Seminar Exam 2 Flashcards
causes of SIADH
- inappropriate, continued secretion or action of ADH despite normal or increased plasma volume
- resulting in impaired water excretion
symptoms of SCC
- pain
- fatigue
- SOB
- loss of sensation
- loss of motivation d/t treatment (high dose opioids)
- anemia
- injured RBCs hemolyzing, making new ones (taxing on bone marrow), RBCs don’t carry as much oxygen, doesn’t deliver well, doesn’t get to tissues as well
etiologies of HHS
- pre-existing T2DM
- esp. elderly
- infection/sepsis
- CVA, MI, pancreatitis, GI bleed
- medication interactions
- TPN or enteral
- esp. elderly
- dialysis
- esp. elderly
cerebrospinal fluid
- clear, colorless, odorless fluid that fills ventricles, subarachnoid space and spinal cord
- cushions brain and spinal cord against injury (absorbs shock)
- food and wate removal system of brain
- 3rd circulation after blood and lymph
- made up of
- water, protein, oxygen, carbon dioxide
- electrolytes: Na, K, Cl, glucose
- 120-150 ml in circulation; 25 ml produced/hr, 500 ml/day
GI/other symtpoms suggesting adrenal insufficiency
- N/V
- abdominal pain
- general weakness
thinking associated with dementia
- cognitive decline with problems in memory plus one or more:
- aphasia
- apraxi
- agnosia
- executive functioning
define depression
- cluster of depressive symptoms (via SIG E CAPS depression criteria) is present on most days, for most of the time, for at least 2 weeks
- symptoms of such intensity they are out of the ordinary for individual
- biologically based illness affecting a person’s thoughts, feelings, behavior, and physical health
positioning and stimuli for pt with increased ICP
- positioning
- 30 degrees
- head and neck neutral for adquate venous draining
- minimize stimuli
- quite environment
- lights dim
- don’t cluster nursing interventions
symptoms of mild TBI
- # 1: LOC lasting few sec to minutes
- # 2: N/V - early symptom
- headahce, lightheadedness, dizziness
- confusion, tiredness, sleepiness
- blurred vision, ringing in ears
- bad taste in mouth
- sleep changes, behavior/mood changes
- trouble with memory, concentration, attention, thinking
- sensitivity to light/sound
define Addison’s disease
- adrenal insufficiency
- deficiency of glucocorticoids
- primary - issue with adrenal glands
- secondary - issue with pituitary
- tertiary - issue with hypothalamus
why high flow oxygen for croup?
- open airway
- improve oxygenation
- blows of CO2
- decreases inspiratory resistance by keeping nasopharyngeal area open
- support oxygenation by increasing pressure
- controlled by respiratory therapist or provider
sypmtoms of septic shock
- fever
- rigors
- hypotension
- tachycardia
- tachypnea
- oliguria
- restlessness
- N/V/D
cranial nerves
- olfactory
- optic
- oculomotor
- trochlear
- trigeminal
- abducen
- facial
- vestibular
- glossopharyngeal
- vagus
- accessory
- hypoglossal
management of neutropenia
- granulocyte-colony stimulating factor
- side effect: bone pain
- chemotherapy dose adjustment for subsequent regimens
- broad spectrum IV abx if sepsis suspected
- PO prophylactic abx
- patient education
paracrine hormone secretion
hormone acts locally by diffusing from source to target cells in neighborhood
overview of HHS
- hyperglycemia hyperosmolar state
- affects individuals with T2DM
- severe hyperglycemia, hyperosmolarity, dehydration
- absence of ketosis and acidosis
- severe hyperglycemia causes osmotic diuresis
managing PTSD
- not just a veteran’s disorder
- any life/health threatening injury can result in PTSD
- management is often overlooked
- nurses play a role
- treating a patient post injury
- seeing them in a return capacity
- assessing symptoms
nursing management of patient with increased ICP
- ID early
- airway
- CPP 60-100
- euvolemia
- positioning
- minimize stimuli
- prevent increased metabolic demand
- pharmacologics
- ventricular drainage
- monitor for complications
nursing interventions for HHS
- vitals
- insulin, monitor BG hourly
- fluid replacement with NSS
- I&O
- monitor/treat electrolytes
- monitor for thromboembolic event
- formation promoted by dehydration, immobility, critical illness
- education
medical interventions for HHS
- restore fluid balance
- 0.9%, D545% when BG = 250-300
- 1-2 L in first 2 hours
- may need upt o 12 L in first 24-36 hrs
- insulin
- SC or IV bolus
- gtt not typically needed
define incretins
intestinal hormones releasedin response to meals which enhance insulin production
hypertonic saline to decrease ICP/metabolic demand
- if mannitol is not effective
- 3% continuous infusion or 5% bolus
- to combat effects of inappropriate influx of sodium into cells
SCD overview
- SCD vs SCA (anemia)
- SCA = diagnosis; SCD = presentation; SCC = crisis
- problems begin at 5-6 mo
- average life expectancy 40-60 yrs
- 90% to age 20; 50% to age 50
define TBI
nondegenerative, noncongenital insult to the brain from an external mechanical force, possibly leading to permanent or temporary impairment of cognitive, physical, and psychosocial functions, with an associated diminished or altered state of consciousness






