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Level 3 > Complex Exam 4 - metabolism: posterior pituitary > Flashcards

Complex Exam 4 - metabolism: posterior pituitary Flashcards

1
Q

What type of respirations occur with SIADH?

A

cheyne-stokes

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2
Q

What can decreased sodium cause with SIADH?

A
  • personality changes (hostility)
  • decreased DTR’s
  • N/V/D
  • oliguria with dark yellow concentrated urine
  • S/C/D
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3
Q

What does FVE look like with SIADH?

A
  • tachycardia
  • bounding pulses
  • HTN
  • crackles
  • JVD
  • taut skin
  • weight gain w/o edema
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4
Q

What is the urine chemistry result of SIADH?

A
  • concentrated
  • increased Na
  • increased osmolarity
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5
Q

What is the blood chemistry result of SIADH?

A
  • dilute
  • decreased Na
  • decreased osmolarity
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6
Q

When should SIADH medication demeclocycline be avoided?

A
  • with impaired kidney function
  • calcium
  • iron
  • magnesium
  • antacids
  • milk products
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7
Q

What should you monitor for with SIADH medication demeclocycline?

A
  • yeast infection
  • diarrhea
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8
Q

What is the purpose of giving tolvaptan or conivaptan for SIADH?

A

promotes excretion without sodium loss

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9
Q

What should be monitored with SIADH medications tolvaptan and conivaptan?

A
  • glucose
  • sodium
  • I&O’s
  • bowel patterns
  • dehydration
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10
Q

What should be done frequently with SIADH medications tolvaptan and conivaptan?

A

oral care

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11
Q

What should be monitored with loop diuretics used for SIADH?

A

hyponatremia: N/V, decreased appetite

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12
Q

What rate should hypertonic sodium chloride be given for SIADH?

A

no faster than 1 mEq/hr for a total of 200-300 mL

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13
Q

What should be monitored with hypertonic sodium chloride for SIADH?

A
  • hypervolemia: weight gain, difficulty breathing
  • neuro changes, tremors, disorientation
  • central pontine demyelination: permanent parkinson’s-like state
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14
Q

What is the priority intervention for SIADH?

A

restricting oral fluids to 500-1000 mL/day

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15
Q

What comfort measures can be given for thirst with SIADH?

A
  • mouth care
  • lozenges
  • ice chips
  • staggered water intake
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16
Q

What vital sign changes occur with SIADH?

A
  • increased BP
  • increased HR
  • decreased temp
17
Q

What should be reported for SIADH?

A

weight gain of 2.2 lbs/1 kg

18
Q

What precautions are needed for SIADH?

A

seizure precautions

19
Q

What should enteral and gastric tubes be flushed with for SIADH?

A

NS

20
Q

Do the 3 P’s occur with DI?

A

yes

21
Q

How much output usually occurs per day with DI?

A

4-30 L of dilute urine

22
Q

What dehydration symptoms occur with DI?

A
  • loss/absence of skin turgor
  • dry mucous membranes
  • weak/fatigue
  • poor peripheral pulses
  • decreased cognition (confusion)
  • weight loss
  • dry, cracked lips
23
Q

What happens to BP and HR with DI?

A
  • tachycardia
  • hypotension
24
Q

What type of diet should be promoted with DI?

A

a diet that restricts diuresis (NO caffeine, coffee)

25
Q

What safety considerations should be used with DI?

A
  • side rails up while in bed
  • assistance with ambulation
  • easy access to bedpan and bathroom
26
Q

Why is IV therapy used with DI?

A
  • F&E replacement
  • ADH replacement
27
Q

What labs should be monitored with DI?

A
  • K
  • Na
  • BUN/creatinine
  • specific gravity
  • osmolarity
28
Q

What should be done if a DI patient experiences constipation?

A

add bulk foods and fruit juices to their diet

29
Q

What can happen with DI medication desmopressin?

A
  • HA
  • confusion
  • water toxicity
30
Q

What should a DI patient be educated on with desmopressin?

A

it is a lifelong medication

31
Q

What should be increased in the diet of someone with DI?

A

fiber

32
Q

What should be restricted with DI?

A
  • fluids
  • alcohol
33
Q

What causes decreased ADH with primary DI?

A

defects in the hypothalamus or pituitary gland

34
Q

What causes secondary DI?

A
  • head injury
  • infection (meningitis)
  • tumor @/near the hypothalamus or pituitary gland
  • brain surgery
35
Q

What causes nephrogenic DI?

A

ADH is produced but not responded to

36
Q

What medications can cause drug-induced DI?

A
  • lithium carbonate
  • demeclocycline

Level 3 (29 decks)

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