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54 Cards in this Set
- Front
- Back
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What type of patient gets DDAVP (desmopressin)? What is there medical problem?
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What type of patient gets DDAVP (desmopressin)? What is there medical problem?
- Diabetes Insipidus |
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Is sinusitis a reason to change a pt’s prescription for the DDAVP if it’s the nasal spray?
If you have inflammation of your sinuses, are you going to get a nasal spray? |
Is sinusitis a reason to change a pt’s prescription for the DDAVP if it’s the nasal spray?
If you have inflammation of your sinuses, are you going to get a nasal spray? - no - “Do not use intranasal drugs in sinusitis” |
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Pt’s on diapid (Tx for Diabetes Insipidus) (intranasal spray), when pt on it, they have an increase in thirst, what are they to do?
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Pt’s on Diapid (Tx for Diabetes Insipidus) (Intranasal Spray), when pt on it, they have an increase in thirst, what are they to do?
- the drug is not working... so take more - if using drug & pt is still thirsty, it is still not working so take more! |
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Is DDAVP (desmopressin) a pituitary hormone?
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Is DDAVP (desmopressin) a pituitary hormone?
- yes |
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What does Vasopressin (Pitressin synthetic) and its derivative, desmopressin (DDAVP) do?
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What does Vasopressin (Pitressin synthetic) and its derivative, Desmopressin (DDAVP) do?
- Regulates the Re-absorption of water by the Kidneys. |
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How does Vasopressin in the Diabetes Insipidus patient work?
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How does Vasopressin in the Diabetes Insipidus patient work?
- Increases Re-absorption of Water in the Tubules (Kidneys) |
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If the pt on DDAVP gains weight while on drug in short period of time, what do u do?
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If the pt on DDAVP gains weight while on drug in short period of time, what do u do?
- gaining about 2 lb a day is considered excessive. too much weight gain in a short time - monitor I & O. Weigh the pt daily. make sure that they have not gained too much weight (FYI: 1 liter 1000mL = 1 Kg or 2.2lb = 1 liter) |
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Would u give a pt with Diabetes Insipidus who is experiencing angina, vasopressin?
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Would u give a pt with Diabetes Insipidus who is experiencing angina, vasopressin?
- NO, it will make it Worse |
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What is clomid for?
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What is Clomid for?
- Ovulatory Drugs (Induce Ovulation) - Nonsteroidal Ovarian Stimulant |
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*What do u expect to see, urine wise, after Pitressin (Vasopressin) injections in the Diabetes Insipidus patient? (sqeezing out of interstitial spaces, where does it go? )
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*What do u expect to see, urine wise, after Pitressin (Vasopressin) injections in the Diabetes Insipidus patient? (sqeezing out of interstitial spaces, where does it go? )
- out by way of urine. - pee it out. More than the regular amount. Know how much (know the urine output) - increased urine output (know urine amounts.) (FYI: Pitressin is an antidiuretic used to treat diabetes insipidus, Pitressin is a medicine that reduces the amount of urine excreted by the body.) |
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Why does patient on a Choriogonadotropin (Clomid) hormone substitute need regular ultrasounds on her pelvis?
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Why does patient on a Choriogonadotropin (Clomid) hormone substitute need regular ultrasounds on her pelvis?
- to monitor her Ovaries - sudden Ovarian Enlargement, Ovarian Stimulation - regular Pelvic Ultrasounds may be ordered for the client |
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What are side effects expected with Clomid?
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What are side effects expected with Clomid?
- Weight Gain, Increased Appetite, and Constipation |
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If a pt on Cetrotide (for infertility), and experience visual problems, what do they do?
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If a pt on Cetrotide (for infertility), and experience visual problems, what do you tell them to do?
- tell pt to discontinue the drug & go see an Ophthalmologist (eye dr). |
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Is having increased urination, increased hunger and increased thirst a cause for concern in a 10yr old who just got growth hormones?
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Is having increased urination, increased hunger and increased thirst a cause for concern in a 10yr old who just got growth hormones?
- yes. Could have Diabetes Mellitus or DM - Instruct parents to report lack of growth, S/S of diabetes (polyuria, polydipsia, and polyphagia), or S/S of hypothyroidism |
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Your pt on somatropin, begins treatment, what do they do anually?
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Your pt on Somatropin, begins treatment, what do they do annually?
- Bone Assessment (to see if they are growing) - Bone age is monitored periodically for growth and to detect Epiphyseal closure |
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Due to possible orthostatic hypotention due to the drug Parlodel (bromocriptine) (Tx for acromegaly) what instruct for safety?
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Due to possible orthostatic hypotention due to the drug Parlodel (bromocriptine) (Tx for acromegaly) what instruct for safety?
- Don't drive - Sit down for a while - Monitor their positioning |
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Why give somastatin to patients with pituitary tumors?
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Why give somastatin to patients with pituitary tumors?
- somastatin stops or slows release of Growth Hormone. They have over secreting GH - disease is acromegaly (enlarged hands, feet, mandible, nose, ears. Thickened tongue (dysphagia)) |
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What dietary restriction do we warn pt about who have secondary adrenal insufficiency on ACTH (corticotropin)?
