Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NSG 420 Caring for Adult II > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

main adrenal problems

A

cushing’s, addison’s, hyperaldosteronism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what occurs in cushing’s syndrome?

A

increase in adrenal hormones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

causes of cushing’s

A
  • excess corticosteroids
  • ACTH-secreting pituitary adenoma
  • tumors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

manifestations of cushing’s

A

buffalo hump, moon face, striae on stomach, weight gain, increased BG, muscle wasting, thin hair and skin, acne, male characteristics in females (hair on body), female characteristics in males (gynecomastia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

treatment of cushing’s

A
  • decrease corticosteroids
  • surgery to remove tumor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what occurs in addison’s disease?

A

decrease in adrenal hormones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

addison’s is a _______ disease

A

autoimmune

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

causes of addison’s disease

A
  • all 3 corticosteroids are decreased (glucocorticoids, mineralocorticoids, androgens)
  • pituitary disease or suppression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

manifestations of addison’s disease

A

weight loss, hyperpigmentation of skin, cold intolerance, weak, fatigued, orthostatic hypotension, anorexia, nausea, abdominal pain, diarrhea, headache, salt craving, joint pain, depression, irritability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

addisonian crisis

A

sudden decrease in hormones due to stress, sudden withdrawal of steroids, adrenal surgery or pituitary gland destructions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

manifestations of addisonian crisis

A
  • decreased BP, increased HR
  • dehydrated: decreased Na+ and increased K+
  • decreased BG
  • fever
  • weakness, confusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

treatment of addison’s

A

lifelong hormone therapy (hydrocortisone)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

when should hormone therapy be increased?

A

when stressed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

when should hormone therapy be taken and why?

A

in the AM due to GI upset

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

causes of hyperaldosteronism

A
  • Na+ retention
  • K+ and hydrogen ion excretion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

manifestations of hyperaldosteronism

A

HTN with hypokalemic alkalosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

treatment of hyperaldosteronism

A
  • surgical removal of adenoma
  • K+ and diuretics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

main thyroid problems

A
  • graves disease
  • hypothyroidism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

graves’ disease

A

increased thyroid hormone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

graves’ is an ____________ disease

A

autoimmune

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

causes of graves’

A
  • toxic nodula goiter
  • thyroiditis
  • increased iodine intake
  • pituitary tumors
  • thyroid cancer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

manifestations of graves’

A

goiter, exopthalamous, weight loss, clubbing of fingers, anxiety, palpitations, tremors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

treatment of graves’

A
  • antithyroid meds
  • radioactive iodine
  • surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

thyrotoxic crisis/thyroid storm

A

increased thyroid hormone is released from stressors or being on meds for hypothyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

manifestations of thyroid storm

A
  • increased HR, HF, shock
  • hyperthermia
  • agitation, delirium, seizures
  • abdominal pain, vomiting, diarrhea
  • coma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what occurs in hypothyroidism

A
  • decreased thyroid hormone
  • slow metabolic rate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

causes of hypothyroidism

A
  • iodine deficiency
  • destruction of thyroid tissue
  • defective hormone synthesis
  • pituitary disease with decreased TSH
  • hypothalamic dysfunction with decreased TRH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

manifestations of hypothyroidism

A
  • tired, lethargic, neuro changes
  • weight gain
  • decreased CO
  • decreased exercise tolerance, SOB
  • increased cholesterol and triglycerides
  • cold and dry skin, hair loss, cold intolerance
  • constipation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

treatment of hypothyroidism

A
  • low calories
  • levothyroxine lifelong
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

myxedema

A

severe, longstanding hypothyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

manifestations of myxedema

A
  • alters physical appearance
  • puffiness, periorbital and facial edema
  • mask-like effect
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

what can myxedema lead to?

A

myxedema coma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what is myxedema coma precipitated by?

A

infection, drugs, cold, trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

type 1 DM

A

no insulin from pancreas; need to give a lot of insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

type 2 DM

A

diet, exercise, etc. are factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

normal BG

A

60-100

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

most common manifestations of DM

A

polyuria, polydipsia, polyphagia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

goal of an A1C

A

< 7.0%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

who is HHS more common in?

A

type 2 diabetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

causes of HHS

A

UTIs, newly diagnosed type 2, sepsis, acute illness, pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

manifestations of HHS

A
  • increased BG (>600) leading to neuro problems: coma, somnolence, seizures, hemiparesis, aphasia ~ looks like a stroke
  • lethargic
  • decreased BP, increased HR
  • peeing a lot (can’t replace fast enough), BUN and creatinine increased
  • no or little ketones
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

treatment of HHS

A
  • immediate IV insulin and NaCl (be careful with large volume fluids, they might have HF or kidney issues)
  • when BG reaches about 250, start IV dextrose to prevent hypoglycemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

who is DKA more common in?

