Pharm 201 CH43

An adult client is preparing to begin corticosteroid treatment for rheumatoid arthritis. When teaching this client about the appropriate use of corticosteroids, the nurse should include what teaching point?

"You will likely gain some weight after you start taking this drug."

A client has been prescribed a daily dose of 7.5 mg of bromocriptine mesylate for dizziness. The available drug is in the form of 2.5-mg tablets. How many tablets will be administered to the client to meet the recommended course for 4 days?

12

The nurse receives an order to administer leuprolide 5 mcg/kg subcutaneously to a child with precocious puberty. The child weighs 66 lbs. What is the correct dosage for this child?

150

A child weighing 14.5 kg has von Willebrand's disease and has been prescribed desmopressin 0.3 mcg/kg IV. How much desmopressin (DDAVP) should the nurse administer?

4.4 mcg

The health care provider has ordered a daily dose of corticosteroid for a client. What should the nurse teach the client about the time to take a daily dose of a corticosteroid?

8:00AM

A prescription for corticosteroid therapy for which clients should be questioned by the nurse? Select all that apply.

A 42-year-old diagnosed with a systemic fungal infection An 8-year-old who recently received a live influenza vaccine A 25-year-old who has been diagnosed with leukemia

The nurse is teaching a client who will require long-term corticosteroid therapy how to reduce the risk of infection. What suggestions will the nurse include?

"Avoid large crowds of people in confined spaces."

The home health nurse is making a plass, a student asks the instructor what a clinical indication for the use of corticosteroids would be. What would be the instructor's best response?

A disease with an inflammatory component

While learning about corticosteroids in pharmacology class, a student asks the instructor what a clinical indication for the use of corticosteroids would be. What would be the instructor's best response?

A disease with an inflammatory component

A 2-year-old client is placed on a course of prednisone following a series of hypersensitivity responses. What instruction should the nurse provide the client's family about this drug?

"Don't stop this medication suddenly; you will have to taper dosage gradually."

A nurse is caring for a client who is receiving a corticosteroid for arthritic pain. Which statement made by the client would raise concern about medication dosage revision?

"I recently lost my health care coverage and need to look for another job."

The nurse just completed client education relative to chronic adrenocortical insufficiency and corticosteroid medication treatment. Which statement indicates the client requires further instruction?

"I will start this medication as soon as I am feeling ill or tired."

When providing client education relative to an inhaled glucocorticoid, the nurse should include which instruction to prevent a common side effect of the medication?

"Rinse your mouth completely after using the inhaler."

The home health nurse provides client teaching to a client who is taking oral prednisolone. The nurse provides what instruction to the client?

"Take it first thing in the morning."

To minimize adrenal suppression, when should the nurse encourage a client to take his or her daily dose of prescribed prednisone?

"Take your medications in the morning."

While the nurse is preparing the client for discharge, the client asks why the health care provider has prescribed prednisone every other day instead of daily. What would be the nurse's best response?

"Taking it every other day minimizes adverse effects."

A client with severe arthritis is taking high dose corticosteroids. The client approaches the clinic nurse and requests a pneumonia vaccine. What would be the nurse's best response?

"Vaccines cannot be given to people who are significantly immune suppressed."

What hormone does the posterior pituitary gland store and release?

ADH

Deficiency of which hormone causes excessive and frequent urination and excessive thirst?

ADH deficiency

A client learning to self-administer desmopressin subcutaneously should be taught to administer the injection at which site?

Abdomen

The nurse is teaching a client who is receiving prednisone about possible adverse effects. The client demonstrates understanding of the teaching when the client identifies what possible effect?

Abdominal distention

A group of students are reviewing the contraindications for glucocorticoid therapy. The students demonstrate understanding when they identify which condition?

Acute infection

A client has suddenly stopped corticosteroid therapy because the symptoms are now under control. The nurse should assess the client for signs and symptoms similar to what disorder?

Addison's disease

What is the most prevalent mineralocorticoid that regulates fluid balance?

