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Pharm NUR140 > Exam 4 Blueprint Based Cards > Flashcards

Exam 4 Blueprint Based Cards Flashcards

(103 cards)

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1
Q

Hypoglycemia Signs and Symptoms

A

Shakiness and Dizziness

Sweating

Hunger

Headaches

Muscle weakness

Blurry or double vision

Convulsions or Seizures

Unconsciousness

Death

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2
Q

Hyperglycemia Signs and Symptoms

A

Frequent urination

Increased thirst

Fruity-smelling breath

Dry mouth

Shortness of breath

Abdominal pain

Coma

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3
Q

What is the Somogyi Effect?

A

The Phenomenon occurs when you take insulin before bed and wake up with high blood sugar levels

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4
Q

Blood Glucose Diagnostic Testing

A

Blood test,

Glucose Test,

Hemoglobin A1C,

Clinical urine tests

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5
Q

Glyburide (DiaBeta) MOA

A

Hypoglycemia action of glyburide results from the stimulation of pancreatic beta cells

Drug is Protein bound

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6
Q

Glyburide (DiaBeta) Adverse Effects

A

Hypoglycemia,

Anorexia,

Nausea and Vomiting,

Heartburn,

Metallic taste in the mouth

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7
Q

Glyburide (DiaBeta) Patient Teaching

A

Teach about diabetes management

Teach patients and families the signs and symptoms of hypoglycemia

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8
Q

Glyburide (DiaBeta) Nursing Actions

A

Administer before first main meal of the day

Monitor the patient’s blood glucose levels periodically throughout therapy to detect hypoglycemia.

Monitor patients with renal and hepatic impairment for signs of adverse effects

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9
Q

Metformin (Glucophage) MOA

A

Decreases hepatic glucose production,

Decreases intestinal absorption of glucose,

Improves insulin sensitivity by increasing peripheral glucose uptake

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10
Q

Metformin (Glucophage) Adverse Effects

A

Anorexia,

Nausea and Vomiting,

Weight loss,

Abdominal discomfort,

Dyspepsia,

Flatulence,

Diarrhea,

Metallic taste sensation

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11
Q

Metformin (Glucophage) Nursing Actions

A

Administer twice a day with morning and evening meal.

Adherence with recommended diet and daily exercise help in control of type 2 diabetes

Taking the drug at mealtimes and using gradual dosage increments minimize these effects

Monitor blood glucose levels:
Fasting Glucose
Hemoglobin A1C

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12
Q

Metformin (Glucophage) Patient Teaching

A

Teach patients to take with meals, morning and evening

Emphasize that patients should not use alcohol while taking metformin

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13
Q

Repaglinide (Prandin) MOA

A

Repaglinide lowers blood glucose by stimulating the release of insulin from the beta islet cells of the pancreas.

This depolarizes the beta cells, opening the cells’ calcium channels,.

The resulting calcium influx induces insulin secretion.

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14
Q

Rosiglitazone (Avandia)

MOA

A

Rosiglitazone improves glycemic control by improving insulin sensitivity.

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15
Q

Pioglitazone (Actos) MOA

A

Pioglitazone decreases insulin resistance in the periphery and in the liver resulting in increased insulin-dependent glucose disposal and decreased hepatic glucose output.

Unlike sulfonylureas, pioglitazone is not an insulin secretagogue.

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16
Q

Acarbose (Precose) MOA

A

Acarbose is a complex oligosaccharide that delays the digestion of ingested carbohydrates, thereby resulting in a smaller rise in blood glucose concentration following meals..

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17
Q

Glipizide MOA

A

Glipizide partially blocks potassium channels among beta cells of pancreatic islets of Langerhans.

By blocking potassium channels, the cell depolarizes, which results in the opening of voltage-gated calcium channels.

The resulting calcium influx encourages insulin release from beta cells.

