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CCRN REVIEW QUESTIONS WITH ANSWERS 2024.
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CCRN REVIEW QUESTIONS WITH ANSWERS 2024.
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CCRN REVIEW QUESTIONS WITHANSWERS 2024
SIADH - ANSWER: ➡ too much ADH t t tt t t t
low Na, hypo-osmolar, low UOP
t t t t
ADH - ANSWER: ➡ made in hypothalamus
t t tt t t t
stored in pituitary t t
released to kidney and makes kidney hold onto h20
t t t t t t t t
serum osmolarity - ANSWER: ➡ Na X2
t t t tt t t t
275-295
low=fluid overloaded t
high=concentrated
SIADH CAUSES - ANSWER: ➡ oat cell carcinoma (bronchogenic CA)-makes its own ADH
t t t tt t t t t t t t t
Viral PNA t
Head Problem t
inc. serum osmo, anesthesia, analgesics, stress
t t t t t
COMPLICATIONS OF SIADH - ANSWER: ➡ Sz's t t t t tt t
TREATMENT of SIADH - ANSWER: ➡ get rid of causes t t t t tt t t t t
fluid restrictions
t
hypertonic solutions (3%, D5NS, D51/2NS) give 25-50cc/hr d/t CHF
t t t t t t t t
,DI - ANSWER: ➡ No ADH (no h20 at kidney)
t t tt t t t t t t
inc Na+ levels, inc osmolarity, inc. UOP (spec grav 1.001-1.005)
t t t t t t t t t
DI Causes - ANSWER: ➡ head problems
t t t tt t t
dilantin
DI Treatment - ANSWER: ➡ Give ADH (PItressin or vasopressin)
t t t tt t t t t t
Give fluids to increase Intravascular volume
t t t t t
monitor UOP t
*monitor fo ischemia t t
Hypoglycemia - ANSWER: ➡ CVS s/s t t tt t t
tachycardia, palpitations, diaphoresis, irritable, restlessness t t t t
CNS s/s t
confusion, lethargy, slurred speech, sz, coma t t t t t
hypoglycemia pathophys - ANSWER: ➡ low glucose->adrenal medulla knows and releases t t t tt t t t t t t
adrenaline->liver releases glycogen which is converted into glucose to increase BGL
t t t t t t t t t t t
if block in adrenaline or liver cant convert glycogen into glucose (AKA BETA BLOCKERS) then
t t t t t t t t t t t t t t
CVS s/s wont occur
t t t t
DKA s/s - ANSWER: ➡ only in insulin dependent diabetics
t t t tt t t t t t
BGL 400-900 t
dehydrated (4-6L lost) t t
No circulating insulin
t t
+acidosis b/c body breaks down fat into ketones t t t t t t t
, Kussmaul (inc rate depth to blow off c02) t t t t t t t
DKA and HHNK treatment - ANSWER: ➡ insulin gtt
t t t t t tt t t
IVF (more for HHNK)
t t t
NS 1st- to hydrate vascular compartment
t t t t t
1/2NS to hydrate cell t t t
D51/2NS to prevent hypoglycemia t t t
**for every decrease in pH by 0.1, K+increases by 0.6
t t t t t t t t t
HHNK vulnerable population - ANSWER: ➡ OLD AGE (pancrease gets tired)
t t t t tt t t t t t
diet controlled diabetics
t t
people on TPN (gets 80% glucose IV->pancreatic fatigue
t t t t t t t
pancreatitis
HHNK s/s - ANSWER: ➡ BGL 1000-2000
t t t tt t t
Severe dehydration (6-8L lost) t t t
+insulin (prevents breakdown of fat) t t t t
No acidosis (baby breaths)
t t t
somogyi phenomenon - ANSWER: ➡ Rapid decrease in serum glucose, usually at night, that
t t t tt t t t t t t t t t
generates the release of glucose-elevating hormones that manifests as an elevated glucose level
t t t t t t t t t t t t t
in the morning.
t t t
dehydration is not a component of this t t t t t t
NPH peak - ANSWER: ➡ 6-10 hrs
t t t tt t t
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