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107 Cards in this Set
- Front
- Back
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What is the indication and side effects of tolbutamide (Orinase)?
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Ind: Type II DM
SE: Hypoglycemia Weight Gain |
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What is the indication and side effects of glipizide (Glucotrol)?
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Ind: Type II DM
SE: Hypoglycemia Weight Gain |
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What is the indication and side effects of glyburide (Micronase)?
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Ind: Type II DM
SE: Hypoglycemia Cardiac Ischemia (angina) Weight Gain |
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What is the indication and side effects of glimepiride (Amaryl)?
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Ind: Type II DM
SE: Hypoglycemia Weight Gain |
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How do Orinase, Glucotrol, Micronase, and Amaryl work in the body?
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Promote insulin release from pancreas (dependent on functioning beta cells).
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How does rapaglinide (Prandin) and nateglinide (Starlix) work in the body?
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Stimulate the release of insulin from the pancreas
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What is the indication and major side effect for Prandin?
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Ind: Type II DM
SE: Hypoglycemia |
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What is the indication and major side effect for Starlix?
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Ind: Type II DM
SE: Hypoglycemia |
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What are the nursing interventions for Prandin?
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-NO PRANDIN WITH LIVER FAILURE
-Take 30 min before meals -Do not take if meal is skipped. |
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What are the nursing interventions for Starlix?
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-Take 30 min before meals
-Do not take if meal is skipped. |
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What is the indication and major side effects of metformin (Glucophage)?
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Ind: Type II DM
SE: Anorexia Decreased absorption B12 and folic acid |
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What are the Contraindications for metformin (Glucophage)?
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-Alcohol
-Kidney/Liver failure |
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How does metformin (Glucophage) work in the body?
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-Decreases hepatic glucose output
-Peripheral glucose utilization (Insulin sensitizer) |
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What is the indication and side effects of rosiglitazone (Avandia)?
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Ind: Type II DM
SE: Fluid Retention CHF Hepatotoxicity Increased risk of bone fracture |
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What is the indication and side effects of pioglitazone (Actos)?
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Ind: Type II DM
SE: Fluid Retention CHF Hepatotoxicity Increased risk of bone fracture |
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What are the nursing interventions for Avandia?
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-Monitor LFTS
-Educate signs of CHF -*Takes 6-14 weeks to take effect* |
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What are the nursing interventions for Actos?
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-Monitor LFTS
-Educate signs of CHF -*Takes 6-14 weeks to take effect* |
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How does rosiglitizone (Avandia) and pioglitazone (Actos) work in the body?
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Increase insulin sensitivity in adipose tissue, skeletal muscle, and liver, thus increasing the effect of insulin and decreasing blood glucose.
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What is the indication and side effects of acarbose (Precose)?
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Ind: Type II DM
SE: Flatulence Cramps Distention Borborygymus Diarrhea *Monitor LFTs |
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What is the indication and side effects of mitlitol (Glyset)
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Ind: Type II DM
SE: Flatulence Cramps Distention Borborygymus Diarrhea *Monitor LFTs |
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How does Precose and Glyset work in the body?
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Delays absorption of carbs in stomach/intestine which leads to decreased blood glucose after meals.
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What are the nursing implications for ALL oral hypoglycemic agents?
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-encourage diet restrictions and exercise
-weigh at least once a week -Assess skin for poor healing, vision problems, renal failure -Monitor for signs/symptoms of hypoglycemia or hyperglycemia -Monitor for liver function problems -Encourage pt to carry source of glucose at all times |
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What are ALL oral hypoglycemic agents contraindicated with?
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-alcohol (increased risk of altering blood glucose and calorie source)
-anticoagulants -beta blockers (mask symptoms of hypoglycemia) |
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What is human insulin (Exubra) and for whom is it indicated?
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It is an inhaled, dry powder form of rapid acting human insulin for use in Type I and II Diabetics.
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What are the side effects for human insulin (Exubra)?
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-Hypoglycemia
-Mild to Moderate cough |
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What are the nursing interventions for human insulin (Exubra)?
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-Weight-based dosage
-Check lung functions often |
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What is human insulin (Exubra) contraindicated with?
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-smoking
-asthma/COPD -lung disease |
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What does exenatide(Byetta)do in the body?
