final part 4

Question 1

Management of Hyperos hypergly

Answer 1

Similar to DKA, more fluid, might need a foley, breath sounds, IV- normal half normal, add dextrose at 250, insulin electrolytes, watch cardiac, renal, Mental status.

Question 2

What is the number for hypoglycemia

Answer 2

less than 70

Question 3

Types of DI and about them

Answer 3

Central- Interference with ADH production tumors, infections, brain surgery
Neph-kidneys wont respond- Lith, renal damage
primary- Thirst issues

Question 4

Manifestations of di 5 causes with with r/t s/s

Answer 4

polydipsia, polyuria,- 2-20 l a day with low SG
Increased plasma osmolality
Sleepy from nocturia
dehydration-thirst, hypo, tachy, shock
Hyperna+ irritable, mental dullness, coma

Question 5

DI and three things to watch for one thing to teach

Specific tx for neph and central-

Answer 5

Hyperna+-Watch s/s, hypotonic solutions, dextrose-watch glucose and its diuretic effect.
Increase fluids-DDAVP and aqueous vassopressin
FVD- Thirst- CLor and carban, I and O, Vitals-esspecially volume rt, Specific gravity, daily weights, flushed skin- sign of FVD
Long term mat
Nephro-Fluids and decrease Na+ no hormones, thiazides, indometh-NSAID and increases kid sensitivity.

Question 6

Explain test for DI

Answer 6

Water deprivation test 
before test measure body weight, urine osmo, volume, and sg
no water for 8-12 hr
Give presser 
Central-increse urine osmo
nephro- no increase in urine osmo

Question 7

Myedexema coma

Answer 7

Long standing hypothyroidism from acculumulation of hydrophilic monopolysacerides, in dermis and tissue

Question 8

Myedex coma s/s 5

caused by?

Answer 8

Puffy face and peri orbital,
coma-mentally slow, drowsy, lathargic
infection, drugs, cold, trauma, stopping tx

Question 9

Manifestaions of My coma 4

Answer 9

Subnormal temp, hypotn, hypovolemia, cardiac collapse- hypovent, hypona hypogly lactic acidosis,

Question 10

Care for myex coma

two drugs

Answer 10

Mechanical respiration, cardiac monitoring, temp, skin care, vitals weights i LOC
IV thyroid hormone vassopressors

Question 11

Cushings cause
types
Common

Answer 11

Over exposure to corticosteroids, iatrogenic- prednisone, ACTH Secreting pituitary adneoma or adrenal tumor
Ectopic-Tumors somewhere else- lungs and pancreas
women 20-40

Question 12

Manifestations that you don’t know of chushings

Answer 12

hyperglycemia, mm weak and atrophy, osteoporosis, weak skin, delayed wound healing, hypoK, hypertn, acne, buffalo hump edema, awkward gate, CNS changes, GI increased Acid, bruise and petechiae

Question 13

What tests would you expect with cushings.

Answer 13

MRI or CT for tumor, Plasma ACH- low or high, blood penias-white, glucose in urine, hyperca, hypo k and alkolosis

Question 14

TX for cushings

Answer 14

Radiation- for those who can’t have surg,
surgery
drugs-destroy adrenal-ketoconazole and mitotane
Mifepristone0 for hypergly

Question 15

What to watch for with cushings

Answer 15

Thrombolytic event, medical alert bracelet, no extreme temps, may need more steroids for stress, watch for infection and OSHTN

Question 16

Addisons causes

Answer 16

TB, amylodisis, fungal infection, AIDS, meta cancer. chemo, ketoconazole, bilat adrenoectomy, Anticoag therapy

Question 17

pheochromcytoma

Answer 17

Tumor in the medulla affecting chromaffin cells aka catecolamines

Question 18

pheochromcytoma s/s 7

Answer 18

Severe pounding HA, High BP, tachy, chest pain, diaphoresis ab pain

Question 19

Causes of pheochromcytoma 10

Answer 19

direct trauma, stress, sex, alcohol, smoking, drugs antihypertensives, opioidsm contrast, tri antidepressants,

Question 20

tx of pheochromcytoma

Answer 20

Alpha and beta blockers sin and lol surg decrease bp and dysr
watch orthp

Question 21

ANION GAP

Answer 21

(na+-k+)- (Cl+HCO3)

normal 8-10

Question 22

stoma colors 
rose to brick pink 
pale
blanching, dark red to purple
small blood

Answer 22

Rose- viable stoma mucosa
maybe anemia
inadequate blood supply
when touched is normal from high vascularity

Question 23

bile billy and ammonia

Answer 23

Bile salts aid in digestion by making cholesterol, fats, and fat-soluble vitamins easier to absorb from the intestine. Bilirubin is the main pigment in bile. Bilirubin is a waste product that is formed from hemoglobin (the protein that carries oxygen in the blood) and is excreted in bile.
Ammonia is protein breakdown that turns into urea in the liver and leaves

Question 24

Manifestations of acute pancreatitis

Answer 24

Sudden inflam, edema, necrosis, hemorrhage, fat necrosis, vascular perm, smooth mm contractions, shock, ab pain in LUQ, and mid epi that radiates to shoulder and worse with food, N/V that dosent help pain, low fever, Hypotension, Jaundice, gry turners sign, cullens sign (eccymosis), Hyposctive or no bowel sounds, crackles,

Question 25

Complications of acute pancreatitis

Answer 25

plural effusion, atelectasis, pneumonia, ARDS,
Emboli, DIC
Hypotension
hypocalcemia-Tetany
Pseudo cyst- from all the gunk
Ab pain, palpable mass, anorexia, NV, Perf, peritonitis
Abscess- infection of pseudocyst