Unit 9 Part 1
Indication Nursing Implications &
Pharmacologic Drug Class Action Drug Examples Adverse Reactions Side Effects
(Areas of Use) Patient Education
T3, T4 and TSH; interacts with antidiabetic
Tachycardia/HTN Tremors/Irritability
Thyroid (metformin), digoxin, and anticoagulant medications.
Monitor v/s, weight, s/s thyroid storm (Page 617) and
Replaces deficient T4 Weight Loss myxedema (Page 615)
Replacement hormones.
Palpitations
Sweating Contraindications/Cautions:
Review Nursing Levothyroxine Hypothyroidism Seizures GI Upset
MI - Angina; DM; HTN; MANY Drug Interactions
Increases thyroid
Process pg. 617 & function. Exophthalmos
Patient Teaching (Page 617):
Prototype pg. 615 Cardiac
Dysrhythmias Nervousness/Insomnia
Fatigue/Dizziness T3, T4 and TSH; CBC; Monitor for signs of infection
Block thyroid functions Fever/Flu-like and agranulocytosis (decrease WBC).
Antithyroid and conversion of T4 to Hyperthyroidism Symptoms GI Upset – Constipation
Caution – Anticoagulants and Diabetic Meds
T3. Propylthiouracil
Review Nursing (PTU) Agranulocytosis
Weight gain Patient Teaching (Page 617):
Process pg. 617 Decreases thyroid Grave’s Disease Sore throat
function. Hypothyroidism
Hypotension/Bradycardia
Promotes calcium Monitor calcium levels for effectiveness.
Vitamin D absorption from the GI Hypocalcemia GI Distress – NVDC
s/s hypocalcemia (pg 619) - Chvostek’s and
Hypercalcemia Trousseau’s
Analogue tract and calcium (Chronic Renal
Anorexia Contraindications/Cautions:
secretion from the bone Failure)
Review Nursing into the bloodstream. Calcitriol HTN Hypercalcemia; Acute Renal Failure
Renal Calculi; Cardiac disease. Calcium channel
Fatigue/Weakness blockers; Thiazide diuretics.
Process & Prototype Parathyroid
Cardiac Arrhythmias Patient Teaching (Page 619):
Increases serum Disorders Dizziness/Vertigo
pg. 619 calcium levels.
Adrenal Insufficiency Cushing’s Syndrome Long-term use can lead to immune suppression.
Hyperglycemia Pg.613: Monitor BG levels, electrolytes, signs of infections,
and weights. s/s Cushing’s – Page 613 (vs Addison)
Addison Disease Edema – Na+ Retention Ensure Taper – Page 620.
GI Upset/Reflux
Cardiac Dysfunction Increased Appetite Contraindications/Cautions: DM; MI; Seizure d/o;
Immune Suppression
Replacement of Mood Changes/Swings Psychosis; PUD; Active infections (fungal); Glaucoma;
Glucocorticoid adrenocortical GI Bleed Cataracts CHF; Digoxin; ASA/NSAIDs
Decrease Inflammation Moon Face
Review Nursing hormone to decrease
Prednisone Fractures
Lipodystrophy Patient Teaching (Pg 622-623):
inflammation and Allergic Reactions Headaches
Process & Prototype Menstrual Changes
suppress immune Tendon Rupture Osteoporosis
pg.621-622 response.
Asthma
Insomnia
Infection Risk
Prevent organ rejection Hypokalemia Diaphoresis
Thinning of Skin
Autoimmune HTN Bruising
Disorders Delayed wound healing
Monitor electrolytes; I/O; weight, fluid status and BP.
Mimics the actions of Hypokalemia GI Upset
Given to supplement
aldosterone, facilitating
Mineralocorticoid sodium retention and Fludrocortisone
corticosteroids to
Fluid Overload Anorexia
Contraindications:
Cardiac Disease; HF
treat Addison’s
Review pg. 621 promoting potassium
Disease
Patient Teaching:
excretion. HTN Weakness
Indication Nursing Implications &
Pharmacologic Drug Class Action Drug Examples Adverse Reactions Side Effects
(Areas of Use) Patient Education
T3, T4 and TSH; interacts with antidiabetic
Tachycardia/HTN Tremors/Irritability
Thyroid (metformin), digoxin, and anticoagulant medications.
