Endocrine Meds
Which of the following is a contraindication for the use of somatropin for GH deficiency?
A) diabetes mellitus
B) epiphysis closure
C) acromegaly
D) cardiomyopathy
B
How does the dosage for hydrocortisone need to be changes during times of stress?
A) increase dose
B) decrease dose
C) maintain dose
D) the drug should be discontinued because excessive stress makes it ineffective
A
Increased stress means that the body has a higher demand for stress hormone, therefore the dose should be increased.
True or False: Thiazide diuretics are more potent than loop diuretics and provide immediate diuresis affects.
FALSE
Thiazide diuretics are NOT more potent than loop diuretics and do not provide immediate diuresis affects like loop diuretics. Loop diuretics inhibit sodium reabsorption in the loop of Henle, which is responsible for about 25% of sodium reabsorption….whereas, thiazide diuretics inhibit sodium reabsorption in the early part of the distal convoluted tubule, which is responsible for about 5-7% of sodium reabsorption. Therefore, the higher percentage of sodium reabsorption inhibited the stronger the effects, which makes loop diuretics more potent.
Which of the following is an adverse effect of phenazopyridine?
A) hypertension
B) reddish-orange urine
C) bluish-green urine
D) pregnancy
B
When caring for a male client with diabetes insipidus, nurse Juliet expects to administer:
A. desmopressin
B. furosemide (Lasix).
C. regular insulin.
D. 10% dextrose.
A
Because diabetes insipidus results from decreased antidiuretic hormone production, the nurse should expect to administer desmopressin for hormone replacement therapy to decrease urine output.
When assessing for potential side effects of fludrocortisone (Florinef), the nurse monitors for signs and symptoms of which adverse effects? Select all that apply.
A) Hyponatremia
B) Hypernatremia
C) Hypokalemia
D) Hyperkalemia
E) Hypovolemia
E)
B, C
Fludrocortisone has mineralocorticoid properties, resulting in sodium and fluid retention along with potassium excretion.
Which of these diuretic medications can be used to treat glaucoma? Select all that apply.
A) hydrochlorothiazide
B) acetazolamide
C) mannitol
D) bumetanide
B, C
Phenazopyridine belongs to which class of medications?
A) beta 3 selective receptor blockers
B) opioid analgesics
C) UTI antibiotics
D) urinary analgesics
D
The nurse caring for a patient taking desmopressin for diabetes insidious knows to monitor for s/sx of what condition that can be caused by this medication?
A) hyperkalemia
B) hyperglycemia
C) dehydration
D) water intoxication
D
Desmopressin is hormone replacement for ADH and can cause water intoxication. S/sx of water intoxication include sleepiness, pounding headache, and convulsions.
A patient is taking prednisone and experiencing eye pain, changes in personality, and tarry stools. The nurse should anticipate the provider doing which of the following?
A. tapering off the medication
B. discontinuing the medication
C. prescribe a mood stabilizer
D. recommend the patient see an Ophthalmologist
A
The nurse should know that steroids should never be stopped abruptly to avoid adrenal insufficiency.
A 91-year-old patient is being discharged on the diuretic spironolactone (Aldactone). What is the major adverse effect of this type of medication?A) Hypokalemia
B) Hyperkalemia
C) Gastric irritation
D) Hypertension
B
Spironolactone is a potassium-sparing diuretic and can cause hyperkalemia.
Urinary tract antispasmodics block the pain and discomfort associated with spasm in the smooth muscle of the urinary tract. The numerous adverse effects associated with these drugs are related to
A) their blockade of sympathetic beta-receptors.
B) their stimulation of cholinergic receptors.
C) their stimulation of sympathetic receptors.
D) their blockade of cholinergic receptors.
D
Urinary tract antispasmodics such as oxybutynin exert their therapeutic effects by blocking cholinergic receptors. This medication has anticholinergic adverse effects such as nausea, vomiting, dry mouth, nervousness, tachycardia, and vision changes.
