Advanced Pharmacology Fundamentals Endocrine - Test Bank

Please explain the value and reason for doing your own work and not copying or taking answers from another source and claiming them as your own. Your Answer: My own skills will support my future practice as nurse practitioner but also will help my professional growth. I will have confidence by providing right care without collaborating with other peers although it may be beneficial in some point to ask other specialties opinion in order to provide quality of care. Copying someone’s answer does not guarantee it’s the right answer of information. Lastly, under the ANA code of ethics provision 9, must articulate nursing values and maintain integrity of the profession. Question 2 Not yet graded / 10 pts Use the John Jones case study to answer the following question. Using diagnostic criteria for diabetes, what is John’s diabetic status? What treatment plan should be introduced at this time? Your Answer: John. has diabetes and he requires pharmacological intervention. In persons without diabetes, hemoglobin A1c values typically range from 4% and 5.6 %. You have pre diabetes and are at an elevated risk for diabetes when blood hemoglobin A1c is around 5.7 and 6.4 percent. If your blood glucose levels exceed 6.5 percent or more, you have diabetes. Question 3 Not yet graded / 10 pts Use the John Jones case study to answer the following question. Which of John’s behaviors should be addressed to encourage lifestyle changes and decrease A1C levels? Your Answer: John’s blood pressure was 130/90 and his diet consists of fast-food meals. He consumes sugary drinks which is sweet tea with every meal and he weight 235 lbs. His daily work routine sits at a desk several hours a day. John need a lifestyle change of moderate exercise and weight loss to reduces the risk for the development of type 2 diabetes and improves outcomes of type 2 diabetes (Rosenthal & Burchum, 2021). Question 4 Not yet graded / 10 pts Use the John Jones case study to answer the following question. Which behavior in John’s social history poses a potential concern with first line pharmacological treatment for diabetes and why? Your Answer: John reported he’s drinking a few beers on the weekend during football season. Metformin is contraindicated in alcoholics increases the risk of lactic acidosis. Intense education of drug interactions and adverse effect to John should be provided to John risk along with signs and symptoms of lactic acidosis (Rosenthal & Burchum, 2021). Metformin is contraindicated in alcoholics. John’s history indicates routine alcohol consumption so further assessment is needed. The reason alcohol is contraindicated with alcohol is related to exacerbation of a potential risk with metformin itself regardless of alcohol intake. Question 5 Not yet graded / 10 pts Use the John Jones case study to answer the following question. Name the specific names of labs you would order and the intervals at which you would order them to monitor the safety and efficacy of metformin. Your Answer: Labs that needs to be monitor before and after metformin treatment would be liver function, renal function, and blood sugar. Lab work related to both hepatic function, renal function, and blood sugar all need to be monitored both before and during treatment. Question 6 Not yet graded / 10 pts Use the Alfonso Giuliani case study to answer the following question. Atherosclerotic cardiovascular disease (ASCVD) risk factors include age, gender, race, blood pressure, cholesterol values, history of diabetes, tobacco use, treatment of hypertension, statin therapy, and aspirin therapy. Look at Alfonson’s ASCVD risk factors. Should Alfonso be taking something for hyperlipidemia? If so, what would you recommend? Your Answer: Based on the Alfonso’s risk factors, he should be started on statin therapy. Question 7 Not yet graded / 10 pts Use the Alfonso Giuliani case study to answer the following question. Which diabetic drug classes should be considered in addition to metformin to prescribe for Alfonso and why? Your Answer: According to the American Diabetes Association Standards of Medical Care in Diabetes-2020, GLP-1 and SGLT2i drugs are recommended in conjunction with metformin. Alfonso’s ASCVD predominates and his ASCVD risk score is more than 40%. Question 8 Use the Alfonso Giuliani case study to answer the following question. There are two drug classes to consider for prescribing for Alfonso in addition to metformin. What baseline data will you need to obtain for each of those drug classes? Provide the name of the drug class and the