Adult 3 Final (Xavier ABSN)
biguanide (metformin) - CORRECT ANSWER--contraindicated in hepatically impaired
individuals as it can cause lactic acidosis
-wait for normal renal function tests and at least 48 hours after procedure to re-introduce
biguanide if radioactive contrast is usde
-check liver function tests
adverse effects/contraindications fludrocortisone - CORRECT ANSWER--peptic ulcer,
acne, bruising, rash, cataracts, MUSCLE WEAKNESS, diaphoresis
-contraindicated for: known hypersensitivity or systemic fungal infection
pt teaching fludrocortisone - CORRECT ANSWER--take med for the rest of your life
-take with food
-report gastric distress
grave's disease - CORRECT ANSWER--autoimmune disorder
-most common cause of hyperthyroidism
radioactive iodine therapy - CORRECT ANSWER--damages or destroys cells so they
produce less TH
-given PO
-result in 6-8 weeks
-does not require hospitalization or radiation precautions
-pt may develop hypothyroidism and require lifelong TH replacement
post-op care subtotal thyroidectomy - CORRECT ANSWER--positive Chovstek's and
Trousseau's sign due to hypocalcemia
-tetany due to calcium deficiency
-tingling of toes, fingers, and lip muscular twitches
-give calcium sluconate IV
myxedema coma - CORRECT ANSWER--hypothermia
-may need to intubate- intubation tray handy
nursing responsibilities r/t levothyroxine (synthroid) - CORRECT ANSWER--give 1h
before meals or 2h after meals
health education r/t levothyroxine (synthroid) - CORRECT ANSWER--do not substitute
for other brands
-must be taken forever
, -report s/s of excess TH (excess weight loss, palpitations, leg cramps, nervousness,
insomnia)
-monitor BG
-limit iodine
-monitor for bleeding
-report changes in menstruation
-take in AM 30min before eating to prevent insomnia
-take other medications such as calcium carbonate, iron, or antacids at least 4h before
or after taking thyroid drugs
-monitor BP and HR (older pts)
-avoid walnuts and high fiber
pathophysiology of Cushing's syndrome - CORRECT ANSWER--pituitary:
hypersecretion of ACTH, 40% of cases
s/s Cushing's syndrome - CORRECT ANSWER--CENTRAL OBESITY
-buffalo hump
-moon face
-muscle weakness/wasting
-thinning skin
-abdominal striae
-easy bruising
-hyperglycemia
-hypernatremia
-hypokalemia
-increased susceptibility to infections
-compression fractures from osteoporosis
declining changes in older adults - CORRECT ANSWER--thinning and graying of all
hair
-decreased height
-slowed reaction time
-increased insulin resistance
Environment Fit Theory - CORRECT ANSWER-interaction between characteristics of
the individual and the environment, whereby the individual not only influences his or her
environment, but the environment also affects the individual
cognitive changes in older adults - CORRECT ANSWER--slowed, not altered
-cognitive deficits that interfere with daily life are not normal
-memory deficits more common >85 y/o
-KEEP ENVIRONMENT CONSISTENT
sensory memory - CORRECT ANSWER-momentary perception of stimuli from the
environment
biguanide (metformin) - CORRECT ANSWER--contraindicated in hepatically impaired
individuals as it can cause lactic acidosis
-wait for normal renal function tests and at least 48 hours after procedure to re-introduce
biguanide if radioactive contrast is usde
-check liver function tests
adverse effects/contraindications fludrocortisone - CORRECT ANSWER--peptic ulcer,
acne, bruising, rash, cataracts, MUSCLE WEAKNESS, diaphoresis
-contraindicated for: known hypersensitivity or systemic fungal infection
pt teaching fludrocortisone - CORRECT ANSWER--take med for the rest of your life
-take with food
-report gastric distress
grave's disease - CORRECT ANSWER--autoimmune disorder
-most common cause of hyperthyroidism
radioactive iodine therapy - CORRECT ANSWER--damages or destroys cells so they
produce less TH
-given PO
-result in 6-8 weeks
-does not require hospitalization or radiation precautions
-pt may develop hypothyroidism and require lifelong TH replacement
post-op care subtotal thyroidectomy - CORRECT ANSWER--positive Chovstek's and
Trousseau's sign due to hypocalcemia
-tetany due to calcium deficiency
-tingling of toes, fingers, and lip muscular twitches
-give calcium sluconate IV
myxedema coma - CORRECT ANSWER--hypothermia
-may need to intubate- intubation tray handy
nursing responsibilities r/t levothyroxine (synthroid) - CORRECT ANSWER--give 1h
before meals or 2h after meals
health education r/t levothyroxine (synthroid) - CORRECT ANSWER--do not substitute
for other brands
-must be taken forever
, -report s/s of excess TH (excess weight loss, palpitations, leg cramps, nervousness,
insomnia)
-monitor BG
-limit iodine
-monitor for bleeding
-report changes in menstruation
-take in AM 30min before eating to prevent insomnia
-take other medications such as calcium carbonate, iron, or antacids at least 4h before
or after taking thyroid drugs
-monitor BP and HR (older pts)
-avoid walnuts and high fiber
pathophysiology of Cushing's syndrome - CORRECT ANSWER--pituitary:
hypersecretion of ACTH, 40% of cases
s/s Cushing's syndrome - CORRECT ANSWER--CENTRAL OBESITY
-buffalo hump
-moon face
-muscle weakness/wasting
-thinning skin
-abdominal striae
-easy bruising
-hyperglycemia
-hypernatremia
-hypokalemia
-increased susceptibility to infections
-compression fractures from osteoporosis
declining changes in older adults - CORRECT ANSWER--thinning and graying of all
hair
-decreased height
-slowed reaction time
-increased insulin resistance
Environment Fit Theory - CORRECT ANSWER-interaction between characteristics of
the individual and the environment, whereby the individual not only influences his or her
environment, but the environment also affects the individual
cognitive changes in older adults - CORRECT ANSWER--slowed, not altered
-cognitive deficits that interfere with daily life are not normal
-memory deficits more common >85 y/o
-KEEP ENVIRONMENT CONSISTENT
sensory memory - CORRECT ANSWER-momentary perception of stimuli from the
environment
