Exam (elaborations)
NR566 MIDTERM TEST QUESTIONS WITH VERIFIED ANSWERS
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NR566 MIDTERM TEST QUESTIONS WITH VERIFIED ANSWERS
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NR566 MIDTERM TEST QUESTIONSWITH VERIFIED ANSWERS
Albuterol - Answer--increases levels of digoxin
-safe if children
-first line therapy
Etidronate (Didronel) - Answer-Bisphosphonates
-90 day half life
-preg cat B
reduces bone reabsorption
TX: low bone density, d/t cystic fibrosis, pagets disease (monitor xrays and labs),
heterotropic ossification, hip replacement, spinal cord injury
CI: entercolitis
Alendeonate (fosamax) - Answer-Biphosphonates
-10 yr. half life
( $cheapest)
TX: osteoporosis men, postmenopausal women, gluccorticoids induced, pagets diseae
bioavailability of biphosphonates - Answer-histamine 2 blocking, ranitadine agents
double ALENDRONATE
TILUDRONATE decrease 50 % by aspirin and is increased by INDOMENTHACIN
*consider each nsaid individually
Anastozole, letroxole, exemestane - Answer-aromatase inhibitors
*hormone therapy to tx hormone receptor positive breast cancer.
AE: vertigo, insomnia, sleepiness, confusion, LIFE THREATENING BLOOD
CLOTTING, LOSS BONE MASS,
*take Ca+ vit D supplementation
*measure bone density
GH (somatotropin) - Answer-*used in children with GH deficiency treats hypoglycemia
Biophosphanates pt education - Answer-*empty stomach 8 oz water
avoid anitacids/ alcohol
ETIDRONATE increase in fx with pagets disease monitor labs and xrays
drugs associated with bone loss that should be monitored - Answer-aromatase
inhibitors, thyroid hormones, gluccocorticoid, PPI, SSRI
Antidiabetic mediations to avoid in elderly - Answer-Sulfonylureas -hypoglycemia
Glimpride
Glyburide- most likely to cause hypo
,metformin *renal insuffiency HF
Alpha-glycosidase inhibitors- not well tolerated
Screening of Type 2 DM - Answer->45 yrs old BMI >25 *test yearly
>45 yrs old BMI WNL *q 3 yrs
<45 yrs old VMI >25* test more frequent.
Lispro, Aspart, Glulisine - Answer-rapid acting insulin
15 min peak 1 hr duration
Regular insulin
Regular U -500 - Answer-short acting insulin * used as bolus to correct hyperglycemia
Regular insulin onset 30-60- peak 2-3 dura. 3-7
U-500 onset 30-45, peak 2-4, duration 8-24 hr
Neutral Protamine Hagedorn (NPH) - Answer-NPH onset 30-60 peak 4-10 duration 10-
16
Inhaled human insulin (afrezza) - Answer-most rapid
less weight gain
onset 12 min peak 1 hr duration 2-3 hrs
Acarbose, miglitol, voglibose - Answer-Alpha Glucosidase inbitors
-no weight gain
-can give in combination with sulfonyureas
-CI digoxin
-reduce A1C
Propythouracil PTU - Answer-TX hyperthyroidism
-safe in pregnancy
-risk for hepatic toxicity
Hyperthyroidism
cause
s/s
lab testing - Answer--overactie thyroid gland r/t graves disease (mc) anterior pituitary
disorder, plummers disease, amiodarone therapy
-s/s: tachycardia, cardiac arrythmias, chest pain, tremors, nervousness, insomnia,
irritability, diarrhea, vomiting, weight loss, menstural irregularites, heat intolerance
-labs increase free T4 decrease TSH
Hypothyroidism S/S - Answer-fatigue, memory impairment, depression, swollen face,
decrease sv, hr, increase periph resistance, macrocytic anemia (ass. B12 def.)
decrease appetite, weight gain, enlarged thyroid glad
Diabetic meds that need renal adjustment - Answer-Metformin
, Diabetic medications with increased risk for genital mycotic infections - Answer-SGLT-2
selective sodium glucose co -transporter
Diabetic meds to avoid when taking digoxin - Answer-metformin * dig increases effects
leading to lactic acidosis
Biguanides (Metformin) - Answer--used in children >10
*INITAL DRUG OF CHOICE
*insulin production is necessary for metformin to be productive.
calculate appropriate daily dose of insulin - Answer-0.3-0.5 units kg day
DM diagnosis - Answer-2 hr post load >200mg/dl
fasting plasma glucose >126
HBA1C >6.5
A1C monitoring - Answer-2x per year- meeting goals
every 3 mo- not meeting goals
goal A1c <7 or 6.5
Insulin Gargine
Insulin determir
Insulin degludec - Answer-Long acting:
gargine and determir
onset 60 min duration 24 hrs
degludec 42 hrs.
Metaproteronol - Answer--nebulizer formula for infants
Terbutaline - Answer-Off label inhibits uterine contractions
Preg B
Formoterol and Salmeterol - Answer-Black box not used as monotherapy
-not used for acute exacerbations
-*can worsen symptoms of asthma if pt is deteriorating
-CI children < 4 yrs.
Drug interactions with Beta agonists - Answer-Tricyclic antidepressants and MAOIs
potentiate effects on the vascular system
Digoxin increase the risk arrhythmias (albuterol and levalbuterol
beta agonist contraindications - Answer-Cardiac arrythmias, tachycardia, heart block,
dig toxicity, angina, narrow angle glaucoma, organic brain damage, shock during
anesthesia
-diabetics cause hyperglycemia
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