Growth Hormones and Suppressants

Every question here, with the answer

1. A child with growth hormone deficiency is prescribed somatropin. X-rays show closed epiphyses. What should the nurse do?

   1. Give the first dose as ordered.
   2. Question the order because closed epiphyses are a contraindication.
   3. Give the drug orally instead of by injection.
   4. Double the dose to speed growth.

   Answer: Question the order because closed epiphyses are a contraindication.

   Somatropin is contraindicated in clients with closed epiphyses, as well as in critical illness, active malignancy, diabetes, and hypersensitivity. Changing the route or dose does not remove a contraindication.

2. A client with type 2 diabetes is starting somatropin. What should the nurse anticipate?

   1. The diabetes drug dose may need to be changed because somatropin increases blood glucose.
   2. Blood glucose will drop, so insulin should be stopped.
   3. The client should stop checking glucose.
   4. Somatropin has no effect on glucose.

   Answer: The diabetes drug dose may need to be changed because somatropin increases blood glucose.

   Insulin or oral diabetes drugs may need dosage changes because somatropin increases blood glucose. The other options contradict this interaction.

3. A client is learning to self-inject a growth hormone suppressant. Which instructions are correct? Select all that apply.

   1. Avoid areas that are bruised, red, scarred, or hard.
   2. Use the thigh, abdomen, or buttock as recommended.
   3. Clean the site with alcohol and let it dry for 30 seconds.
   4. Dispose of needles in an FDA-approved sharps container.
   5. Reuse needles to save money.

   Answer: Avoid areas that are bruised, red, scarred, or hard., Use the thigh, abdomen, or buttock as recommended., Clean the site with alcohol and let it dry for 30 seconds., Dispose of needles in an FDA-approved sharps container.

   The client chooses the thigh, abdomen, or buttock, avoids damaged areas, cleans and lets the site dry, and uses a sharps container. Needles must not be reused.

4. A client taking bromocriptine for acromegaly tells the nurse she plans to become pregnant. What should the nurse do?

   1. Tell her pregnancy has no effect on this drug.
   2. Advise her to speak with the provider, because pregnancy is a contraindication.
   3. Suggest doubling the dose before conception.
   4. Tell her to stop the drug immediately without telling the provider.

   Answer: Advise her to speak with the provider, because pregnancy is a contraindication.

   Bromocriptine is contraindicated in pregnancy, and clients should talk to their provider before becoming pregnant because these drugs can affect the fetus. Stopping on one's own is discouraged because the drugs replace or suppress growth hormone.

5. A nurse is monitoring a client on a growth hormone suppressant. Which should be monitored and reported if abnormal? Select all that apply.

   1. Hearing
   2. IGF-1 levels
   3. Blood glucose
   4. Thyroid function
   5. Liver function

   Answer: IGF-1 levels, Blood glucose, Thyroid function, Liver function

   The nurse monitors IGF-1 levels and liver function and watches for thyroid suppression and elevated glucose. Hearing is not a listed assessment.

6. A client with severe liver disease is being considered for a growth hormone suppressant. Why is this a concern?

   1. These drugs are metabolized by the liver and can worsen hepatic impairment.
   2. Liver disease increases growth hormone.
   3. The liver is not involved in these drugs.
   4. These drugs improve liver function.

   Answer: These drugs are metabolized by the liver and can worsen hepatic impairment.

   Growth hormone suppressants are metabolized by the liver and can cause further hepatic impairment, so severe liver disease is a contraindication. The other statements are not supported.