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NUR 265 HESI Med Surg Questions With Answers Graded A+ Assured Success $8.39   Add to cart

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NUR 265 HESI Med Surg Questions With Answers Graded A+ Assured Success

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SIADH Pituitary (Hypothalamus) - Excess ADH (vasopressin), fluid overload Cause: SSRI's, Small Cell Lung Therapy Manif: Dillusional Hyponatremia (below 115), LOC, seizure, coma, loss deep tendon reflexes, hypothermia, bounding pulse Interv: Tolvaptan / Conovaptan - promotes water excretion w/o ...

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  • September 10, 2024
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  • NUR 265 HESI Med Surg
  • NUR 265 HESI Med Surg
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PatrickKaylian
NUR 265 HESI Med Surg
SIADH Pituitary (Hypothalamus) - Excess ADH (vasopressin), fluid overload

Cause: SSRI's, Small Cell Lung Therapy

Manif: Dillusional Hyponatremia (below 115), LOC, seizure, coma,

loss deep tendon reflexes, hypothermia, bounding pulse

Interv: Tolvaptan / Conovaptan - promotes water excretion w/o NA

loss, Admin in Hospital (Black Box)

Diuretics

Hypertonic Saline #% Sodium Chloride

Restrict fluid intake 600mL

#1 monitor lung sounds (ABC's)



Hemodialysis - Pharmokenetic excretion adversely affected

Monitor for digtoxicity / hyperkalemia / dillusional hyponatremia

3 requirements: access to blood, semipermeable membrane, dialysate

More Effective/ Shorter time

#1 Complication - Disequilibrium Syndrome causing ICP

Admin Anticonvulsants (Dilantin)



Peritoneal Dialysis - Monitor Albumin

#1 Complication - Peritonitis leads to septic shock

Ridge Board Like Abdomen

Cloudy Excretion - Infection

Interventions: heparinization required

weigh before / after, acquire baselines

^ protein intake - excreted at dialysis

Teaching: know signs for peritonitis, cloudy excretion, monitor

,glucose for hyperglycemia



Dialysis Air Embolism - clamp catheter

Patient Left Lateral Trendelenburg

Notify Physician

Admin Oxygen



DKA - Lacks insulin, DMI (insulin dependent), Ketones

Sudden Onset - infection, injury, stress

Uncontrolled hyperglycemia

Met. Acidosis - Kussmaul Respirations

Polyuria / dipsia / phagia

Dehydration, Osmotic Diuresis 6 - 10 L

Glucose >250

Interventions: #1 assess airway, #2 LOC, #3 Hydration (Dextrose)

Admin Insulin

Before Admin IV K+ assure output 30ml +




ARF Post Renal - Renal Calculus: Lithiasis, BPH

Risk for Hyperparathyroidism ^ Calcium

Pathological Fractures

Prevent Volume Depletion

Manif: low urine output, decreased BP / Pulse

Orthostatic Hypotension, thirst

^ Blood Osmolarity

, HHNKS - DMII, Insulin Resistant, Gradual Onset

Glucose >600

Major factor is obesity

Worse Diuresis / Dehydration

Neurological - coma, seizures, stroke

Met. Alkalosis

Interventions: #1 Hydration, #2 LOC

Admin Insulin restoring glucose w/I 72hrs

Evaluate Fluid Volume / Daily Weights

Teaching: store unopened insulin vials in refrigerator or room temp

for 28 days

Draw regular insulin into syringe first when mixing insulins

Exercise decreases blood sugar levels

Sick Days: keep taking insulin

monitor glucose more frequently

watch for signs of hyperglycemia

**If in doubt if hyper / hypo glycemic, treat for hypoglycemia



Hypoglycemia - Glucose <70, rapid decline

Excess Insulin, wrong time / type

Manif: #1 early -Neurogenic (Cholinergic / Adrenergic)

#2 Central Neuroglycopenic: confusion, seizure, coma

Interv: Mild - admin carbs / protein

Severe -admin Glucagon

Teach: avoid exercise / alcohol

New bottle Insulin / more potent

Change injection site

Med Alert Bracelet / Carry carb snack

Drink alcohol with food / after meal

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