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It stimulates the release of insulin from the pancreas.
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What route is Byetta given?
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SC - prefilled injection pen
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What are the side effects for exenatide (Byetta)?
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-hypoglycemia
-slowed gastric emptying (Pt feels full and eats less) |
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What are the nursing interventions for exenatide (Byetta)?
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-Taken 2x/day within 60 min before meal.
-*OFF LABEL USE - weight loss* -last resort before putting pt on insulin |
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What does sitagliptin (Januvia) do in the body?
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Promotes insulin production in response to the presence of hyperglycemia.
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What route is Januvia given?
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po
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What are the side effects for sitagliptin (Januvia)?
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Flu/Cold symptoms:
-HA -Stuffy Nose -Sore throat |
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What does pramlintide (Symlin) do in the body and for whom is it indicated?
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Synthetic analog of human amylin - a hormone (like insulin) secreted to control glucose levels in Type I and II diabetic pts.
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What are the side effects for pramlintide(Symlin)?
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-Hypoglycemia
-Decreased appetite -Nausea(most common) |
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What are the nursing interventions for pramlintide (Symlin)?
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-Given at meal time
*Must have conversion chart from mcg to Units *Do NOT mix with insulin for injection. |
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What route is Symlin given?
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SC
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What does glucagon do in the body and what is it indicated for?
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Promotes the breakdown of glycogen, decreases glycogen synthesis, and stimulates the biosynthesis of glucose.
Indicated for Insulin OD - used in emergencies to restore consciousness in diabetics experiencing extreme hypoglycemia. |
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What are the side effects of glucagon?
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hypoglycemia.
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What are the nursing interventions for glucagon?
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-Document VS and LOC often
-Monitor blood glucose before and after administration -May interact with anticoagulants *Risk for aspiration - monitor respirations* |
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What is levothyroxine (Synthroid, Levoxyl, Levothroid)indicated for?
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Hypothyroidism*
Goiter* Cretinism Myxedema Diagnostic testing Postthyroidextomy* |
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What are the side effects for levothyroxine (Synthroid, Levoxyl, Levothroid)?
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*Opposite of manifestations*
Thyrotoxicosis: -Increased HR -Heat intolerance -Hyperthermia -Sweating -Angina -Tremor -Insomnia |
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What is the clinical manifestation of Hypothyroidism?
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*Decrease in almost everything except weight*
-dry skin -brittle hair/hair loss -Decreased HR -Hypothermia -Cold intolerance -Lethargy -weight gain |
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What are the contraindications for levothyroxine?
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-Calcium supplements
-Antacids -Iron Supplements -Coumadin -Dilantin -Tegretol -Zoloft -Phenobarbitol -catecholamines |
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What are the nursing interventions for levothyroxine (Synthroid, Levoxyl, Levothroid)?
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-No brand switching
*Highly protein bound* (long half life) *Take on EMPTY stomach* -lifelong therapy |
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What is the clinical manifestation of Hyperthyroidism?
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*Increase in everything except weight*
-Tachycardia -dyrhythmias -angina -insomnia -muscle weakness -hyperthermia -heat intolerance *protruding eyes* -weight loss |
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What is the indication for propylthiouracil(PTU)?
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Hyperthyroidism (Grave's Disease)
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What is the indication for radioactive iodine (131 I)?
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Hyperthyroidism (Grave's Disease)
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What is the indication for iodine solution (Lugol's solution)?
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Hyperthyroidism (Grave's Disease)
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What are the side effects of propylthiouracil (PTU)?
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Hypothyroidism
Agranulocytosis |
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Why is PTU given?
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preop suppression of thyroid gland
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What are the side effects of radioactive iodine (131 I)?
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permanent hypothyroidism
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Why is radioactive iodine (131 I) given?
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Used to destroy thyroid tissue for pts with overproduction or cancer.
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What are the side effects of iodine solution (Lugol's Solution)?
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Hypothyroidism
*Can be fatal* |
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Why is iodine solution (Lugol's Solution) given?
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preop suppression effect on the thyroid.
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What is the indication for somatrem (Protropin)?
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pediatric growth deficiency
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What is the indication for somatropin (Humatrope, Nutropin)?
