Activity # 8A

NURSING CONSIDERATIONS FOR AUTONOMIC ENDOCRINE SYSTEM DRUGS

Choose one drug given in the lecture for each of the three classes of ENDOCRINE
SYSTEM DRUGS drug in the first row of the table and fill up the necessary information
in the succeeding rows:

NURSING ENDOCRINE SYSTEM DRUGS (write your chosen drug on the blanks)
PROCESS
Hypothalamic Anterior Pituitary Posterior Pituitary
Releasing Factors: Hormones: Hormones:
CRH (Corticotropin GROWTH HORMONE ANTI DIURETIC
releasing hormones) _ HORMONES
_
Assess skin lesions; Assess height, weight, Assess for contraindications
orientation and affect; thyroid function tests, or cautions (e.g. history of
Assessment liver evaluation; serum glucose tolerance tests, allergy, pregnancy, renal
calcium, magnesium, and GH levels to dysfunction, etc.) to avoid
and alkaline phosphate determine baseline adverse effects.
levels; and radiographs status before beginning
of bones as appropriate, therapy and for any
to determine baseline potential adverse
status before beginning effects.
therapy and for any
potential adverse effects.
Acute pain related to GI Imbalanced nutrition: Altered urinary elimination
Nursing and CNS effects less than body
Diagnosis requirements related to
metabolic changes

Monitor serum calcium Reconstitute the drug Monitor patient fluid volume
concentration before and following manufacturer’s to watch for signs of water
periodically during directions because intoxication and fluid excess
Planning treatment to allow for individual products vary; or excessive fluid loss.
adjustment of dose to administer IM or SQ as
maintain calcium levels ordered for appropriate
within normal limit. drug delivery.
Provide supportive Monitor thyroid function, Monitor condition of nasal
measures (e.g. glucose tolerance, and passages if given
Implementation analgesics, small and GH levels periodically to intranasally to observe for
frequent meals, help with monitor endocrine nasal ulceration, which can
activities of daily living) changes and to institute occur and could affect drug
to help patient deal with treatment as needed. absorption.
CNS and GI effects of
the drug.

Evaluate patient Monitor patient response Monitor for adverse effects

understanding on drug to therapy (return of GH (e.g. water intoxication, GI
Evaluation therapy by asking patient levels to normal, growth problems).
to name the drug, its and development).
indication, and adverse
effects to watch for.
Activity # 8B

NURSING CONSIDERATIONS FOR AUTONOMIC ENDOCRINE SYSTEM DRUGS

Choose one drug given in the lecture for each of the three classes of ENDOCRINE
SYSTEM DRUGS drug in the first row of the table and fill up the necessary information
in the succeeding rows:

NURSING ENDOCRINE SYSTEM DRUGS (write your chosen drug on the

PROCESS blanks)
Glucocorticoids: Replacement Anti-thyroid agents:
Betamethasome Thyroid Hormone:
levothyroxine _
_
These drugs are Assess apical pulse  Monitor response
indicated for many and blood pressure of symptoms of
Assessment conditions. Assess prior to and hyperthyroidism or
involved system periodically during
thyrotoxicosis
before and therapy assess for
periodically during tachyarrhythmias and (tachycardia,
therapy. chest pain palpitations,
nervousness,
insomnia, fever,
diaphoresis, heat
intolerance, tremors,
weight loss,
diarrhea).
 Assess patient
for development of
hypothyroidism
(intolerance to cold,
constipation, dry skin,
headache,
listlessness,
tiredness, or
weakness). Dose
adjustment may be
required.
 Assess patient
for skin rash or
swelling of cervical
lymph nodes.
Treatment may be
discontinued if this
occurs.

Infection, risk for Knowledge  Deficient

(side effects) deficient related to
Nursing medication regimen knowledge, related to
Diagnosis Body image, medication
disturbed (side regimen (Patient/Fam
effects)
ily/Teaching) 
 Noncompliance (
Patient/Family/Teachi
ng) 

Instruct patient on Instruct patient to take  Instruct patient to

correct technique of medication as directed take medication
medication advice at the same time each exactly as directed,
Planning patient to take day.  doses as soon as
around the clock. If a
medications as remembered unless
directed take miss almost time for your dose is missed, take
doses as soon as next dose if more than as soon as
remember unless two to three doses are remembered; take
almost time for your missed notify both doses together if
next dose do not healthcare almost time for next
double doses professional do not dose; check with
stopping the discontinue without health care
medication suddenly consulting healthcare
professional if more
may result in adrenal professional
insufficiency if these than 1 dose is
signs appear notify missed. Consult
healthcare health care
professional professional prior to
immediately period discontinuing
this can be life medication.
threatening.

Do not confuse Administer as a single  Do not confuse

prednisone with me dose preferably before propylthiouracil with
Implementatio feel prednisolone breakfast to prevent Purinethol
n with insomnia
(mercaptopurine).
methylprednisolone
or primidone.  if  Can be
dose is ordered daily compounded by
or every other pharmacist into
day administer in the enema or
morning to coincide suppository.
with the body's  PO Administer at
normal secretion of same time in relation
cortisol
to meals every day.
Food may either
increase or decrease
absorption.

