Schrader Mini Lecture Test 3

Question 1

Normal Serum Osmolality

Answer 1

280-305

high os, high specific gravity

Question 2

Whats bad about a high serum Os?

Answer 2

• makes blood more concentrated/ thick

- risk for clots, stroke, MI, etc

Question 3

what does an ion gap tell you?

normal range?

Answer 3

• diagnoses metabolic disorders that result in acidosis and electrolyte imbalance, such a severe dehydration
• 8-16 mmol/L

Question 4

things that tell you about dehydration

Answer 4

• BUN is abnormal but creatinine is not
• increased ion gap
• increased serum osmolality
• low Na+

Question 5

treatment of DKA

Answer 5

• Always give IV NS first to get them hydrated
• Give insulin drip
• Give K+
• Switch to D5NS

Question 6

how do we know DKA is getting better?

Answer 6

• glucose goes down
• ketones are negative
• hydrated: Na+ up; ion gap down; serum os down
• acidosis better: kussmal’s stops
• fruity breath gone
• better LOC

Question 7

number one cause of DKA and HHS

Answer 7

infection

Question 8

patient teaching for DKA and HHS

Answer 8

• s/s of infection

- sick day rules and check BG more often… before every meal and at bedtime

Question 9

problem with give giving too many fluids and electrolytes at onces (as with HHS)

Answer 9

could cause seizures

Question 10

problem with actose and precose

Answer 10

-works rapidly, so they have to take it right when they’re about to eat or they will bottom out

Question 11

priorities with thyroid storm

Answer 11

• temp is priority… hypothermic blankets, ice packs
• beta blockers (Inderol)
• fluids last bc its hard on the heart

Question 12

priorities with Addisonian crisis

Answer 12

• hypothermia… Fluids first

- hypotensive… eip, norepinephrine, dopamine

Question 13

priorities for Myxedema Coma

Answer 13

-levothyroxine