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aproximadamente 11 anos atrás
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Questão | Responda |
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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