ATI The Endocrine System test

A nurse at a provider's office is assessing a client who has been taking hydrocortisone for adrenal insufficiency. The client reports fatigue and feeling overwhelmed by personal responsibilities. Which of the following findings should the nurse identify as an indication the provider might need to increase the client's dosage?

hypotension hypotension and fatigue are findings of adrenal insufficiency. during times of stress, the client might need a dosage increase to prevent adrenal insufficiency. the nurse should report the findings to the provider.

A nurse is educating the parents of a child who has a new diagnosis of Prader-Willi Syndrome (PWS) and has been prescribed somatropin. Which of the following statements by a parent indicates understanding of the teaching?

"we will use a different spot for injection each time we give the medication" to avoid atrophy of the tissue, administration of somatropin includes rotating the injection site each time. the nurse should identify this statement as an understanding of somatropin administration.

To determine the effectiveness of desmopressin (DDAVP) a health care professional should monitor a patients

urine output. Desmopressin, an antidiuretic hormone, treats diabetes insipidus. The health care professional should monitor the patient's fluid intake and urine output along with urine and serum osmolality and blood pressure.

A health care professional administers pramlintide (Symlink) at 0800 to a patient who has type 1 diabetes mellitus. At which of the following times should the patient expect the drug to exert its peak action?

0820. Pramlintide, an amylin mimetic, peaks 20 min after administration. The health care professional should monitor the patient for indications of hypoglycemia, such as diaphoresis and tremors.

A health care professional is caring for a patient who is about to begin taking pioglitazone (Actos) to treat type 2 diabetes mellitus. The health care professional should explain to the patient the need to monitor which of the following laboratory test?

ALT. Pioglitazone can cause liver injury. The health care professional should monitor ALT at the start of therapy and every 3 to 6 months thereafter. The health care professional should tell the patient to report jaundice, dark-colored urine, or abdominal pain. LDL. Pioglitazone can cause elevations in both high-density lipoproteins, which is a beneficial effect, and LDLs, which is a detrimental effect. The health care professional should monitor the patient's plasma lipid levels at baseline and periodically throughout drug therapy.

A patent who is taking metformin (Glugophage) to treat type 2 diabetes mellitus plans to undergo angiography using iodine-containing contrast dye. The health care professional should recognize that an interaction between metformin and the IV contrast dye can increase the patients risk for which of the following

Acute renal failure. Metformin, a biguanide, can interact with iodine-containing contrast dye, causing acute renal failure and lactic acidosis. The health care professional should withhold metformin for 48 hr prior to and following the procedure. The health care professional should also monitor the patient for indications of acute renal failure or lactic acidosis, such as reduced urine output, hyperventilation, and abdominal pain.

The talking to a patient who is about to begin glipizide (Glucotrol) therapy to treat type 2 diabetes mellitus, the health care professional should include which of the following instructions

Avoid drinking alcohol the nurse should instruct the client to avoid drinking alcohol. alcohol can interact with glipizde, a sulfonylurea, causing nausea, palpitations, and flushing. Alcohol also increases the drug's hypoglycemia effects.

When talking with a patient who is about to begin repaglinide (Prandin) therapy to treat type 2 diabetes mellitus, the health care professional should include which of the following instructions?

Do not drink more that 1 L of grapefruit juice per day. More than 1 L of grapefruit juice per day can increase the hypoglycemic effects of repaglinide, a meglitinide. The health care professional should tell the patient to avoid drinking large amounts of grapefruit juice.

A health care professional is caring for a patient who is about to begin acarbose ( Precose) therapy to treat type 2 diabetes mellitus. which of the following instructions should the health care professional include when talking with the patient about the drug?

Eat more iron rich foods. acarbose, an alpha-glucosidase inhibitor, can cause iron-deficiency anemia. The health care professional should tell the patient to increase his intake of iron-rich foods, such as red meat, spinach, and grains, and monitor the patient's CBC.

A health care professional is caring for a patient who is about to begin levothyroxine (Synthroid) therapy to treat hypothyroidism. Which of the following instructions should the health care professional include when talking with the patient about taking the drug.

Expect a long life therapy with this drug. Therapy with levothyroxine, a thyroid replacement hormone, usually continues for life because there are no other therapies that can restore thyroid function.

A health care professional is caring for a patient who is about to begin taking radioactive iodine -131 (Iodotope) to treat Graves' disease. Which of the following instructions should the health care professional include when talking with the patient about the drug?