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18
Q

Glipizide Drug Class

A

Sulfonylureas

Second generation

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19
Q

Glipizide Adverse Effects

A

Hypoglycemia

Nausea and Vomiting

Epigastric discomfort

Heartburn

Anorexia

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20
Q

Glipizide Drug-Drug Interactions

A

Beta-blockers

Alcohol

Any drug that acidifies urine

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21
Q

R Insulin MOA

A

Injected insulin mimics the effect of endogenous insulin

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22
Q

R Insulin Indications

A

All types of diabetes mellitus

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23
Q

R Insulin Contraindications

A

Hypoglycemia

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24
Q

R Insulin Drug-Drug Interactions

A

Alcohol,

Beta blockers,

Dobutamine,

Niacin,

MAOIs,

Thiazide Diuretics,

Tetracycline

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25
R Insulin Nursing Actions
Evaluate ability to administer insulin. Monitor fasting blood glucose and hemoglobin A1C levels.
26
R Insulin Patient Teaching
Discuss how to administer insulin properly, Discuss storage of insulin, Discuss side effects of therapy
27
Levemir Insulin Nursing Interventions
Levemir (insulin detemir) cannot be mixed in solution with any other drug, including other insulins Levemir is given in the evening.
28
Levemir Insulin Patient Teaching
Rotate injection sites regularly Monitor urine or blood levels for ketones and glucose Wear medical alert tag Avoid alcohol Report fever, sore throat, vomiting, hypoglycemic or hyperglycemic reactions, rash
29
Glucagon MOA
Increases blood glucose levels by stimulating glycogenolysis in the peripheral tissues
30
Glucagon Indications
Hypoglycemia (first line of defense)
31
Glucagon Contraindications
Pregnancy Category B Hypersensitivity, Heart disease, Migraines, Glaucoma
32
Glucagon Adverse Effects
Hypotension, Respiratory distress, Nausea and Vomiting
33
Glucagon Drug-Drug Interactions
Blood thinners (Warfarin), Beta-Blockers Thiazide Diuretics
34
Glucagon Nursing Interventions
Administer supplemental carbohydrates ASAP once consciousness has been achieved Use reconstituted glucagon immediately A dose of 0.5 to 1.0 mg is usually effective
35
Glucagon Patient Teaching
Emphasize to patients and family members measures to prevent hypoglycemic reactions from insulin. Instruct family members in the proper technique for emergency administration of glucagon.
36
Portable Insulin Pump Function
small, computerized devices that mimic the way the human pancreas works by delivering small doses of short acting insulin continuously (basal rate)
37
Portable Insulin Pump Use
used to deliver variable amounts of insulin when a meal is eaten (bolus)
38
Novolog Onset
10-20 minutes
39
Novolog Peak
40-50 minutes
40
Novolog Duration
3-5 hours
41
Humalog Onset
15-30 minutes
42
Humalog Peak
30-90 minutes
43
Humalog Duration
3-5 hours
44
Novolin R Onset
30 minutes - 1 hour
45
Novolin R Peak
2-5 hours
46
Novolin R Duration
5-8 hours
47
Humulin N Onset
1-2 hours
48
Humulin N Peak
4-12 hours
49
Humulin N Duration
18-24 hours
50
Novolin N Onset
1-2 hours
51
Novolin N Peak
4-12 hours
52
Novolin N Duration
up to 24 hours
53
Insulin Glargine (Lantus, Basaglar, Toujeo) Onset
1 - 1.5 hours
54
Insulin Glargine (Lantus, Basaglar, Toujeo) Peak
Does not have a peak time. Insulin is delivered at a steady rate
55
Insulin Glargine (Lantus, Basaglar, Toujeo) Duration
up to 24 hours
56
Thyroid Hormones
Tetraiodothyronine or levothyroxine (T4) Triiodothyronine or liothyronine (T3)
57
Thyroid Hormone Function
Removes iodine from the blood, concentrates it, and prepares it for attachment to tyrosine, an amino acid
58
What is PTH?
The parathyroids produce a hormone called parathyroid hormone (PTH).
