Pharm Respiratory & Endocrine

Respiratory and Endocrine Meds

Heather Miller, RN, BSN

Objectives

• Explain the expected therapeutic effects of respiratory and endocrine systems medications

• Summarize the pharmacological action of respiratory and endocrine systems medications

• Monitor for common adverse effects of respiratory and endocrine systems medications  

• Apply the concept of safe medication administration and dosage calculation when administering respiratory and endocrine systems medications client education regarding respiratory and endocrine systems medications

• Determine if the respiratory and endocrine systems medications are appropriate for the client

• Monitor for potential interactions that can cause adverse or life-threatening effects when administering respiratory and endocrine systems medications

Respiratory System

Respiratory Disorders

• Asthma

• Chronic Obstructive Pulmonary Disease (COPD)

• Rhinitis

• Cystic Fibrosis

• Bronchitis

• Pneumonia

• Bronchodilators

  • SABA

  • LABA

• Methylxanthines

• Anticholinergics

• Glucocorticoids

• Leukotriene modifiers

• Combination inhalers

Airflow Disorder Medications

Dropdown

A nurse is reinforcing teaching with a client who has asthma and is prescribed a short-acting beta₂-agonist (SABA) inhaler. Which of the following information should the nurse include in the teaching?
​

Select answer

Multiple Choice

A nurse is reinforcing education for a client who is prescribed an inhaled corticosteroid to manage asthma. Which of the following instructions should the nurse include for the client to perform after using the inhaler?

• Deep breathe from 2 minutes

• Rinse their mouth

• Wait 5 minutes until eating or drinking

• Exercise

Match

Match the following

• Albuterol

• Ipratropium

• Beclomethasone

• Theophylline

• Montelukast

Short-acting beta agonist (SABA)

Anticholinergic

Inhaled corticosteroid

Methylxanthine

Leukotriene modifier

• Short-acting beta agonist (SABA)

• Anticholinergic

• Inhaled corticosteroid

• Methylxanthine

• Leukotriene modifier

• Antihistamine

• Antitussives

  • Opioid

  • Non-opioid

• Expectorants

Upper Respiratory Disorder Medications

Multiple Choice

A nurse is reviewing the medication administration record (MAR) of a client who reports having a nonproductive cough. Which of the following medications would the nurse expect to find prescribed for this client?

• Guaifenesin

• Codeine

• Dextromethorphan

• Diphenhydramine

Multiple Choice

The nurse correctly administers montelukast (Singulair) __________.

• after breakfast.

• three times a day with meals.

• once daily in the evening.

• twice daily in the morning and evening.

Dropdown

The nurse is preparing to administer an expectorant to a client who has a productive cough. The nurse will instruct the client to ​

Select answer

fluid intake to 2000mL a day.

Endocrine System

Hormones of the Hypothalamus and Anterior and Posterior Pituitary

Hypothalamus	Anterior Pituitary	Posterior Pituitary
Growth hormone releasing hormone (GHRH) →	Growth hormone (GH)
Thyrotropin releasing hormone (TRH) →	Thyroid stimulating hormone (TSH)
Corticotropin releasing hormone (CRH) →	Adrenocorticotropic hormone (ACTH)
Gonadotropin releasing hormone (GnRH) →	Follicle stimulating hormone (FSH); Luteinizing hormone (LH)
Antidiuretic hormone – produced in hypothalamus and transported to posterior pituitary via axons (ADH)		Antidiuretic hormone (ADH)
Oxytocin – produced in hypothalamus and transported to posterior pituitary via axons		Oxytocin

• Diabetes mellitus

  • Type 1

  • Type 2

• Hyper-/hypothyroidism

• Diabetes insipidus

• Addison's disease

Endocrine Disorders

• Sulfonylureas

• Biguanide

• Insulin: rapid, short, long

• Hyperglycemics

Onset, Peak, and Duration

Classification	Medication	Onset	Peak	Duration
Rapid-acting	Lispro insulin	15 to 30 min	30 min to 3 hr	3 to 5 hr
Short-acting	Regular insulin	30 min to 1 hr	2 to 4 hr	4 to 12 hr
Intermediate-acting	NPH insulin	1 to 2 hr	4 to 12 hr	14 to 24 hr
Long-acting	Glargine insulin	2 to 4 hr	Minimal	Up to 24 hr

Multiple Choice

A nurse is reviewing the medication administration record (MAR) of a client who has a prescription for insulin glargine. Which of the following is the correct method of administering this medication?

• Within 10 minutes of meals

• Immediately before meals

• Any time within 30 minutes before or after a meal

• At bedtime

Multiple Choice

The nurse is reinforcing teaching for a client newly prescribed insulin lispro. Which of the following statements by the client indicates a correct understanding of the medication?

• “I will make sure to eat right after I take my lispro injection.”

• “I can inject my lispro insulin even if I skip a meal to keep my sugar under control.”

• “I should avoid rotating my injection sites so the insulin works faster.”

• “I can leave unopened insulin vials at room temperature until I need them.”

Multiple Choice

A cloudy vial of NPH insulin having been opened 15 days ago is safe to administer.

• True

• False

• Levothyroxine

Multiple Select

Which of the following are signs/symptoms of hypothyroidism? (SATA)

• Depression

• Bradycardia

• Anorexia

• Tachycardia

• Tremor

Multiple Choice

The nurse informs the client that therapy with the thyroid hormone levothyroxine may be discontinued ________.

• never.

• after 3 months.

• after 6 months.

• when levels are regulated.

• Desmopressin

• Hydrocortisone

Multiple Choice

Which of the following statements made by a client indicates a possible adverse reaction to the administration of desmopressin?

• "I am unable to see well at night."

• "My head is hurting."

• "I have a sore throat."

• "I am hungry all the time."

Multiple Choice

Which of the following instructions should the nurse include to the patient beginning therapy with hydrocortisone (Cortef) to treat adrenocortical insufficiency?

• Increase calcium and vitamin D

• Administer before meals

• Urinate every 4 hours

• Stop taking when symptoms subside