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What dietary restriction do we warn pt about who have secondary adrenal insufficiency on ACTH (corticotropin)?
- Low or Limited Salt or Sodium - Because ACTH (corticotropin) causes Hypernatremia. |
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What lab do we monitor due to expected change while on Prednisone?
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What lab do we monitor due to expected change while on Prednisone?
- Glucose (increased) - Glucocorticoid therapy causes Hyperglycemia |
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What is a bilateral adrenalectomy?
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What is a bilateral adrenalectomy?
- Both adrenals glands are removed |
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What do you teach about prednisone to a patient that will be taking prednisone for a long time for RA?
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What do you teach about Prednisone to a patient that will be taking Prednisone for a long time for RA?
- don't miss a dose, don't stop abruptly, take with food and water - check glucose because prednisone (glucocorticoids) increase glucose (Hyperglycemia) |
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What is the best time of day to take prednisone?
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What is the best time of day to take prednisone?
- 9 am in the morning with food and water |
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What medication do we give patients the day of an immediate post-op adrenalectomy?
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What medication do we give patients the day of an immediate post-op adrenalectomy?
- steroid, words ending in "SONE" (Glucocorticoids) - ex: cortisone, hydrocortisone, prednisone, prednisolone, and triamcinolone |
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What labs do we get for patients on long term coticosteroid?
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What labs do we get for patients on long term coticosteroid?
- Glucose (usually increased) and Potassium (because they can go either way) - Monitor blood glucose levels for hyperglycemia |
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How does Florinef (mineralocorticoid and glucocorticoid) help the addison’s patient?
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How does Florinef (mineralocorticoid and glucocorticoid) help the addison’s patient?
(nasal spray) - raises the blood pressure with sodium - You know the Florinef is working when the blood pressure, sodium, potassium, water balance, and glucose is normal |
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Q1. Do we teach pts on Florinef to monitor their weight?
Q2. Do we want our patients on Florinef to report any kind of rapid weight gain (edema) or elevated B/P (HTN). |
Q1. Do we teach pts on Florinef to monitor their weight?
- yes Q2. Do we want our patients on Florinef to report any kind of rapid weight gain (edema) or elevated B/P (HTN). - yes, because they are retaining water. That is a S/E of an overdose of Florinef. |
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What is Florinef?
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What is Florinef?
- Florinef is used for replacement therapy for adrenocortical deficiency. - Important in controlling salt and water balance. |
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Q1. What is Synthroid for?
Q2. When is the best time to take Synthroid? |
Q1. What is Synthroid for?
- Hypothyroidism. Q2. When is the best time to take Synthroid? - Take in the morning before or with breakfast - to get the internal clock moving - “Thyroid hormones are administered once a day, early in the morning (stimulant that may cause insomnia if given at bedtime), and preferably before breakfast.” - “Empty stomach increases absorption of the oral drug.” |
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Should you expect mild diuresis (Excessive urine production, sweating) in a pt on thyroid replacement (like Synthroid) drug?
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Should you expect mild diuresis (Excessive urine production, sweating) in a pt on thyroid replacement (like Synthroid) drug?
- YES - Therapeutic response includes mild diuresis |
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Why must patients who have had bilateral thyroidectomy, forever (lifetime) taking thyroid hormones?
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Why must patients who have had bilateral thyroidectomy, forever (lifetime) taking thyroid hormones?
- Because they don't have the thyroid anymore (not releasing thyroid hormones) |
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If pt not taking enough Synthroid as prescribed, what would be symptoms?
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If pt not taking enough Synthroid as prescribed, what would be symptoms?
- Lethergy - Weight Gain - Constipation - Cold Intolerance - Bradycardia - Hypotension - Dry Skin (same stuff as hypothyroidism) |
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Is cardiac dysrhythmias a possible symptom of hypothyroidism?
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Is cardiac dysrhythmias a possible symptom of hypothyroidism?
- Yes - especially the newly diagnosed and the elderly |
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What’s the best answer on why patients take thyroid medications?
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What’s the best answer on why patients take thyroid medications?
- the thyroid glands are not producing enough thyroid hormones |
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Why do pts who have significant weight gain on Synthroid need to report this?
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Why do pts who have significant weight gain on Synthroid need to report this?
- Because the Synthroid dose is to low (is not working). (check the lab levels: T3, T4, TSH) - Weight loss is normal |
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Patients on Cytomel (Form of T3) need to take or need to monitor for what daily?
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Patients on Cytomel (Form of T3) need to take or need to monitor for what daily?
- Heart rate (normal pulse 60-100) – because Cytomel increases pulse |
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Why do you monitor patient on Cytomel for angina (chest pain due to lack of o2)?
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Why do you monitor patient on Cytomel for angina (chest pain due to lack of o2)?
- possible MI - cardiac problems - Used cautiously in clients with cardiac disease (may cause angina). |
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If a patient takes Tapazole (methimazole, antithyroid drug) daily, what endocrine problem do u think they have?