A

type 1 diabetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

DKA characteristics

A
  • increased BG
  • ketosis
  • acidosis
  • dehydration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

causes of DKA

A
  • illness
  • infection
  • inadequate insulin dosage
  • undiagnosed type 1
  • lack of education
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

how do ketones form in DKA?

A

since body can’t use glucose for energy, it breaks down fat instead -> ketones -> ketosis -> acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

manifestations of DKA

A
  • increased HR, orthostatic hypotension
  • dehydration
  • lethargic, weak
  • anorexia, N/V
  • acetone, sweet fruity breath
  • kussmaul RR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

treatment of DKA

A

F/E replacement, starts dextrose when BG around 250

49
Q

what do you want to check for before starting insulin?

A

potassium levels ~ it can decrease it even more ~ replace first before starting insulin

50
Q

immunologic disorders of the kindeys

A
  • glomerulonephritis
  • APSGN
  • chronic glomerulonephritis
  • goodpasture syndrome
  • rapidly progressive glomerulonephritis
  • nephrotic syndrome
51
Q

prerenal AKI

A

factors that reduce systemic circulation -> decreased BF

52
Q

example of prerenal AKI

A
  • dehydration
  • HF
  • decreased CO
  • nonretaining BF
53
Q

intrarenal AKI

A

includes problems that cause direct damage to kidneys

54
Q

examples of intrarenal AKI

A
  • prolonged ischemia
  • nephrotoxins
  • Hgb. released from hemolyzed RBCs
  • myoglobin released from necrotic muscle cells
  • acute tubular necrosis
55
Q

postrenal AKI

A

involves mechanical obstruction in the outflow of urine

56
Q

examples of postrenal AKI

A
  • BPH
  • prostate cancer
  • stones
  • trauma
  • extrarenal tumors
  • leads to hydronephrosis
57
Q

which two types of AKI resolve quickly if treated?

A

prerenal and postrenal

58
Q

three phases of AKI manifestations

A

oliguric, diuretic, recovery

59
Q

oliguric phase

A
  • occurs within 1-7 days and can last for 2 weeks
  • S/S: no or little urine output (<400 mL/day), hypovolemia, fluid retention, metabolic acidosis, increased K+, decreased Na+, leukocytosis, increased BUN and creatinine, fatigue, seizures, coma
60
Q

diuretic phase

A
  • can last 1-3 weeks
  • S/S: daily urine output is 1-3 L, up to 5 L, inability to concentrate urine, hypovolemia, hypotension, F/E imbalance
61
Q

recovery phase

A
  • up to 12 months
  • S/S increased GFR, BUN and creatinine decrease
62
Q

what happens if a patient does not recover from AKI?

A

CKD -> ESRD

63
Q

a good diagnostic test for AKI at first

A

US

64
Q

treatment of AKI

A
  • eliminate cause
  • manage S/S
  • prevent complication
  • diuretics
  • adequate calories to prevent breakdown of proteins
  • Na+ restriction
  • increased fat intake
65
Q

method for treating AKI

A

CRRT

66
Q

CRRT

A
  • continual renal replacement therapy
  • uremic toxins and fluids removed, taking workload off heart
  • ultrafiltrate should be clear yellow
67
Q

what is more prevalent: AKI or CKD?

A

CKD

68
Q

5th stage of CKD meaning

A

GFR <15 -> dialysis or transplant

69
Q

causes of CKD

A
  • DM
  • HTN
  • obesity
  • increased age
  • glomerulonephritis, cystic disease, urologic disease
70
Q

manifestations of CKD

A
  • uremia, fluid retention
  • hyperglycemia, hyperinsulinemia
  • increased triglycerides, increased K+
  • urine odor of breath
  • neuro changes
  • CKD-MBD
71
Q

most common cause of death in CKD

A

CVD

72
Q

how would insulin work in CKD?

A

they might require less

73
Q

labs for CKD

A

decreased GFR, increased BUN and creatinine, proteinuria, albuminemia, biopsy

74
Q

treatment for CKD

A

control BP, reduce CVD risks, protein restriction, fluid restriction with HD, Na+ and K+ restriction, phosphate restriction

75
Q

gastric ulcer S/S

A
  • 1-2 hours after meal
  • burning or gaseous
  • high recurrence
76
Q

where do gastric ulcers occur

A

in any part of stomach

77
Q

where to duodenal ulcers occur?

