Patient has a blood sugar of 34 and is unresponsive. Glucagon is needed to raise blood sugar. Is this
given IM or SQ?
-IM
Name a few signs and symptoms of a thyroid storm?
-Fever, nervousness, insomnia, diarrhea, nausea, vomiting, palpitations, seizures, goiter, thyroiditis,
exopthalamos, weakness (muscle wasting), restlessness with emotional swings, confusion, hepatomegaly
with jaundice, tachycardia, A Fib, shock and coma.
What should you teach a patient taking steroids?
-Watch for fever as it can be life threatening & wash hands frequently
If a patient is taking steroids, which vital signs should you be most concerned about: BP 160/90, R 24, P
102, T 99.6, O2 97%?
-Temp of 99.6 as this can be life threatening for a patient on steroids
What are some signs and symptoms of Hypoglycemia?
-Diaphoresis, sweating, clammy, tremors, pallor, agitation, confusion
If you abruptly stop a corticosteroid, what can happen?
-Can develop Addison’s Disease
Who should avoid hormonal contraception?
-Smokers, Patients over age 35
What is the peak of NPH insulin?
-4-12 hours. NPH is cloudy. An intermediate acting insulin
Which lab would indicate if a patient’s thyroid is increased or decreased?
-Tsh
What are some side effects of Prednisone?
-Insomnia, bruising, hyperglycemia, hunger, weight gain, moon face/buffalo hump.
Can ASA be given with Prednisone? Why or why not?
-They should NOT be given together due to bleeding. They are both anti-inflammatories
If a patient has hypothyroidism and is now medicated properly they should notice what?
-An increase in their energy level
How should Levothyroxine be taken?
-In the morning on an empty stomach. NPO except water 1 hour after taking medication.
If a patient is seeking emergency contraception what is important that you find out?
-The last time she had sex. It must be given within 72 hours of when she had sex.
, What should you avoid if you are taking a Quinolone such as Ciprofloxacin/Cipro or
Levofloxacin/Levaquin?
-Avoid antacids, iron, zinc, magnesium, and aluminum.
What do you need to monitor for with an Aminoglycoside, such as Vancomycin?
-Ototoxicity and Nephrotoxicity. Also monitor peak and trough levels.
If you give your patient an antibiotic and soon after the patient states that their tongue is swelling, what
should you do?
-Administer Epinephrine and call the MD
If a patient is taking Desmopressin and excessively drinking water, what should you do?
-Stop the med and call the MD. Desmopressin- trying to increase fluid volume…if they are excessively
drinking they can go into fluid volume overload, if this happens you would stop the desmopressin and
contact the MD.
If a patient is on IV Vancomycin and Aminoglycoside and is complaining of pain at their IV site what is
likely happening and what should you do?
-Infiltration or phlebitis, Stop the med immediately and change the site that medication is administered.
Patient is on multiple antibiotics including: a macrolide, tetracycline, cephalosporin and a quinolone.
Which class of medication has an antabuse reaction with alcohol?
-Cephalosporin (Keflex/cephalexin, Cefdinir, Cefaclor, Ceftriaxone/rocephin)
If a patient has increased liver enzymes, which of the following antibiotic classes can contribute to liver
dysfunction or hepatotoxicity? Sulfa, Cephalosporin, Macrolide, or Aminoglycoside?
-Macrolide (Erythromycin, Azithromycin, Clarithromycin)
If a patient is taking a quinolone such as Ciprofloxacin and a steroid, what are they at risk for?
-Achilles tendon rupture
What would happen if a patient was taking an antimicrobial such as Flagyl and consumed alcohol?
-Antabuse reaction will occur
If a patient has TB and is taking Rifampin, What happens to their urine, tears and sweat?
-It turns orange
If a patient is taking prednisone for arthritis, what is a sign that the prednisone is working?
-The patient has increased ROM
How is Rocephin, a cephalosporin administered?
-IM with 1% lidocaine due to the burning
What cannot receive a live vaccine?
-An immunocompromised patient or anyone 55 and older