On the roids...the corticosteroids!
Name a few important teaching considerations when speaking with a patient on corticosteroids?
1. Taper medication before discontinuing
2. Educate on increased risk of opportunistic infection
3. Monitor weight changes
4. Take with food
Since Sodium Glucose Cotransporter-2 (SGLT-2) Inhibitors produce a diuretic effect, you know to monitor the patient for:
Hypotension
What medication class is used to treat Addison's Disease?
Corticosteroids
A patient arrives at the Emergency Department with abrupt onset of wheezing, chest tightness, and dyspnea after performing yard work in early spring. What medication do you anticipate administering to the patient?
Albuterol (Proventil)
James, a patient with hypothyroidism, is prescribed Levothyroxine (Synthroid). As his nurse, you know to administer this medication:
On an empty stomach in the morning
Dave, a 92-year-old patient, is a type-2 diabetic that is given prednisone for an exacerbation of asthma. What adverse effect must we most closely monitor Dave for while on this medication?
Hyperglycemia
The nurse has an order to give the patient Insulin Lispro (Humalog). When should this insulin be administered?
5-15 minutes before a meal
Pro-Thyroid Drugs, which treat hypothyroidism, have a black box warning that indicates these are
not for:
Weight loss
When providing education to patients with a Fluticasone (Flonase, Flovent) Inhaler, what do you inform your patient of?
Rinse your mouth
In addition to administering Vasopressin (Vasostrict) for a patient with Diabetes Insipidus, what intervention should the nurse implement?
Fall precautions
Linda, a 83-year-old patient, has been on long-term corticosteroid use for Lupus. What adverse effect must we most closely monitor for while taking this medication?
Osteoporosis
Maria, a patient with Diabetes Mellitus, is scheduled to get a dose of Insulin Aspart (Novolog) TID with meals. When you enter her room to administer the medication, you notice that she is confused, clammy, pale, shaky, and complaining of nausea. You suspect she is suffering from hypoglycemia and take her sugar, which is low, what do you do next?
Do not give the medication and contact the physician immediately
A patient has just been prescribed Lugol’s solution 4 to 8 drops Q8H. The nurse will plan care to address which health problem?
Thyrotoxic Crisis
A 17-year-old patient is admitted to the Pediatric Psychiatric Unit for reports of suicidal ideation. What respiratory medication in the MAR would alert you to a possible adverse effect of a medication?
Montelukast (Singulair)
Which generation of Antihistamines causes the MOST amount of sedation?
1st Generation
Tony, a 52-year-old patient, arrives at the ER with back pain, confusion, and joint pain. The nurse, when assessing him, notes a fever, hypotension, and low blood sugar. Tony mentions that he was recently taking hydrocortisone for arthritis and he abruptly stopped taking his medication. Tony is experiencing:
Adrenal Crisis
A patient on the unit is due for Repaglinide (Prandin) but the meal trays have not been delivered yet. What should you, as the nurse, do in this situation?
Withold administering the medication until the meal trays are delivered
Anna, a patient with hypothyroidism, is taking Liothyronine (Cytomel). You worry she is suffering from hyperthyroidism from her medication. What signs and symptoms would she
present with?
Tachycardia, insomnia, weight loss, increased alertness, hypertension
Jane, a 45-year-old patient, is inquiring about taking Pseudoephedrine (Sudafed) for chronic allergies and sinusitis. What vital sign abnormality would contraindicate use of the medication?
Elevated blood pressure (Hypertension)
What protocol is used to prevent adrenal crisis or insufficient rebound of the HPA axis when taking corticosteroids?
Alternate day therapy- low dose followed by double dose
Systemic fungal infections
A Type 2 Diabetic presents to your clinic with an upper respiratory tract infection with a runny nose, sore throat, and headache. You know, based on these symptoms, the patient must be taking:
Linagliptin (Tradjenta)
Bill presents to the Emergency Room with extreme polydipsia, polyuria, weakness, and hypernatremia. You suspect that he may be suffering from Diabetes Insipidus, which is a deficiency in Antidiuretic Hormone production. Which of the following may be administered for
this patient?
Desmopressin Acetate (DDAVP), Vasopressing (Vasostrict)
A patient was administered Albuterol (Proventil) at the onset of an Asthma Attack during soccer practice. A friend, concerned about the patient, asks the school nurse how fast the patient will feel better. What is the correct time range to tell the friend?
5-15 minutes
A patient with pulmonary hypertension is prescribed Sildenafil (Revatio) to produce vasodilation of vessels. What medication needs to be avoided while taking this drug?
Nitrates