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pharm-drugs thyroid Flashcards

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1
Q

symptoms of Hypothyroidism

A

Slowed motion,
speech, mental
process

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2
Q

symptoms of Thyrotoxicosis

A

Increased temperature, pulse, BP, increased appetite, and weight loss

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3
Q

two classes of drugs for thyroid disease

A

Thyroid replacement hormones (hypothyroid) and Antithyroid agents (hyperthyroid)

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4
Q

If surgery is planned for hypothyroidism then?

A

Order tracheostomy set at bedside, consider risk of Respiratory distress, and Tetany; have IV calcium available at bedside

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5
Q

most common thyroid replacement drug

A

Levothyroxine

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6
Q

levothyroxine action

A

Replace deficient T3 and T4 hormones

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7
Q

Levothyroxine interactions

A

Warfarin, Digoxin, Estrogens, and Cholestyramine

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8
Q

what does levothyroxine need?

A

increased dosage of anticoagulants and decreased dose of digoxin

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9
Q

what requires you to wear latex gloves and watch for personnel allergies?

A

iodine 131

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10
Q

how long does it take to see the full effect of iodine 131?

A

3-6 months

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11
Q

name a sign of hyperthyroidism

A

hyperglycemia

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12
Q

what does diabetes lead to?

A

retinopathy, cardiomyopathy, and neuropathic complications

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13
Q

diabetes is a higher incidence in…?

A

African Americans, Hispanics, American Indians, Native Alaskans, and women.

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14
Q

type 1 diabetes is caused by

A

autoimmune destruction of the beta cells in the pancreas (Pancreas can no longer secrete insulin)

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15
Q

what does type 1 diabetes require?

A

Requires insulin for the rest of their life

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16
Q

define exogenous

A

Originating or produced from outside a cell, tissue, or organism

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17
Q

what are the symptoms of type 1 diabetes?

A

Polydipsia, Polyphagia, Polyuria, and Weight loss

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18
Q

90% to 95% of pt’s with diabetes are?

A

type 2

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19
Q

Supplemental insulin or oral antidiabetic drugs are prescribed to these pt’s

A

Type 2

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20
Q

<100 mg/dL

A

normal fasting glucose

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21
Q

≥100 mg/dL

A

impaired fasting glucose

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22
Q

a glucose of <126 mg/dL demonstrates

A

impaired fasting glucose

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23
Q

Microvascular complications(Destruction of capillaries) Causes…

A

blindness, renal failure, and neuropathies

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24
Q

with macrovascular complications what can occur?

