Pharmacology and the Nursing Process
7th Edition
ISBN: 9780323087896
Author: Linda Lane Lilley
Publisher: Elsevier Health Sciences
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Chapter 21, Problem 7NERQ
Summary Introduction
The parasympathetic nervous system is a part of the autonomic nervous system, in which the transmission of impulses is carried to the effector cells by the neurotransmitter, acetylcholine. The cholinergic-blocking drugs are used to block the effects of the parasympathetic nervous system.
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DaVita Dietitian Reference Manual
Module 6 - Mineral and Bone Disorder Management
DISCUSSION QUESTIONS
1. What are calcitriol, Hectorol and Zemplar?
• Why are they prescribed?
• How are they given?
• How is therapy monitored?
• What is the patient's role in therapy?
2. What is cinacalcet and when is it used?
. What is the Dietitian's role?
3. What are the differences between the oral forms of active vitamin D/vitamin D
analogs (calcitriol /Hectorol/Zemplar)?
• When they are used?
4. What are 3 effects of high phosphorus levels?
5. What is calciphylaxis? Metastatic calcification?
6. Name four phosphate binder options.
• How are phosphate binders dosed?
• What are advantages and disadvantages of each?
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Copyrighted Material
Page 26 of 44
Origination Date: April 2001
DaVita Dietitian Reference Manual
Module 6 - Mineral and Bone Disorder Management
REVIEW QUESTIONS
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
True False
In patients with below-normal albumin levels, it is important to
obtain a corrected calcium value to recognize potential
hypercalcemia.
Hectorol is an active vitamin D analog.
Parathyroid hormone is produced in the pancreas.
A good substitute for Dr. Pepper is Sprite.
Chocolate, nuts and seeds are high in phosphorus.
Cinacalcet replaces binder therapy for controlling
phosphorus.
Calcium carbonate taken between meals acts as a calcium
supplement.
High serum phosphorus levels are linked to the development
of secondary hyperparathyroidism in CKD and a
predisposition to metastatic calcification.
Bone meal, dolomite, or oyster shell should not be used as a
calcium binder because they may contain dangerous amounts
of lead.
Phosphate binders should be taken between meals.
Alucaps are the first choice phosphate binder to try on…
DaVita Dietitian Reference Manual
Module 6 - Mineral and Bone Disorder Management
Case 3
Sue Ann is a 52 year old Asian female on peritoneal dialysis using cycler therapy. She
has been on dialysis 2 years. She weighs 64 kg. She is taking oral calcitriol and her
binder prescription is Renvela 1 tablet with each meal and snack.
Labs
Intact PTH
Corrected
Calcium
Phos
Oral
Calcitriol
6/30
400
8.9
7.4
.25 mcg
3x/week
8/11
11.0
7.0
25 mcg
2x/week
9/11
626
9.0
6.8
.25 mcg
3x/week
10/12
555
10.3
6.9
25 mcg
2x/week
11/14
680
10.4
6.6
What are your thoughts regarding the Intact PTH and other labs?
What therapy options would you recommend?
What are your thoughts regarding patient education needs?
Knowledge Booster
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