Endocrine
What nursing care considerations would the nurse need to know to care for a client who received radioactive iodine treatment? (Select all that apply)
1. The patient needs a private toilet and should flush more than once after each use.
2. Monitor for s/s of hypothyroidism
3. Monitor for s/s of hyperthyroidism
4. The patient should avoid pregnant women and children for 7 days after treatment.
5. The patient will see a delayed response in treatment.
Answer 1, 2, 4, 5
The nurse should also know that they need separate laundry.
The medication is used to treat hyperthyroidism by destroying the thyroid
The nurse is completing discharge planning for a patient prescribed Ipratropium. The nurse should include the following in the patient teaching. (Select all that apply)
1. Sip on fluids, suck on hard candies for dry mouth.
2. Increase fiber in the diet for constipation.
3. Monitor for GI upset and diarrhea.
4. Rinse mouth after inhalation.
5. This medication is used to treat acute episodes of wheezing
Answer 1, 2, 4
Ipratropium is a bronchodilator that is only approved for COPD
Adverse effects include dry mouth constipation urinary retention
This medication is not used to treat acute episodes of wheezing.
A nurse is caring for a client who is receiving IV heparin for a DVT. The client begins to vomit blood. After stopping the heparin which medication should the nurse expect to administer?
1. Vitamin K
2. Atropine
3. Protamine sulfate
4. Calcium gluconate
Answer 3
Protamine reverses the anticoagulation effect of heparin.
Vitamin K reverses the effects of warfarin
Atropine is used to reverse bradycardia caused by Beta Blockers
Calcium gluconate is used to treat magnesium sulfate toxicity.
A patient is prescribed aluminum hydroxide for GERD. The nurse should teach the patient which of the following about this medication. (Select the best answer)
1. Take all other meds 1hr before or after taking the antacid.
2. Take this medication daily with food.
3. Drink Grapefruit juice when taking this medication.
4. This medication can cause black tarry stools.
Answer 1
All other answers do not apply to this medication.
A patient on the telemetry unit is due for their digoxin. The nurse should hold the medication for which of the following reasons? (select all that apply)
1. Apical Pulse of 53
2. Radial Pulse of 87
3. Digoxin lab level is 2.5ng
4. Respiratory rate of 22
Answer
1 and 3
Apical pulse less than 60
Digoxin therapeutic level is 0.5 to 2ng
The nurse is administering levothyroxine to a patient. The nurse understands that the patient is experiencing adverse effects of the medication when the patient reports which of the following? (select the best answer)
1. Chest pain, palpations, and dysrhythmias
2. GI upset, nausea and vomiting.
3. Yellowing of the skin and eyes.
4. Dizziness and shortness of breath
Answer 1
Adverse effects include the following:
Chest pain, palpations, and dysrhythmias
Neuro: Nervousness, tremors, insomnia
A client received albuterol per nebulizer. The client reports feeling shaky. The client's pulse pre-treatment was 100 and post-treatment is 110. The nurse determines that:
1. This is an expected adverse effect
2. This is an allergic reaction
3. This is an idiosyncratic reaction
4. This is a medication error.
Answer
1 – beta2 agonist can cause cardiac stimulation resulting in chest pain, palpitations, and hypertension
A nurse is monitoring a client who takes aspirin 81mg PO daily. The nurse should identify which of the following manifestations as adverse effects of daily aspirin therapy. (select all that apply)
1. Hypertension
2. coffee-ground emesis
3. Tinnitus
4. Parasthesias of the extremities
5. Nausea
Answer 2, 3 and 5
Hypotension and shock can result if severe aspirin allergy occurs, but hypertension is not an adverse effect of aspirin therapy.
Paresthesia is not an adverse effect of aspirin therapy
A postoperative client has a PRN prescription for ondansetron. Which condition would the nurse administer this medication for?
1. Paralytic Ileus
2. Incisional Pain
3. Urinary Retention
4. Nausea and Vomiting
Answer 4
The nurse is getting ready to administer digoxin. The nurse knows to check which of the following before administration? (Fill in the blank)
1. _____________________
2. _____________________
3. ______________________
Answer
Apical Pulse less than 60
Potassium levels
Digoxin level
The nurse is caring for a client who is diagnosed with Cushing’s disease and is started on Ketoconazole. The nurse should monitor the client closely for which adverse effect of the medication.
1. Monitor Liver Function Test (LFT)
2. Monitor for hypotension
3. Monitor for hypercalcemia
4. Monitor for discolored urine.
Answer 1.
ADVERSE EFFECTS Dizziness, Hepatotoxicity, Nausea, and Vomiting
Nursing Care – Take with food, Monitor LFT
The nurse is teaching the patient about the adverse effects of prednisone. The nurse should include all the following except in the patient teaching.