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pediatric growth deficiency
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What are the side effects for somatropin (Humatrope, Nutropin)?
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Hyperglycemia, Hypothyroidism
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What are the side effects for somatrem (Protropin)?
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Hyperglycemia, Hypothyroidism
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What are the nursing interventions for somatropin (Humatrope, Nutropin)?
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-Monitor growth and weight
*Monitor epiphyseal closure* - D/C when closed -Mix gently - do NOT use if cloudy *HUGE POTENTIAL FOR ABUSE* (athletes, etc) |
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What are the nursing interventions for sometrem (Protropin)?
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-Monitor growth and weight
*Monitor epiphyseal closure* - D/C when closed -Mix gently - do NOT use if cloudy *HUGE POTENTIAL FOR ABUSE* (athletes, etc) |
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What is somatrem (Protropin) contraindicated with?
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-tumors
-diabetes -hypothyroidism |
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What is somatropin (Humatrope, Nutropin contraindicated with?
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-tumors
-diabetes -hypothyroidism |
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What is vasopressin (Pitression) indicated for?
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Diabetes Insipidus and Esophageal Varices
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What is desmopressin (DDAVP) indicated for?
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Diabetes Insipidus and Esophageal Varices
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What are the side effects of vasopression (Pitression)?
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-Water intoxication
-CV effects: SOB, Chest pain, MI, HTN -Extravasation |
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What are the side effects of desmopressin (DDAVP)?
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-Water intoxication
-CV effects: MI, HTN, SOB, chest pain -Extravasation |
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What are the nursing interventions for vasopression (Pitression)?
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-Monitor I&O and weight
-Monitor Chest pain, MI, HTN, SOB -Monitor EKGs -Caution with CAD pts |
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What are the nursing interventions for desmopressin (DDAVP)?
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-Monitor I&O, weight
-Monitor chest pain, MI< HTN, SOB -Monitor EKGs -Caution with CAD pts |
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What is the major indication for betamethasone?
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Inflammation
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What is the indication for dexamethasone?
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Inflammation
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What is the indication for hydrocortisone?
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Inflammation
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What is the indication for methylprednisolone (Solu-Medrol)?
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Inflammation
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What is the indication for prednisone?
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Inflammation
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What are the side effects for betamethasone?
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-HTN
-Increase blood glucose -Hypokalemia -Delayed wound healing -Osteoporosis -Altered fat distribution -Edema, weight gain -Immunosuppression -Increase in gastric acid -Cataracts, Glaucoma -infection |
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What are the side effects for dexamethasone?
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-HTN
-Increased blood glucose -Hypokalemia -Delayed wound healing -Osteoporosis -Altered fat distribution -Edema, weight gain -Immunosuppression -Increase in gastric acid -Cataracts, Glaucoma -Infections |
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What are the side effects for hydrocortisone?
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-HTN
-Increased blood glucose -Hypokalemia -Delayed wound healing -Osteoporosis -Altered fat distribution -Edema, weight gain -Immunosuppression -Cataracts, Glaucoma -Increased gastric acid -Infection |
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What are the side effects for methylprednisolone (Solu-Medrol)?
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-HTN
-Increased blood glucose -Hypokalemia -Delayed Wound Healing -Osteoporosis -Altered fat distribution -Edema, weight gain -Immunosuppression -Increase in gastric acid -Cataracts, Glaucoma -Infection |
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What are the side effects for prednisone?
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-HTN
-Increased blood glucose -Hypokalemia -Delayed wound healing -Osteoporosis -Altered fat distribution -Edema, weight gain -Immunosuppression -Increase in gastric acid -Cataracts/Glaucoma -Infection |
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What are the nursing interventions for betamethasone?
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-Monitor BP, CHF
-Monitor glucose levels - give insulin PRN -Give K Supplements -Monitor skin breakdown -Monitor I&O, weight -No fungal infections -No TB or AIDS -Taper -Watch for blood in stools - sign of GI bleeding -Monitor for DVT or PE -Discuss body image changes -Complex schedule |
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What are the nursing interventions for dexamethasone?
