Exam (elaborations)
NUR 2060 Exam 4 (1)
- Course
- NR 667 VISE
- Institution
- NR 667 VISE
Exam of 13 pages for the course NR 667 VISE at NR 667 VISE (NUR 2060 Exam 4 (1))
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NUR 2060 Exam 4Bart is a 32 year old male with a known history of abuse with Xanax andheroin. He states that
he has been sober for 2 years. He presents to theoffice reporting some anxiety. He tells you "I
started a new job and justmoved to the area. I am feeling some anxiety about all the new
changes. Ihave been working with my addiction coach and they thought I should talkto my
doctor. I want to start something to help my nerves. I do not wantanything addicting though. I
have been clean for a few years and reallywant to stay on the positive track.
Which of the following do you anticipate that the physician may prescribe?pick the BEST -
ANS-catapres
Which of the following patients would you most likely administer atropine to: (HINT, pick the
BEST). - ANS-Mrs. Ganine a 65 year old female with a diagnosis of myastheniagravis who is
experiencing excessive sweating, muscle paralysisand respiratory distress.
You are a new nurse in the emergency department. Your patient, Mr.Seiz, is a 54 year old male
with a known history of seizures. Hepresents to the Emergency center having an active grand
malseizure. He is witness having violent contractions and loss ofconsciousness. Which of the
following medications do you anticipatethat the physician will order for this acute seizure
episode. Pick the best - ANS-valium
Black Cohosh - ANS-Uses
- symptoms of menopause (hot flashes, vaginal dryness, palpitations, insomnia, irritability)
Action
- unknown
ADRs
- usually minor (GI and other)
Cautions
- not for use during pregnancy
Soy - ANS-Use
- prevention of breast cancer in post menopausal women, treatment of hot flashes, prevent
osteoporosis
Action
- mixed estrogen/antiestrogen effects
Few ADRs
, Cautions
- estrogen dependent breast cancer patients not with tamoxifen
What do you know about the herbal supplement, black cohosh? - ANS-black cohosh should not
be taken in pregnancy
Type 1 Diabetes Mellitus - ANS-- insulin-dependent (IDDM), juvenile-onset, autoimmune
- absolute deficiency of insulin
- beta cells are destroyed by own immune system
Type 2 Diabetes Mellitus - ANS-- non=insulin-dependent (NIDDM), adult onset
- body's cells become resistant to insulin
- beta cell function intact so adequate amounts insulin possible
The 3 P's in diabetes - ANS-Polyphagia, Polydipsia, Polyuria
Treatment of Type 1 - ANS-- exercise, diet, insulin
Treatment of Type 2 - ANS-- diet, exercise, medications (oral or injectable anti diabetic agents,
or insulin or combo of both)
Treatment options of Diabetes Mellitus goal - ANS-decrease and maintain A1c to less than 7%
Treatment options of Diabetes Mellitus meds - ANS-- insulin: increases available insulin
- PO: stimulate release of insulin, decrease cellular resistance to insulin, decrease glucose
absorption, promote glucose excretion in urine
- SQ: increase pancreatic insulin release and decrease glucagon levels, suppress appetite
Hemoglobin a1c - ANS-- under 5.7% is normal
- over 6.5 % is diabetes
- in-between is at-risk
Insulin- actions - ANS-- most cells (except brain) require insulin to allow entry of glucose
- converts glucose to glycogen in liver
- decrease rate of gluconeogenesis (formation of glucose from noncarbohydrate, protein, fat)
- in muscle -> glucose to energy for exercise
- absence of insulin -> glucose not utilized, gluconeogenesis not suppressed, amino acids
converted to glucose, fat stores to fatty acid & glycerol -> glycosuria & ketoacidosis
Short duration, rapid acting insulin (analogs) - ANS-- insulin lisper (Humalog)
- insulin aspart (Novolog)
- insulin glulisine (Apidra)
Short duration, rapid-acting - ANS-- regular (Humulin-R, Novocain R)
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