1
NUR 354 Exam 4 Study Worksheet
1. A charge nurse is asked which insulins can be given via the IV route. How
should they respond?
a. Shortacting(regular)insulin
2. Discuss some considerations when discharging a newly Type 1 diabetic
patient home with insulin injections.
a. Eataconsistentamountoffoodeveryday;followdiabeticdiet.
b. Obtainregularbloodsugarreadingsandfollowprovider’sordersonwhen
toadministerinsulindependingonglucoselevels.
c.Insulin Administration:injectsubcutaneously(lowerabdomen,fattypart
oftheupperarm,andoutersideofthethigh);rotatesites
3. What is the most important teaching point for a patient with prescribed
insulin therapy?
a. Checkbloodglucoselevelsbeforegivinginsulin.
4. What lab value is most important to monitor in relation to a diabetic patient’s
overall glucose control? What are the parameters of this lab value?
a. HemoglobinA1c(HbA1c)
b.Parameters:
i.Normal Range:4–5.6%
ii.Prediabetes:5.7–6.4%
iii.Diabetes:6.5%orabove
5. Within what time frame would we want our diabetic patient to eat if we are
scheduled to administer insulin lispro at 0800?
a. Thediabeticpatientshouldeatat0805.
6. Be able to list the steps to mix regular insulin and intermediate insulin.
a. RollNPHvialtomix.
b. InjectairequaltoNPHdoseintoNPHvial.
c. Injectairequaltoregulardoseintoregularvial.
d. Withdrawregularinsulindose.
e. WithdrawNPHdose.
, 2
7. What are some consequences of overmedication with a thionamide such as
propylthiouracil or methimazole?
a.Signs & Symptoms of Overdose:GIupset,headache,fever,jointpain,
pruritus,andedema
b.Methimazole Consequences:hepatotoxicity,agranulocytosis,
thrombocytopenia
c.Propylthiouracil Consequences:hepatotoxicity,Stevens-Johnson
Syndrome,agranulocytosis,&aplasticanemia
d. Monitorfors/sofhyper&hypo-thyroidismorthyrotoxicosis
8. Discuss the adverse effects of propylthiouracil and methimazole.
a.Methimazole Adverse Effects:rash,skindiscoloration,urticaria,nausea,
vomiting,diarrhea,drowsiness,headache,vertigo,fever,&arthralgia
b.Propylthiouracil Adverse Effects:edema,vasculitis,nausea,vomiting,
diarrhea,rash,hairloss,skindiscoloration,urticaria,drowsiness,
headache,paresthesia,vertigo,&fever
9.What lab value do we use to measure the effectiveness of medication for
thyroid disorders?
a.Lab Values:TSH,T-3,&T-4
i.TSH Normal Range:0.3–5.0microunits/mL
ii.T-3 Normal Range:70–205ng/dL
iii.T-4 Normal Range:4–12mcg/dL
b.Hyperthyroidism:highT-4levels,lowTSHlevels
c.Hypothyroidism:highTSH,lowthyroidlevels
10. When a patient is started on levothyroxine, it is important to monitor thyroid
function periodically. How oen would we measure thyroid function aer
initiating therapy and aer any dose adjustments?
a. Thyroidfunctionshouldbemonitoredtoensurethepatientiseuthyroid
andtoensurethyroidlevelsarewithinnormalrange.
, 3
11. If a patient is being medicated for hyperthyroidism, what would we expect
from their lab work to indicate therapy is effective? What about
hypothyroidism? How oen would we check their labs?
a.Hyperthyroidism:stabilizedthyroidhormones,withinnormalranges
i. Checklabsonamonthlybasis.
b.Hypothyroidism:stabilizedthyroidhormones,withinnormalranges
i. Checklabsonceayear.
c.Euthyroid:havinganormallyfunctioningthyroidgland
12. Discuss signs and symptoms of hypothyroidism.
a.Underactive Thyroid:fatigue,activityintolerance,coldintolerance,
weightgain,constipation,menstrualdisturbances,dryskin&hair,and
muscleaches
i.Late Clinical Manifestations:belownormaltemperature,
bradycardia,weightgain,decreasedLOC,thickenedskin,and
cardiaccomplications
13. Discuss signs and symptoms of hyperthyroidism.
a.Overactive Thyroid:fatigue,nervousness/irritability/anxiety,heat
intolerance,weightloss,diarrhea/frequentbowelmovements,muscle
weakness,rapidorirregularheartbeat,fine/straighthair,bulgingeyes,and
goiter
14. What questions would you ask a patient experiencing insomnia related to
taking synthetic thyroid hormone replacement?
a.