59
PTH Function
Raises the blood calcium level by breaking down the bone and causing calcium release which increases the body's ability to absorb calcium from food
60
Hypothyroidism Signs & Symptoms
Dry and Coarse Skin, Fatigue, Weight Gain, Bradycardia, Depression, Muscle Weakness, Increased sensitivity to cold, Hypotension
61
Hyperthyroidism Signs and Symptoms
Moist & Thin Skin, Insomnia, Weight Loss, Tachycardia, Restlessness, Hyperactive Reflexes, Heat intolerance, Systolic Hypertension
62
Levothyroxine (Synthroid) Pharmacotherapeutics
Used as a replacement therapy for hypothyroidism
63
Levothyroxine (Synthroid) Pharmacokinetics
Administered: Oral, Metabolism: Liver, Excreted: Bile, Onset: 6-8 hours
64
Levothyroxine (Synthroid) Pharmacodynamics
Acts as a replacement for natural thyroid hormone
65
Levothyroxine (Synthroid) Contraindications and Precuations
Hypersensitivity, Thyrotoxicosis, Acute MI complicated by hypothyroidism
66
Levothyroxine (Synthroid) Adverse Effects
Hypertension, Tachycardia, Arrhythmias, Anxiety, Headache, Nervousness, GI irritation, Sweating, Heat intolerance
67
Levothyroxine (Synthroid) Drug Interactions
Many drugs including: antacids, anticonvulsants
68
Levothyroxine (Synthroid) Maximizing Therapeutic Effects
Replacement therapy is a lifelong occurrence, During drug therapy, monitor cardiovascular response and serum thyroid function
69
Levothyroxine (Synthroid) Minimizing Adverse Effects
Young adults without evidence of CAD can begin a full replacement dose
70
Levothyroxine (Synthroid) Patient and Family Education
Explain the purpose of drug therapy, Advise patients to avoid OTC drugs
71
Levothyroxine (Synthroid) Ongoing Assessment and Evaluation
Monitor serum thyroid hormone levels periodically
72
Methimazole (Tapazole) Pharmacotherapeutics
Palliative treatment of hyperthyroidism
73
Methimazole (Tapazole) Pharmacokinetics
Administered: Oral, Metabolism: Liver, Excreted: Kidneys
74
Methimazole (Tapazole) Pharmacodynamics
Inhibits the synthesis of thyroid hormones
75
Methimazole Contraindications and Precautions
Hypersensitivity to the drug
76
Methimazole (Tapazole) Adverse Effects
Hives, Itching, Rash, Fever, Arthralgia, Joint swelling, Vertigo, Drowsiness, Nausea and Vomiting, Altered taste sensation
77
Methimazole (Tapazole) Drug Interactions
Beta-Blocking Agents, Theophylline, Warfarin
78
Methimazole (Tapazole) Maximizing Therapeutic Effects
Ensure drug is being administered appropriately
79
Methimazole (Tapazole) Minimizing Adverse Effects
During drug therapy arrange for periodic blood tests to monitor for hematologic and thyroid functions, Monitor the patient's bone marrow function
80
Methimazole (Tapazole) Patient and Family Education
Explain purpose of therapy, If drug is taken in divided doses instruct patients to taken them every eight hours around the clock
81
Methimazole (Tapazole) Ongoing Assessment and Evaluation
Monitor serum thyroid hormone levels periodically to evaluate the effectiveness of MMI and to assess the need for replacement thyroid hormone because the thyroid gland is suppressed
82
Lugol's Solution (Strong Iodine Solution) Action
Reduces the size and vascularity of the thyroid gland
83
Lugol's Solution (Strong Iodine Solution) Indication
Reduce Thyroid Storm Use before surgery
84
Radioactive Iodine Therapy (Iodine 131) Indications
Thyroid Cancer, Alternate for patients who cannot have surgery
85
Radioactive Iodine Therapy (Iodine 131) Pregnancy Category
X (Contraindicated)
86
Calcitonin Salmon (Miacalcin) Pharmacotherapeutics
Treatment of symptomatic Paget disease
87
Calcitonin Salmon (Miacalcin) Pharmacokinetics
Administered: SC, IM, or Intranasal, Metabolism: Kidneys, Excreted: Kidneys
88
Calcitonin Salmon (Miacalcin) Pharmacodynamics
A synthetic polypeptide with essentially the same actions as calcitonin
89
Calcitonin Salmon (Miacalcin) Actions
