Syndrome of inappropriate antidiuretic hormone secretion (SIADH) are?
"Soaked inside"
Seizures=KILLS!
Increase Blood pressure
Sticky Thick Urine
Kidney are not working propely!
Diabetes insipidus
"Dry Inside"
Decreased blood pressure=KILLS!
Dry skin
Diluted
Syndrome of inappropriate antidiuretic hormone secretion (SIADH) 7 S's?
1.Stop's urination (Low urine output)
*Decreased urine output
2.Sticky & THICK "urine" HIGH specific gravity 1.030+
Dark urine with increased specific gravity
3. Soaked Inside "Low & Liquidy"Labs. -HYPO osmolality (LOW)
*Low blood osmolality
-HYPOnatremia below 135 Na+ (LOW)
*Hyponatreamia
4. SODIUM Low!! (Headache Early Sign)
5. SEIZURES- Headache, confusion
6. SEVERE HIGH blood pressure
7. STOP ALL FLUIDS+GIVE Salt + Diuretics
(NO IV or drinking) + (IV 3% Saline+ Eat Salt)
Weight gain with edema!
sodium level below 135
Diabetes insipidus "Dehydrated"
"DIE " ADH !
7 D's are ?
1.DIURESE "Drain"
2. DILUTED urine Low specific Gravity (1.005)
*Low Urine Osmolality
3. DRY Inside "High & Dry" Labs
HYPER osmolality (HIGH)
*Increased serum osmolality
HYPERnatremia over 145 Na+ (HIGH)
4. DRINKING a lot "thirsty"
5. DEHYDRATED Dry Mucosa & Skin
6. DECREASED blood pressure
7. DESMOpressin "Vasopressin" (ADH)= Decrease Urine Output
Causes Death By Headache! (Low Na+)135 or Less
Causes Diabetes insipidus?
Damage to brain (Tumors,Trauma,Surgery)
Causes Syndrome of inappropriate antidiuretic hormone secretion (SIADH)?
Small cell lung cancer
Severe Brain Trauma(trauma/Surgery)
Sepsis infections of the brain (meningitis)
SIADH Vs. DI TREATMENTS
DAILY WEIGHTS
WEIGHT GAIN = Water Gain
When caring for a patient with SIADH, what does the nurse expect to implement? Select all that apply?
1.Fluid restriction
2.Seizure precautions
3.Monitor urine I & O (Intake & Output)
A client with a brain tumor develops Diabetes insipidus, which data should nurse expect to find? Select all that apply
High blood serum osmolality
Increased thirst
Sodium above 145
High urine output
Inappropriate antidiuretic hormone secretion (SIADH) Lab findings?
Low serum
Hemodilution
increase urine specific gravity
Low BUN
Diabetes insipidus finding labs?
Increase Serum sodium
Hemoconcentraction
decrease urine specific gravity
increase BUN
Inappropriate antidiuretic hormone secretion (SIADH) Clinical features?
Fluid retention without edema
Decreased body temprature --> hypothermia
oliguria
Normal to elevated blood pressure
Thirst despite fluid retention
Ranges of Urine specific gravity =1.005-1.030
Diabetes insipidus finding Clinical features?
Dehydration
Thready peripheral pulses
Orthostatic hypotension
polyuria (4-30 L/day)
Increased thirst
Addisons Disease =Absent Steroid LOW (Small, weak,tanned)
Low blood pressure "MOST CRITICAL" weight =Water loss
Low temp." Cold intolerance
Low Hair "alopesia"
Low Mood "depression"
Low Energy "Fatigue"
Low sodium BELOW 135 (Normal 135-145)
Low glucose
Slow or absent period (amenorrhea)
HIGH on
Pigmentation "Bronze pigment"
(NOT acanthosis nigricans)
Potassium (K+) OVER 5.0 (Normal 3.5-5.0)
Hyperkalemia
Potassium pumps
Muscle spasms
ECG: Peaked T waves, ST elevation
Cushings
Cushing of Steroid HIGH
Big,Round,Hairy
BIG Blood pressure (over 140 systolic ) Normal 120/80)
BIG Glucose & sodium Na+
BIG Belly "Truncal Obesity "
BIG Face "Mood Face"
BIG Buffalo hump "fat pad
BIG HAIR "Hirsutism"
BIG Stretch marks "Purple Striae"
BIG Red Face "rosy cheeks "
BIG Infection "Slow wound healing"
The nurse is assessing a client with hyperparathyroidism. Which of the following findings would support a diagnosis of hyperparathyroidism?
