Chapter 41: Pituitary and Adrenocortical Hormones Introductory Clinical Pharmacology 12th Edition by Susan M Ford

Introductory Clinical Pharmacology 12th Edition by Susan M Ford 1. The nurse has administered gonadotropin to a client. Which assessment finding should the nurse prioritize? a. Abdominal pain b. Visual disturbances c. Auditory disturbances d. Ascites Answer: B Rationale: If the client reports visual disturbances, the drug therapy is discontinued and the primary health care provider notified. An examination by an ophthalmologist is usually indicated. Abdominal pain and ascites are adverse reactions that may or may not require discontinuation of the drug. Auditory disturbances are not associated with this drug. Question Format: Multiple Choice Chapter: 41 Learning Objective: 3 Cognitive Level: Apply Client Needs: Physiological Integrity: Reduction of Risk Potential Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 553, Client Receiving a Gonadotropin 2. The nurse is teaching a client about the ACTH which has been prescribed. The nurse determines the session is successful when the client correctly points out they will need to avoid which medication? a. Live vaccines b. Thyroid hormones c. NSAIDs d. Cold preparations Answer: A Rationale: Clients taking ACTH should avoid any vaccination with live virus as it may increase any adverse reaction to the vaccine, and decrease the client's antibody response to the vaccine. Clients with hypothyroidism should use glucocorticoids cautiously. The use of NSAIDs and cold preparations are not contraindicated with the use of ACTH; however, the nurse should evaluate each client individually to ensure there are no other reasons to avoid these medications. Question Format: Multiple Choice Chapter: 41 Learning Objective: 5 Cognitive Level: Apply Client Needs: Physiological Integrity: Reduction of Risk Potential Integrated Process: Teaching/Learning Reference: p. 557, Uses 3. A client with nocturnal enuresis is prescribed desmopressin acetate. Which assessment finding should the nurse prioritize for this client? a. Nasal congestion b. Breast tenderness c. Fluid retention d. Gynecomastia Answer: A Rationale: The nurse should monitor for nasal congestion, abdominal cramps, headache, and nausea in the client as the adverse reactions to desmopressin acetate. When the client is administered gonadotropin, the nurse needs to monitor for fluid retention and gynecomastia as the adverse reactions to the drug. When choriogonadotropin alfa is administered to the client, the nurse should monitor for breast tenderness, ovarian overstimulation, and vasomotor flushes as the adverse reactions to the drug. Question Format: Multiple Choice Chapter: 41 Learning Objective: 2 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 563, Summary Drug Table 4. A health care provider has prescribed vasopressin to the client. Which assessment should the nurse perform on the ongoing assessment? a. Observe for and report any evidence of edema, such as dyspnea. b. Measure and record the client's abdominal girth every hour. c. Observe the client for blanching of the skin, abdominal cramps, and nausea. d. Weigh the client every day to obtain a baseline weight. Answer: C Rationale: After vasopressin is administered to the client, the nurse should observe the client every 10 to 15 minutes for signs of an excessive dosage, which include blanching of the skin, abdominal cramps, and nausea. After corticotropin is administered to the client, the nurse needs to observe for and report any evidence of edema, such as weight gain, rales, increased pulse or dyspnea, or swollen extremities. If the client is receiving vasopressin for abdominal distention, the nurse needs to auscultate the abdomen every 15 to 30 minutes and measure abdominal girth hourly. The nurse needs to weigh the client to obtain a baseline weight for future comparison before administering vasopressin to the client. Question Format: Multiple Choice Chapter: 41 Learning Objective: 3 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 550, Client Receiving Vasopressin 5. A nurse is preparing to administer gonadotropin to a client. The nurse would question this order if which disorder is documented in the client's medical history? a. Sensitivity to benzyl alcohol b. Epiphyseal closure c. Adrenal dysfunction d. Epilepsy Answer: C Rationale: Gonadotropins are contraindicated in clients with adrenal dysfunction, high gonadotropin levels, thyroid dysfunction, liver disease, abnormal bleeding, ovarian cysts, sex-hormone-dependent tumors, or organic intracranial lesions (pituitary tumors). Gonadotropins should be used cautiously in clients with epilepsy. Somatropin growth hormones are contraindicated in clients with sensitivity to benzyl alcohol, epiphyseal closure, and underlying cranial lesions. Question Format: Multiple Choice Chapter: 41 Learning Objective: 2 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 553, Generalized Reactions 6. A nurse is preparing discharge teaching for a client who is prescribed glucocorticoid therapy. Which instructions should the nurse point out in the teaching plan for the client and caregivers? a. Report any symptoms of sore throat or fever immediately. b. Notify the primary health care provider if glucose appears in the urine. c. Measure the amount of fluids taken each day. d. Take the oral drug with meals or snacks. Answer: D Rationale: The nurse should instruct the client to take the oral drug with meals or snacks to decrease the gastrointestinal effects and upsets in the teaching plan for the client and caregivers. Reporting any symptoms of sore throat or fever immediately and notifying the primary health care provider if glucose appears in the urine should be included in the teaching plan for a client undergoing adrenocorticotropic hormone (ACTH) therapy. The nurse should instruct the client to measure the amount of fluids taken each day in the teaching plan for the client receiving vasopressin. Question Format: Multiple Choice Chapter: 41 Learning Objective: 5 Cognitive Level: Apply Client Needs: Physiological Integrity: Reduction of Risk Potential Integrated Process: Teaching/Learning Reference: p. 562, Educating the Client and Family 7. An elderly client with diabetes insipidus has been prescribed vasopressin. Which nursing action should the nurse prioritize for this client?