15. Discuss possible adverse effects for patients taking desmopressin. What
condition/disorder does this patient likely have to be prescribed
desmopressin?
a.Desmopressin Adverse Effects:edema,hypertension,hypotension,
tachycardia,hyponatremia,fluidretention,drymouth,nasaldiscomfort
(congestion,rhinitis,sneezing),abdominalcramping,nausea,seizures,
drowsiness,dizziness,headache,&dyspnea
NUR 354 Exam 4 Study Worksheet
1. A charge nurse is asked which insulins can be given via the IV route. How
should they respond?
a. Shortacting(regular)insulin
2. Discuss some considerations when discharging a newly Type 1 diabetic
patient home with insulin injections.
a. Eataconsistentamountoffoodeveryday;followdiabeticdiet.
b. Obtainregularbloodsugarreadingsandfollowprovider’sordersonwhen
toadministerinsulindependingonglucoselevels.
c.Insulin Administration:injectsubcutaneously(lowerabdomen,fattypart
oftheupperarm,andoutersideofthethigh);rotatesites
3. What is the most important teaching point for a patient with prescribed
insulin therapy?
a. Checkbloodglucoselevelsbeforegivinginsulin.
4. What lab value is most important to monitor in relation to a diabetic patient’s
overall glucose control? What are the parameters of this lab value?
a. HemoglobinA1c(HbA1c)
b.Parameters:
i.Normal Range:4–5.6%
ii.Prediabetes:5.7–6.4%
iii.Diabetes:6.5%orabove
5. Within what time frame would we want our diabetic patient to eat if we are
scheduled to administer insulin lispro at 0800?
a. Thediabeticpatientshouldeatat0805.
6. Be able to list the steps to mix regular insulin and intermediate insulin.
a. RollNPHvialtomix.
b. InjectairequaltoNPHdoseintoNPHvial.
c. Injectairequaltoregulardoseintoregularvial.
d. Withdrawregularinsulindose.
e. WithdrawNPHdose.
, 2
7. What are some consequences of overmedication with a thionamide such as
propylthiouracil or methimazole?
a.Signs & Symptoms of Overdose:GIupset,headache,fever,jointpain,
pruritus,andedema
b.Methimazole Consequences:hepatotoxicity,agranulocytosis,
thrombocytopenia
c.Propylthiouracil Consequences:hepatotoxicity,Stevens-Johnson
Syndrome,agranulocytosis,&aplasticanemia
d. Monitorfors/sofhyper&hypo-thyroidismorthyrotoxicosis
8. Discuss the adverse effects of propylthiouracil and methimazole.
a.Methimazole Adverse Effects:rash,skindiscoloration,urticaria,nausea,
vomiting,diarrhea,drowsiness,headache,vertigo,fever,&arthralgia
b.Propylthiouracil Adverse Effects:edema,vasculitis,nausea,vomiting,
diarrhea,rash,hairloss,skindiscoloration,urticaria,drowsiness,
headache,paresthesia,vertigo,&fever
9.What lab value do we use to measure the effectiveness of medication for
thyroid disorders?
a.Lab Values:TSH,T-3,&T-4
i.TSH Normal Range:0.3–5.0microunits/mL
ii.T-3 Normal Range:70–205ng/dL
iii.T-4 Normal Range:4–12mcg/dL
b.Hyperthyroidism:highT-4levels,lowTSHlevels
c.Hypothyroidism:highTSH,lowthyroidlevels
10. When a patient is started on levothyroxine, it is important to monitor thyroid
function periodically. How oen would we measure thyroid function aer
initiating therapy and aer any dose adjustments?
a. Thyroidfunctionshouldbemonitoredtoensurethepatientiseuthyroid
andtoensurethyroidlevelsarewithinnormalrange.
, 3
11. If a patient is being medicated for hyperthyroidism, what would we expect
from their lab work to indicate therapy is effective? What about
hypothyroidism? How oen would we check their labs?
a.Hyperthyroidism:stabilizedthyroidhormones,withinnormalranges
i. Checklabsonamonthlybasis.
b.Hypothyroidism:stabilizedthyroidhormones,withinnormalranges
i. Checklabsonceayear.
c.Euthyroid:havinganormallyfunctioningthyroidgland
12. Discuss signs and symptoms of hypothyroidism.
a.Underactive Thyroid:fatigue,activityintolerance,coldintolerance,
weightgain,constipation,menstrualdisturbances,dryskin&hair,and
muscleaches
i.Late Clinical Manifestations:belownormaltemperature,
bradycardia,weightgain,decreasedLOC,thickenedskin,and
cardiaccomplications
13. Discuss signs and symptoms of hyperthyroidism.
a.Overactive Thyroid:fatigue,nervousness/irritability/anxiety,heat
intolerance,weightloss,diarrhea/frequentbowelmovements,muscle
weakness,rapidorirregularheartbeat,fine/straighthair,bulgingeyes,and
goiter
14. What questions would you ask a patient experiencing insomnia related to
taking synthetic thyroid hormone replacement?
a.
15. Discuss possible adverse effects for patients taking desmopressin. What
condition/disorder does this patient likely have to be prescribed
desmopressin?
a.Desmopressin Adverse Effects:edema,hypertension,hypotension,
tachycardia,hyponatremia,fluidretention,drymouth,nasaldiscomfort
(congestion,rhinitis,sneezing),abdominalcramping,nausea,seizures,
drowsiness,dizziness,headache,&dyspnea
