Mega Review Exam 3 NURS 615 Latest
With a Compete Study Guide
*Dosing for low dose colchicineANSWERS-1.2 mg followed by 0.6 one hour later or 1.8
mg total
*Dosing for high dose colchicineANSWERS-1.2 mg followed by 0.6 mg every 4 to 6
hours; or 4.8 mg total.
What is the difference between low dosing and high dosing of colchicineANSWERS-low
dose is as effective as high dose with lower side effect profile
What medication is used for gout?ANSWERS-Colchicine
What does colchicine do?ANSWERS-Used for gout and to treat and prevent gout
attacks. Also Behcets syndrome.
Sid effects of CochicineANSWERS-Always Diarrhea. Upset Stomach, nausea,
abdominal pain.
Instructions for colchicineANSWERS-take with food to help decrease GI side effects
What should be checked with colchicine?ANSWERS-Renal Function before and during
treatment. (BUN, Creatinine)
Patient Education for ColchicineANSWERS-Always causes severe degree of diarrhea
so make sure that people understand that.
Mr. Holloway presents to your clinic with a significantly swollen, painful big toe and you
diagnose him with gout. Of the following options which would be the best treatment for
Mr. Holloway?
a. Acetaminophen with codeine
b. Low-dose colchicine
c. High-dose colchicine
d. High-dose aspirinANSWERS-Low-dose colchicine. Low-dose colchicine is 1.2 mg
followed by 0.6 mg one hour later or 1.8 mg total. High-dose colchicine is 1.2 mg
followed by 0.6 mg Q4 to Q6 hours or 4.8 mg total. The difference between the two is
low-dose is as effective as high-dose with a lower side effect profile.
Patient education when prescribing colchicine includes?
a. Moderate amounts of alcohol are safe with colchicine
,b. Colchicine may be constipating
c. Colchicine always causes some degree of diarrhea
d. Mild muscle weakness is normalANSWERS-B. Colchicine always causes some
degree of diarrhea
What lab value should be monitored with gout?ANSWERS-Check renal function test,
BUN, Creatine
CholchesineANSWERS-for gout, think about alcohol
Allopurinol is used for what?ANSWERS-Gout
MOA AllopurinolANSWERS-xanthine oxidase inhibitor. uric acid reducer, prevents flare
ups and kidney stones
SE of AllopurinolANSWERS-skin rash, flu like symptoms, painful or little urination,
drowsi, dizzy
Monitor what with AllopurinolANSWERS-BUN, Creatinine, Liver Function
You have a patient who is taking allopurinol to prevent gout. What labs will you monitor
for this patient on allopurinol?
a. Blood glucose
b. Complete blood count
c. BUN, creatinine, and creatinine clearance
d. C-reactive proteinANSWERS-BUN, creatinine, and creatinine clearance
Patient teaching for UloricANSWERS-Gout may worsen with therapy initially
Uloric other medicationANSWERS-Febuxostat
Febuxostat (Uloric) MOAANSWERS-xanthine oxidase inhibitor, uric acid reducer for its
with gout and prevent flares.
SE of Febuxostat (Uloric)ANSWERS-gout flares, nausea, mild rash, liver problems,
heart attack symptoms
Febuxostat (Uloric) need to monitor what?ANSWERS-liver and renal function
Patient education for UloricANSWERS-Got may worsen with therapy initially
What medication can you take with Uloric?ANSWERS-NSAID or colchicine for up to 6
months w/ beginning of treatment for gouty flare ups
Mr. Thompson has just started taking febuxostat (Uloric) to treat his gout and he needs
to be educated on what to expect.
,a. Feuxostat may cause severe diarrhea
b. He will need frequent CBC monitoring
c. He should consume a high-calcium diet
d. Gout may worsen with therapyANSWERS-D. Gout may worsen with therapy
ADV effects of corticosteroids if given longer than 6 months?ANSWERS-The main thing
you want to worry about is osteoporosis, it can also worsen diabetic control and patients
should report any tarry black stools or abdominal pain. PEPTIC ULCER DISEASE.
What should long term corticosteroids be used for?ANSWERS-Exacerbation of
autoimmune diseases, and in bursts for type 1 hypersensitivity reactions/sensitivities.
Risk for long term corticosteroids?ANSWERS-Decreased ability to fight infections, slow
immune response, osteoporosis, increased blood glucose
Recommendations for patients who are taking long term corticosteroidsANSWERS-
Getting vaccinations
Corticosteroids medication endingANSWERS-"sone"
Corticosteroids are used to treat what?ANSWERS-RA, lupus, asthma, allergies
SE of corticosANSWERS-High BP, weight gain, muscle weakness, insomnia
ADV of corticos after 6 monthsANSWERS-osteoporosis, can also worsen diabetic
control (raise BGL)
What should be given with corticosteroids?ANSWERS-vitamin supplements
What should be reported with corticosteroidsANSWERS-black tarry stool and abdominal
pain
What can happen with long term therapy of corticosteroids?ANSWERS-Adrenal
Suppression
S/S of adrenal suppressionANSWERS-malaise, myalgia, fever, hypotension.