Nephrolithiasis
Hyperparathyroidism causes a client to develop hypercalcemia. While most clients are asymptomatic, clients may go on to develop manifestations such as nephrolithiasis, polyuria, confusion, constipation, and shortened QT interval. The client with hyperparathyroidism would cause the client to develop hypercalcemia, which increases the client's proclivity to develop nephrolithiasis. The reason for nephrolithiasis is that the urinary calcium levels are high, which makes conditions favorable for stone formation.
The nurse is performing discharge teaching for a client with Graves' disease.
Which of the following client statements indicates effective understanding?
"I should tell my physician if my blood pressure's top number exceeds 140."
Grave's disease is the most common form of hyperthyroidism. A significant complication of this condition is the potential for a thyroid storm. A thyroid storm is caused by a surge in thyroid hormone in the bloodstream, which causes the client to experience tachycardia, fever, hypertension, diaphoresis, and tachydysrhythmias.
The nurse is caring for a client prescribed propylthiouracil (PTU). To monitor the effectiveness of this medication, the nurse anticipates the primary healthcare provider will order a
Thyroid panel.
PTU is an antithyroid medication used in the treatment of hyperthyroidism. This medication is also emergently indicated if a client should develop a thyroid storm. To determine the effectiveness of the medication, the physician will monitor the client's thyroid panel for efficacy.
The nurse is reviewing the diet of the client with hypoparathyroidism. The nurse understands that the client should be on what type of diet?
High-calcium, low-phosphorus diet
A client with hypoparathyroidism is at risk of hypocalcemia and should therefore be on a diet high in calcium and low in phosphorus. The high calcium serves to increase the client's serum calcium levels. Since calcium and phosphorus have an inversely proportional relationship, the low phosphorus portion of this diet ensures that the client's phosphorus levels are reduced to the point of not interfering with the client's calcium levels.
The nurse has received an order to prepare a client for a water deprivation test.
The nurse understands that this test is used to diagnose?
diabetes insipidus (DI)
DI can be divided into either neurogenic (central) or nephrogenic. The water deprivation test is used to help differentiate whether the DI is neurogenic or nephrogenic. In this test, the client is deprived of water for up to eight hours (they may still eat dry foods). Serial labs, including plasma and urine osmolality measurements, are obtained during that time. Additionally, the client's urine volume and weight are meticulously measured hourly. If the client's body weight should decrease, this supports the diagnosis of DI. At the end of the eight hours, a dose of desmopressin is administered. If there is an increase in urine osmolarity and a decrease in urine volume, it is considered central/neurogenic DI (because the problem responded to the DDAVP). If no response is observed after the DDAVP is administered, nephrogenic DI is likely.
The nurse is planning care for a client experiencing a hyperglycemic hyperosmolar state (HHS).
Which prescription should the nurse anticipate from the primary healthcare provider (PHCP)?
Infusion intravenous fluids
Hyperglycemic-hyperosmolar state (HHS) is likely to develop in individuals with diabetes mellitus (type two). The client secretes just enough insulin to prevent ketosis in HHS but not enough to prevent hyperglycemia. Severe hyperglycemia causes an individual to experience significant diuresis, causing severe dehydration. Correcting fluid and electrolyte imbalances is essential for an individual with HHS. The clinical guideline is to infuse one liter of saline in one hour and reassess the client’s volume status thereafter. Hypotonic intravenous fluids (e.g., 0.45% saline) may be prescribed depending on the client's electrolytes.
