occur: thyroid tenderness and swelling, fever, malaise, genetically transmissible chromosomal abnormalities, and blood dyscrasis
Antidiuretic Hormone

55
Vasopressin- Tannate
Oxytocin
Oily not given IV
Vasopressin Action

56
increases reabsorption of water in the kidney; causes constriction of splanchic (chest and esophagel vessels)
Vasopressin Use

57
Antidiuretic to treat diabetes insibpidus;
Gi hemmorrhage related to esophageal varices- associated with liver disease
Vasopressin Contraindications

58
chest pain, recent MI, migraines, pregnancy
Vasopressin Nursing implications

59
Vasopressin tannate is only given Im, Never IV!!!
Monitor for signs and symptoms of water intoxication (confusion, lethargy, seizures, coma, increased urine specific graity, decreased serum osmolarity, decreased and concentrated urine, weight gain)
Monitor blood pressure for hypertension and assess for chest pain.
Monitor for relief of polyuria and thirst.
Desmopressin Acetate (DDAVP)Action

60
synthetic analong of the posterior pituitary hormone vasopressin
Desmopressin Acetate Use

61
to treat diabetes insipidus to increase factor VIII for patients with hemophilia A and von Willebrand's disease to treat enuresis in children.
Desmopressin Acetate Administration

62
Intranasal
Desmopressin Acetate Contraidications

63
Adverse effects and nursing implications as for vasopressin.