Don't do what with corticosteroids?ANSWERS-Stop Abruptly, must taper off
Why do you taper corticosteroids?ANSWERS-necessary to prevent withdrawal
symptoms
What should you do with 1 gram of a corticosteroid?ANSWERS-PPI (omeprazole)
Ms. Jensen has been on prednisone for 6 months. Patients who have been on
prednisone for some time should be assessed for what?
, a. Iron deficiency anemia
b. Renal dysfunction
c. Osteoporosis
d. GoutANSWERS-Osteoporosis. Prednisone can also worsen diabetic control and you
must educate your patients to report any tarry black stools or abdominal pain.
When you place a patient on prednisone and the total dose exceeds 1 gram, what
additional drug should you prescribe?
a. Naproxen, an NSAID for joint pain
b. Omeprazole, a proton-pump inhibitor to prevent PUD
c. Metformin, a biguanide to prevent diabetes
d. Furosemide, a diuretic to treat fluid retentionANSWERS-Omeprazole
Patients who are currently on or will start chronic corticosteroid therapy should be
monitored for what?
a. Stool culture
b. Vitamin B12
c. Serum glucose
d. Folate levelsANSWERS-Serum glucose. FYI: remember steroid therapy will raise
glucose levels even in your nondiabetic patients.
Patients with rheumatoid arthritis who are on a chronic low-dose prednisone will need
co-treatment with which medications to prevent further adverse effects?
a. Vitamin D
b. Calcium supplementation
c. A bisphosphonate
d. All of the aboveANSWERS-D. All of the above. FYI: long term steroid therapy can
contribute to weakened bones.
Why do you taper corticosteroids?ANSWERS-Tapering must be done carefully to avoid
both recurrent activity of the underlying disease process and possible cortisol deficiency
resulting from the hypothalamic-pituitary adrenal cis of HPA suppression during the
period of steroid therapy.
Margaret has been on 60 mg of prednisone for 10 days for her severe asthma
exacerbation. Since she is breathing much better it is time to discontinue the
medication. What should you know when discontinuing this drug?
a. Prednisone can be abruptly discontinued with no adverse effects
b. Substitute the prednisone with another anti-inflammatory such as ibuprofen
c. Develop a tapering schedule to slowly wean Margaret off the prednisone
d. Transition patient onto an inhaled corticosteroidANSWERS-Develop a tapering
schedule because tapering helps to avoid both recurrent activity of the underlying
disease process and possible cortisol deficiency resulting from the hypothalamic-
pituitary-adrenal axis (HPA) suppression during the period of steroid therapy.
With a Compete Study Guide
*Dosing for low dose colchicineANSWERS-1.2 mg followed by 0.6 one hour later or 1.8
mg total
*Dosing for high dose colchicineANSWERS-1.2 mg followed by 0.6 mg every 4 to 6
hours; or 4.8 mg total.
What is the difference between low dosing and high dosing of colchicineANSWERS-low
dose is as effective as high dose with lower side effect profile
What medication is used for gout?ANSWERS-Colchicine
What does colchicine do?ANSWERS-Used for gout and to treat and prevent gout
attacks. Also Behcets syndrome.
Sid effects of CochicineANSWERS-Always Diarrhea. Upset Stomach, nausea,
abdominal pain.
Instructions for colchicineANSWERS-take with food to help decrease GI side effects
What should be checked with colchicine?ANSWERS-Renal Function before and during
treatment. (BUN, Creatinine)
Patient Education for ColchicineANSWERS-Always causes severe degree of diarrhea
so make sure that people understand that.
Mr. Holloway presents to your clinic with a significantly swollen, painful big toe and you
diagnose him with gout. Of the following options which would be the best treatment for
Mr. Holloway?
a. Acetaminophen with codeine
b. Low-dose colchicine
c. High-dose colchicine
d. High-dose aspirinANSWERS-Low-dose colchicine. Low-dose colchicine is 1.2 mg
followed by 0.6 mg one hour later or 1.8 mg total. High-dose colchicine is 1.2 mg
followed by 0.6 mg Q4 to Q6 hours or 4.8 mg total. The difference between the two is
low-dose is as effective as high-dose with a lower side effect profile.
Patient education when prescribing colchicine includes?
a. Moderate amounts of alcohol are safe with colchicine
,b. Colchicine may be constipating
c. Colchicine always causes some degree of diarrhea
d. Mild muscle weakness is normalANSWERS-B. Colchicine always causes some
degree of diarrhea
What lab value should be monitored with gout?ANSWERS-Check renal function test,
BUN, Creatine
CholchesineANSWERS-for gout, think about alcohol
Allopurinol is used for what?ANSWERS-Gout
MOA AllopurinolANSWERS-xanthine oxidase inhibitor. uric acid reducer, prevents flare
ups and kidney stones
SE of AllopurinolANSWERS-skin rash, flu like symptoms, painful or little urination,
drowsi, dizzy
Monitor what with AllopurinolANSWERS-BUN, Creatinine, Liver Function
You have a patient who is taking allopurinol to prevent gout. What labs will you monitor
for this patient on allopurinol?
a. Blood glucose
b. Complete blood count
c. BUN, creatinine, and creatinine clearance
d. C-reactive proteinANSWERS-BUN, creatinine, and creatinine clearance
Patient teaching for UloricANSWERS-Gout may worsen with therapy initially
Uloric other medicationANSWERS-Febuxostat
Febuxostat (Uloric) MOAANSWERS-xanthine oxidase inhibitor, uric acid reducer for its
with gout and prevent flares.
