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Maryville University Nursing 615 Exam 3
Review questions with answers
Low-dose colchine - ** VERIFIED ANSWERS ** โโ 1.2 mg at first sign of flare, followed by 0.6 mg one hour later for a total dose of 1.8 mg. High-dose colchine - ** VERIFIED ANSWERS ** โโ 1.2 mg followed by 0.6 mg every 4-6 hours totaling 4.8 mg. Gout - ** VERIFIED ANSWERS ** โโ BUN, creatinine, and creatinine clearance should be monitored in the treatment of this disease Colchine - ** VERIFIED ANSWERS ** โโ This medication can cause severe diarrhea, nausea, vomiting, abdominal pain Febuxostat (Uloric) - ** VERIFIED ANSWERS ** โโ When prescribing this medication, patients should be taught that gout may worsen with therapy before it improves Corticosteroids - ** VERIFIED ANSWERS ** โโ These medications can cause the following adverse effects if taken for six months or more: Osteoporosis and poor diabetic control. Patients should report black, tarry stools or abdominal pain. Corticosteroids - ** VERIFIED ANSWERS ** โโ These medications should be tapered to avoid recurrent activity of the underlying disease and possible cortisol deficiency resulting from the hypothalamic-pituitary-adrenal axis suppression during the period of steroid therapy. Black Box Warning on NSAIDS - ** VERIFIED ANSWERS ** โโ Increased risk of serious cardiovascular thrombotic events, such as myocardial infarction and stroke. These medications can also cause serious GI events such as bleeding, ulceration or perforation of stomach or intestines, which can be fatal.
Pain management - ** VERIFIED ANSWERS ** โโ When treating this common issue, it is recommended to begin with NSAIDS and work up from there as needed Ibuprofen - ** VERIFIED ANSWERS ** โโ This medication works by inhibiting the COX enzymes; however, the exact mechanism of action for this particular medication is unknown. Acetaminophen - ** VERIFIED ANSWERS ** โโ A serious adverse effect related to this medication is referred to as "------------- poisoning" Symptoms of hypoglycemia - ** VERIFIED ANSWERS ** โโ Decreased LOC, hunger, diaphoresis, weakness, dizziness and tachycardia Symptoms of hyperglycemia - ** VERIFIED ANSWERS ** โโ Polyuria, polydipsia and polyphagia (weight loss) Symptoms of DKA - ** VERIFIED ANSWERS ** โโ Kussmaul's respiration, ketone odor of the breath (fruity breath), vomiting, dehydration, abdominal pain, and neurologic symptoms such as lethargy; can progress to coma in later stages if left untreated. Metformin - ** VERIFIED ANSWERS ** โโ This medication decreases hepatic glucose output inhibiting gluconeogenesis. It also increases insulin mediated glucose utilization in peripheral tissues. This medication decreases intestinal absorption of glucose. This medication may also be used in diabetics to decrease cholesterol and triglyceride levels. Metformin - ** VERIFIED ANSWERS ** โโ When patients are prescribed this medication, the primary care provider should assess serum creatinine, renal function, and creatinine clearance initially and annually. Gliptins (DPP4 inhibitors) - ** VERIFIED ANSWERS ** โโ These medications increase the incretin levels, which inhibit glucagon release; this subsequently
PTU - ** VERIFIED ANSWERS ** โโ This medication inhibits the enzyme thyroperoxidase, which normally acts in the thyroid hormone synthesis by oxidizing the anion iodide to iodine, facilitating iodine's addition to tyrosine residues on the hormone precursor thyroglobuin. This medication also acts by inhibiting enzyme 5 deiodenase which converts T4 to the active form T3. This medication works in the thyroid and peripherally in target tissues. Levothyroxine - ** VERIFIED ANSWERS ** โโ This medication should be taken on an empty stomach approximately 30 minutes before meals. Black Box Warning for TZDs - ** VERIFIED ANSWERS ** โโ This medication can lead to significant water retention, which can then create decompensation