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NU404 Exam # 3 With Complete Solution
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NU404 Exam # 3 With Complete Solution ...
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NU404 Exam # 3 With CompleteSolution
What hormones are released from anterior pituitary? - Answer gonadotropin, growth
hormone, thyrotropin, and prolactin
S/S acromegaly - Answer large hands/feet, splenomegaly, increased sweating, coarse
features, supraorbital bulging, broadened bones, enlarged colon, loss of color
discrimination
complications following a hypophysectomy - Answer monitor for bleeding and nasal
drainage for possible CSF leak (assess drainage for glucose of halo sign); assess
neurological condition every hour for first 24 hours and every 4 hours after
- could lead to meningitis
lab values for diabetes insipidus - Answer increased sodium
increased serum osmolality
decreased urine osmolality
s/s of diabetes insipidus - Answer Polyuria
Polydipsia
Nocturia
Dilute Urine
Dehydration
Hypovolemic Shock
Decreased LOC
Increased HR
hypotension
weak pulse and accelerated
neurogenic DI medication treatment - Answer thiazide diuretics
Central DI medication treatment - Answer desmopressin to increase blood pressure and
help make kidneys more responsive to ADH
nursing interventions in DI - Answer - monitor vitals and I+O's
,- encourage hydration
- fluid replacement
- administer electrolyte replacements
- fall and seizure precautions
complications of DI - Answer - hypovolemia and shock
- severe dehydration
- circulatory collapse
- acute renal insufficiency
lab values SIADH - Answer decreased serum sodium and serum osmolality
increased urine osmolality
- very concentrated urine
s/s of SIADH - Answer seizures, s/s of fluid overload, malaise, confusion, weakness,
irritability, headache, neuro changes due to cerebral edema and increased ICP
medications for SIADH - Answer - first fluid restriction
- diuretics such as furosemide may be administered to increase urine output
- replace sodium if low by slow IV administration of 3% NS
what should you check before giving furosemide? - Answer potassium levels
s/s of addisonian crisis - Answer N/V, confusion, abdominal pain, extreme weakness,
hypoglycemia, dehydration, severe hypotension, loss of consciousness
major complication of addisonian crisis - Answer hypovolemic shock, seizures,
hypoglycemia, hyponatremia, hypotension
- if untreated death
Addisonian crisis triggers - Answer injury, surgery, or infection
- already in adrenal hypofunction
Treatment of Addisonian crisis - Answer IV Hydrocortisone
NS boluses
hormone replacements in Addison's disease - Answer cortisol, glucocorticoids, and
aldosterone
- taken for life
, s/s of Cushings disease - Answer hyperglycemia, hypokalemia, fluid retention, abnormal
fat distribution, muscle atrophy, purple stretch marks, easy bruising, skin thinning,
progressive proximal muscle weakness, decreased libido, emotional lability
Females: male sex characteristics, vocal changes, breast atrophy, and amenorrhea
cushings disease/syndrome - Answer HYPERsecretion of glucocorticoids
addisons disease - Answer adrenal insufficiency
lab values of cushings - Answer HYPERglycemia
HYPOkalemia
HYPERcortisolism
HYPERaldosteronism
HYPERnatremia
causes of Cushing's - Answer Excess corticosteroids, possibly adenoma tumor (possibly
in lungs) that excessively secretes cortisol and aldosterone
s/s of pheochromocytoma - Answer bounding pulses, widening pulse pressure,
vasoconstriction, tachycardia, hypertension, headaches, palpitations, hyperhidrosis,
hypermetabolism, hyperglycemia, palpitations, patterns of release/spells
pathophysiology of pheochromocytoma - Answer Catecholamine-secreting tumors of
the adrenal medulla and usually unilateral that secrete epinephrine and norepinephrine
in the body and occurs in episodes
Leads to hypertension, widening pulse pressure, tachycardia
interventions for pheochromocytoma - Answer preoperative: correct fluid volume
changes and manage hypertension
intraoperative: tx of hypertension --> nitroprusside
Postoperative: measure metanephrines to ensure resection completion
medications for pheochromocytoma - Answer alpha blocker, beta blockers, calcium
channel blockers, angiotensin blockers may be used
TX: adrenalectomy
triggers for DKA - Answer - most common in type 1
- infection, stress, and surgery
S/S of DKA - Answer Polydispia, polyuria, polyphagia, fruity breath, kussmaul breathing,
abdominal pain, changes in LOC, hot to touch, urinary incontinence, flushing,
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