NURS 595
NURS 565 Pharmacology Final
Chamberlain Midterm Study Exam 2026
Signs and symptoms of hypothyroidism - -Face is pale, puffy, and expressionless.
Skin is cold and dry.
Hair is brittle, and hair loss occurs.
Heart rate and temperature are lowered. The patient lethargy, fatigue, and intolerance
to cold.
Mentation may be impaired.
Signs and symptoms of hyperthyroidism - -Heart Rate is Rapid; Possible
arrhythmia/angina
Nervousness, insomnia, rapid thought flow, and rapid speech
Skeletal muscles may weaken and atrophy
Metabolic rate is raised, resulting in increased heat production, increased body
temperature, intolerance to heat, and skin that is warm and moist
Weight loss occurs if caloric intake fails to match the increase in metabolic rate
Severe hypothyroidism - -Myxedema
Hypothyroid Treatment - -Levothyroxine is the drug of choice for most patients who
require thyroid hormone replacement.
Levothyroxine (Synthroid) Therapeutic Goal - -Resolution of signs and symptoms of
hypothyroidism and restoration of normal laboratory values for serum thyroid-stimulating
hormone (TSH) and free thyroxine (T4).
Major forms of hyperthyroidism - -Graves disease and toxic nodular goiter (also known
as Plummer disease).
Graves Disease - -Most common cause of excessive thyroid hormone secretion
What adjunctive therapy is good to prescribe to control symptoms of hyperthyroidism
other than thyroid specific medications? - -β-Blockers and nonradioactive iodine may be
used as adjunctive therapy.
β-Blockers suppress tachycardia by blocking β-receptors on the heart.
Nonradioactive iodine inhibits synthesis and release of thyroid hormones.
Monitoring needs and intervals for Levothyroxine - -Check TSH 6-8 weeks after initiating
therapy and after any dosage change.
Check TSH at least once a year after serum TSH is stabilized.
,NURS 595
Hyperthyroid Treatment - -thionamide drugs—methimazole and propylthiouracil (PTU)—
suppress synthesis of thyroid hormones.
Methimazole Therapeutic Goal - -(1) reduction of thyroid hormone production in Graves'
disease, (2) control of hyperthyroidism until the effects of radiation on the thyroid
become manifest, (3) suppression of thyroid hormone production before subtotal
thyroidectomy, (4) treatment of thyrotoxic crisis.
Monitoring needs and intervals for Methimazole - -Check CBC with differential if signs or
symptoms of infection. Check LFTs if signs or symptoms of liver dysfunction.
High Risk Patients for Methimazole - -Should be avoided in the first trimester of
pregnancy.
Methimazole Toxicity - -Agranulocytosis is the most dangerous toxicity.
PTU High Risk Warning - -Carries a risk for liver toxicity. Although rare, the FDA
recommends against using as a first-line treatment due to potential for hepatic toxicity.
Effects of maternal hypothyroidism on offspring and appropriate patient teaching related
to need for treatment. - -Can cause delay in mental development and derangement of
growth. In the absence of thyroid hormones, the child develops a large and protruding
tongue, potbelly, and dwarfish stature. Development of the nervous system, bones,
teeth, and muscles is impaired.
Congenital Hypothyroidism Treatment - -requires replacement therapy with thyroid
hormones. If treatment is initiated within a few days of birth, physical and mental
development will be normal.
replacement therapy should continue for 3 years, after which it should be stopped for 4
weeks to determine whether thyroid deficiency is permanent or transient.
Patient Teaching for Methimazole - -Tell your healthcare providers that you are taking
this drug.
Check blood work as directed.
Taking this drug may cause harm to the unborn baby if you are pregnant, especially in
the first trimester.
If you are pregnant or become pregnant while taking this drug, call your healthcare
provider right away.
Tell your healthcare provider if you are breast-feeding to discuss risks to the baby.
Have your baby's thyroid checked if you are using this drug and breast-feeding.
Agranulocytosis is the most dangerous toxicity risk for this medication but is very rare.