Aldosterone

A client is receiving hydrocortisone 40 mg by mouth daily for treatment of severe autoimmune inflammation. Which nursing intervention is the most important to implement?

Assess daily blood glucose.

The nurse is caring for a client who receives monthly injections of goserelin. What assessment should the nurse perform when monitoring the client for therapeutic effects?

Assess the character and severity of the client's cancer pain

When growth in a child is impaired by a deficiency of endogenous growth hormone, somatropin may be prescribed. When in the period of growth and development must somatropin (Humatrope) be administered to children?

Before epiphyses closure

The parents of a prepubescent boy are speaking with his health care provider about treatment of the child's cryptorchidism with human chorionic gonadotropin (HCG). The provider should inform the parents that prolonged use of HCG can cause what adverse effect?

Breast enlargement

A nurse is overseeing the care of a young man whose ulcerative colitis is being treated with oral prednisone. Which action should the nurse take in order to minimize the potential for risks associated with prednisone treatment?

Carefully assess the client for infections.

An 11-year-old client with growth failure due to lack of growth hormone has somatropin (Saizen) administered. What outcome would indicate that the drug should be stopped?

Closure of the epiphyses in long bones

A male client taking oral prednisone informs the home care nurse that the medication is upsetting his stomach. What guidance can the nurse provide to help the client?

Confirm that the client takes the medication with a meal.

Which would be used to diagnose adrenal function?

Corticotropin

After administering desmopressin to a client with diabetes insipidus, which would the nurse identify as indicating drug effectiveness?

Decreased reports of thirst

A client diagnosed with diabetes insipidus is taking vasopressin (Desmopressin). What outcome would indicate to the nurse that the desmopressin is producing a therapeutic effect?

Decreased urine output

You are caring for a client with cerebral edema caused by trauma. Which of the following medications would you anticipate being administered?

Dexamethasone

A head injury has resulted in the hospitalization of a client. Nursing assessments confirm that the client is producing substantial amounts of dilute urine and is consuming large amounts of liquids. Considering the history and assessment findings support the possibility of what metabolic disorder?

Diabetes insipidus (DI)

When planning care for a client prescribed a growth hormone antagonist, the nurse should monitor for which possible adverse effect? (Select all that apply.)

Dizziness Glucose intolerance Nausea Headache

A physician has advised the client to self-administer vasopressin by the parenteral route. What instructions should the nurse include in the teaching plan for self-administering the drug?

Drink water immediately before taking the drug Measure the amount of fluids taken each day Rotate injection sites while administering the drug

A client has been placed on daily glucocorticoid therapy. The nurse should teach the client to take the medication at which time of day?

Early morning

A client is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH) and has been prescribed a medication to affect the posterior pituitary gland's production of antidiuretic hormone (ADH). Which nursing assessment is critical to this client's safety?

Fluid balance

A hospitalized client's serum glucose level is 160mg/dL. Which hormone is most likely being secreted and leading to this elevated lab value?

Glucocorticoid

A clinic nurse is following a 9-year-old boy who is taking somatropin. What will the nurse monitor periodically?

Height

What is the nurse's priority assessment when administering hypothalamic or pituitary agents to older adults?

Hydration and nutrition

When describing the possible adverse effects associated with a mineralocorticoid, which would be included? (Select all that apply.)

Hypernatremia Headache Edema

The nurse is assessing a client with adrenocortical excess resulting from long-term use of corticosteroids. What is not a side effect related to this client's corticosteroid use?

Hypotension

A 55-year-old female client has just been diagnosed with multiple sclerosis. The client is admitted to the hospital with an acute exacerbation of the disease. What treatment would the nurse expect to see ordered for this client?

IV steroids

The nurse is providing client education to a client taking corticosteroids. When would the nurse advise the client to take their medication?

Immediately on awakening in the morning

The nurse is talking to a class of nursing students about corticosteroid therapy. What dietary change would the nurse tell the students is most likely to be ordered for a client on long-term corticosteroid administration?