Monitor v/s, weight, s/s thyroid storm (Page 617) and
Replaces deficient T4 Weight Loss myxedema (Page 615)
Replacement hormones.
Palpitations
Sweating Contraindications/Cautions:
Review Nursing Levothyroxine Hypothyroidism Seizures GI Upset
MI - Angina; DM; HTN; MANY Drug Interactions
Increases thyroid
Process pg. 617 & function. Exophthalmos
Patient Teaching (Page 617):
Prototype pg. 615 Cardiac
Dysrhythmias Nervousness/Insomnia
Fatigue/Dizziness T3, T4 and TSH; CBC; Monitor for signs of infection
Block thyroid functions Fever/Flu-like and agranulocytosis (decrease WBC).
Antithyroid and conversion of T4 to Hyperthyroidism Symptoms GI Upset – Constipation
Caution – Anticoagulants and Diabetic Meds
T3. Propylthiouracil
Review Nursing (PTU) Agranulocytosis
Weight gain Patient Teaching (Page 617):
Process pg. 617 Decreases thyroid Grave’s Disease Sore throat
function. Hypothyroidism
Hypotension/Bradycardia
Promotes calcium Monitor calcium levels for effectiveness.
Vitamin D absorption from the GI Hypocalcemia GI Distress – NVDC
s/s hypocalcemia (pg 619) - Chvostek’s and
Hypercalcemia Trousseau’s
Analogue tract and calcium (Chronic Renal
Anorexia Contraindications/Cautions:
secretion from the bone Failure)
Review Nursing into the bloodstream. Calcitriol HTN Hypercalcemia; Acute Renal Failure
Renal Calculi; Cardiac disease. Calcium channel
Fatigue/Weakness blockers; Thiazide diuretics.
Process & Prototype Parathyroid
Cardiac Arrhythmias Patient Teaching (Page 619):
Increases serum Disorders Dizziness/Vertigo
pg. 619 calcium levels.
Adrenal Insufficiency Cushing’s Syndrome Long-term use can lead to immune suppression.
Hyperglycemia Pg.613: Monitor BG levels, electrolytes, signs of infections,
and weights. s/s Cushing’s – Page 613 (vs Addison)
Addison Disease Edema – Na+ Retention Ensure Taper – Page 620.
GI Upset/Reflux
Cardiac Dysfunction Increased Appetite Contraindications/Cautions: DM; MI; Seizure d/o;
Immune Suppression
Replacement of Mood Changes/Swings Psychosis; PUD; Active infections (fungal); Glaucoma;
Glucocorticoid adrenocortical GI Bleed Cataracts CHF; Digoxin; ASA/NSAIDs
Decrease Inflammation Moon Face
Review Nursing hormone to decrease
Prednisone Fractures
Lipodystrophy Patient Teaching (Pg 622-623):
inflammation and Allergic Reactions Headaches
Process & Prototype Menstrual Changes
suppress immune Tendon Rupture Osteoporosis
pg.621-622 response.
Asthma
Insomnia
Infection Risk
Prevent organ rejection Hypokalemia Diaphoresis
Thinning of Skin
Autoimmune HTN Bruising
Disorders Delayed wound healing
Monitor electrolytes; I/O; weight, fluid status and BP.
Mimics the actions of Hypokalemia GI Upset
Given to supplement
aldosterone, facilitating
Mineralocorticoid sodium retention and Fludrocortisone
corticosteroids to
Fluid Overload Anorexia
Contraindications:
Cardiac Disease; HF
treat Addison’s
Review pg. 621 promoting potassium
Disease
Patient Teaching:
excretion. HTN Weakness
