Which are indications for discontinuing growth hormone (GH) ...

[Destiiny22]

Which are indications for discontinuing growth hormone (GH) therapy in children with documented growth hormone deficiency? (Select all that apply.)
 
  a. Epiphyseal closure has begun.
  b. A satisfactory adult height has been achieved.
  c. Serum GH levels have been normal for 12 consecutive months.
  d. Normal serum growth hormone levels occur.
  e. The child no longer responds to the hor-mone.

Question 2

A prescriber has ordered methyldopa for a patient with hypertension. The nurse teaches the patient about drug actions, adverse effects, and the ongoing blood tests necessary with this drug. The nurse is correct to tell the patient what?
 
  a. If you have a positive Coombs' test re-sult, you will need to discontinue the me-dication, because this means you have hemolytic anemia.
  b. Methyldopa can be used for its analgesic effects and for its hypertensive effects.
  c. Xerostomia and orthostatic hypotension are serious side effects and indications for withdrawing the medication.
  d. You will need to contact the provider and stop taking the medication if your eyes look yellow.

[nital]

Answer to Question 1

A, B, E
Treatment with GH for a child with a documented GH deficiency may continue until a satisfac-tory adult height has been achieved, if a child does not show a response to the hormone, or until epiphyseal closure begins. Treatment does not continue for life, and GH should not be adminis-tered during or after closure of the epiphyses. Treatment does not depend on growth hormone levels; these are measured to ensure therapeutic dosing.

Answer to Question 2

D
Hepatotoxicity is a serious adverse effect of methyldopa and is an indication for withdrawal of the drug to prevent fatal hepatic necrosis. Jaundice is a sign of liver toxicity. Patients should un-dergo periodic liver function tests while taking the drug. Liver function usually improves when the drug is withdrawn. A positive Coombs' test result is not an indication for withdrawal of the drug in itself. About 5 of patients with a positive Coombs' test result develop hemolytic ane-mia; withdrawal of the drug is indicated for those patients. Methyldopa does not have analgesic effects. Xerostomia and orthostatic hypotension are known side effects of methyldopa but usual-ly are not serious.

[Destiiny22]

Excellent

[bblaney]

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