due to an unrecognized form of heart failure. In addition, if these medications are used for more than 1 year there is an increased risk of bladder cancer. Thyroid replacement hormone - ** VERIFIED ANSWERS ** โโ Too much of these medications can cause Tachycardia, insomnia, or nervousness Levothyroxine - ** VERIFIED ANSWERS ** โโ When a patient is taking this medication, Blood free thyroxine and TSH levels should be monitored 4-8 weeks after the initiation of therapy or after a change in dose. When an adequate dose has been identified, TSH levels can be repeated at 6 and 12 months, unless there is a change in symptoms Rapid-acting insulins: Lispro (Humalog), Aspart (Novolog), and Glulisine (Apidra) - ** VERIFIED ANSWERS ** โโ Onset: 5 minutes, Peak: 1 hour, Duration: 4-5 hours Short-acting insulin: Regular (Humulin) - ** VERIFIED ANSWERS ** โโ Onset: used around meal times and is taken 30-45 minutes before eating, Peak: 3-4 hours, Duration: 4-10 hours Intermediate-acting insulins: NPH - ** VERIFIED ANSWERS ** โโ This medication has to be mixed before administration. Onset: 60-90 minutes, Peak: 4-10 hours, Duration: 12-24 hours
Long-acting: Glargine (Lantus) or Detemir (Levemir) - ** VERIFIED ANSWERS ** โโ Onset: 2-4 hours, Peak: little or no peak, Duration 24 hours. Glargine - ** VERIFIED ANSWERS ** โโ Initial dose of this medication should be reduced by 20% to avoid hypoglycemia when switching from NPH Insulin - ** VERIFIED ANSWERS ** โโ These medications have side effects of hypoglycemia and hypokalemia Antihypertensives - ** VERIFIED ANSWERS ** โโ A thorough renal and liver function assessment should be completed before prescribing these medications ACE inhibitors - ** VERIFIED ANSWERS ** โโ These medications are preferred in patients who are diabetic with hypertension as the reduce the adverse effects of diabetes on the kidneys. ACE inhibitors - ** VERIFIED ANSWERS ** โโ The most common side effect of these medications is a dry, hacking cough dihydropyridine-type calcium channel blockers - ** VERIFIED ANSWERS ** โโ These medications have adverse effects of reflex tachycardia, proteinuria, increased edema in the hands and feet, and headaches Statins - ** VERIFIED ANSWERS ** โโ These medications can cause Rhabdomyolysis, as well as an increased risk of diabetes, elevated liver enzymes, cognitive loss, neuropathy, pancreatic and hepatic dysfunction, and sexual dysfunction Statins - ** VERIFIED ANSWERS ** โโ The patient should report to the primary care provider if they have any muscle weakness or tenderness and dark urine immediately when taking these medications Fibric acid derivatives - ** VERIFIED ANSWERS ** โโ These medications are used mainly to treat elevated triglycerides. These medications can be used in combination with other hypercholesterolemia medications.
Congestive heart failure - ** VERIFIED ANSWERS ** โโ First-line treatment for patients with this condition should include ACE inhibitors (or ARBs) and beta blockers Alternative treatment regimen for CHF - ** VERIFIED ANSWERS ** โโ In people who are intolerant of ACE inhibitors or ARBs or who have significant kidney dysfunction, the use of combined hydralazine and a long-acting nitrate such as isosorbide nitrate is an effective alternative strategy. This has been shown to reduce mortality in people with moderate heart failure, especially African Americans. Digitalis - ** VERIFIED ANSWERS ** โโ This medication can be used as a second- line medication for patients with congestive heart failure Procainamide - ** VERIFIED ANSWERS ** โโ This medication can cause ventricular dysrhythmias, bradycardia, hypotension, shock, drug-induced fever and other allergic responses; this medication can also cause systemic lupus, which may cause polyarthralgia, myalgia, and pleurisy. Amiodarone - ** VERIFIED ANSWERS ** โโ This medication is structurally similar to thyroxine, which can cause induced abnormalities in thyroid function
