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A nurse prepares to administer sodium polystyrene sulfonate(kayexalate) to the client. Before administaring the medication, the nurse reviews the action of the medication and understands that it:
Releases sodium ions in exchange for primarily potassium ions.
- Rational:
- Sodium polystyrene sulfonate (kayexalate) is a cation exchang resin used in the treatment of hyperkalemia. The resin either passes through the intestine or is retained in the colon.
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A nurse is caring for a client with hyperparathyroidism and notes that the client,s serum calsium level is 13mg/dl. Which medication would the nurse prepare to administer as prescribed to the client?
calcitonin (calcimar)
- Rational:
- The normal serum calsium level is 8.6 to 10 mg/dl. This client is experiencing hypercalcemia. calcium gluconate and calcium chloride are medications used in the treatment of tetany, which occurs as a result of acute hypocalcemia.
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A nurse is caring for the client following thyroidectomy and notes that calcium gluconate is prescribed for the client. The nurse determines that this medication has been prescribed to:
Treat hypocalcemic tetany
Rational:HYpocalcemia can develop after thyroidectomy if the parathyroid glands are are removed accidentaly removed during surgery. Manifestations develops numbness and tingling around the mouth, fingertips or toes, muscle spasm, or twitching, the physician is notified immediatly.calcium gluconate should be kept at the bedside.
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A client is taking nph insulin daily every morning. The nurse instructs the client that the most likely time for a hypoglycemis reaction to occur is:
6-14 hours after administration
- Rational:
- NPH is an intermediate-acting insulin. The onset of action is 1-2 hours, it peaks in 6-14 hours, and its duration of action is 24 hours. Hypoglycemic reactions most likely occur during peak time.
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Somatren (protropin) is administered to a client with pituitary dwarfism. The expected theraputic effect of this medication is to:
Stimulate linear growth
- Rational:
- Protopin is a growth failure stimulator used in the long-term treatment of growth failure resulting from growth hormone deficiency. It stimulates linear growth, increases the number and size of muscle cells, and red cell mass. if affects carbohydrate metabolism by antagonizing the action of insulin, increasing mobilization of fats, and increasing cellular protein synthesis.
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A nurse is monitoring a client receiving demospressin (DDAVP). Which of the following, if noted in the client, would indicate an adverse effect of the medication?
Drowsiness
- Rational:
- Water intoxication or hyponatremia is an adverse reaction to DDAVP. Early signs include drowsiness, listlessness, and heasdache. Decreased urination, rapid weight gain, confusion, sezures, and coma may also occur in everhydration.
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A nurse reinforces instructions to a client taking levothyroxine (Synthroid). The nurse determines that the teaching was effective if the client states he or she will take the medication:
on an empty stomach
- Rational:
- Oral doses of levothyroxine should be taken on an empty stomach to enhance absorption. The medication should be taken in the morning before breakfast.
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A nurse reinforces medication instructions to a client taking levothyroxine (SYnthroid). The nurse instructs the client to notify the physician if which of the following occurs?
Tremors
- Rational:
- Excessive doses of levothyroxine can produce signs and symptoms of hyperthyroidism(thyrotoxicosis). These include tachycardia, angina, tremors, nervousness, insomia, hyperthermia, heat intolerance, and sweating. The client should be instructed to notify the physcian if the these occur.
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A nurse reviews the health record of client seen in the physician's office and notes that the client is taking propythiouracil (PTU) daily. The nurse suspects that the client has a history of:
Grave's disease
- Rational:
- PTU inhibits thyroid hormone synthesis and is used to treat hyperthyroidism or grave's disease.
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Myexdema indicates
hypothyroidism
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chushing's syndrome and Addison's disease are disorders realted to
adrenal function.
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A nurse is reinforcing instructions to a client regarding the administration of lypresin (Diapid). The nurse instructs the client that the medication will be taken by which of the following routes?
