Exam (elaborations)
NR 565 FINAL EXAM STUDY GUIDE QUESTIONS AND ANSWERS
- Course
- Institution
NR 565 FINAL EXAM STUDY GUIDE QUESTIONS AND ANSWERS
[Show more]
Content preview
NR 565 FINAL EXAM STUDY GUIDEQUESTIONS AND ANSWERS
What labs are used to diagnose Thyroid? - Answer-TSH, total T4 and T3, free T4 and
T3
Timeframe for re-check of labs after starting levothyroxine - Answer-6-8 wks after
starting therapy
Signs and symptoms of hypothyroidism - Answer-Face: Pale, puffy, expressionless
Skin: Cold and dry
Hair: Brittle and hair loss
Heart rate and temp are lowered
Complaints by patient: lethargy, fatigue, intolerance to cold
Mentation may be impaired
Thyroid enlargement if ↓'d levels of T3 and T4 promoting excessive release of TSH
Treatment of thyroid storm - Answer-High dose potassium iodide or strong iodine
solution to suppress thyroid hormone release,
methimazole to suppress thyroid hormone synthesis,
beta blocker to reduce heart rate, sedation cooling glucocorticoids and IV fluids
Result of not treating hypothyroidism during pregnancy - Answer-permanent
neurological defects, ↓'d IQ, large protruding tongue, potbelly dwarfish stature, impaired
development of nervous system bone teeth and muscles.
Medication to treat symptoms of hyperthyroidism (notice this is treating symptoms and
not the hyperthyroidism itself) - Answer-Metoprolol could be used to treat tachycardia
experienced with hyperthyroidism, but it does not treat hyperthyroidism itself.
Drug/Food/Supplement interactions with levothyroxine Absorption REDUCED by: -
Answer-Histamine 2 receptor blockers (Cimetidine [Tagamet])
Proton pump inhibitors (Lansoprazole)
Sucralfate (Carafate)
Cholestyramine (Questran)
Colestipol (Colestid)
Aluminum containing antacids (maalox, mylanta)
Calcium supplements (tums, os-cal)
Iron supplements
Magnesium salts
Orlistat (Xenical)
* 4 hours between levothyroxine and the above meds is recommended and food
reduces absorption as well
, How to confirm a diagnosis of DM prior to beginning treatment - Answer-Hemoglobin
A1C > 6.5%,
Fasting plasma glucose ≧ 126 mg/dL, Random plasma glucose ≧200 mg/dL plus
symptoms of diabetes,
Oral glucose tolerance test (OGTT):
2-h plasma glucose ≧200 mg/dL
A1C General goals - Answer-less than 7%, less than 8% in patients with severe
hypoglycemia, limited life expectancy, or advanced microvascular or macrovascular
complications
A1c - Older Adult goal - Answer-
When should insulin be considered? - Answer-Type 1 Diabetics All are on insulin
Type 2 Diabetics
Step 3 - Three drug combination (inclusive of metformin)
Step 4 - Three drug therapy and basal insulin fails to reach goals after 3-6 months -
injectable regimen inclusive of insulin and possibly GLP-1 receptor agonist.
EXCEPTIONS: patient with A1C greater than 9% or greater start dual therapy (start at
step 2) and patients with A1C greater than 10 % and fasting blood glucose of 300 or
more or symptomatic may be started on combination injectable therapy immediately
At what time interval should A1c be re-checked? - Answer-every 3 months until A1C
drops below 7% and then every 6 months thereafter.
Action of Insulin - Answer-Anabolic-promotes conservation of energy and buildup of
energy stores (Glycogen)
Stimulates cellular transport (Uptake) of glucose, amino acids, nucleotides & K
Promotes synthesis of complex molecules
Glucose ⇒ Glycogen, Amino Acids ⇒ Proteins, Fatty Acids ⇒ Triglycerides
Promotes cellular growth and division
Energy conservation
Pioglitazone contraindications - Answer-Pioglitazone is contraindicated in patients with
severe heart failure and should be used with caution in patients with mild heart failure.
Should not be used in patients that have active bladder cancer or history of bladder
cancer
Be familiar with abbreviations of diabetic drug classifications (GLP-1, TZD, DPP4-I,
SGLT2i) - Answer-GLP-1: Glucagon-like Peptide -1 Receptor Agonist
TZD: Thiazolidinediones (Glitazones)
DPP-4i: Dipeptidyl Peptidase- 4 Inhibitors (Gliptins)
SGLT2i: Sodium-Glucose Cotransporter 2 Inhibitors
Which drug class should be considered for diabetes prior to insulin? - Answer-
Biguanides (Metformin)
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller biggdreamer. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $15.49. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
67096 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now