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Pregunta	Respuesta
Nursing diagnosis for Diabetes Insipadus 1 2 3	fluid vol deficit Decreased cardiac output impaired tissue perfusion
medication for diabetes insipidus is	Desmopressin DDAVP a nasal spray causes increased water resabsorption
diabetes insipidus 1. deficit of what hormone 2. pt becomes ___ and what electrolyte is effected and how 3 the specific gravity is	1. ADH 2 dehydrated and hyPERnatremic 3. Low
this type of diabetes insipidus is from renal tubules are not sensitive to ADH. this is familar in renal failure	nephrogenic diabetes insipidus
this type of diabetes insipidus is a result from either disruption of the hypothalmus and pitutary glands from trauma irrdiation or cranial surgery or idiopathic	Neurogenic diabetes insipidus
Two types of Diabetes insipidus are	Neurogenic and Nephrogenic
Syndrome of inappropriate antidiuretic hormone secretion Nursing Diagnosis for SAIDH are 1 2 3 4	Fluid vol. excess increased cardiact out put fluid vol. overload fall risk
Some common causes of SIADH include	Meningitis Head injury Subarachnoid hemorrhage Cancers Lung cancer (especially small-cell lung cancer, as well as other small-cell malignancies of other organs) Infections Brain abscess Pneumonia Lung abscess Guillain-Barré syndrome Drugs Chlorpropamide Clofibrate Phenothiazine Ifosfamide Cyclophosphamide Carbamazepine Selective serotonin reuptake inhibitors (SSRIs, a class of antidepressants) Methylenedioxymethamphetamine (MDMA, commonly called Ecstasy. SIADH due to taking ecstasy was cited as a factor in the death of Leah Betts) Oxytocin Vincristine Morphine Amitriptyline Hypothyroidism Sarcoidosis
HyPERfunction of anterior pitutary gland GH during Adulthood causes GH before puberty	Acromegaly Gigantism
Drugs used for SIADS are	Demeclycycline (tetracycline)
Treatment and nursing practices of SIADS is	keep pt safe, restrict fluids to 1 L a day for 3 - 10 days Demecloycycline a(tetracycline) antibiotic , correct underlying cause
signs and symptoms brain cells, causing neurologic symptoms including headache, changes in mental status or personalit, lethargy and irriatability, weight gain from retention of fludea with no edema	SIADA
Manifestation of SIADH are usually nonspecific but are related to ___ and __ __	hyponatremia and water intoxication and lung cancer
what is suppressed as a result of renal excretions of sodium increases	Aldosterone
SIADH is most often caused by Other causes may be	ectopic production of ADH by maligant tumor oat cell carcinoma of lung, pancreatic carcinoma, leukemia and Hodgkins. follow a head injury, pituitary surgery or use of medications such as barbiturates, anesthetics or diuretics
Treatment of addisonian crisis is	rapid fluid and glucorcorticoids replacement
Regular symptoms of addison disease + high fever, severe pain in the abdomen, lower back pain, legs, severe vomitting, diarrhea, circulatory collapse, shock, coma this is	Addisonian crisis
typical symptoms of addisons	Muscle weakness and fatigue Weight loss and decreased appetite Darkening of your skin (hyperpigmentation) Low blood pressure, even fainting Salt craving Low blood sugar (hypoglycemia) Nausea, diarrhea or vomiting Muscle or joint pains Irritability Depression Body hair loss or sexual dysfunction in women
results when your adrenal glands are damaged, producing insufficient amounts of the hormone cortisol and often aldosterone as well. These glands are located just above your kidneys	Addison's disease
addisions disease is loss of what hormones	cortisol and often aldosterone
Medication for acromegaly is called ? It suppresses the anterior pituitary gland and decreases the? Side effects of the medication are	1. Octreotide Sandostatin 2 GH levesl 3 GI first few weeks and 25% pt develop cholesterol gallstones in a year
acromegaly is treated by surgical removal or irradiation of the ? the two types of surgery are called	1 pituitary tumor 2 transspheonidal or transfrontal