Intracanal
- Rational:
- Lypressin is administered by the intranasal route. It is used for diabetes insipidus. The usual adult dosege is one or two sprays into each nostril four times daily.
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A client seen by the physician for complaints of fatigue, a lack of energy. constipation, and depression. Following diagnotic studies, hypothyroidism is diagnosed. levothyroxine(Synthroid) is prescribed. The nurse tells the client that the primary expected outcome of the medication is to:
Achieve normal thyroid hoemone levels.
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Propythiouracil (PTU) is prescribed for a client with hyperthyroidism and the nurse reinforces instructions to the client regarding the medication. The nurse informs the client to notify the physician if which of the following signs occur?
Sore throat
- Rational:
- An adverse effect of PTU is agranulocytosis. The client needs to be informed of the early signs of this adverse effects, which includes fever, soar throat.
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A client is scheduled for subtotal thyroidectomy. Iodine solution (Lugol solution) is prescribed. The nurse understands that the therapeudic effect of this medication is to:
Suppress thryroid hormone production
- Rational:
- Lugol solution is administered to hyperthyroid individuals in preparation for thyroidectomy to suppress thyroid function. Initial effects develop with 24 hours; peak effects develops in 10 to 15 days.
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A nurse reinforces instructions to the client taking fludrocortisone (Florinef). The nurse tells the client to notify the physician if which of the following occurs?
Swelling of the feet
- Rational:
- Excessive doses of fludrocortisone cause retention of sodium and water and excessive excretion of potassium, resulting in expansion of blood volume, hypertension, cardiac enlargement, edema, and hypokalemia. The client needs to be informed about the signs of sodium and water retention, such as unusual weight gain or swelling of the feet or lower legs. If these signs occur, the physicians needs to be notified.
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A nurse is teaching the client how to mix rehular insulin and NPH insulin in the same syringe. Which of the following actions, if perfomed by the client, would indicate the need for further teaching?
Whithdraws the NPH insulin first
- Rational:
- When preparing a mixtiure of regular insulin with another insulin preparation, the regular insulin should be drawn into the syringe first. The sequence will avoid contaminating the vial of regular insulin of another type.
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Lispro insulin (HUmalog). a rapid acting form of insulin, is prescribed for a client. The nurse instructs the client to administer the insulin:
Immediately before eating
- Rational:
- The effect of lispro insulin within 5 minutes of subcutaneous injection and persists for 2-4 hours. Lispro insulin acts more rapidly than regular insulin but has a shorter duration of action. Because of its rapid onset, it can be administered immediatly before eating.
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Etidronate (Didronel), an antihypercalcemic medication, is prescribed for a client to take the medication:
Two hours before meals
- Rational:
- Etidronate should be taken on an empty stomach 2 hours before meals. It should bot be taken with in 2 hours of vitamins, mineral supplements, antacids, or medications high in calcium, magnesium, iron, or albumin.
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Fludrocortisone (florinef) is prescribed for a client with Addison's disease. The nurse prepares to administer the medication knowing that the primary action of this medication is to:
Promote the reabsorption of sodium and chloride ions in the distal tubules of the kidney.
- Rational:
- Fludrocortisone has mineralocorticoid activity and also has a glucocordicoid effect. It acts primarily on the kidney's distal tubules, enhancing the reabsorption of sodium and chloride ions and the excretion of potassium and hydrogen ions. It promotes water retention.
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Iodine solution (Lugol's solution) is prescribed for a client. The client calls the nurse at the clinic and complains of brassy taste and burning sensation in the mouth. The nurse tells the client to:
Contact the physician
- Ratinal:
- Chronic ingestion of iodine can produce iodism. The client needs to be instructed about the symptoms of iodism, which include a brassy tate, burning sensations in the mouth, soreness of gums and teeth, frontal headache, coryza, salivation, and skin eruptions. The client should be instructed to notify the physician if these symptoms occur.
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