Brainscape's Knowledge GenomeTM

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


See full index

aa Orgo > Medsurg Final 1 > Flashcards

Medsurg Final 1 Flashcards

1
Q

A deficiency of ADH causes

A

diabetes insipidus

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

Excessive secretion of ADH causes

A

SIADH

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

In SIADH the kidneys

A

retain water

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

In SIADH urine becomes

A

concentrated

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

In SIADH extracellular fluid volume is

A

increased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Diagnostic tests for the posterior pituitary gland include the water ___ test

A

water deprivation test

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

The water deprivation test measures the kidneys’ ability to

A

concentrate urine

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

The water deprivation test is performed for clients who have a diagnosis of

A

diabetes insipidus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Water deprivation test: The test is positive for diabetes insipidus if the kidneys are unable to concentrate urine despite

A

increased plasma osmolality.

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

Water deprivation test: Begin test by withholding fluids for 8 to 12 hr, or until

A

3% to 5% of body weight is lost.

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

Water deprivation test: Ensure that someone

A

remains with client during test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Water deprivation test: obtain __ access

A

IV

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

Water deprivation test: Obtain 7 to 10 mL of heparinized blood in an iced tube and send to the laboratory for immediate processing to determine ___ level

A

sodium

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

Water deprivation test: Repeat the three steps – weigh, measure urine, obtain serum – ___ and record any findings

A

hourly

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

Water deprivation test: Continue the steps until the serum sodium concentration or osmolality

A

rises above the upper limit of the expected reference range.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

TESTS TO DIAGNOSE SIADH: Blood is obtained and transported to the laboratory within

A

10 min

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

Low ___ sodium is expected with SIADH

A

serum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

High ___ sodium is expected with SIADH

A

urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Cushing’s disease and Cushing’s syndrome (hypercortisolism) are characterized by a ____ adrenal cortex

A

hyperfunctioning

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

Cushing’s disease and Cushing’s syndrome (hypercortisolism) are characterized by an excess production of

A

cortisol

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

Addison’s disease is characterized by ____ of the adrenal cortex

A

hypofunctioning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Addison’s disease is characterized by low serum _____.

A

cortisol

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

A CT scan and/or an MRI may be performed to determine if there is ____ of the adrenal glands causing hypofunction

A

atrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

A low dose of ____ is given to screen a client for Cushing’s disease; high doses are given to determine the cause of the disease

A

dexamethasone

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

dexamethasone is given to screen a client for

A

Cushing’s disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

When dexamethasone is given to clients who have Cushing’s disease, there is no decrease in the

A

production of ACTH and cortisol (so that’s how they diagnose it)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Cortisol: higher levels are present in the early morning, and the lowest levels occur around

A

midnight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Cortisol: Diurnal variations are not seen in a client who has

A

Cushing’s syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Nursing Actions: Plasma cortisol is usually collected at

A

midnight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

ACTH may be elevated with

A

Addison’s disease

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

ACTH may be decreased with

A

Cushing’s disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Serum ACTH is most accurate if performed

A

in the morning

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

If no increase in cortisol occurs after administration of ACTH, the test is

A

positive for Addison’s disease or hypocortisolism.

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

ACTH STIMULATION TEST: Two consecutive _________ are used, one prior to and one after the administration of ACTH.

A

collections of 24-hr urine

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

Disorders of the adrenal medulla may cause hypersecretion of catecholamines, resulting in

A

stimulation of a sympathetic response, such as tachycardia, hypertension, and diaphoresis

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

Adrenal Medulla disorders: VMA testing is a ________ for vanillylmandelic acid (VMA), a breakdown product of catecholamines

A

24-hr urine collection

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

Indications of VMA testing

A

diagnosis of pheochromocytoma

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

____ VMA levels at rest indicate pheochromocytoma.

A

Elevated

39
Q

VMA testing: client may also be asked to withhold ___ and ____ medications.

A

aspirin and antihypertensive

40
Q

VMA testing: Instruct the client to maintain a _____ level of activity.

A

moderate

41
Q

Clonidine suppression test Indications

A

Pheochromocytoma

42
Q

pheochromocytoma

A

adrenal gland tumor

43
Q

Clonidine suppression test: If a client does NOT have a pheochromocytoma, _____ suppresses catecholamine release and decreases the serum level of catecholamines (decreases blood pressure)

A

clonidine

44
Q

Clonidine suppression test: If a client does not have a pheochromocytoma, clonidine suppresses

A

catecholamine release (decreases blood pressure)

45
Q

Clonidine suppression test: If the client does have a pheochromocytoma, the clonidine

A

has no effect (no decreased blood pressure)

46
Q

Clonidine suppression test: monitor the patient for

A

hypotension

47
Q

Clonidine suppression test: Inform the client that ___ may occur after the test.