Patients who are receiving GH replacement therapy must be monitored closely. Routine follow-up examinations would include
A) a bowel program to deal with constipation.
B) tests of thyroid function and glucose tolerance.
C) a calorie check to control weight gain.
D) tests of adrenal hormone levels.
5.
B
Adverse effects of somatropin include hypothyroidism and hyperglycemia, therefore thyroid function and glucose tolerance should be monitored while on GH therapy.
A patient with type 2 diabetes is being discharged on glucocorticoid (prednisone) therapy for rheumatoid arthritis. Which information will the nurse include in discharge teaching? (Select all that apply.)
A) "Daily, single dose therapy should be taken in the morning."
B) "The metabolic needs of your body will be increased."
C) "Steroids should never be discontinued abruptly."
D) "Signs and symptoms of infections may not be evident."
E) "Blood glucose levels will be elevated on corticosteroid therapy."
A, C, D, E
During steroid replacement therapy, the drugs should mimic the body's circadian rhythm. Steroids ordered once a day are given early in the morning. Steroid replacement therapy is gradually tapered in small increments before discontinuation to ensure that the patient's adrenal glands are able to start secreting steroids to compensate for the reduced drug dosage. Glucocorticoids have an antiinflammatory action and therefore suppress the signs and symptoms of an infection. An adverse effect of glucocorticoid therapy is increased blood sugar levels. Glucocorticoids do not increase the body's metabolic needs.
Which of the following are adverse effects of loop diuretics? Select all that apply.
A) Hypokalemia
B) Hypercalcemia
C) Hypotension
D) Alkalosis
E) Ototoxicity
F) Hypoglycemia
A, C, D, E
Loop diuretics can cause hypokalemia, hypocalcemia, hypotension, alkalosis, hyperglycemia, and ototoxicity.
The use of oxybutynin would be contraindicated in which patient?
A) patient with GI obstruction
B) patient with UTI
C) patient with BPH
D) patient who is incontinent
A
Oxybutynin is an anticholinergic medication and would be contraindicated for use in a patient with a GI obstruction because this medications effects could exacerbate this condition.
A father brought his 15-year-old son to the endocrine clinic because the boy was only 5 ft tall. He wanted his son to receive GH therapy because short stature would be a detriment to his success as an adult. The boy would be considered for this therapy under which of the following circumstances?
a. If he were against the use of cadaver parts
b. If his epiphyses were closed
c. If his GH levels were very low
d. If he were also diabetic
e. If he had chronic renal failure
f. If he had hypothyroidism
C, E
GH can be used to treat growth failure caused either by lack of GH or by renal failure.
Patients who are taking corticosteroids would be expected to report which findings?
A. Weight gain
B. Round or “moon face” appearance
C. Feeling of well-being
D. Weight loss
E. Excessive hair growth
F. Fragile skin
A, B, C, F
Steroid therapy may cause Cushing's syndrome, s/sx of which include: weight gain, "moon face" appearance, fragile skin, hair loss.
What are other side effects of steroid therapy?
A 55-year-old-male with hypertension is prescribed a thiazide diuretic. The patient has a health history of diabetes type I and gout. What lab results below represent some known side effects of this medication and requires the nurse to report the lab results to the physician?
A) Potassium 5.3
B) Calcium 9
C) Blood glucose 300
D) Blood glucose 25
C
Thiazide diuretics can cause an increase in blood glucose (hyperglycemia), hypokalemia (low potassium levels), and hypercalcemia (high calcium levels). Due to the patient’s health history of diabetes, the nurse should monitor the patient’s glucose and should report a glucose level of 300.
Important educational points for clients with cystitis include which information?
A) Avoidance of bubble baths
B) Voiding immediately after sexual intercourse
C) Always wiping from back to front
D) Avoidance of foods high in alkaline ash
E) Tight fluid restriction
F) Always wiping from front to back
A, B, D, F