A

atherosclerosis, stroke, and myocardial infarction

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25
diabetic pt's are more susceptible to...?
infection
26
postprandial hyperglycemia
an exaggerated rise in blood sugar following a meal
27
Patient should check blood glucose level before
each meal and at bedtime
28
make sure your pt. has food on the | unit or in front of them...
before administering insulin
29
physical indicators of diabetes
Hyperglycemic or hypoglycemic episodes
30
diabetic laboratory study
Hemoglobin A1c
31
To detect vascular changes
check vision frequently
32
what is the importance of foot care?
because of neuropathy the nurse needs to check for infection
33
Patient Education
Maintain blood pressure control, Maintain normal blood lipids, and Maintain BMI <25 kg/m2
34
Somatrin
a growth hormone, treats growth hormone deficiencies, such as turners syndrome
35
Hydrocortizone
a glucocorticoid, provides replacement therapy for acute and chronic adrenocortical insufficiency, such as Addison's disease.
36
glucagon
a hyperglycemic that treats severe hypoglycemia from insulin toxicity
37
desmopressin
antidiuretic hormone that treats diabetes insipidus
38
hydrocortisone is identical to cortisol, the primary...
glucocorticoid the adrenal cortex generates
39
does a diabetic pt need carbs?
yes (45% to 65%)
40
Monitor glucose level
before, during, and after exercise
41
what causes hypoglycemia?
too much insulin, insufficient food intake, vomiting and diarrhea, and excessive exercise
42
symptoms of hypoglycemia
Nervousness, tremors, headache, apprehension, sweating, cold and clammy skin, and hunger
43
treatments for hypoglycemia
Administering food/liquids if able to swallow | If unable to swallow, administer glucagon or IV fluids with 50% dextrose
44
what causes hyperglycemia?
nonadherence, overeating, acute illness, or infection
45
symptoms of hyperglycemia
Headache, nausea and vomiting, abdominal pain, dizziness, rapid pulse, rapid shallow respirations, and acetone odor to breath
46
treatment for hyperglycemia
Administration of IV fluids; insulin; monitoring blood glucose, ketones, and potassium
47
insulin is needed so that...
glucose can enter skeletal muscle and fat, needed for protein and lipid metabolism
48
adverse effects of insulin
Hyperglycemia, hypoglycemia, and allergic reactions
49
insulin can cause death due to hypoglycemia. What else does the nurse need to remember?
site infection
50
should you shake insulin?
no, roll vial gently in palm of hand to warm and resuspend
51
what two insulins should not be mixed?
short and rapid acting
52
glucagon drug action
Breaks down stored glycogen to glucose
53
drug use of glucagon
treatment of hypoglycemic reactions
54
adverse of effects of glucagon
Nausea and vomiting
55
glucagon administration
SC, IM, or IV. Should respond in 5 to 20 minutes; if not, 1 to 2 additional doses
56
metformin drug action
Decreases hepatic glucose production (increases insulin sensitivity)
57
adverse effects of metformin
abdominal cramps, flatulence (Numerous drug/alcohol interactions)
58
metformin is used when
diet and exercise alone are not effective
59
metformin will not cause
hypoglycemia
60
IV radiopaque dyes can induce temporary renal insufficiency; metformin should be discontinued ...
24 to 48 hours before procedures and 2 to 3 days after procedure until normal renal function
61
Sulfonylurea action
Stimulate release of insulin from beta cells of pancreas
62
Sulfonylurea use
for type 2 diabetes mellitus
63
Sulfonylurea adverse effects
Hypoglycemia, vomiting, and abdominal cramps
64
if a Patient is allergic to sulfonamides they may be allergic to
sulfonylureas
65
Acarbose (Precose) drug action
Controls diabetes by inhibiting the enzymes that break down starches and carbohydrates in the intestines, lowering the necessity for insulin.
66
Acarbose will not cause
hypoglycemia
67
what does insulin do in the body?
insulin attaches to the cell and allows glucose to come in to make atp
68
what is the opposite medication to insulin?
glucagon
69
does a pt with gestational diabetes get insulin?
yes
70
what type of insulin has the shortest duration?
rapid acting
71
what is an example of a long acting insulin?
lantis
72
what should a nurse be concerned about with a pt suffering from hypoglycemia?
confusion
73
the pancreas is the biggest factor in both
types of diabetes
74
when you maintain a diabetics blood glucose you are maintaining their...
homeostasis
75
insulin must be taken by
injection
76
a pt needs multiple injections a day because....
it balances the multiple meals
77
warfarin causes...
hypoglycemia
78
40 degree angle for a very
thin pt
79
type 1 medication tells
cells to open up
80
type 2 medication tells
body to be more receptive to insulin
81
Sulfonylureas
glipizide, glimepride, and glyburide
82
always give insulin to a type 1 diabetic if your not sure never...
hold it
83
avandia (Rosiglitazone)
increases insulin sensitivity
84
you do not put a pt back on metformin until what is done ?
any kind of renal test
85
a pt is NPO but glucose levels are low. What do you do?
give glucagon
86
educate a pt that they wont be stuck on insulin if they are administered it because?
they only need the insulin while in that sick state. When they recover they can return their usual regimen
87
a important nursing intervention for diabetic pt's is...
patient education
88
quickest way to determine someone is a diabetic is?
fasting glucose
89
if a diabetic pt is sick do they need more insulin?
it depends on the situation

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