The patient is admitted to the critical care unit because of uncontrolled chest pain , radiating to the shoulder. Think about what interventions will be carried on ? What medications will be administered and why ? What laboratory tests will be done and why? What is the nurses/ yours higest priority ? What nursing diagnosis will be the highest priority ?	Medication administration (ASA, nitroglycerin, morphine), O2 supplementation initially. Fibrinolysis or Percutaneous Coronary Intervention via balloon angiography and stent deployment may be indicated. In the acute phase… ASA: to inhibit platelet activity, and thus clot formation. Nitroglycerin: a vasodilator, to possibly reduce chest pain and determine whether the episode is an actual MI or just angina. Morphine sulfate: for pain relief if nitro is contraindicated or ineffective. Also, relief of anxiety. Fibrinolytics: to dissolve clots. Patients have to qualify. Recent history of bleeding is one important exclusion criteria. Glycoprotein IIb/IIIa Antagonists: often used in conjunction with PCI to inhibit platelet aggregation. Long-term… Beta blockers: to decrease incidence of ventricular arrythmias, recurrent ischemia and infarction, size of infarct, and short-term mortality. Heparin: until the ruptured plaque has resolved. Warfarin: in certain cases only (e.g. atrial fibrillation) to reduce recurrence. Pradaxa is a newer “replacement” for Warfarin. ACE inhibitors: decreases afterload through vasodilation. Statins: reduces serum cholesterol to decrease progress of atherosclerosis CBC: RBCs, H&H could be down due to hypoxia. WBC could be up due to infection. CK/CK-MB: indicator of myocardial injury. Troponins: most specific indicator for myocardial damage. Myoglobin: indicator of any muscle injury, including cardiac. Electrolytes: could be off due to MI Immediately, relief of pain would be the highest priority. Acute pain
Sodium polystyrene sulfonate also known as Kayexalate is medication treats what	Hyperkalemia Sodium polystyrene sulfonate is used to treat increased amounts of potassium in the body
Manifestation of acromegaly	Manifestations of this include peripheral nerve damage from entrapment of nerves, headache, hypertension, congestive heart failure, seizures and visual disturbances. impaired glucose tolerance and diebetes many occure. Arthritis
Signs of Large forehead, maxilla lengthens ,tongue enlarges and voice deepens. Overgrowth of bone and soft tissue in the hands and feet.	Acromegaly
Acromegaly usually begins during	Adulthood
This occurs when GH hypersecretion begins before puberty and the closure of the epephyseal plate. Height and body proportions are relatively normal. Usually tumor involved	Giantism
Nursing diagnosis with addison	1 fluid volume deficit
Medication for Addison is 1.coticosteroid called and used for 2. Mineralocorticoids 3 diet is	1. hydrocortisone (cortef) to replace cortisol 2. fludrocortisone florinef to replace mineralocorticoids also INcrease Sodium in diet
blood and urine test for Addison's 1. cortisol 2. BUN 3. sodium 4. Potassium 5. glucose 6 Urine 17-5s	1. decreased 2. increased 3. decreased 4 increased 5decreased 6 low or absent **all are decreased except for Bun and Potassium
Manifestation of addisons are 1.Integumentary system 2.Cardiovascular 3. Central nervous system 4. Musculoskeletal 5. Gastronintestinal system 6. reporductive 7. Metabolic effects	1.Delayed wound healing and Hyperigmentation 2. postural hypotension, arrhythmias and tachycardia 3. Lethargy, tremors, emotional labilty, confusion 4. weakness, muscle wasting, joint pain, muscle pain 5. anorexia, nausea and vomiting and diarrhea 6. Menstrual changes 7. HyPERKalemia, hyPOnatremia, HyPOglycemia
in Addison disease results in a chronic deficiency of accompanied by age is usually more common in	cortisol, aldosterone, and adreanl androgens skin pigmentations under 60 women
this is a disorder resulting from destruction or dysfunctino of the adrenal cortex	addisons disease
Nursing diagnosis and interventions for Cushing's syndrome is	Fluid volume excess because of excess cortisol Risk for injury Risk for infection Distrubed body image