Expect full effects in 2 to 3 months. The full therapeutic effects of radioactive iodine-131, an antithyroid drug, take 2 to 3 months, and with successful treatment, hypothyroidism can result.

Which of the following drugs should a health care professional have available for a patient who is experiencing an insulin overdose/ insulin toxicty.

Glucagon Glucagon, a hyperglycemic that can be given subcutaneously, IM, or IV, treats severe hypoglycemia from an insulin overdose in patients who are unconscious and for whom IV glucose is not readily available. If the patient does not respond to glucagon, the health care professional should administer a glucose solution IV.

When considering replacement therapy options for a patient who had chronic adrenocortical insufficiency, the primary care provider should chose which of the following drugs?

Hydrocortisone (Cortef). Hydrocortisone, a glucocorticoid, provides replacement therapy for acute and chronic adrenocortical insufficiency, such as Addison's disease.Hydrocortisone is identical to cortisol, the primary glucocorticoid the adrenal cortex generates.

A patient who is taking propylthiouracil (PTU) contacts the health care professional to report weight gain, drowsiness, and depression. The health care professional should suspect which of the following adverse reactions to the propylthiouracil?

Hypothyroidism. Propylthiouracil, an antithyroid drug, can cause hypothyroidism, manifesting as drowsiness, depression, weight gain, edema, and bradycardia. The health care professional should request that the primary care provider prescribe a lower dosage of the drug for the patient.

A health care professional is caring for a patient who is about to begin pramlintide (Symlink) therapy to treat type 1 diabetes mellitus. Which of the following instructions should the health care professional include when talking with the patient about using the drug?

Inject pramlintide before meals. The patient should inject pramlintide, an amylin mimetic, 20 min before a meal that contains at least 30 g of carbohydrates.

When talking with a patient who is about to begin exenatide (Byetta) therapy to treat type 2 diabetes mellitus, the health care professional should include which of the following instructions?

Inject the drug subcutaneously. The patient should inject exenatide, an incretin mimetic, into the subcutaneous tissue of the thigh, upper arm, or abdomen. Expect the peak effect in 2 hr. Levels of exenatide peak 2 hr after administration and then decrease gradually, with a half-life of 2.4 hr. Use the drug a supplement to an oral hypoglycemic. Exenatide supplements the action of an oral hypoglycemic, such as a sulfonylurea or metformin (Glucophage).

A patient who is taking metformin (Glucophage) to treat type 2 diabetes mellitus contacts the health care professional to report muscle pain. The health care professional should suspect which of the following adverse reactions?

Lactic acidosis. Metformin, a biguanide, can cause lactic acidosis, which is a life-threatening complication, manifesting as muscle aches, sleepiness, malaise, and hyperventilation. The patient should stop taking the drug and seek medical care immediately.

A health care professional should question the use of levothyroxine (Synthroid) for a patient who has had

Myocardial infarction. Levothyroxine, a thyroid replacement hormone, can cause tachycardia, palpitations, and hypertension, especially when the patient requires a dosage adjustment; therefore, it is contraindicated for patients who have recently had a myocardial infarction.

A patient who is taking glipizide (Glucotrol) to treat type 2 diabetes mellitus contracts the health care professional to report feeling shaky, hungry, fatigued. The health care professional should tell the patient to do which of the following

Prefer a fingerstick blood glucose check. Glipizide, a sulfonylurea, can cause hypoglycemia, which can manifest as diaphoresis, shakiness, hunger, and fatigue. The health care professional should tell the patient to check her blood glucose level, and if it indicates hypoglycemia, consume a snack of 15 to 20 g of carbohydrates, retest in 15 to 20 min, and repeat if her blood glucose level is still low.

A primary care provider should prescribe a lower does of sitagliptin (Januvia) for a patient who has type 2 diabetes mellitus and who also has which of the following?

Renal impairment. Sitagliptin, a gliptin, requires cautious use with patients who have renal dysfunction and low creatinine clearance because the kidneys eliminate the drug virtually intact. The primary care provider should prescribe a lower dose for this patient or prescribe a different hypoglycemic drug.

A health care professional is caring for a patient who is taking repaglinide (Prandin) 15 to 30 minutes before each meal to treat type 2 diabetes mellitus. The patient asks the health care professional what to do if he skips a meal. Which of the following is the appropriate response?

