A nurse is providing teaching for a nondiabetic adult who ...

[lracut11]

A nurse is providing teaching for a nondiabetic adult who develops growth hormone deficiency and who will begin treatment with somatropin (Humatrope). Which statement by the patient indicates understanding of the teaching?
 
  a. Intramuscular dosing is more effective than subcutaneous dosing.
  b. I will have increased muscle mass and strength as well as increased height.
  c. I will need to monitor my blood pressure frequently while taking this drug.
  d. I will need to take insulin while using this, because it causes hyperglycemia.

Question 2

A 7-year-old child who is otherwise healthy is receiving mecasermin (Increlex) replacement therapy to treat severe primary deficiency of insulin-like growth factor-1 (IGF-1). The child develops tonsillar hypertrophy.
 
  The nurse anticipates that the provider will recommend:
  a. antibiotics.
  b. reducing the dose of mecasermin.
  c. discontinuing the mecasermin.
  d. tonsillectomy.

[jamesnevil303]

Answer to Question 1

ANS: C
Growth hormone in adults causes an increase in systolic blood pressure, so patients should be taught to monitor blood pressure while taking the drug. Subcutaneous dosing is as effective as IM dosing and is preferred, because it is less painful. Although muscle mass will increase, strength and height will not. Growth hormone is diabetogenic but causes significant problems in patients with pre-existing diabetes.

Answer to Question 2

ANS: D
Mecasermin can cause hypertrophy of the tonsils, which can be managed by tonsillectomy if needed. Antibiotics are not indicated, because the tonsil enlargement is not caused by infection. Neither reducing the dose of mecasermin nor discontinuing the drug is indicated.

[lracut11]

Excellent

[aruss1303]

TYSM