Increased potassium

When caring for a client receiving long-term therapy with corticosteroids, the nurse would plan care incorporating interventions aimed at preventing what?

Infection

When providing education to a client regarding ACTH, the nurse should include what as the primary safety concern when taking this hormone?

Live virus vaccination

The nurse is caring for an 84-year-old client with diabetes who is receiving hydrocortisone 40 mg daily PO for treatment of an arthritic flare-up. When writing a plan of care for this client, which nursing intervention would be most appropriate?

Monitoring blood glucose levels frequently

Based on the metabolic action of glucocorticoids, a client who is on long-term glucocorticoid therapy is at risk of developing what disease?

Osteoporosis

Naturally occurring aldosterone is regulated by which mechanism?

Pituitary ACTH levels

A 7-year-old child is diagnosed with adrenocortical insufficiency and has been prescribed prolonged steroid therapy. Which is a steroid used for prolonged therapy?

Prednisone

The nursing class is studying family nursing. What hormone would the instructor tell the students plays a part in milk production?

Prolactin

What does release of antidiuretic hormone (ADH) cause?

Reabsorption of water

A nurse is writing a plan of care for a client who is receiving a glucocorticoid. What would be an appropriate nursing diagnosis for this client?

Risk for infection related to immunosuppression

The nurse is caring for a client receiving tolvaptan and digoxin. When assessing for drug-drug interactions, the nurse should prioritize what laboratory result?

Serum potassium level

After teaching a group of students about growth hormone agonists and antagonists, the instructor determines that additional teaching is needed when the students identify which agent as a growth hormone antagonist?

Somatropin

Growth hormones cause all of the following EXCEPT:

Suppression of triglyceride synthesis.

A client being treated with desmopressin exhibits confusion and drowsiness, and reports a headache. What is the nurse's best action?

Take the client's vital signs.

The home health nurse is making a plan of care for a new client who is taking oral prednisolone. What suggestion may decrease the nausea related to oral administration of prednisolone?

Take with a meal

The nursing instructor is discussing short-term versus long-term corticoid steroid therapy with the nursing students. What would be the most appropriate teaching for a client on long-term corticosteroid therapy?

Taper doses when discontinuing drug

After having developed a pituitary tumor that is affecting the the secretion of growth hormone (GH), which client will require especially cautious treatment with a growth hormone antagonist?

The client diagnosed with diabetes

A 13-year-old boy who is in the first percentile of height for his age has been referred for care. Which assessment finding would contraindicate the safe and effective use of somatropin to treat his growth deficiency?

The epiphyses of the boy's long bones have closed.

A client with a diagnosis of asthma has responded well to treatment with oral corticosteroids, and a switch to inhaled corticosteroids is planned. What strategy for managing this change in treatment should be implemented?

The inhaled drug should be started during tapering of the oral drug.

What would a nurse keep in mind about glucocorticoids when teaching a client?

They promote fat storage.

The nurse is doing discharge teaching when the client asks the nurse why their prednisone has been ordered on alternate days. What would be the nurse's best response?

To minimize adverse effects

A client is diagnosed with a pituitary tumor in adulthood. What information should the nurse include when discussing the outcomes of their condition? (Select all that apply.)

Treatment may include radiation therapy The resulting physical changes will include enlarged hands and feet. The heart typically enlarges Drug therapy is an option when radiation and surgery are contraindicated

What medication is used to treat diabetes insipidus caused by hypofunction of the posterior pituitary gland?

Vasopressin (Pitressin)

What is the most effective method to determine a client's ability to self-administer their prescribed nasal desmopressin?

Watch them administer a scheduled dose of the medication.

A client who takes vasopressin will be traveling abroad. What should the nurse teach this client?

Wear a medical alert bracelet.

A nurse is providing client education to a female client who is taking fludrocortisone. The nurse will instruct the client to monitor what at home?

Weight gain

A female client has been taking prednisone for her asthma for 1 month. The nurse will teach her to gradually decrease her dose of prednisone to avoid:

adrenal insufficiency.