baseline data needed for that drug class. Your Answer: The GLP-1 and SGLT2i medication classes are other option should be taken into consideration for Alfonso's treatment. The GLP-1 class requires the following baseline data: fasting plasma glucose, random plasma glucose, hemoglobin A1C, serum electrolytes, urine glucose and ketones, and a random plasma glucose reading. The SGLT2i class requires a random plasma glucose, a hemoglobin A1C, and serum electrolytes as part of their baseline data. Not yet graded / 10 pts Question 9 Not yet graded / 10 pts Use the Alfonso Giuliani case study to answer the following question. You decide to prescribe liraglutide (Victoza) in addition to metformin for Alfonso. What patient teaching do you need to provide when prescribing medication from this drug class? Your Answer: Alfonso should be educated about signs and symptoms of hypoglycemia and usage of medication which includes to never mix insulin and Victoza together. According to Victoza website, Victoza cab also be taken alone or in combination with one or more common oral type 2 diabetes medications. These include biguanides (such as metformin), sulfonylureas (SUs), and thiazolidinediones. Metformin and Victoza (liraglutide) are used for treating type 2 diabetes. While Metformin is an oral medication and Victoza is administered by injection under the skin (subcutaneously). Victoza can be taken any time of day same time every day with or without food. Although you can eat any food while taking Victoza, it is best to avoid food that is less healthy, such as fast food. drinks that are high in sugar. Mild side effects of Victoza includes nausea and vomiting, constipation, decreased appetite, indigestion, diarrhea, headache and hypoglycemia. Side effects of Metformin Feeling sick (nausea) Take metformin with food to reduce the chances of feeling sick. Being sick (vomiting) Take small or frequent sips avoid dehydration. Question 10 Not yet graded / 10 pts Use the Helen Smith case study to answer the following question. Why is caution indicated if metformin was prescribed for Helen? Your Answer: B However, in one trial, HF patients who took the medication had a lower mortality rate than those who used sulfonylureas. These findings imply that metformin use in HF is much safer than previously thought. Question 11 Not yet graded / 10 pts Use the Helen Smith case study to answer the following question. If the standard starting dose of levothyroxine 1.6 mcg/kg/dose is prescribed for Helen, what is the correct dose? Would this be the correct starting dose for Helen? Why or why not? Your Answer: The correct dose is 175mcg/dose. Calculations are 1.6 mcg/kg/dose. Helen weighs 242 pounds; therefore, the dose calculation is 1.6mcg/110kg (242 pounds) or =175.63. This is a high dose to start for an older patient like Helen who has with heart disease so it would be appropriate to choose a lower starting dose for and then titrate up. The correct answer to this question is calculation of the correct dose base on Helen’s weight of 242lbs. There are some age considerations regarding what dose to start some medications. Question 12 Not yet graded / 10 pts Use the Helen Smith case study to answer the following question. Which of the Helen’s lab values require consideration for possible treatment?Provide the lab name and Helen’s result. Use these sources for lab reference values: Helen has 6 lab values that are abnormal and warrant consideration for possible treatment. Question 13 Not yet graded / 10 pts Use the Helen Smith case study to answer the following question. Which DM drug class is contraindicated in patients with heart failure and why? The why portion of this question will require some independent web or article searching to understand why this contraindication exists. Be sure to cite your sources. Your Answer: Thiazolidinedones, an anti-diabetic medication, is contraindicated in patients with heart failure because it can increase fluid retention, which can exacerbate heart failure. Patients with diabetes mellitus and concurrent heart disease or heart failure are not administered this, for that reason (Flaherty, 2012). In order to stimulate adipogenesis and fatty acid uptake, thiazolidinediones, which operate as insulin sensitizers, bind to the peroxisome proliferatoractivated receptor gamma in adipocytes. to ultimately improve insulin action and raise insulin sensitivity in important tissues. Along with raising adiponectin levels and lowering gluconeogenesis in the liver, these medications also boost insulin-dependent glucose absorption in lean muscle and fat.