Endocrine Pharmacology

A nurse is providing teaching for a pt who has diabetes and a new prescription for insulin glargine. Which of the following instructions should the nurse provide regarding this type of insulin?

Insulin glargine has a duration of 18 to 24 hr. - only dosed once a day

A nurse is caring for a pt who has developed agranulocytosis as a result of taking propylthiouracil to treat hyperthyroidism. The nurse should understand that this pt is at increased risk for which of the following conditions?

Infection - Agranulocytosis is a failure of the bone marrow to make enough white blood cells, causing neutropenia and lowering the body defenses against infection.

A nurse is caring for a pt with diabetes mellitus who is preyed regular insulin via a sliding scale. After administering the correct dose at 0715, the nurse should ensure the pt receives breakfast at which of the following times?

0745 -Regular insulin should be given 20 to 30 minutes before eating because the onset of action is 30 minutes. There are circumstances when this lag time guide can be adjusted.

A nurse is preparing to administer 10 units of reg insulin and 20 units of NPH insulin to a pt. What is the sequence of events the nurse should follow?

1. inspect vials for contaminants 2. Roll NPH vial between palm of hands 3. Inject air into NPH insulin vial 4. Inject air into reg insulin vial 5. Withdraw short-acting insulin into syringe 6. Add intermediate insulin to syringe

A nurse is preparing to administer lispro insulin to a pt who has type 1 diabetes mellitus. Which of the following actions should the nurse take?

Inject the insulin 15 min before a meal

A nurse is reviewing the medical record of a pt who has been on levothyroxin for several months. Which of the following findings indicates a therapeutic response to the medication?

Decrease in level of thyroid stimulating hormone (TSH) - In hypothyroidism, the nonfunctioning thyroid gland is unable to respond to the TSH, and no endogenous thyroid hormones are released. This results in an elevation of the TSH level as the anterior pituitary continues to release the TSH to stimulate the thyroid gland. Administration of exogenous thyroid hormones, such as levothyroxine, turns off this feedback loop, which results in a decreased level of TSH.

A nurse is teaching a pt how to draw up regular insulin and NPH insulin into the same syringe. Which of the following instructions should the nurse include?

Discard the regular insulin that appears cloudy

A nurse is teaching a pt who has diabetes mellitus and receives 25 units of NPH insulin every morning if her blood glucose level is above 200 mg/dL. Which of the following information should the nurse include?

Expect the NPH insulin to peak in 6 to 14 hrs

A nurse is caring for a pt who has diabetes and plans to administer his regular insulin subq before he eats breakfast at 0800. After checking the pt's morning glucose level, which of the following actions should the nurse take?

Give the insulin at 0730

A nurse is providing teaching about self-administration of insulin to the parent of a school-age child who has a new of diabetes mellitus. Which of the following statements by the parent indicates a need for further teaching?

I will be sure my child aspirates before injecting the insulin

A nurse is evaluating teaching with a pt who is receiving continuous subq insulin via an external insulin pump. Which of the following statement by the pt indicates a need for further teaching?

I will use insulin glargine in my insulin pump. - The client should use a short-acting insulin in the insulin pump. The insulin pump is designed to administer rapid-acting or short-acting insulin 24 hr a day. Insulin glargine is classified as a long-acting insulin and is administered at the same time each day to maintain stable blood glucose concentration for a 24-hr period.

A nurse is teaching a pt who has a new prescription for reg insulin and NPH insulin. Which of the following instructions should the nurse include in the teaching?

Keep the open vial of insulin at room temp

A nurse is providing teaching to a pt who has a new diagnosis of hypothyroidism. On which of the following medications should the nurse prepare to instruct the pt?

Levothyroxine - Levothyroxine is a synthetic thyroid hormone that is chemically identical to thyroxine (T4). It is used in the treatment of hypothyroidism. The nurse should prepare to instruct the client on the use of this medication.

A nurse is caring for a pt who has type 1 diabetes mellitus. The nurse misread the pt's morning blood glucose level as 210 mg/dL instead of 120 mg/dL and administered the insulin dose appropriate for a reading over 200 mg/dL before the pt's breakfast. Which of the following actions is the nurse's priority?

Monitor the pt for hypoglycemia - The first action the nurse should take using the nursing process is to assess or collect data from the client. The nurse should immediately check the client's blood glucose level, expecting it to be low because of the excessive dose of insulin. If it is within the expected reference range, the nurse should continue to monitor the client for signs of hypoglycemia.

A nurse is providing teaching to a pt who has a new prescription for levothyroxine for hypothyroidism. The nurse should instruct the pt to avoid which of the following herbal supplements?

Soy - reduces the effectiveness of the levothyroxine

A nurse is teaching a pt who has a new diagnosis of Type 1 diabetes mellitus about self-administration of insulin. Which of the following instructions should the nurse include?

Store the current bottle of insulin at room temp

A nurse is talking with a pt whose thyroid-stimulating hormone (TSH) level will be measured. Which of the following statements by the nurse explains the purpose of this test?

This test determines whether your thyroid gland is overactive, appropriately active, or underactive

A nurse is teaching about tlevothyroxine with a pt who has primary hypothyroidism. Which of the following statements should the nurse use when teaching the pt?

Tremors, nervousness, and insomnia may indicate your dose is too high

A nurse is assessing a pt who is taking levothyroxine. The nurse should recognize that which of the following findings is a manifestation of levothyroxine overdose?

insomnia