Sore throat and fever should be reported immediately.
Patient Teaching for Levothyroxine - -works best if you take it on an empty stomach, 30
to 60 minutes before breakfast.
, NURS 595
take the medicine at the same time each day.
Ideal HbA1C goal for diabetic, non-pregnant adults - -less than 7%.
HbA1C 8% - -history of severe hypoglycemia, limited life expectancy, or advanced
microvascular or macrovascular complications
HBA1C Value considered diagnostic of diabetes. - -a value of 6.5% or greater
HbA1C Measuring Interval - -every 3 months until value is <7%; every 6 months
thereafter
HbA1C Goal for Older Adults - -<7.5% [58 mmol/mol]), while those with multiple
coexisting chronic illnesses, cognitive impairment, or functional dependence should
have less stringent glycemic goals (such as A1C <8.0-8.5% [64-69 mmol/mol]).
Criteria for the Diagnosis of Diabetes Mellitus - --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/dLcor
-Hemoglobin A1c 6.5% or higher
T1DM Etiology and MOA - -Autoimmune process; Loss of pancreatic β cells;
T2DM Etiology and MOA - -Unknown—but there is a strong familial association,
suggesting that heredity is a risk factor; Insulin resistance and inappropriate insulin
secretion
the total daily dose (TDD) of insulin calculation - -total weight of the patient in kilograms
(kg), multiplied by 0.6 units
Basal insulin replacement - -50% of the total daily insulin dose which replaces insulin
from fasting (overnight) and between meals.
Bolus insulin replacement - -50% of the total daily insulin dose and provides
carbohydrate coverage and high blood sugar correction.
Biguanides Drug Class - -Metformin
Metformin - -Decreases glucose production by the liver (glucogenesis), increases tissue
response to insulin;
Decrease glucose absorption; Increase glucose uptake
drug of choice for initial therapy in most patients with type 2 diabetes
Metformin contraindications - -renal disease, acidosis from hepatic disease, alcoholics,
or in patients with hypoxia.
NURS 565 Pharmacology Final
Chamberlain Midterm Study Exam 2026
Signs and symptoms of hypothyroidism - -Face is pale, puffy, and expressionless.
Skin is cold and dry.
Hair is brittle, and hair loss occurs.
Heart rate and temperature are lowered. The patient lethargy, fatigue, and intolerance
to cold.
Mentation may be impaired.
Signs and symptoms of hyperthyroidism - -Heart Rate is Rapid; Possible
arrhythmia/angina
Nervousness, insomnia, rapid thought flow, and rapid speech
Skeletal muscles may weaken and atrophy
Metabolic rate is raised, resulting in increased heat production, increased body
temperature, intolerance to heat, and skin that is warm and moist
Weight loss occurs if caloric intake fails to match the increase in metabolic rate
Severe hypothyroidism - -Myxedema
Hypothyroid Treatment - -Levothyroxine is the drug of choice for most patients who
require thyroid hormone replacement.
Levothyroxine (Synthroid) Therapeutic Goal - -Resolution of signs and symptoms of
hypothyroidism and restoration of normal laboratory values for serum thyroid-stimulating
hormone (TSH) and free thyroxine (T4).
Major forms of hyperthyroidism - -Graves disease and toxic nodular goiter (also known
as Plummer disease).
Graves Disease - -Most common cause of excessive thyroid hormone secretion
What adjunctive therapy is good to prescribe to control symptoms of hyperthyroidism
other than thyroid specific medications? - -β-Blockers and nonradioactive iodine may be
used as adjunctive therapy.
β-Blockers suppress tachycardia by blocking β-receptors on the heart.
Nonradioactive iodine inhibits synthesis and release of thyroid hormones.
Monitoring needs and intervals for Levothyroxine - -Check TSH 6-8 weeks after initiating
therapy and after any dosage change.
Check TSH at least once a year after serum TSH is stabilized.
,NURS 595
Hyperthyroid Treatment - -thionamide drugs—methimazole and propylthiouracil (PTU)—
suppress synthesis of thyroid hormones.