SE of Febuxostat (Uloric)ANSWERS-gout flares, nausea, mild rash, liver problems,
heart attack symptoms
Febuxostat (Uloric) need to monitor what?ANSWERS-liver and renal function
Patient education for UloricANSWERS-Got may worsen with therapy initially
What medication can you take with Uloric?ANSWERS-NSAID or colchicine for up to 6
months w/ beginning of treatment for gouty flare ups
Mr. Thompson has just started taking febuxostat (Uloric) to treat his gout and he needs
to be educated on what to expect.
,a. Feuxostat may cause severe diarrhea
b. He will need frequent CBC monitoring
c. He should consume a high-calcium diet
d. Gout may worsen with therapyANSWERS-D. Gout may worsen with therapy
ADV effects of corticosteroids if given longer than 6 months?ANSWERS-The main thing
you want to worry about is osteoporosis, it can also worsen diabetic control and patients
should report any tarry black stools or abdominal pain. PEPTIC ULCER DISEASE.
What should long term corticosteroids be used for?ANSWERS-Exacerbation of
autoimmune diseases, and in bursts for type 1 hypersensitivity reactions/sensitivities.
Risk for long term corticosteroids?ANSWERS-Decreased ability to fight infections, slow
immune response, osteoporosis, increased blood glucose
Recommendations for patients who are taking long term corticosteroidsANSWERS-
Getting vaccinations
Corticosteroids medication endingANSWERS-"sone"
Corticosteroids are used to treat what?ANSWERS-RA, lupus, asthma, allergies
SE of corticosANSWERS-High BP, weight gain, muscle weakness, insomnia
ADV of corticos after 6 monthsANSWERS-osteoporosis, can also worsen diabetic
control (raise BGL)
What should be given with corticosteroids?ANSWERS-vitamin supplements
What should be reported with corticosteroidsANSWERS-black tarry stool and abdominal
pain
What can happen with long term therapy of corticosteroids?ANSWERS-Adrenal
Suppression
S/S of adrenal suppressionANSWERS-malaise, myalgia, fever, hypotension.
Don't do what with corticosteroids?ANSWERS-Stop Abruptly, must taper off
Why do you taper corticosteroids?ANSWERS-necessary to prevent withdrawal
symptoms
What should you do with 1 gram of a corticosteroid?ANSWERS-PPI (omeprazole)
Ms. Jensen has been on prednisone for 6 months. Patients who have been on
prednisone for some time should be assessed for what?
, a. Iron deficiency anemia
b. Renal dysfunction
c. Osteoporosis
d. GoutANSWERS-Osteoporosis. Prednisone can also worsen diabetic control and you
must educate your patients to report any tarry black stools or abdominal pain.
When you place a patient on prednisone and the total dose exceeds 1 gram, what
additional drug should you prescribe?
a. Naproxen, an NSAID for joint pain
b. Omeprazole, a proton-pump inhibitor to prevent PUD
c. Metformin, a biguanide to prevent diabetes
d. Furosemide, a diuretic to treat fluid retentionANSWERS-Omeprazole
Patients who are currently on or will start chronic corticosteroid therapy should be
monitored for what?
a. Stool culture
b. Vitamin B12
c. Serum glucose
d. Folate levelsANSWERS-Serum glucose. FYI: remember steroid therapy will raise
glucose levels even in your nondiabetic patients.
Patients with rheumatoid arthritis who are on a chronic low-dose prednisone will need
co-treatment with which medications to prevent further adverse effects?
a. Vitamin D
b. Calcium supplementation
c. A bisphosphonate
d. All of the aboveANSWERS-D. All of the above. FYI: long term steroid therapy can
contribute to weakened bones.
Why do you taper corticosteroids?ANSWERS-Tapering must be done carefully to avoid
both recurrent activity of the underlying disease process and possible cortisol deficiency
resulting from the hypothalamic-pituitary adrenal cis of HPA suppression during the
period of steroid therapy.
Margaret has been on 60 mg of prednisone for 10 days for her severe asthma
exacerbation. Since she is breathing much better it is time to discontinue the
medication. What should you know when discontinuing this drug?
a. Prednisone can be abruptly discontinued with no adverse effects
b. Substitute the prednisone with another anti-inflammatory such as ibuprofen
c. Develop a tapering schedule to slowly wean Margaret off the prednisone
d. Transition patient onto an inhaled corticosteroidANSWERS-Develop a tapering
schedule because tapering helps to avoid both recurrent activity of the underlying
disease process and possible cortisol deficiency resulting from the hypothalamic-
pituitary-adrenal axis (HPA) suppression during the period of steroid therapy.