Skip the dose. To avoid a sudden and serious drop in blood glucose level, the patient should skip the dose of repaglinide, a meglitinide, whenever he skips a meal, and try to avoid skipping meals.

A health care professional is caring for a patient who is about to begin taking propylthiouracil (PTU) to treat hyperthyroidism. The health care professional should tell the patient to report which of the following adverse effects?

Sore throat. Propylthiouracil, an antithyroid drug, can cause agranulocytosis. The health care professional should monitor the patient's CBC, and tell the patient to report fever or sore throat. Joint/Muscle pain. Propylthiouracil can cause arthralgia and myalgia. The health care professional should tell the patient to report these effects and take over-the-counter analgesics for pain relief. Bradycardia. Propylthiouracil can cause hypothyroidism, manifesting as bradycardia, drowsiness, and weight gain. The health care professional should tell the patient to report these effects. Rash. Propylthiouracil can cause urticaria or a skin rash. The health care professional should tell the patient to report these effects.

A health care professional is caring for a patient who is about to begin taking somatropin (Genotropin). The health care professional should explain the need to monitor which of the following laboratory tests?

Urine calcium. Somatropin can cause hypercalciuria. The health care professional should monitor the patient's urine calcium, and tell the patient to report flank pain, urinary frequency, or hematuria. Blood Glucose. Somatropin can cause hyperglycemia. The health care professional should monitor the patient's blood glucose levels, and tell the patient to report polyphagia, polydipsia, and polyuria.

When talking wth a patient about taking fludrocortisone to treatadrenocortical insufficiency, the health care professional should tell the patient to do which of the following to reduce the risk of adverse reactions?

Weigh yourself daily. Fludrocortisone, a mineralocorticoid, can cause fluid and electrolyte imbalances, such as hypernatremia. Tracking weight on a daily basis can help identify weight gain and edema; reporting it can expedite any essential interventions. Report weakness or palpitations. Fludrocortisone can cause hypokalemia. The health care professional should monitor the patient's potassium levels, and tell her to report muscle weakness or palpitations. Have your blood pressure checked regularly. Fludrocortisone can cause fluid retention and hypertension. The health care professional should monitor the patient's fluid balance and blood pressure to expedite any essential interventions.

A health care professional is caring for a patient who is taking pioglitazone (Actos) to treat type 2 diabetes mellitus. The health care professional should monitor for which of the following findings that indicates an adverse effect?

Weight gain. Pioglitazone, a thiazolidinedione, can cause fluid retention. The health care professional should monitor weight or other indications of fluid retention or heart failure, including dyspnea, crackles, and wheezing.

A heath care professional is caring for a patient who is about to begin insulin glargine (Lantus ) therapy. The health care professional should recognize the need for additional precautions because the patient also takes which of the following types of drugs.

beta blockers. Patients who take insulin and also take beta blockers are at risk for failing to promptly recognize the symptoms of hypoglycemia because they mask symptoms such as tachycardia and tremors. They also increase hypoglycemic effects.

A nurse is caring for a client who is taking metformin to treat type 2 diabetes mellitus and reports muscle pain. Which of the following adverse reactions should the nurse suspect?

lactic acidosis metformin, a biguanide, can cause lactic acidosis, which is a life-threatening complication that manifests as muscle aches, sleepiness, malaise, and hyperventilation. the client should stop taking the drug and seek care immediately.

A health care professional is talking to a patient about self-injecting regular insulin (Humulin). The health care professional should tell the patient to rotate injection sites to prevent which of the following ?

lipohypertrophy. Lipohypertrophy, also called lipodystrophy, is a proliferation of fat at the sites of repeated insulin injections. It affects skin sensitivity and appearance. To prevent it, the patient should rotate injection sites, keeping them at least 1 inch apart, and avoid using the same spot within the same month.

A nurse is speaking with a client who is taking glipizide to treat type 2 diabetes mellitus and has called to report feeling shaky, hungry, and fatigued. Which of the following actions should the nurse instruct the client to take?

perform a finger stick blood glucose check glipizide, a sulfonylurea, can cause hypoglycemia, which can manifest as diaphoresis, shakiness, hunger, and fatigue. the nurse should tell the client to check their blood glucose level and, if it indicates hypoglycemia, to consume a snack of 15 to 20 g(0.5 to 0.7 oz) of carbohydrates, retest in 15 to 20 minutes, and repeat if their blood glucose level is still low.