Question

16. Fludrocortisones (Florinef) a. What type of medication is this? M_ b. Action: Increases _reabsorption in renal tubules and Increases _and hydrogen excretion = water and sodium retention C. Indications for use d. Is this medication given in combination with glucocorticoids? Why? e. Contraindicated in hypertension, CHF, heart disease - Why? f. Adverse reaction - i. Why headache (frontal/occipital) ii. Other adverse effects: why edema? and ? 8. Nursing Assessment: electrolytes, VS plus? What electrolyte imbalances would you monitor for? h. What nursing diagnoses would you identify for a patient taking Florinef i. What would you expect the patient's blood glucose to be when taking a corticostero 17. Define Hypothyroid and Hyperthyroid a. What is the role of iodine in thyroid function? b. What hormones are produced by the thyroid gland? c. Identify major symptoms of hypothyroid and hyperthyroid 18. What does calcitonin do? 19. What is Myxedema Coma? What is Thyroid storm? 20. What is the best screening blood work for thyroid function? (TH 21. When is screening recommended for adults - age 35 and then every years 22. Severe hypothyroidism is associated with elevated C___E_E__L levels 23. Levothyroxine (T4) Synthroid or Levothroid a. Onset? b. When would the patient expect to see improvement? C. Identify significant side effects d. What symptoms / side effects should the patient be instructed to call and tell the physician? e. Patient Teaching? f. Drug interaction - Decreased digitalis levels, Diabetic patients may require ? g. How should this medication be taken?

Answer 1

16, Fludrocortisone
a, It is a man-made natural substance, also known as glucocorticoids made by the body.
b, action: Increase sodium ions reabsorption in renal tubules and increase urinary excretion of potassium and hydrogen excretion=water and sodium retention.
c, Indications for use
It is a partial replacement therapy for primary and secondary adrenocortical insufficiency in Addison's disease in case of salt-losing adrenogenital syndrome.
d, Combination of Fludrocortisone with glucocorticoid to provide substitution therapy to make adrenal activity normal to reduce the adverse effects.
e, Average and large dose of cortisone can elevate the blood pressure, water and salt retention and high potassium excretion.
f, Adverse effect:
i, headache:
When fludrocortisone used for a prolonged period it increases the  intracranial pressure and causes headache
ii, edema:
Due to mineralocorticoid activity, there will be sodium and water retention it includes hypertension, edema, cardiac enlargement, congestive heart failure, potassium loss, and hypokalemic alkalosis.
g, Patient should be monitored for serum electrolyte determinants because high salt and water retention can cause high potassium excretion
Monitor the patient salt intake, edema, and weight gain
Have dietary salt restriction and potassium supplements
there will be calcium excretion due to high corticosteroids.
h, nursing diagnosis
-Fluid volume retention
-Acute pain
-Electrolyte imbalance
-risk for injury