Decrease in Resolution of  Decrease in

presenting symptoms symptoms of severity of symptoms
Evaluation with minimal hypothyroidism of hyperthyroidism
systemic side effects response.  increased (lowered pulse rate
suppression of the sense of well-being and weight gain).
inflammatory and increase energy pulse
 Return of thyroid
immune responses in rate appetite
autoimmune psychomotor activity function studies to
disorders, allergic normal.
reaction and  May be used as
neoplasms. short-term adjunctive
therapy to prepare
patient for
thyroidectomy or
radiation therapy or
may be used in
treatment of
hyperthyroidism.
Treatment of 6 mo to
several yr may be
necessary, usually
averaging 1 yr.
Activity # 8C

NURSING CONSIDERATIONS FOR AUTONOMIC ENDOCRINE SYSTEM DRUGS

Choose one drug given in the lecture for each of the three classes of ENDOCRINE
SYSTEM DRUGS drug in the first row of the table and fill up the necessary information
in the succeeding rows:

NURSING ENDOCRINE SYSTEM DRUGS (write your chosen drug on

PROCESS the blanks)
Antihypocalcem Antihypercalcemic Mineralocorticoids:
ic agents: agents: Florinef (fludrocortisone)
Calcitriol Alendronate _
_
Assess for symptoms Osteoporosis patient for Monitor weight and
of vitamin deficiency low bone mass before I&O ratio to observe
Assessment prior to and and periodically during onset of fluid
periodically during therapy paget's disease accumulation,
therapy assess symptoms of paget's especially if patient
patient for bone pain disease bone pain
is on unrestricted
and weakness prior headache decreased
to and during therapy visual and auditory acuity salt intake and
increase skull size without potassium
supplement. Report
weight gain of 2 kg
(5 lb)/wk.

Monitor and record

BP daily. If
hypertension
develops as a
consequence of
therapy, report to
physician. Usually,
the dose will be
reduced to 0.05
mg/d.

Check BP q4–6h
and weight at least
every other day
during periods of
dosage adjustment.

Nutrition imbalance Injury, risk for indication Injury, risk for indication
Nursing less than body
Diagnosis requirements
 Advise patient to take Instruct patient on the Report signs of
medication as importance of eating hypokalemia (see
directed thickness exactly as directed first Appendix F).
Planning doses as soon as sting in the morning 30
remember that day minutes before other
Be aware of signs of
unless almost time medication beverages or
for next dose do not food waiting longer than
potassium depletion
double act up doses 30 minutes will improve associated with high
absorption sodium intake:
Muscle weakness,
paresthesias,
circumoral
numbness; fatigue,
anorexia, nausea,
mental depression,
polyuria, delirium,
diminished reflexes,
arrhythmias, cardiac
failure, ileus, ECG
changes.

Advise patient to eat

foods with high
potassium content.

Do not confuse as Do not confuse fosamax Monitor weight

calciferol with with flomax and I&O ratio to observe
Implementation calcitriol. because onset of fluid
solitary vitamin accumulation, especially
deficiency are rare
if patient is on
combinations are
commonly
unrestricted salt intake
administered and without potassium
supplement. ...
Monitor and
record BP daily. ...
Check BP q4–6h
and weight at least
every other day during
periods of dosage
adjustment.

Normalization of Prevention of or Decreased

serum calcium in decrease in the provision corticosteroid effects by
Evaluation parathyroid hormone of osteoporosis in rifampin, barbiturates,
levels decrease bone postmenopausal women and hydantoins
pain and weakness in treatment of Decreased salicylate
patients with renal osteoporosis in men
levels
osteodystrophy decrease in the decrease
improvement of paget's disease
in symptoms of
vitamin d resistant
rickets
 Assignment # 7

Define The following:

Hyperglycemia
refers to high levels of sugar, or glucose, in the blood. It occurs when the body does
not produce or use enough insulin, which is a hormone that absorbs glucose into cells
for use as energy

Ketosis
a metabolic state in which there’s a high concentration of ketones in the blood. This
happens when fat provides most of the fuel for the body, and there’s limited access to
glucose. Glucose (blood sugar) is the preferred fuel source for many cells in the body

Diabetes mellitus
metabolic disease that causes high blood sugar. The hormone insulin moves sugar
from the blood into your cells to be stored or used for energy. With diabetes, your body
either doesn't make enough insulin or can't effectively use the insulin it does make.

Hypoglycemia
refers to high levels of sugar, or glucose, in the blood. It occurs when the body
does not produce or use enough insulin, which is a hormone that absorbs glucose into cells
for use as energy
ANTI-DIABETIC AGENTS

Complete the tables below:

Parenteral Anti-hyperglycemic Agents

Drugs Dosage & Route Usual Indications

Insulin (various types)
Intravenous Insulin requirements may
Administration: U-100 be altered during stress,
insulin major illness, or with
changes in exercise, meal
patterns, or
coadministered drugs

Oral Anti-hyperglycemic Agents

Drugs Dosage & Route Usual Indications

Acetohexamide (Dymelor) Oral (Adults) 250 mg Management of type 2
once daily; dose can be ↑ diabetes mellitus as an
as needed by 250–500 adjunct to diet.
mg daily every 5–7 days
(not to exceed 1.5 g/day;
doses >1 g/day should be
given as divided doses).
Chlorpropamide 250 mg/day PO initially; Administer 30 minutes
(Diabenese) may increase or decrease before meal to improve
PRN by 50-125 mg/day at absorption
3- to 5-day intervals
Metformin (Glucophage) Initial: 500 mg PO q12hr Adjunctive therapy to diet
or 850 mg PO qDay with and exercise to improve
meals; increase dose in glycemic control in adults
increments of 500 with type 2 diabetes
mg/week or 850 mg
q2Weeks on the basis of
glycemic control and
tolerability