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51 Cards in this Set

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thyroid hormone
proto: levothyroxine (Synthroid, Levothroid)

other: liothyronine (Cytomel)
liotrix (Thyrolar)
thyroid: (Thyroid USP)
thyroid hormone MOA
synthetic form of thyroxine (T4), form of liothyronine (T3) or a combination of T4 and T3 that increase metabolic rate, protein synthesis, cardiac output, renal perfusion, oxygen use, body temp, blood volume, growth processes
thyroid hormone use
treatment of hypothyroidism
emergency treatment of myxedema coma (IV route)
thyroid hormone adverse
overmedication can result in hyperthyroidism
thyroid hormone contraindications
pregnancy and lactation
thyrotoxicosis
following an MI
caution: cardiovascular problems
not for use in treatment of obesity
thyroid hormone interactions
binding agents and sucralfate (Carafate) reduce levothyroxine absorption with concurrent use
antiseizure and antidepressant meds- increase levothyroxine metabolism
increases anticoagulant effects of warfarin by breaking down Vit. K- monitor PT and INR, check for signs of bleeding or bruising
thyroid hormone admin
monitor clients T4 and TSH levels
take daily on an empty stomach
inform client of importance of lifelong replacement
check with provider before switching to another brand of levothyroxine
thyroid hormone effectiveness
decreased TSH levels
T4 levels within expected reference range
absence of hypothyroidism
antithyroid meds
proto: propylthiouracil (PTU)
other: methimazole (Tapazole)
antithyroid meds MOA
blocks synthesis of thyroid hormones
prevents oxidation of iodide
blocks conversion of T4 into T3
antithyroid meds use
treatment of Grave's disease
produces a euthyroid state prior to thyroid removal surgery
adjunct to irradiation of the thyroid gland
emergency treatment of thyrotoxicosis
antithyroid meds adverse
overmedication can result in indications of hypothyroidism- (drowsiness, depression, weight gain, edema, bradycardia, anorexia, cold intolerance, dry skin, menorrhagia)
agranulocytosis
liver injury, hepatitis
antithyroid contraindications
pregnancy
lactation
bone marrow depression
clients at risk for liver failure
antithyroid interactions
anticoagulants- may increase anticoagulation- monitor PT, INR, and aPTT
digoxin (Lanoxin)- may increase glycoside level
antithyroid admin
take meds with meals
monitor for signs of hyperthyroidism
clients with hyperthyroidism may be given a etaadrenergic antagonist to decrease tremors and tachycardia
monitor for hypothyroidism
monitor CBC
antithyroid effectivness
weight gain
decreased T4 levels
absence of signs of hyperthyroidism
radioactive iodine (antithyroid)
absorbed by the thyroid and destroys some of the thyroid producing cells
at high doses, thyroid-radioactive iodine destroys thyroid cells
radioactive iodine uses
High doses:
hyperthyroidism
thyroid cancer

Low doses:
thyroid function studies
radioactive iodine adverse
radiation sickness
bone marrow depression
hypothyroidism
radioactive iodine contraindications
pregnancy
lactation
radioactive iodine interactions
concurrent use of other antithyroid meds- reduces reuptake of radioactive iodine
radioactive iodine admin
void frequently
increase fluid intake
avoid coughing and expectoration
limit contact with clients to 30 min day
strong iodine solution (Lugol's solution)- nonradioactive iodine
creates high levels of iodinethat will reduce iodine uptake, inhibit thyroid hormone production, and block release of thyroid hormones into the bloodstream
strong iodine solution uses
development of euthyroid state and reduction of thyroid gland size prior to thyroid removal surgery
thyroid- nonradioactive iodine is used for emergency treatment of thyrotoxicosis
strong iodine adverse
iodism due to corrosive property - administer sodium thiosulfate to reverse
strong iodine interactions
concurrent intake of foods high in iodine increases risk for iodism
strong iodine admin
dilute strong iodine solution with juice to improve taste
increase fluid intake
strong iodine effectiveness
weight gain
decreased T4 levels
reduction in size of thyroid gland
client will be able to get adequate sleep, free of complications of hyperthyroidism
anterior pituitary hormones/growth hormones
somatropin (Genotropin, Nutropin)
other: somatrem (Protropin)
anterior pituitary hormone MOA
stimulate overall growth and production of protein and decrease of the use of glucose
anterior pituitary hormone use
treat growth hormone deficiencies
anterior pituitary hormone adverse
hyperglycemia
hypercalciuria and renal calculi
anterior pituitary hormone contraindications
severe obesity
severe respiratory impairment (sleep apnea)
diabetes- risk of hyperglycemia
treatment should be stopped prior to epiphyseal closure
anterior pituitary hormone interactions
glucocorticoids- counteract growth-promoting effects
anterior pituitary hormone effectivess
client increases height and weight
antidiuretic hormone
proto: vasopressin (Pitressin synthetic)
other: desmopressin (DDAVP, stimate)
antidiuretic hormone MOA
promotes reabsorption of water within the kidney
natural ADH causes vasoconstriction because of the contraction of vascular smooth muscle
antidiuretic hormone Use
treat diabetes insipidus
antidiuretic hormones are sometimes used during CPR to temporarily decrease blood flow from the periphery and increase flow to the brain and heart
antidiuretic hormone adverse
reabsorption of too much water
myocardial ischemia from excessive vasoconstriction
antidiuretic hormone contraindications
carbamazepine and TCAs may increase antidiuretic hormone
alcohol, heparin, lithium and phenytoin may increase antidiuretic effects
antidiuretic effectiveness
reduction in large volumes of urine output associated with diabetes insipidus
cardiac arrest survival
adrenal hormone replacement
hydrocortisone (Hydrocortone, Solu-Cortef)
other: prednisone (Deltasone) dexamethasone (Decadron)
mineral corticoids: fldrocortisone (Florinef)
adrenal hormone MOA
mimic effect of natural hormones
adrenal hormone use
acute and chronic replacement therapy for adrenocortical insuffieciency (Addison's disease)
Nonendocrine disorders include cancer, inflammation, allergic reactions
hydrocortisone adverse (glucocorticoid)
osteoporosis
adrenal suppression
PUD
GI discomfort
infection
fludrocortisone (mineralocorticoid) adverse
retention of sodium and water- leads to hypertension, edema, HF and hypokalemia
hydrocortisone interactions
NSAIDS
alcohol
oral anticoagulants
potassium depleting agents
vaccines and toxoids- may reduce antibody response
fludrocortisone interactions
barbiturates
phenytoin
insulin , sulfonylureas- antidiabetic effects are decreased when used with fludrocortisone
adrenal hormone replacement contraindications
viral, bacterial infection
recent MI, gastric ulcer, hypertension, kidney disorder, osteoporosis, DM, hypothyroidism, myasenthia gravis, glaucoma, seizure disorders
adrenal hormone replacement nursing admin
monitor for indcation of acute adrenal insufficiency ( fever, muscle, joint pain, weakness, fatigue
adrenal hormone replacement effectiveness
relief of effects of adrenocortical deficiency, weakness, hypoglycemia, hyperkalemia, fatigue, minimal adverse effects