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NUR 201 > Exam 4 > Flashcards

Exam 4 Flashcards

1
Q

Most pituitary tumors are malignant/benign resulting in over secretion of the hormones supplied by the gland

A

benign

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2
Q

Removal of the pituitary is called

A

transphenoidal hypophysectomy

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3
Q

Patients who have had a transphenoidal hypophysectomy will likely need lifelong replacement of what?

A

thyroid hormones, glucocorticoids, and mineralcorticoids

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4
Q

Nose drip pad with glucose indicates what?

A

CSF leak

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5
Q

After pituitary removal, lack of ADH may cause what condition, requiring need to monitor urine specific gravity?

A

Diabetes Insipidus

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6
Q

What should a pt NOT do s/p transphenoidal hypophysectomy?

A

No blowing nose, coughing, sneezing, straining to BM, brushing teeth, or bending. Elevate HOB & report post nasal drip.

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7
Q

Vasopressin is also known as what? Also, it is a potent what?

A

Anti diuretic hormone; potent vasoconstrictor

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8
Q

S/S of Diabetes Insipidus are:

A 
thirst (polydispsia)   
nocturia  
tachycardia   
fatigue    
5-20L a day (up to 1,000 cc/hr)   Can not concentrate urine
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9
Q

SIADH is a syndrome of what?

A

Inappropriate ADH- too much anti diuretic hormone.

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10
Q

Problems caused by SIADH are:

A 
< UO   
weight gain (water weight)   
<Na (lost in urine)/hyponatremia   
non pitting edema  
confusion  
seizures
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11
Q

Tx for SIADH

A

fluid restrict; may give 3% saline; lasix if Na 125 or >, HOB flat

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12
Q

Pheochromocytoma is

A

a benign tumor = severe hypertention

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13
Q

Addisons Disease

A

adrenocortical insufficiency- auitoimmune

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14
Q

Addison’s Disease is a decrease in:

A

cortisol, mineralcorticoids, and androgens

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15
Q

Adrenal insufficiency has:

A

K

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16
Q

Tx for Addison’s

A

hydrocortisone…pts should have 100 IM hydrocortisone on them and wear a medi alert bracelet
Times of stress call for > of hydrocortisone & >Na

17
Q

Testing for Addison’s includes

A

ACTH stimulation test- adrenals will release cortisol if they’re working

18
Q

Addisonian crisis s/s are

A

sudden, penetrating pain in lower back, abdomen, legs
severe vomiting/diarrhea
low BP
often triggered by stress, infection, or surgery

19
Q

Tx for Addisonian crisis

A

rapid admin of NS
Hydrocortisone IV
Insulin and dextrose

20
Q

Cushings Disease and Syndrome have:

A

> Na
BS
BP

<K

21
Q

Cushings/hypercortisolisms causes

A 
fluid retention & weight gain
CHF
insomnia psychosis
hyperglycemia (glucose intolerance and insulin resistance)
osteoporosis
muscle wasting
fragile skin
peptic ulcer
22
Q

To Dx Cushings, do a

A

dexamethasone suppression test

23
Q

Tx for Cushings

A 
Hydrate
Meds
Radiation
surgically remove primary adenomas
Hypophysectomy
Adrenalectomy
24
Q

If both adrenals are removed (bilateral adrenalectomy), what must be replaced for life?

A

glucocorticoids

25
Q

Teaching for adrenalectomy

A 
glucocortioid replacement if bilateral
medi alert bracelet
daily weights
regular f/u visits
Avoid NSAIDs, caffeine, ETOH, and smoking
26
Q

S/S of hypokalemia are

A

muscle weakness, paresthesias, fatigue

27
Q

S/S of hypernatremia are

A

HTN, headache, visual changes

28
Q

Hyperaldosteronism affects the renal tubules causing

A

hypernatremia (>Na)

hypokalemia ( pH due to hydrogen loss)

29
Q

Tx for hyperaldosteronism

A 
remove adrenals (adrenalectomy)
diuretics
30
Q

Pheochromocytoma is

A

an adrenal tumor that releases catecholamines (epinephrine and nor epinephrine- most often benign

31
Q

S/S of a Pheochromocytoma are

A 
intermittent HTN episodes
severe headaches
palpitations
diaphoresis
flushing
apprehension
impending doom
can be triggered by abdominal palpation
32
Q

Tx for Pheochromocytoma

A

remove one or both adrenal glands
do not palpate abdomen pre op
monitor for BP changes

33
Q

The best time to take exogenous glucocorticoids is

A

in the AM before 9 to minimize HPA suppression

34
Q

Someone with Cushing syndrome should eat a diet that is

A

high in protein
high in potassium
low in sodium

NUR 201 (1 decks)

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