Drugs used for cushing syndrom are 1. used to treat matastic adrenal cancer 2. This is used for ectopic ACTH secreting tumors that cannot be surgicall removed 3. This durgs suppresses ACTH secretions in some clinets	1. Mitotane suppresses activity of the adrenal cortes 2. Aminogluthemide or Ketoconazole or both they inhibit cortisol synthesis by the adrenal cortex 3. Somatostatin analog Octreotide suppresses ACTH secretion
in primary Cushing syndrome ACTH levels are	Decreased
in secondary cushing sydrome ACTH leves are	elevated
other changes in cushing syndrome are electrolytes imbalances and they are 1. calcium changes cause 2. potassium is 3.sodium is 4. risk for peptic ulcers 5 cardiovascular system changes 6. Reporductive system	1. osteoporosis, compression fractures, reanl calculi 2. lost 3. retained 4. increases 5. Hypertension 6 Oligomenorrhea or amenorrhea, impotence and decreased libido
steroid excess inhibits fibroblast resulting in loss of collagen and connective tissue results are	thinning of skin, abdominal strie red purple stretch marks, easy bruising, poor wound healing and frequent skin infections
cushing syndrom obesity and redistribution of body fate is in what regions	Abdominal region, fat pads under clavical, buffalow hump over upper back and round moon face
this type of cushings is from long term glucocorticoid use	Iatrogenic Cushing syndrome
this type of cushing is resulting from excessive cortisol secretion by a benign or malignant adrenal tumor. Excess secretation supresses pituitary ACTH production, resulting in atrophy of the uninvolved adrenal cortex. Thirty two percento of cushing disease is due to excessive autonomous secretion of cortisol by adrenal glands	Adrenal form
type of cushing caused by ACTH secreting tumor such as small cell lung cancer	Ectopic form of cushing
this form of cushing is is associaqted with ACTH hypersecretation by tumor of pituitary. This si most commonly causecd by a small pitutiary adenoma with persistent but disorderly and random overproduction of ACTH. Forty three persent of cushing is due to hypersecretation of ACTH by pituitary	Pituitary form
4 types of cushing syndrome is	pituitary form, ectopic form adrenal form, and iatrogenic
which is the only endocrine organ that can be palpated during physical assessment	thyroid gland
When conductring a health history focused on the endocrin system, which of the following questions should be included	Have you noticed any increased signs of thirst.
What assessment might be made to identify low calcium levels	Trousseaus and is done by inflating a blood pressure cuff above the antecubital area, higher than the systolic blood pressure, for two to five minutes, A positive test causes carpal spasmn and the fingers and hand will contract on the arm where the blood pressure cuff is inflated Chvostek’stroke of face and get a nose or lip twitch
stroke face and get a lip twitch or nose twitch on same side of face	Chvostek’stroke
inflating a blood pressure cuff above the anticubital area, higher than the systolic blood pressure, for two to five minutes, A positive test causes carpal spasm and the fingers and hand will contract on the arm where the blood pressure cuff is inflated	Trousseaus
Trousseaus and Chvostek’stroke used to check for	Hypocalcaemia low calcium
what physiologic response is expected if the pituitary produces and increased amount of ADH	decreased urine out put because adh antiduret hormone helps to concentrate urine, which would decrease urin output. the adh couses the distal tubules in the kidney to reablsorb water which will concentrate the urinie
extreme larg bones may indicate	acromegaly
ultered sensation may be seen in what three endo disorders	diabetes, hypothyroidism and acromegaly
increased pigmentatin of the nails is seen in what disease	Addisons
Purple striae over the abdomen and brusing may be sinn in what syndrome	cushing syndrome
corticosteroids Glucocorticosteroids and minerocorticosteriods have effects on endocrine areas	Adreal glands the cortex
What gland posterior gland stimulates retention of water	ADH
What posterior gland stimulates uterine contractions, milk ejection reflex in the mammary glands	Oxytosin
What gland stimulates development of testes and ovaries	LH
what gland stimulates Thyroid gland to produce hormones	TSH

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