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NURS 642 (Nephrology) EXAM 3 STUDY GUIDE LATEST UPDATED RATED A. $15.49   Add to cart

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NURS 642 (Nephrology) EXAM 3 STUDY GUIDE LATEST UPDATED RATED A.

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NURS 642 (Nephrology) EXAM 3 STUDY GUIDE LATEST UPDATED RATED A.

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  • November 6, 2024
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  • 2024/2025
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  • nurs 642
  • nurs 642 nephrology
  • NURS 642
  • NURS 642
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NURS 642 (Nephrology) EXAM 3 STUDY
GUIDE LATEST UPDATED RATED A.
Adrenocortical Insufficiency Lab Findings
✔✔Cosyntropin is unable to stimulate an increase in serum cortisol >20


Plasma ACTH level elevated


Acute Adrenal Insufficiency Symptoms
✔✔headache, lassitude, N/V/D, abdominal pain


confusion, coma, high fever, dehydration


hypotension, shock, recurrent hypoglycemia


Adrenocortical Insufficiency DDX
✔✔other causes of hypotension/shock


other causes hyperkalemia


other causes hyponatremia


isolated hypoaldosteronism

,secondary adrenal insufficiency (hypopituitarism)


Adrenocortical insufficiency Lab Findings
✔✔Hyponatremia, Hyperkalemia, Hypercalcemia, Hypoglycemia


Plasma Cortisol level <3


COsyntropin stim test is positive


Plasma ACTH markedly elevated (>200)


Diagnostics for Adrenocortical Insufficiency
✔✔CT Abd to assess adrenal glands---enlargement (neoplasm, granuloma)
calcification (pheochromocytoma)


Adrenocortical Insufficiency Treament
✔✔corticosteriod replacement (hydrocortisone in acute, pred in OP)


most cases require fludrocortisone (mineralcorticoid) replacement as well


Treat infections immediately


Treat hypoglycemia with D5W

,careful monitoring of electrolytes, renal function


Cushing syndrome general considerations
✔✔excessive corticosteroids, generally caused by corticosteroid drugs


Cushing Disease general considerations
✔✔ACTH hypersecretion from pituitary adenoma or nonpituitary neoplasm


more than 3x more common in women than men


Cushing Syndrome S&S
✔✔Central Obesity, moon face, buff hump


supraclavicular fat pads, protuberant abdomen, thin extrem


muscle atrophy causes weakness


sexual dysfunction


acne, superficial skin infections, easy bruising, impaired wound healing


hirsutism

, Cushing DDx
✔✔Chronic alcoholism


DM


Depression


Primary hyperaldosteronism


Cushing labs
✔✔Hyperglycemia, Hypokalemia without hypernatremia


Leukocytosis


Midnight serum cortisol level >7.5 indicative


24 hour free cortisol and creatinine


Plasma ACTH after dx <20 indicates prob adrenal tumor . High or norm ACTH
indicates pituitary or ectopic tumors


Cushings Diagnostics
✔✔MRI pituitary

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