1. Rinse mouth out and monitor for white patches on the tongue.
2. Once the symptoms go away stop the medication.
3. Monitor for infection.
4. Do not stop the medication abruptly
Answer
2
The patient should not stop abruptly- Medication is tapered slowly. Take with food and avoid prolonged use
The nurse is providing teaching to a client on anticoagulant therapy. The nurse should which of the following in the patient teaching? (select all that apply)
1. Bleeding precautions
2. Increase intake of foods high in vitamin K
3. You can still have a glass of wine at night.
4. Do not take any Aspirin or NSAIDS with this medication.
Answer
1 and 4
Keep vitamin K consistent in the diet or decrease vitamin K
NO ALCOHOL with anticoagulants
The nurse is educating the client on the adverse effects of Estradiol. The nurse should include the following in the patient teaching: (Select all that apply)
1. This medication can lead to deep vein thrombosis.
2. This medication can increase the risk of breast cancer.
3. This medication can elevate Liver enzymes.
4. This medication can cause central nervous system depression.
Answer 1, 2
A nurse is planning care for a client who is receiving furosemide. Which of the following interventions should the nurse include in the plan of care? (select all that apply)
1. Assess for tinnitus
2. Recommend that the client eat a banana daily
3. Instruct the client to take the medication at night.
4. Change positions slowly before walking
Answer
1, 2, 4
The patient should take medication during the day as it makes you urinate
Fill in the blank with the following insulins
Lispro, Regular insulin, Insulin glargine (LANTUS), NPH
? 15m onset, 1-2hr Peak, 15m before meals.
? 30-60min onset, 1-5hr Peak, 30-45min before meals, IV.
? 1-2hr onset, 6-14hr Peak, Cloudy mixture can be mixed with short or rapid insulins.
? 1-2hr Onset, No Peak, Administer daily or BID
DO NOT MIX with any other insulins
Answer:
Lispro, Regular Insulin, NPH, Insulin glargine (LATUS)
A nurse is providing care to a client who is having difficulty coughing up thick secretions. The nurse should expect to administer which medication to the client?
1. Ipratropium
2. Prednisone
3. Acetylcysteine
4. Albuterol
Answer 3
Acetylcysteine is a mucolytic that loosens thick respiratory secretions
Ipratropium is a bronchodilator that is prescribed for COPD
Prednisone – Glucocorticoid that reduces inflammation
Albuterol – Bronchodilator that is used for the treatment of asthma, COPD, and bronchospasms
A nurse is talking to a patient who is prescribed warfarin. The nurse should include the following in the patient teaching? (select all that apply)
1. Do not take any over-the-counter herbal products.
2. Take at the same time each day.
3. Eat a diet high in vitamin K.
4. Monitor for signs of bleeding.
5. Reduce alcohol intake.
Answer
1, 2, 4
The client should limit foods high in vitamin K.
No alcohol intake with Warfarin
A nurse is providing teaching to a client about sildenafil to treat erectile dysfunction. Which of the following instructions should the nurse include?
1. Do not take nitrates with this medication.
2. Increase intake of foods rich in vitamin K with this medication
3. Avoid tyramine-containing foods with this medication.
4. Take this medication with a glass of grapefruit juice to increase absorption.
Answer is 1
A nurse is caring for a client who has a new prescription for niacin to reduce cholesterol. The nurse should monitor for which of the following findings as an adverse effect of niacin? (Select all that apply)
1. Muscle aches
2. Hearing loss
3. Flushing of the skin
4. Jaundice
3, 4
Flushing of the skin along with tingling of the extremities can occur with taking niacin.
Niacin can cause liver disorders, so the nurse should monitor for jaundice
A nurse is caring for a patient that is taking metformin and is scheduled to undergo angiography using iodine-containing contrast dye. The patient is at risk for which of the following conditions?
1. Hypokalemia
2. Hyperglycemia
3. Acute renal failure
4. Acute pancreatitis
Answer 3
Metformin can interact with iodine-containing contrast dye and cause acute renal failure and lactic acidosis. The nurse should withhold the metformin. Metformin should be held for 48 hours prior to and following the procedure.
A nurse is receiving a report on a client who is receiving IV theophylline. Nursing care of the client should include monitoring which of the following? (Select all that apply)
1. Serum theophylline blood levels.
2. Cardiac monitoring for dysrhythmias
3. Client report of palpitations
4. Skin changes and rash
Answer
1, 2, 3
The therapeutic level is 10-20
Skin changes and rash are not adverse effects of theophylline.
A patient is being discharged home with nitroglycerin. The nurse instructs the patient to do the following if they experience chest pain? (Put in order)
Place nitroglycerin under the tongue.
Stop activity and rest.
Wait 5 minutes.
Call 9-1-1
Take nitroglycerin tablet 2
Answer
1 Stop activity and rest.
2 Take a nitroglycerin place under the tongue.
3 Wait 5 minutes
4 Call 9-1-1
5 Take nitroglycerin tablet 2
A nurse is receiving a report on a client who is receiving IV theophylline. The nurse should expect to monitor for which adverse effects? Select all that apply.
1. Serum theophylline blood levels.
2. Cardiac monitoring for dysrhythmias
3. Abdominal Cramping
4. Skin changes and rash
Answer
1, 2, 3
The therapeutic level is 10-20
Skin changes and a rash is not an adverse effect of theophylline.
The nurse is caring for a client prescribed hydrochlorothiazide for treatment of heart failure. The client tells the nurse that when they get up to the bathroom, they get dizzy.
Which statement by the nurse would be the most therapeutic.
1. Change positions slowly and allow your body time to acclimate to the new position.
2. It’s the medication, I will call the doctor and have it changed.
3. Limit how much water you drink so you don’t have to get up to go to the bathroom as much.
4. Take this medication at night
Answer 1