Nurs 210 Test 1 Endocrine

Front 1

Diabetes insipidus

Back 1

A disorder of water metabolism caused bey def ADH either a decrease in ADH synthesis or an inability of kidneys to respond appropriately to ADH.

Front 2

ADH deficiency results in?

Back 2

the excretion of lg amts dilute urine. Due to without ADH the distal tubules and collecting ducts of kidney are impermeable to water. The water is excreted as urine rather than being absorbed.

Front 3

Polyuria

Back 3

excessive urination with loss of free water.

Front 4

How is dehydration caused?

Back 4

the massive diuresis results in an increase plasma osmolarity which stimulate the osmoreceptors to relay the sensation of thirst to cerebral cortex.

Front 5

Nephrogenic diabetes insipidus

Back 5

an inherited disorder. the renal tubules do not respond to the action of ADH which causes inadequate water reabsorption by the kidneys. the actual amount of hormone produced is no deficient.

Front 6

primary diabetes insipidus

Back 6

caused by a defect in the hypothal or pit gland resulting in lack of ADH production or release.

Front 7

Secondary diabetes insipidus

Back 7

result from tumors within or adjacent to the hypothal or pit gland, head trauma,infectious process, surgical proceduresor metastatic tumors

Front 8

Drug related diabetes insipidus

Back 8

is caused by admin of lith caronate and Declomycin. these drug interefere with kidneys response to ADH.

Front 9

Name the key features of Diabetes insipidus for Cardio.

Back 9

Hypotension
Decreased pulse pressure
tachycardia
perph pulse weakness
increase hgb hct.

Front 10

key renal features of Diabetes insipidus

Back 10

increase urine output
dilute, low spec gravity
Hypo-osmolar

Front 11

Key integ features of Diabetes insipidus

Back 11

poor turgor

dry mucous membranes

Front 12

Key neuro features of Diabetes Insipidus

Back 12

Increase thirst
irritability
decreased cognition
hyperthermia
lethargy to coma
ataxia

Front 13

Name nursing interventions for Diabetes Insipidus

Back 13

aimed at early detection of dehydration and the maintenece of adequate hydration. accurately measure I&O urine spec gravity and daily wts.
encourage pt to take in fluids equal to urine output. if IV check patency of cath and watch how much infused each hour.

Front 14

What med is given to clients with permanent Diabetes insipidus?

Back 14

vasopression

Front 15

Clients should know polyuria and polydipsia are signals for what?

Back 15

need for another dose of medication.

Front 16

What do clients taking vasopressin need to do daily?

Back 16

weigh self on same scale same time of day wearing similar clothing. if weight gain notify Dr. also should wear a medical bracelt to Id problem.

Front 17

What is the syndrome of inapproppriate antidiurectic hormone? (SIADH)

Back 17

when vassopressin (ADH) is secreted even when plasma osmolality is low or normal.
in SIADH the feedback mech that regulate ADH do not function properly.

Front 18

Name symptoms of SIADH

Back 18

Water Retention
Gi disturbances loss of appetite N& V.
Change of level of consciousness is an early sign of SIADH. letargy ha disorientation seizure and coma. deep tendon reflexes may be sluggish. tachycardia(caused by increased fluid vol) hypothermia caused by cns disturbance.

Front 19

What are the interventions for SIADH?

Back 19

Resrict fluid intake
promote sectretion of water, replace lost sodium
Diuecrics are sometimes given.
Hypertonic saline 3% NaCl is given.
watch closely for fluid vol overload..

Front 20

How will nurse provide safe enviroment for pt with SIADH?

Back 20

watch for change in neuro status

assess for subtle changes such as muscle twitchingbefore progress to seizure or coma.

orientation to time,place, person checked q2hrs.

noise and lights reduced to prevent overstimulation.

Front 21

Name the primary causes of Adrenal Insufficiency

Back 21

idiopathic disease
TB
Metastatic ca
fungal lesions
AIDS
Hemorrhage
gram neg sepsis
adrenalectomy
abdomial radiation therapy
drugs and toxins

Front 22

Name the sec causes of Adrenal insufficiency.

Back 22

Pit tumors
Postpartum pit necrosis
Hypophysectomy
high dose pit radiation
high dose whole brain radiation

Front 23

What is the nursing care for the client with acute adrenal insuff?

Back 23

Before tx obtain cbc,electrolyte,blood urea nitrogen and plasma cortisol levels as ordered by the dr.
give an initial dose of hydocortisone sodium 100-300mg Ivto infuse over 8 hrs.
after resolution of crisis adjust dosage ordered by dr.

Front 24

What are the key neuromuscular features of adrenal insuff?

Back 24

muscle weakness
fatigue
joint/muscle pain

Front 25

key Gi features of Adrenal Insuff?

Back 25

Anorexia
N&V
ab pain
bowel changes
wt loss
salt cravings

Front 26

Key Integ features of Adrenal insuff

Back 26

Vitiligo

hyperpigmentation

Front 27

key cardio features of adrenal insuff

Back 27

anemia
hypotension
hyponatremia
hyperkalemia
hypercalcemia

Front 28

nurse interventions for adrenal insufficency

Back 28

promote fluid balance and monitor for fluid deficit.weigh pt daily. I&O,vital signs every 1-4 hrs.

Front 29

what is the normal sodium range?

Back 29

136-145 meq/ml

Front 30

what is he normal potassium range?

Back 30

3.4-4.5 meq/L

Front 31

Glucose range

Back 31

74-106 mg/Dl

Front 32

normal calcium

Back 32

8.6-10.0 mg/dl total

4.6-5.08mg/dL ionized

Front 33

Leukocytes normal range

Back 33

20-40%

Front 34

bun normal range

Back 34

6-20mg/L