A

fatigue

48
Q

Phentolamine blocking test: Phentolamine (Regitine), an ___ ___, is administered

A

alpha blocker

49
Q

Phentolamine blocking test: Indications

A

pheochromocytoma

50
Q

Phentolamine blocking test: Interpretation of Findings – A rapid decrease in systolic blood pressure with the administration of phentolamine is diagnostic for

A

pheochromocytoma

51
Q

Phentolamine blocking test: Interpretation of Findings:

A

A rapid decrease in systolic blood pressure with the administration of phentolamine is diagnostic for pheochromocytoma

52
Q

Dysfunction of carbohydrate metabolism may be caused by insulin deficiency resulting in

A

hyperglycemia

53
Q

Fasting blood glucose: Determines blood glucose when no foods or fluids (__ ___ ___) have been consumed for the past 8 hr.

A

other than water

54
Q

HbA1c of __ or less indicates absence of diabetes mellitus

A

5%

55
Q

HbA1c of ___ to ___ indicates prediabetes mellitus

A

5.5% to 6.5%

56
Q

and HbA1c of ___ or higher indicates diabetes mellitus.

A

6.5%

57
Q

Assists in evaluating DM treatment effectiveness and compliance with the diet plan, medication regimen, and exercise schedule

A

A1c

58
Q

A1c: test prep

A

none

59
Q

Hyperthyroidism and hypothyroidism are conditions in which there are

A

inappropriate amounts T3 and T4 circulating

60
Q

inappropriate amounts of T3 and T4 cause an increase or decrease in ____ rate that affects all body systems.

A

metabolic

61
Q

Hyposecretion of TSH may lead to ____ hypothyroidism

A

secondary

62
Q

a high level of ___ is more diagnostic of hyperthyroidism than is ___

A

T3 more than T4

63
Q

Posterior pituitary disorders mainly result in

A

fluid and electrolyte imbalance

64
Q

Types of diabetes insipidus: Caused by damage to the hypothalamus or
pituitary gland from trauma, irradiation, or cranial surgery.

A

Neurogenic (also known as central or primary)

65
Q

Types of diabetes insipidus: inherited; renal tubules do not react to ADH.

A

Nephrogenic

66
Q

Types of diabetes insipidus: Lithium carbonate (Lithobid) or demeclocycline (Declomycin) may alter the way the kidneys respond to ADH.

A

Drug-induced

67
Q

diabetes insipidus Urine chemistry – Think

A

DILUTE

68
Q

diabetes insipidus Serum chemistry – Think

A

CONCENTRATED

69
Q

desmopressin acetate (DDAVP) or aqueous vasopressin (Pitressin)

A

ADH replacements used to tx DI

70
Q

carbamazepine

A

ADH stimulant (an Anticonvulsants)

71
Q

carbamazepine (ADH stimulant (an Anticonvulsant)): monitor for

A

thrombocytopenia (sore throat, bruising, fever).

72
Q

Give vasopressin cautiously to clients who have __ ___ disease because the
medication may cause vasoconstriction

A

coronary artery

73
Q

DI tx might include life long

A

vasopressin injections

74
Q

DI diet:

A

high fiber

75
Q

Which electrolyte are you worried about in DI

A

sodium

76
Q

____ losses due to diuretic use can further contribute to the problems caused by SIADH

A

Sodium (because you already have low sodium in the Blood with SIADH)

77
Q

SIADH symptoms can include weight gain (without ___ because water, not sodium, is retained)

A

edema

78
Q

SIADH: As the serum sodium level decreases, the client experiences

A

personality changes, hostility, sluggish deep tendon reflexes

79
Q

SIADH Urine chemistry – Think

A

CONCENTRATED

80
Q

SIADH Blood chemistry – Think

A

DILUTE

81
Q

SIADH first priority

A

restrict fluids to 500 to 1,000 mL/day

82
Q

SIADH patient that has a feeding tube

A

flush with NS instead of water (because you’re supposed to be restricting water)

83
Q

A weight gain of 0.9 kg (2 lb) indicates a gain of

A

1 L of fluid

84
Q

SIADH: environment

A

reduce stimuli

85
Q

SIADH: Monitor the client for indications of ___ ___, which can occur from fluid overload.

A

heart failure

86
Q

SIADH: Monitor the client for indications of heart failure, which can occur from fluid overload. Use of a ___ ___ may be indicated.

A

loop diuretic

87
Q

Demeclocycline, which is a medication used for SIADH may cause

A

DI

88
Q

Demeclocycline is a medication used for SIADH. Monitor for

A

yeast infection, such as a white, cheese-like film inside the mouth.

89
Q

Lithium (Lithium Carbonate) can be used to

A

block the renal response to ADH (treats SIADH)

90
Q

Lithium (Lithium Carbonate) can be used to tx SIADH, but it can cause

A

DI

91
Q

Low serum sodium is a problem in SIADH. If it gets really bad, the IV you need is

A

3% sodium chloride

92
Q

Treatment for SIADH may result in CPM. This most commonly occurs when a client is being treated for hyponatremia and

A

the sodium levels rise too fast.

93
Q

Treatment for SIADH may result in CPM, a condition characterized by ___ damage

A

nerve

aa Orgo (196 decks)

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