A

in the small intestine

78
Q

S/S of duodenal ulcers

A
  • 2-5 hours after eating
  • burning or cramplike
  • midepigastric pain
  • back pain
  • occur, disappear, recur
79
Q

major risk factor for PUD

A

H. pylori infection

80
Q

complications of PUD

A

bleeding, perforation, gastric outlet obstruction

81
Q

types of upper GI bleed

A

hematemesis, melena, occult

82
Q

fast bleeding =

A

bright red blood

83
Q

slow bleeding =

A

coffee ground, black, tarry

84
Q

how do we determine where an upper GI bleed is?

A

endoscopy

85
Q

treatment of upper GI bleed

A
  • IV fluids, blood, packed RBCs, plasma
  • endoscopy
  • surgery
  • PPIs
  • NGT
86
Q

acute abdominal pain causes

A

damage to organs in abdomen or pelvis which leads to inflammation, infection, obstruction, bleeding, and perforation

87
Q

acute abdominal pain manifestations

A

pain, N/V, diarrhea, constipation, fever, flatulence, fatigue, rebound, tenderness, bloating

88
Q

fetal position meaning

A

peritoneal irritation (appendicitis)

89
Q

supine position meaning

A

visceral pain

90
Q

treatment for acute abdominal pain

A

treat cause, pain meds, surgery consult

90
Q

restless meaning

A

kidney stones or gallstones

91
Q

type of acute abdominal pain

A

abdominal trauma

92
Q

what can abdominal trauma put you at risk for?

A

peritonitis

93
Q

treatment for abdominal trauma

A

lavage, NG tube

94
Q

should you remove impaled objects during an abdominal trauma?

A

no, it is stopping the bleeding

95
Q

causes of chronic abdominal pain

A

IBS, PUD, chronic pancreatitis, PID, adhesions, vascular insufficiency

96
Q

manifestations of chronic abdominal pain

A

dull, aching, diffuse

97
Q

two forms of IBD

A

chron’s and UC

98
Q

chron’s disease

A
  • any segment of GI tract affected
  • skip lesions ~ cobblestone appearance
  • involves all layers of the bowel wall so abscess is common
99
Q

ulcerative colitis

A
  • limites to colon
  • occurs in mucosal layer
  • can go up to 20 times/day
100
Q

manifestations of IBD

A

diarrhea, weight loss, abdominal pain, fever, fatigue

101
Q

complications of IBD

A

hemorrhage, strictures, perforation, abscesses, fistulas, CDI, toxic megacolon

102
Q

treatment of IBD

A

rest bowel, control inflammation, malnutrition, symptom relief

103
Q

most common cause of acute pancreatitis

A

gallbladder disease

104
Q

second most common cause of acute pancreatitis

A

alcohol use

105
Q

manifestations of acute pancreatitis

A

abdominal pain in LUQ, N/V, fever, leukocytosis, hypotension, increased HR, jaundice, guarding, decreased bowel sounds, crackles, bruising, shock

106
Q

complications of acute pancreatitis

A
  • pseudocyst, abscess
  • atelectasis
  • tetany
  • abdominal compartment syndrome
107
Q

what labs are important in the pancreas?

A

amylase and lipase

108
Q

treatment for acute pancreatitis

A

pain relief, correct F/E, suppress enzymes (NPO and NGT), prevent infection, surgery on gallbladder

109
Q

most common cause of nonobstructive chronic pancreatitis

A

alcohol use

110
Q

most common cause of obstructive chronic pancreatitis

A

gallstone inflammation and cancer

111
Q

manifestations of chronic pancreatitis

A

abdominal pain more frequent, malabsorption with weight loss, constipation, jaundice, dark urine, steatorrhea, DM

112
Q

treatment for chronic pancreatitis

A
  • small, frequent bland diet
  • decrease smoking, alcohol, and caffeine
  • enzyme replacement with every meal
  • insulin if becomes diabetic
  • endo. therapy
  • surgery
113
Q

early S/S of cirrhosis

A

fatigue, enlarge liver, normal blood tests (compensated)

114
Q

late S/S of cirrhosis

A

jaundice, portal HTN -> edema, ascites, skin lesions, coagulation problems, anemia, female characteristics in males

115
Q

complications of cirrhosis

A

portal HTN, varices, peripheral edema, ascites, hepatic encephalopathy, hepatorenal syndrome

116
Q

most life-threatening complication of cirrhosis

A

varices

117
Q
A

NSG 420 Caring for Adult II (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions