NR 565 Week 8 Final Review

HYPO/HYPERTHYROIDISM • What are signs and symptoms of hypothyroidism? • What are signs and symptoms of hyperthyroidism? • A patient is having just been prescribed levothyroxine. The NP put in a lab order to check TSH levels in: • A patient comes into the clinic complaining of sore throat and fever. She has recently started Methimazole in the last 4 weeks. What does this suggest? • A newly pregnant mother shows understanding of Hypothyroidism in pregnant women by stating (Select all that apply) 1. I can keep my current dose of levothyroxine 2. I know that if I don’t take my medicine, it can cause permanent damage to my baby 3. I will need to increase my dose of medicine for a short time 4. My baby will start to make her own thyroid hormones in week 3 (no, baby makes own hormone during second trimester). HYPER/HYPOTHYROIDISM • Patient Teaching for Hypothyroidism medications? • Patient Teaching for Hyperthyroidism medications? • What is the role of Radioactive Iodine and what is a possible adverse effect? • What adjunctive medication can be used for hyperthyroidism? • What medication is given as an adjunct for Lugol Solution 10 days prior to a thyroidectomy? • A patient has a TSH of .28, a free T4 of 3, and a free T3 over 650. What medication should she be started on? • A patient receives his first lab results showing an AIC of 7.2%. What is the diagnosis? • An A1C of ____ is considered prediabetic • of is considered diabetic? • A person with diabetes has recurrent severe hypoglycemia events. What should his A1C goal be? • When is it okay for a patient to have an A1C goal of 6.5%? • Have often should an A1C be monitored when stable or when unstable? • A person comes in with an A1C of 10% and a fasting glucose of 300, what are the next steps for the provider? DIABETES • Who should not take metformin? • Sulfonylureas should not be used during _ or with __ or _ impairment. • A patient who has a history of bladder cancer and HF should avoid what class of DM medication? • When is it appropriate to increase insulin needs? • What is the TDD of a person that weighs 70kg? • IF a person is eating a 50 carb meal, how much insulin will be needed based on the TDD of 42? DIABETES • What is wrong with this sentence? • A patients states that she will take her Insulin lispro 30-60 minutes before a meal. • “As long as the short-acting insulin is drawn up first I can mix my insulin glargine with it.” • A patient states, “My sugars have been around 65-68 at times but I feel the medication is working.” • A women who is taking Pioglitazone states, “I glad that this medication promotes weight loss.” Next Steps • A female patient taking Canagliflozin comes in with a UTI and 6 months ago had a fungal infection. What are your next steps? • A patient taking Sitagliptin reports abdominal pain with vomiting. What are your next steps? RESPIRATORY • What is the MOA for a long-acting B2RA? • What is the first step (medication) in asthma and COPD control? • A patient wakes up at night a few times a week, has been using his SABA DAILY, and has been experiencing symptoms DAILY, and states he cannot make it up a flight of stairs without trouble breathing. What is the severity of his asthma symptoms and what Step would he be considered? Anti-inflammatory Agents Bronchodilators RESPIRATORY • Methylxanthines: Who is at risk for toxicity? • What are some risk factors of fatal asthma attacks? Intubation and icu admission • At what point is a patient prescribed an oral glucocorticoid? Roflumilast (select all that apply) 1. Reduces inflammation 2. Not intended during pregnancy 3. Approved for asthma 4. First-line drug for COPD GASTROINTESTINAL • PPI SHORT-term use adverse effects are • What patient teaching can a provider give when prescribing a PPI? • What patient teaching can a provider give when prescribing an H2RA? • A patient presents with a complaint of reflux and constipation. He states that he drinks enough water, and admits he has gained 30lbs. He also states that he has been having “reflux” type symptoms. What are your next steps? • Zollinger-Ellison syndrome is due to a _ _producing tumor. Treatment is long-term therapy of what medication class? • A patient who takes NSAIDS almost daily for arthritic pain and refuses to try another medication is at risk for an NSAID-induced ulcer. The provider states, • A young woman who was in a car accident 4 months ago takes NSAIDS for pain-related injuries. She has been dx with an ulcer and taking Misoprostol. She also has found out she is pregnant. What are the providers next steps? GASTROINTESTINAL • A patient comes into the clinic with complaints of bloating and abdominal pain for a few weeks. What are appropriate options for treatment? • A patient has tested positive for H.Pylori what are appropriate treatment options? • What patient education is needed when prescribing Alosetron for IBS? • A TCA is used in IBS for what purpose? • What is the MOA of metoclopramide? • Metoclopramide can be used for (select all that apply) TB AND LAXATIVES • What TB medication is not safe for pregnancy? • What constitutes drug resistant TB? • IF a mother is taking isoniazid and rifampin, can she breastfeed? • How can peripheral neuropathy be treated while taking isoniazid? • Patient Teaching for Ciprofloxacin? • Example of inactive viral antigen? • True contraindication for DTaP or Tdap Vaccine? • Varicella contraindication? • Hep B vaccine? • What is an example of a toxoid vaccine type? • Who can receive attenuated influenza vaccine?