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-Monitor BP, CHF
-Monitor glucose, give insulin PRN -Give K supplements -Monitor skin breakdown -Monitor I&O, weight -No fungal infections -No TB or AIDS -Taper dosage -Watch for blood in stools - sign GI bleeding -Monitor for DVT or PE -Discuss body image changes -Complex Schedule |
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What are the nursing interventions for hydrocortisone?
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-Monitor BP, CHF
-Monitor glucose, give insulin PRN -Give K supplements -Monitor skin breakdown -Monitor I&O, weight -No fungal infections -No TB or AIDS -Taper dosage -Watch for blood in stools - sign GI bleeding -Monitor for DVT or PE -Discuss body image changes -Complex Schedule |
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What are the nursing interventions for methylprednisolone (Solu-Medrol)?
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-Monitor BP, CHF
-Monitor glucose, give insulin PRN -Give K supplements -Monitor skin breakdown -Monitor I&O, weight -No fungal infections -No TB or AIDS -Taper dosage -Watch for blood in stools - sign GI bleeding -Monitor for DVT or PE -Discuss body image changes -Complex Schedule |
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What are the nursing interventions for prednisone?
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-Monitor BP, CHF
-Monitor glucose, give insulin PRN -Give K supplements -Monitor skin breakdown -Monitor I&O, weight -No fungal infections -No TB or AIDS -Taper dosage -Watch for blood in stools - sign GI bleeding -Monitor for DVT or PE -Discuss body image changes -Complex Schedule |
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What are the -sones contraindicated with?
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HTN, CHF, PUD, AIDS, NSAIDS, Digoxin, Vaccines, Osteoporosis
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What is the indication for calcium carbonate (Tums, Caltrate, Oscal, Viactiv)?
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Calcium replacement
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What is the indication for calcium citrate (Citracal)?
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Calcium Replacement
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What is the indication for calcium gluconate?
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Calcium Replacement
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What are the side effects for calcium carbonate (Tums, Caltrate, Oscal, Viactiv)?
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-Hypercalcemia
-Constipation -Increased gastric acid |
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What are the side effects for calcium citrate (Citracal)?
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-Hypercalcemia
-Constipation -Increased gastric acid |
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What are the side effects for calcium gluconate?
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-Hypercalcemia
-Constipation -Increased gastric acid |
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What are the nursing interventions for the "calciums"?
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-No brand switching
-No more that 600 mg -Take with water -Stagger doses |
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What are the "calciums" contraindicated with?
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Prednisone
Tetracycline Thyroid hormone Thiazide Diuretics Spinach, beets, grain cereals Bran cereal |
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What is the indication for alendronate (Fosamax)?
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Osteoporosis
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What is the indication for risedronate (Actonel)?
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Osteoporosis
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What is the indication for ibandronate sodium (Boniva)?
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Osteoporosis
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What are the side effects for alendronate (Fosamax)?
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-Esophagitis
-Ulcers -Gas production -Acid Reflux |
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What are the side effects for risedronate (Actonel)?
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-Esophagitis
-Ulcers -Gas production -Acid reflux -Arthralgia -GI upset -HA |
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What are the side effects for ibandronate sodium (Boniva)?
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-Esophagitis
-Ulcers -Gas production -Acid reflux |
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What are the nursing interventions for alendronate (Fosamax)?
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-Give w/ water
*No eating for 30 min* *Remain upright for 30 min* -No chewing or sucking pill -Maintain Calcium intake |
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What are the nursing interventions for risedronate (Actonel)?
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-Give w/ water
*No eating for 30 min* *Remain upright for 30 min* -No chewing or sucking pill -Maintain calcium intake -Report GI symptoms to MD |
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What are the nursing interventions for ibandronate sodium (Boniva)?
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-Give w/ water
*No eating for 30 min* *Remain upright for 30 min* -No chewing or sucking pill -Maintain calcium intake -Report GI symptoms to MD |
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What are the nursing interventions for once-a-month Boniva?
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*Wait 60 minutes before eating*
*Remain upright for 60 min* -Take first thing in the morning -Give w/ water |
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Why is teriparatide (Forteo) different from other osteoporosis drugs?
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Only drug that increased bone formation (not bone resorption)
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What is the route for teriparatide (Forteo)?
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SC daily
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What is special about zoledronic acid (Reclast)?
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It is a once yearly IV treatment of osteoporosis
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