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NPRO 2000 Exam 3 With Complete Solution
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NPRO 2000 Exam 3 With Complete Solution ...
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NPRO 2000 Exam 3 WithComplete Solution
Levothyroxine
Adverse Effects
Nursing Considerations
Patient Teaching - Answer Treatment of choice for hypothyroidism = replace TH
Adverse effects are those of hyperthyroidism:
- palpitations
- dysrhythmias
- anxiety
- insomnia
- weight loss
- heat intolerance
- menstrual irregularities may occur in females
- long-term use associated with osteoporosis in women
BB Warning:
- use of thyroid hormone in the treatment of obesity or weight loss is contraindicated
Radioactive iodine
Adverse Effects
Nursing Considerations
Patient Teaching - Answer - Treatment for Hyperthyroidism
- These drugs block the formation of thyroid hormone by the thyroid gland
: concentrates in thyroid gland and damages or destroys thyroid cells - variable by
person
- Use beta blockers to stabilitze until antithyroid meds take effect
,- RAI is given orally
- results typically occur in 6-8 weeks
- most cases, client not hospitalized during treatment, and does not require radiation
precautions
- Contraindicated for pregnant women, because RAI crosses the placenta and can have
negative effects on the developing fetal thyroid gland
- Because the amount of gland destroyed by RAI therapy is not readily controllable, the
client may become hypothyroid and require lifelong TH replacement
Adverse reactions include thyroiditis and cardiac instability caused by liberation of
stored TH in the gland.
Clients should be taught to measure their pulse rate and notify the provider if the rate
exceeds 100 BPM following therapy until released stores of TH diminish
Aspirin
Adverse Effects
Nursing Considerations
Patient Teaching - Answer - inhibits prostaglandin synthesis involved in the processes of
pain and inflammation and produces mild to moderate relief of fever
- inhibits both COX-1 and COX-2; (after tissue damage, prostaglandins are formed with
the help of two enzymes COX-1 and COX-2)
: although this inhibition reduces inflammation, the inhibition of COX-1 can result in
bleeding, gastric upset, and reduced kidney function
- greater effect on blood coagulation
- used for the prophylaxis of cardiovascular events
- poses a greater risk for GI bleeding, especially at high doses
ALERTS:
- platelet aggregation inhibition caused by aspirin is irreversible. Aspirin should be
discontinued 1 week prior to elective surgery
- excreted in the urine and affects urine testing for glucose and other metabolites
Methotrexate
Adverse Effects
Nursing Considerations
, Patient Teaching - Answer - One of the most effective and commonly used medicines in
the treatment of several forms of arthritis and other rheumatic conditions
- Blocks several enzymes involved in the immune system
Improvements are first seen in 3-6 weeks, but full benefit not until 12 weeks
- CAN'T BE USED IF PREGNANT
- May be used along with NSAIDs in the initial treatment plan
- a weekly dose can produce a beneficial effect in as few as 2-4 weeks
Adverse effects:
- nausea or vomiting
- abnormalities in liver function tests
- lung problems (persistent cough or unexplained shortness of breath), more common in
people with poor lung function
: persistent cough or shortness of breath should be reported to your doctor
- slow hair loss, but hair grows back when the person stops taking med
- can increase sensitivity of skin to sunlight, so limiting sun exposure and the use of
sunscreen is advised
- folate supplements often given with methotrexate, these are B vitamins and can
decrease side effects during methotrexate treatment
Levodopa/carbidopa
Adverse Effects
Nursing Considerations
Patient Teaching - Answer - relieve tremor/rigidity
- take 30-60 min before meal or take with carb and wait 2 hours for meal
- fewer symptoms than with levodopa alone
: orthostatic hypotension, N/V still problems
- long-term: dyskinesia, off-o phenomenon, confusion, sleep disturbances= vivid dreams
: drug holiday to manage symptoms
Carbamazepine
Adverse Effects
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