Alteration/ Elimination
What is the Bulk Forming Laxative?
Psyllium (best for long term use, take with 8oz of water) (silly not to use psyllium)
Results of an incompetent lower esophageal sphincter? What is this conditions most prevalent clinical manifestation?
GERD (stomach acid or bile regurgitates into the esophagus causing an exposure of esophageal mucosa to gastric acid and pepsin)
Pyrosis (Heartburn)<-- can mimic a heart attack*
What are the three hormones produced by the Thyroid?
What are the hormones produced by the Anterior Pituitary? (Hint 7)
What are the hormones produced by the posterior pituitary?
What are the hormones produced by the Adrenal cortex?
What are the hormones produced by the Adrenal Medulla? (Group discuss the function of these hormones)
Thyroid: T3, T4, Calcitonin
Anterior Pituitary: FSH, LH, ACTH, Growth hormone, TSH, Melanocyte, prolactin
Posterior Pituitary: Oxytocin, ADH
Adrenal Cortex: Glucocorticoids (cortisol), Mineralocorticoid (Aldosterone), Androgens
Adrenal Medulla: Catecholamines; epinephrine, norepinephrine
What electrolytes do you want to monitor for Addison's and Cushing's? In these diseases how would you expect these electrolytes to present (hypo or hyper or normal)?
Sodium, glucose, and potassium
Addison's: Hyponatremia, Hyperkalemia, Hypoglycemia
Cushing's: Hypernatremia, Hypokalemia, Hyperglycemia
What are considerations you want to have with a pt who is prescribed Metformin?
What is the Substance P/Neurokinin1 Antagonist, its use, and nursing considerations?
(Hint: pregnancy)
Aprepitant, delays N/V with chemo, reduces effects of oral contraceptives up to 28 days after administration
An infection of what specific microorganism can cause the development of PUD or GERD?
H. pylori (acquired from food, water, or emesis exposure)
True or false: A goiter can only cause hyperthyroidism?
False: A goiter can cause both hypo and hyperthyroidism (visible enlargement of the thyroid gland, occurs from overstimulation)
What is the 11- Deoxycortisol Inhibitor and its black box warnings?
(Hint: Controls cortisol secretion in Cushing's disease)
Ketoconazole; BBW: can cause hepatotoxicity, BBW: Can prolong QT intervals and cause life threatening ventricular dysrhythmias
What drug controls Post prandial rise in blood glucose by decreasing digestion of starchy foods in the small intestine?
Acarbose (Alpha Glucosidase Inhibitors) (Low digoxin levels can cause pancytopenia)
What 4 things, either separately or together, must be stimulated to produce reverse peristalsis which leads to vomiting?
(Hint: Patho of vomiting)
Activation of chemoreceptor trigger zone (CTZ), Cerebral cortex (Anticipatory), Sensory organs (noxious stimuli), Vestibular Apparatus
What is the difference between a Gastric Ulcer and Duodenal Ulcer (be specific)?
Gastric ulcer: Dull aching pain AFTER eating, longer healing time; Duodenal Ulcer: INTAKE of food RELIEVES pain, symptoms worsen on an empty stomach and at night, shorter healing time
Graves is associated with what disease? What is the treatment for this disease and its BBW?
Graves is associated with hyperthyroidism (Graves RAISES, and Hashimoto's is LOW); Propylthiouracil (antithyroid drug), BBW is severe liver injury resulting in death or acute liver failure w/n 6 months of Tx
What drug is an Antineoplastic and has a BBW that if a pt develops shock or experiences trauma withhold this med because of adrenal suppression?
Mitotane
What are the Meds that you want to monitor for Hypoglycemia?
(Hint: there are 3)
Glyburide, Sitagliptin, Repaglinide (GSRe<-- pronounce as guesser and use as acronym if difficulty remembering)
What are the two categories of cathartics and the generic names for the meds provided?
Stimulant cathartic: Bisacodyl (IRRITATES the GI mucosa and pulls water into the bowel lumen); Saline Cathartic: PEG and PEG ES (used for rapid bowel evacuation)
What medication acts as an alkaline substance that neutralizes acids? (Generic and class); When do we take it?
Inform patient who have hyperthyroidism to restrict these 2 foods because they have what present in them? Also advise them to avoid what that contains this as well?
(Iodine-Induced Hyperthyroidism)
Kelp, Seafood because of they contain high amount of iodine. Also avoid radiographic contrast dyes and iodine- rich medication.
What drug is used to treat Addison's disease and what is the BBW?
Hydrocortisone, BBW: Pts receiving should not recieve LIVE virus vaccines
What is the exception drug in the antidiabetic medications and what is some important considerations?
Exenatide (Incretin Mimetic**), given subcut 2x daily, assess for thyroid modules, BBW r/f c cell thyroid cancer
What lubricates fecal mass and slows colonic absorption of water from fecal mass?
(Provide both class and generic name)
Lubricant Laxatives; Mineral oil
What are the key points for Sulfasalazine? (Group discuss over the diseases this drug is used to alleviate)
May make the urine yellow- orange, administer after meals or with food, with a full glass of water (Used to treat Crohn's and UC)
Give me 5 s/s of hyperthyroidism and 5 s/s of hypothyroidism.
Hyperthyroidism (Tigger): Heat intolerance, fine, straight hair, exophthalmos, facial flushing, enlarged thyroid, tachycardia, hypertension, breast enlargement, muscle wasting, weight loss, increase diarrhea, tremors, clubbing, amenorrhea, localized edema
Hypothyroidism (Eore): Cold intolerance, receding hairline, facial and eyelid edema, dull- blank expression, extreme fatigue, thick tongue, slow speech, anorexia, brittle nails and hair, hair loss, apathy, lethargy, dry skin, muscle aches & weakness, constipation
What are 5 clinical manifestations of Cushing's?
Bronze skin is indicative of what disease?
Cushings: Hyperglycemia, red face, CNS irritability, Moon face, increase risk for infection, edema, purple striae, bruises and petechiae, Buffalo hump, fat deposition on abdomen, gynecomastia
Addison's disease
What are the adverse effects of Rosiglitazone?
AE: Stroke, liver injury, angioedema, URI and sinusitis, dyspnea