Question

11. Give two contraindications for the medication listed above.

      12. Give two medication interactions for Synthyroid and provide a rationale.

      13. Give two food interactions and provide a rationale.

14. Give two nursing administration consideration for Synthyroid.

Adrenal.

15. Fill in the following table. Give a brief description of disorder in your own words. For each side effect describe the intervention and education. (The disorder is given, please fill in the rest).

Disorder and Medication	Side effects (Give 3)	Nursing Intervention/Client Education
Addison’s
Cushing’s

16. Name one condition that is contraindicated for medications used to treat Addison’s disease.

17. Name one condition that is contraindicated for medications used to treat Cushing’s disease.

18. Fill in the following table. Give a brief description of disorder in your own words. For each side effect describe the intervention and education. (The disorder is given, please fill in the rest).

Disorder and Medication	Side effects (Give 3)	Nursing Intervention/Client Education
Conn’s syndrome
Pheochromocytoma

19. Name one condition that is contraindicated for medications used to treat Conn’s syndrome.

20. Name one condition that is contraindicated for medications used to treat Pheochromocytoma.

Answer 1

12.Give two medication interactions for Synthyroid ----------Synthyroid should not be given simultaneously with antacids or simethicone or calcium supplements as these can decrease the amount of thyroid hormone absorbed by the body.At least 4 hours gap is needed

13.Give two food interactions-----------Milk and Cereal (CAsein) and orange juice(aCid) Together they curdle the milk. Destroy the enzyme present in starchy cereal

Give two nursing administration consideration for Synthyroid......To be given orally in empty stomach at least half an hour before breakfast or 3-4 hours after dinner. Never administer it with iron or calcium supplement

15.

14.Fill in the following table. Give a brief description of disorder in your own words. For each side effect describe the intervention and education. (The disorder is given, please fill in the rest).

Disorder and Medication	Side effects (Give 3)	Nursing Intervention/Client Education
Addison’s Oral Hydrocortisone	Susceptibility to infections, Opportunistic infections e.g oral candidiasis may flourish
		Reassurance and education of the patient Application of topical antifungal cream
	2.Osteoporosis especially vertebra and other spongy bone	Educate the patient Reassurance
		If any pain in bony area go for bone densitometry and MRI X ray to see if any fracture
	3,Hyperglycemia may precipitate.	Educate the patient, Reassurance
		Blood glucose level monitoring in regular interval
Cushing’s Cushing syndrome is caused by prolonged exposure to elevated levels of either endogenous glucocorticoids or exogenous glucocorticoids.It is characterized by moon facies buffalo hump, purple striae and truncal obesity,	It is caused by excess Corticosteroids. So minimisation of steroids is the medication and symptomatic treatment needed to prevent complication which is present beforehand such as diabetes mellitus, osteoporosis etc	Patients should be educated about adrenal crisis. Instruction on specific medication use is indicated.
		Morbidity and mortality associated with Cushing syndrome are related primarily to the effects of excess glucocorticoids. Exposure to excess glucocorticoids results in multiple medical problems,

16. Name one condition that is contraindicated for medications used to treat Addison’s disease.

Answer …….Peptic Ulcer and Diabetes Mellitus where corticosteroid used for Addisons disease treatment are contraindicated

17. Name one condition that is contraindicated for medications used to treat Cushing’s disease.

Late stages of Systemic Lupus Erythomatosus where steroids should be given and it is withdrawn in Cushings diseases

18. Fill in the following table. Give a brief description of disorder in your own words. For each side effect describe the intervention and education. (The disorder is given, please fill in the rest).

Disorder and Medication	Side effects (Give 3)	Nursing Intervention/Client Education
Conn’s syndrome is primary aldosteronism due to the presence of an adrenal aldosteronoma (aldosterone-secreting benign adrenal neoplasm). Drug Mineralocorticoid antagonists, such as spironolactone	Dangerous side effect of hyperkalemia if given with Potassium
		Never administer with K+	Monitoring of Biochemical values of serum K=/ andNa etc
	Drowsiness, mental confusion	Don’t allow patient to drive, or any risky function to take while on medication	Routine laboratory studies can show hypernatremia, hypokalemia, and metabolic alkalosis
	Gynecomastia, erectile dysfunction	Educate
Pheochromocytoma Pheochromocytomas a neuroendocrine tumors derived from adrenal. Drug Simultaneous alpha blocker and beta blocker before surgical removal	1.Can precipitate congestive heart failure and can accentuate myocardial insufficiency	To act Accordingly