5). Which assessments should be made prior to beginning growth hormone antagonist therapy in order to identify any medication-related adverse effects? Select all that apply.

affect blood pressure pulse orientation

A diagnosis of precocious puberty primarily considers what client-focused factor? Select all that apply.

age race secondary sexual characteristics

A client has been admitted to the unit with salt-losing adrenogenital syndrome. The client is taking fludrocortisone (Florinef) for replacement therapy in combination with a glucocorticoid. The nurse would know that high-dose fludrocortisone requires the nurse to monitor for:

an increase in sodium and water retention along with potassium depletion.

Deficiency of which hormone causes polyuria and polydipsia?

antidiuretic hormone (ADH)

Which hormone is released in the presence of low blood volume?

antidiuretic hormone (ADH)

A client is being treated with corticosteroids for chronic adrenocortical insufficiency. When should the client be instructed to take the medication?

between 06:00 and 09:00

A child has responded favorably to treatment with somatropin and has grown several centimeters in recent months. When monitoring this client's progress during therapy, the nurse should be aware of the results from what diagnostic tests? Select all that apply.

blood glucose levels thyroid function tests eye examinations

Which finding should alert the nurse to a potential Cushing's syndrome manifestation presented by a client prescribed long-term corticosteroid therapy?

buffalo hump

Which medications bind to estrogen receptors, decreasing the amount of available estrogen receptors and causing the anterior pituitary to increase secretion of FSH and LH?

clomiphene

A nurse is organizing the care of a child who takes somatotropin. The desired outcome the nurse should prioritize in the planning of this child's care is that the client will:

demonstrate in increase in linear growth.

A nurse is preparing medication information for the spouse of a client diagnosed with cerebral edema. Which medication should the nurse include in this information?

dexamethasone

The anterior pituitary gland produces seven hormones. Of the hormones produced by the anterior pituitary gland, which one acts directly on their target tissues? Select all that apply.

growth hormone (GH) prolactin

A nurse is caring for a 78-year-old client with rheumatoid arthritis. The health care provider has prescribed cortisone, a corticosteroid, to the client. The nurse would administer the drug cautiously to a client with which condition? Select all that apply.

heart failure decreased muscle mass osteoporosis

A client is on daily doses of prednisone. To minimize adrenal suppression, the nurse's instructions for administration should include to take the medication:

in the morning.

A female client has a diagnosis of adrenocortical insufficiency and is steroid dependent. The client is to undergo surgery to remove her uterus. The nurse will explain to the client that in order to promote recovery after the stress of the surgery, her steroid dosage will be:

increased.

A nurse taking a medical history on a client prescribed a corticosteroid medication should focus on which condition?

infections

A nurse is providing discharge instructions to a client who will be taking fludrocortisone at home. The nurse will encourage the client to eat a diet that is:

low in sodium, high in potassium.

What stimulus would prompt the hypothalamic-pituitary-adrenal (HPA) axis to increase corticosteroid production?

low serum levels of corticosteroids

A client being treated with oral prednisone is also prescribed furosemide. The nurse should prioritize assessment of what laboratory value?

potassium

A critically ill client is being treated with desmopressin. When reviewing the diagnostic and laboratory findings of a client prescribed desmopressin, the nurse should prioritize what values? Select all that apply.

sodium (Na)

Which hormones are responsible for the growth of the body during childhood, especially the growth of muscles and bones?

somatotropin

Which needs to be used in a child prior to the closure of the bone epiphyses in order to exert its effects?

somatropin

An adult client has been prescribed oral prednisone for the treatment of an acute dermatological condition. When teaching this client about this course of treatment, what teaching point should the nurse emphasize?

the importance of gradually reducing rather than abruptly stopping the drug

Diabetes insipidus is treated with replacement of which hormones?

vasopressin

Which hormones are responsible for the regulation of reabsorption of water by the kidneys?

vasopressin

What is the regulatory function of vasopressin?

water balance