Maryville University Nursing 615 Exam 3 with complete solution graded A+

Low-dose colchine - 1.2 mg at first sign of flare, followed by 0.6 mg one hour later for a total dose of 1.8 mg. High-dose colchine - 1.2 mg followed by 0.6 mg every 4-6 hours totaling 4.8 mg. Gout - BUN, creatinine, and creatinine clearance should be monitored in the treatment of this disease Colchine - This medication can cause severe diarrhea, nausea, vomiting, abdominal pain Febuxostat (Uloric) - When prescribing this medication, patients should be taught that gout may worsen with therapy before it improves Corticosteroids - These medications can cause the following adverse effects if taken for six months or more: Osteoporosis and poor diabetic control. Patients should report black, tarry stools or abdominal pain. Corticosteroids - These medications should be tapered to avoid recurrent activity of the underlying disease and possible cortisol deficiency resulting from the hypothalamic-pituitary-adrenal axis suppression during the period of steroid therapy. Black Box Warning on NSAIDS - Increased risk of serious cardiovascular thrombotic events, such as myocardial infarction and stroke. These medications can also cause serious GI events such as bleeding, ulceration or perforation of stomach or intestines, which can be fatal. Pain management - When treating this common issue, it is recommended to begin with NSAIDS and work up from there as needed Ibuprofen - This medication works by inhibiting the COX enzymes; however, the exact mechanism of action for this particular medication is unknown.Acetaminophen - A serious adverse effect related to this medication is referred to as "------------- poisoning" Symptoms of hypoglycemia - Decreased LOC, hunger, diaphoresis, weakness, dizziness and tachycardia Symptoms of hyperglycemia - Polyuria, polydipsia and polyphagia (weight loss) Symptoms of DKA - Kussmaul's respiration, ketone odor of the breath (fruity breath), vomiting, dehydration, abdominal pain, and neurologic symptoms such as lethargy; can progress to coma in later stages if left untreated. Metformin - This medication decreases hepatic glucose output inhibiting gluconeogenesis. It also increases insulin mediated glucose utilization in peripheral tissues. This medication decreases intestinal absorption of glucose. This medication may also be used in diabetics to decrease cholesterol and triglyceride levels. Metformin - When patients are prescribed this medication, the primary care provider should assess serum creatinine, renal function, and creatinine clearance initially and annually. Gliptins (DPP4 inhibitors) - These medications increase the incretin levels, which inhibit glucagon release; this subsequently increases insulin secretion, decreases gastric emptying and decreases blood glucose levels. GLP-1 agonists - These medications bind directly to the GLP-1 receptor, which then slows gastric emptying and increases insulin secretion by pancreatic beta cells. Exenatide (Byetta) - This medication should be administered 60 minutes before breakfast and dinner. PTU - Adverse effects of this medication include fatal granuloctyopenia (presents as fever and slow throat), vasculitis, temporary alopecia, rash, aplastic anemia, and acute renal failure.Levothyroxine - Adverse effects of this medication include tachycardia and angina, which are more noticable in the elderly.