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If a patient takes Tapazole (methimazole, antithyroid drug) daily, what endocrine problem do u think they have?
- Hyperthyroidism (Graves’ disease) - “Methimazole (Tapazole) and propylthiouracil (PTU) are used for the medical management of hyperthyroidism.” |
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What lab do you monitor while patient is taking PTU (propylthiouracil, antithyroid drug)?
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What lab do you monitor while patient is taking PTU (propylthiouracil, antithyroid drug)?
- monitor for decrease in WBC's (agranulocytosis) (watch for S/S of infection) |
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Why do we ask patients if they are pregnant or ask what birthcontrol patient is on before giving PTU?
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Why do we ask patients if they are pregnant or ask what birthcontrol patient is on before giving PTU?
- causes complication to the fetus - “methimazole and propylthiouracil are used with extreme caution during pregnancy because they can cause hypothyroidism (cretinism) in the fetus.” - “If an antithyroid drug is necessary during pregnancy, propylthiouracil is the preferred drug, because it does not cross the placenta.” |
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What is agranulocytosis?
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What is agranulocytosis?
- condition of NO white blood cells - failure of bone marrow to produce enough WBC’s |
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*If patient is on Tapazole, what am I monitoring for?
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*If patient is on Tapazole, what am I monitoring for?
- agranulocytosis (decreased WBC’s), exfoliative dermatitis (widespread scaling of the skin), granulocytopenia (reduced # of WBC’s), and hypoprothrombinemia (increased bleeding) - running out of immunity (immunosuppressed) |
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Is agranulocytosis a possible complication of Tapazole?
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Is agranulocytosis a possible complication of Tapazole?
- Yes, tell the Dr. |
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Why do we give PTU prior to the patient who is having a thyroidectomy surgery?
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Why do we give PTU prior to the patient who is having a thyroidectomy surgery?
- decreases the size and vascularity (bleeding) of the thyroid gland - “When antithyroid drugs are administered before surgery, the vascularity of the thyroid gland is reduced (typically using potassium iodide) and the tendency to bleed during and immediately after surgery is decreased.” |
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Why take Tapazole?
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Why take Tapazole?
- For graves’ disease (hyperthyroidism) |
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Why does pt complain of fever and sore throat who is on PTU do immediate intervention?
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Why does pt complain of fever and sore throat who is on PTU do immediate intervention?
- because patient has decrease of WBC's (risk for infection, immunsuppresed) - agranulocytosis |
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If pt is complaining of a brassy (metallic) taste in mouth, while on Lugal’s solution, what do u do?
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If pt is complaining of a brassy (metallic) taste in mouth, while on Lugal’s solution, what do u do?
- stop med, & call the Dr. - “Instruct client to stop medication and notify the primary health care provider.” |
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How do we give Lugal’s solution?
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How do we give Lugal’s solution?
- diluted in fruit juice (no grapfruit) - “Dilute solutions with fruit juice; may have salty taste; take same time each day, increase fluid intake.” |
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Who is given Lugal’s solution?
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Who is given Lugal’s solution?
- is given to pre thyroidectomy - “Used for the development of euthyroid (normal) state and reduction of thyroid gland prior to thyroid removal surgery.” |
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What is drug of choice for pt experiencing thyroidtoxosis (thyroid storm)?
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What is drug of choice for pt experiencing thyroidtoxosis (thyroid storm)?
- saturated solution of potassium iodine - SSKI |
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If your hyperthyroid pregnant female received an order for radioactive iodine, what do you do?
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If your hyperthyroid pregnant female received an order for radioactive iodine, what do you do?
- cancel it and call dr. not safe for prego - contraindicated in pregnancy |
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How does radioactive iodine treatment work in pt with hyperthyroidism (graves’ disease)
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How does radioactive iodine treatment work in pt with hyperthyroidism (graves’ disease)
- reduces the vascular, cant produce the T3 & T4 hormone anymore (destroys the tissues) - “The radioactive isotope accumulates in the cells of the thyroid gland, where destruction of thyroid cells (stopping or slowing release of thyroid hormones) occur without damaging other cells throughout the body.” |
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Can you give a glucocorticoid steroids to pt who is Diabetes Mellitus?
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Can you give a glucocorticoid steroids to pt who is Diabetes Mellitus?
- no, because it raises the blood sugar (glucose), Hyperglycemia. |
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Why would you question your patient’s list of meds if they are taking lysodren and has history of primary adrenal insufficiuency?
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Why would you question your patient’s list of meds if they are taking lysodren and has history of primary adrenal insufficiuency?
- Because Lysodren causes a drecrease in adrenal function - it exacerbates the problem |
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Q1. What is Propranolol (Inderal)?
*Q2. Is it contraindicated in pt with asthma? |
Q1. What is Propranolol (Inderal)?
- Beta Blocker *Q2. Is it contraindicated in pt with asthma? - Yes, because is it affects the beta receptors - non-selectively antagonizes beta-1 and beta-2 adrenergic receptors. |
