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When reviewing the medication profile of a patient with a new order for desmopressin, the nurse notes that a drug interaction will occur if which drug is taken with desmopressin?
- A. Aspirin
- B. Digoxin
- C. Lithium
- D. Penicillin
Correct Answer: C
Rationale: Lithium can reduce the therapeutic effect of desmopressin by interfering with its antidiuretic action, potentially worsening polyuria in diabetes insipidus. Aspirin, digoxin, and penicillin do not have significant interactions with desmopressin.
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The nurse notes in a patient's medication history that the patient has been taking desmopressin. Based on this finding, the nurse interprets that the patient has which disorder?
- A. Diabetes mellitus
- B. Diabetes insipidus
- C. Adrenocortical insufficiency
- D. Carcinoid tumor
Correct Answer: B
Rationale: Desmopressin, a synthetic antidiuretic hormone, is used to treat diabetes insipidus by reducing excessive thirst and urination caused by deficient endogenous antidiuretic hormone. It is not indicated for diabetes mellitus, adrenocortical insufficiency, or carcinoid tumors.
A 16-year-old boy who is taking somatropin comes into the office because he had an asthma attack during a race at school. Because of this new development, the nurse expects which intervention to occur next?
- A. He will need to stop participating in school physical education classes.
- B. The somatropin must be discontinued immediately.
- C. The somatropin dosage may be adjusted.
- D. His growth will be documented and monitored for changes.
Correct Answer: C
Rationale: Somatropin should be used cautiously in patients with acute or chronic illnesses like asthma, often requiring dosage adjustments to balance risks and benefits. Immediate discontinuation is not necessary, and growth monitoring is routine but not the primary intervention.
A patient who has been on somatropin has been hospitalized for an acute asthma exacerbation, and is receiving intravenous doses of glucocorticoids. The nurse recognizes that which effect may occur if these drugs are given together?
- A. Reduction of growth effects
- B. Hyperkalemia
- C. Increased urine output
- D. Diarrhea
Correct Answer: A
Rationale: Glucocorticoids can reduce the growth-promoting effects of somatropin by counteracting its anabolic actions, though the benefits of glucocorticoids for asthma may outweigh this risk. Hyperkalemia, increased urine output, and diarrhea are not expected interactions.
A patient's medication order indicates that he is to receive a dose of cosyntropin. The nurse is aware that this drug is used to diagnose which condition?
- A. Adrenocortical insufficiency
- B. Diabetes insipidus
- C. Myasthenia gravis
- D. Pituitary dwarfism
Correct Answer: A
Rationale: Cosyntropin is a synthetic ACTH used to diagnose adrenocortical insufficiency by stimulating cortisol production. It is not used for diagnosing diabetes insipidus, myasthenia gravis, or pituitary dwarfism.
A patient is about to receive a dose of octreotide. The nurse will assess for which contraindications or cautions? (Select all that apply.)
- A. Carcinoid crisis
- B. Diarrhea
- C. Type 1 diabetes mellitus
- D. Gallbladder disease
- E. Chronic renal failure
- F. Esophageal varices
Correct Answer: C,D,E
Rationale: Octreotide requires caution in patients with type 1 or 2 diabetes, gallbladder disease, or chronic renal failure due to potential effects on glucose metabolism, gallbladder function, and renal clearance. Carcinoid crisis, diarrhea, and esophageal varices are indications for octreotide use.