The nurse is caring for a client immediately following transsphenoidal hypophysectomy. It would be essential for the nurse to obtain a prescription for which medication?
Ondansetron
Prophylactic nausea and vomiting prevention is essential following this surgery. If the client were to vomit, this would put pressure on the operative site and cause wound disruption. Following this surgery, the client is instructed not to cough, blow their nose, or sneeze. Vomiting should be avoided because it exerts pressure on the operative site, which is detrimental.
he nurse is preparing a presentation on Cushing's disease.
It would be correct if the nurse states that Cushing's disease is caused by?
Increase in the secretion of adrenocorticotropin hormone (ACTH).
Primary Cushing's disease is characterized by hypersecretion of ACTH from the pituitary gland, which is usually due to a pituitary adenoma. This causes the client to experience multisystem manifestations such as sodium and water retention, leading to weight gain, elevated blood glucose, delayed wound healing, and increased gastric acid secretion.
The nurse preceptor observes a newly hired nurse care for a client with a myxedema coma.
One of the clinical features of a myxedema coma is hypothermia. Passive warming of the client is an effective treatment measure for this emergency.
Hypothyroidism Signs & symptoms
"MOM'S SO TIRED"
Memory loss
Obesity
Malar flush (cheeks)
Slow, sluggish speech
Skin dryness
Onset gradual
Thinning hair
Intolerance to cold
Reduced energy & appetite
Enlarged thyroid
Depression
The nurse in the emergency department is caring for a client with diabetic ketoacidosis. After obtaining the client's blood glucose level, which prescription should the nurse implement First ?
Administer 0.9% sodium chloride 1,000 mL IV bolus
The nurse is caring for a client with syndrome Inappropriate antidiuretic hormone. which of the following actions should the nurse take?Select all that apply
Implement seizure precaution
Perform frequent neurological checks
Keep a strict record of fluid intake and output
The nurse is caring for a client with syndrome Diabetes insipidus . which of the following actions should the nurse take?
Administer vasopressin
The nurse in the intensive care unit is caring for a client who had a hypophysectomy 2 days ago and has developed diabetes insipidus. which action should the nurse take?
Administer Desmopressin
The nurse is caring for a client with diabetes mellitus.The client is ALERT AND ORIENTED but APPEARS SHAKY AND PALE.The client's capillary blood glucose level is 50mg/dL (2.8 mmol/L). Which of the following actions should the nurse take next?
Give the client 4 oz (120 mL) of regular soda.
Traditional manifestations of hypoglycemia in adults?
Altered mental status/anxiety
Shakiness
Diaphoresis
Clammy skin
Tachycardia
Hunger
Weakness/fatigue
The nurse is caring for a client with type 1 diabtes mellitus who is obtunded and responding ONLY TO PAINFUL STIMULI. A STAT blood samples reveals a blood glucose level of 38 mg/dL (2.11 mmol/L).Which initial action by the nurse is best?
Administer 1 mg glucagon IM
The client is teaching a group of clients with type 1 diabetes mellitus about hypoglycemia. Which of the following should the nurse include as sign or symptoms of hypoglycemia? Select all that apply.
Diaphoresis
Pallor
Trembling
The nurse is assessing a client with suspected syndrome of inappropriate antidiuretic hormone (SIADH).Which of the following findings would support a diagnosis of SIADH ? Select all that apply
Decreased serum osmolality
Elevated urine specific gravity
Decreased serum level
The nurse is assessing a client with suspected Diabetes insipidus.Which of the following findings would support a diagnosis of SIADH ? Select all that apply
Increased urine output
Elevated serum osmolality
The nurse is caring for a client with syndrome of inappropriate antidiuretic hormone (SIADH).Which of the following intervention should the nurse include in the plan of care?Select all that apply.
Implement seizure precautions
Monitor daily weights
Monitor serum osmolality
Perform frequent neurological checks
Place the client on fluid restrction