Methimazole Therapeutic Goal - -(1) reduction of thyroid hormone production in Graves'
disease, (2) control of hyperthyroidism until the effects of radiation on the thyroid
become manifest, (3) suppression of thyroid hormone production before subtotal
thyroidectomy, (4) treatment of thyrotoxic crisis.
Monitoring needs and intervals for Methimazole - -Check CBC with differential if signs or
symptoms of infection. Check LFTs if signs or symptoms of liver dysfunction.
High Risk Patients for Methimazole - -Should be avoided in the first trimester of
pregnancy.
Methimazole Toxicity - -Agranulocytosis is the most dangerous toxicity.
PTU High Risk Warning - -Carries a risk for liver toxicity. Although rare, the FDA
recommends against using as a first-line treatment due to potential for hepatic toxicity.
Effects of maternal hypothyroidism on offspring and appropriate patient teaching related
to need for treatment. - -Can cause delay in mental development and derangement of
growth. In the absence of thyroid hormones, the child develops a large and protruding
tongue, potbelly, and dwarfish stature. Development of the nervous system, bones,
teeth, and muscles is impaired.
Congenital Hypothyroidism Treatment - -requires replacement therapy with thyroid
hormones. If treatment is initiated within a few days of birth, physical and mental
development will be normal.
replacement therapy should continue for 3 years, after which it should be stopped for 4
weeks to determine whether thyroid deficiency is permanent or transient.
Patient Teaching for Methimazole - -Tell your healthcare providers that you are taking
this drug.
Check blood work as directed.
Taking this drug may cause harm to the unborn baby if you are pregnant, especially in
the first trimester.
If you are pregnant or become pregnant while taking this drug, call your healthcare
provider right away.
Tell your healthcare provider if you are breast-feeding to discuss risks to the baby.
Have your baby's thyroid checked if you are using this drug and breast-feeding.
Agranulocytosis is the most dangerous toxicity risk for this medication but is very rare.
Sore throat and fever should be reported immediately.
Patient Teaching for Levothyroxine - -works best if you take it on an empty stomach, 30
to 60 minutes before breakfast.
, NURS 595
take the medicine at the same time each day.
Ideal HbA1C goal for diabetic, non-pregnant adults - -less than 7%.
HbA1C 8% - -history of severe hypoglycemia, limited life expectancy, or advanced
microvascular or macrovascular complications
HBA1C Value considered diagnostic of diabetes. - -a value of 6.5% or greater
HbA1C Measuring Interval - -every 3 months until value is <7%; every 6 months
thereafter
HbA1C Goal for Older Adults - -<7.5% [58 mmol/mol]), while those with multiple
coexisting chronic illnesses, cognitive impairment, or functional dependence should
have less stringent glycemic goals (such as A1C <8.0-8.5% [64-69 mmol/mol]).
Criteria for the Diagnosis of Diabetes Mellitus - --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/dLcor
-Hemoglobin A1c 6.5% or higher
T1DM Etiology and MOA - -Autoimmune process; Loss of pancreatic β cells;
T2DM Etiology and MOA - -Unknown—but there is a strong familial association,
suggesting that heredity is a risk factor; Insulin resistance and inappropriate insulin
secretion
the total daily dose (TDD) of insulin calculation - -total weight of the patient in kilograms
(kg), multiplied by 0.6 units
Basal insulin replacement - -50% of the total daily insulin dose which replaces insulin
from fasting (overnight) and between meals.
Bolus insulin replacement - -50% of the total daily insulin dose and provides
carbohydrate coverage and high blood sugar correction.
Biguanides Drug Class - -Metformin
Metformin - -Decreases glucose production by the liver (glucogenesis), increases tissue
response to insulin;
Decrease glucose absorption; Increase glucose uptake
drug of choice for initial therapy in most patients with type 2 diabetes
Metformin contraindications - -renal disease, acidosis from hepatic disease, alcoholics,
or in patients with hypoxia.