Inhibits bone reabsorption, Lowers elevated serum calcium in children and patients with Paget's disease, Increases the excretion of filtered phosphate, calcium, and sodium by the kidneys
90
Calcitonin Salmon (Miacalcin) Contraindications and Precautions
Pregnancy Category: C, Should not be used during lactation, Should not be used with a known allergy to salmon or fish products, Be used with caution in patients with renal dysfunction and pernicious anemia
91
Calcitonin Salmon (Miacalcin) Adverse Effects
Flushing of face and hands, Nausea and Vomiting Local inflammatory reactions at the injection site, Nasal irritation if the nasal form is used
92
Calcitonin Salmon (Miacalcin) Drug Interactions
No clinically important reactions
93
Calcitonin Salmon (Miacalcin) Maximizing Therapeutic Effect
Ensure adequate hydration Provide comfort measures and analgesics
94
Calcitonin Salmon (Miacalcin) Minimizing Adverse Effects
Rotate injection sites and monitor for inflammation Monitor serum calcium regularly
95
Calcitonin Salmon (Miacalcin) Patient and Family Education
Discuss adverse effects and how to avoid them Discuss warning signs of problems Discuss need for regular evaluation if used for longer than recommended
96
Calcitonin Salmon (Miacalcin) Ongoing Assessment and Evaluation
Monitor patient response to drug Evaluate the effectiveness of the teaching plan Monitor the effectiveness of comfort measures and compliance with the regimen
97
In which of the following ways does the thyroid gland use iodine found in the body? A. To stimulate the production of TSH B. To produce the thyroid hormones C. To regulate parathyroid production D. To destroy part of the thyroid gland
B. To produce the thyroid hormones The thyroid gland uses iodine to produce the thyroid hormones that regulate body metabolism. Control of the thyroid gland involves an intricate balance among TRH, TSH, and circulating levels of thyroid hormone.
98
Paget's Disease is a genetically-linked disorder. It's a condition that involves overactive osteoclasts that are eventually replaced by enlarged and softened bony structures. WHAT ARE THE CLINICAL MANIFESTATIONS OF PAGET'S DISEASE? A. Deep bone pain B. Increased hearing acuity C. Increased visual acuity D. Cardiac arrhythmias
A. Deep bone pain Patients who have Paget's Disease report deep bone pain, headaches, and hearing loss and usually have cardiac failure and bone malformation
99
True or False The hormones PTH and calcitonin work together to maintain a delicate balance of serum calcium levels in the body and also to keep serum calcium levels within normal range
True Renal tubular phosphate reabsorption is balanced by calcium secretion into the urine, which causes a drop in serum calcium which in turn stimulates PTH secretion.
100
What percentage of the US population has diabetes mellitus? A. 3% B. 7% C. 14% D. 21%
B. 7% Diabetes mellitus is a common chronic disease that affects 20.8 million people in the United States, or 7% of the population
101
What Subcutaneous site provides the most rapid absorption of insulin therapy? A. Arm B. Abdomen C. Buttocks D. Thigh
B. Abdomen The most rapid absorption occurs when administration is into the abdominal SC layer. It is as much as 50% faster than other routes. The next most rapid is into the (A) arm, followed by the (D) thigh, and finally the (C) buttocks.
102
True or False The mechanism of action of GLYBURIDE is the decreased production of insulin by the liver, which results in decreased blood glucose levels.
False The mechanism of action of glyburide is the stimulation of the beta cells in the pancreas. The hypoglycemic action of glyburide results from the stimulation of pancreatic beta cells.
103
What is the usual dose given of glucagon? A. 0.5-1 mg B. 2.5-5 mg C. 7.5-10 mg D. 12.5-15 mg
A. 0.5-1 mg

Pharm NUR140 (5 decks)

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