Acute & Chronic Health Disruptions In Adults III (NUR 445): Exam Study Review Guides exam 1-4 (all in 1 pdf file)- Latest Updated 100%
Spring 2026 - Arizona College.
NUR 445: Module 1 (Exam 1) Endocrine Disorders
Priority Assessments Critical Cues Priority Actions/Interventions Outcomes
Diabetes Insipidu] Causes: Labs to Know: GOAL = prevent dehydration + replace e normalization
A decrease of ADH production e Central [decreased ADH e | USG<1.005 deficient ADH of urine
leads to water reabsorption from the posterior e | Urine Osmolality | Assess: output, USG,
back into circulation pituitary gland] e HCT e BP (hypotension) serum
e Nephrogenic [kidneys e Sodium Level e |/O electrolytes
Pee out very dilute urine are resistant to ADH =2 Major Complications: e Daily Weight (decrease in weight) e vital signs
d/t renal insufficiency, e Hypovolemia e Visual Acuity normalize
hypercalcemia, e Hypernatremia: e Serum Sodium and Osmolality e body weight is
hypokalemia] confusion, seizures, (hypernatremia) stable
e Head injury or coma, USG (low)
craniotomy neuromuscular Actions/Interventions:
Manifestations: excitability Decreased LOC (Emergent Situation):
e Primary: Polyuria, IV Fluids are indicated
polydipsia, nocturia o Ensure IV access is
e FVD: thirst, skin tenting, established (if they are
fatigue hypotensive, it can be hard
e Hypotension to getin an V)
e Hypernatremia o Hypotonic fluids: 0.45% NS,
D5 In Water
Awake & Alert + Intake Gag Reflex:
PO Hydration
QDesmopressin or Vasopressin
o DDAVP: intranasal, SUBQ,
oral
o Synthetic analog of ADH
o Monitor: fluid status, serum
electrolytes, urine output
Mouth Care:
o d/t FVD pt mucous
membranes can be dry
ES.
, NUR 445: Module 1 (Exam 1) Endocrine Disorders
§yndrome of Inappropriatg Causes: Labs to Know: Assess: Stable body
Antidiuretic Hormone (SIADH) e CNS disorders: tumors, M USG + Urine Neurological status (hyponatremia weight
Increase in ADH causing water medications, carcinoma Osmolality can lead to confusion, headache, Increased
overload = dilutional Manifestations: J Sodium change in LOC) sodium levels
hyponatremia e Primary: hyponatremia J, Urine output Intake and output (decreased urine Equal I/O
Water reabsorption in the e Early: anorexia, nausea, J, Serum output) Labs return to
kidneys malaise Osmolality Serum sodium and osmolality normal
e Others: headache, J HCT (Decreased)
irritable, confused, weak Major Complications: USG + urine osmolality (increased)
e Hyponatremia Sodium <120 = Skin integrity
seizures and coma Actions/Interventions:
Cerebral edema Restrict Fluids
Increased ICP ) Demeclocycline (increases
excretion of water from the kidneys)
3% Saline via Central IV Line (increase
serum sodium)
SEIZURE PRECAUTIONS
€ Medications:
o Vasopressin antagonists
(Tolvaptan) = increase water
excretion and increase serum
sodium
o Tetracycline (demeclocycline)
— promotes urine
production
= Avoid if pt has
kidney disease
o Loop Diuretics (furosemide)
- inhibit reabsorption of
sodium and chloride
o Osmotic Diuretics (Mannitol)
— promotes diuresis
Surgery: transsphenoidal
hypophysectomy to remove pituitary
tumors
ES.
, NUR 445: Module 1 (Exam 1) Endocrine Disorders
[hyroid Storm (Thyrotoxicosis] Causes: Complications: Priority: airway management and fluid Stabilize pt
e Hyperthyroidism e Respiratory resuscitation Stable weight
Manifestations: e Cardiac Interventions: Adjustments
e Tachycardia dysrhythmias e € Antithyroid medications + iodine in thyroid
e Fever e Seizures preparations medications
Systolic hypertension e Tachycardia: © beta-blockers Healthy, active
Abdominal pain e Hyperthermia: cooling blankets lifestyle
Tremors o € Glucocorticoids: decrease the
Change in LOC release of TSH
e Eye lubricant to decrease corneal
irritation
Myxedema Com! Manifestations: Interventions: Stabilization of
Characterized by hypoxia and e Bradycardic e Thyroid replacement therapy labs, weight,
carbon dioxide retention, fluid Hypotensive o © Synthroid: take in the skin turgor,
and electrolyte imbalances. Hypoglycemic morning energy
Hyponatremia e Use sedatives and narcotics with Medication
Sensitivity to sedatives, caution adherence
narcotics, hypnotics e Warming blankets
e Nonpitting edema, e Turn and reposition to promote skin
edema of tongue and integrity d/t myxedema
larynx
[hyroid Surger] For patients with Complications: Postoperative Priorities:
hyperthyroidism a total or e Removal of all e Monitoring for airway compromise,
subtotal thyroidectomy is parathyroid tissue hemorrhage, hypocalcemia, and
performed e Hypoparathyroidism damage to the laryngeal nerve
e Damage to the e Assess for damage to the laryngeal
laryngeal nerve that nerve
affects swallowing o Hoarseness or husky tone
and voice o Q1-2 hours
Normal Subtotal Thyroidectomy Total Thyroidectomy
Interventions:
e Sandbags help keep the head in
proper alignment
ES.
, NUR 445: Module 1 (Exam 1) Endocrine Disorders
Position semi-fowler’s to ease the
work of breathing, decrease
aspiration risk
Humidified air 2 secretions
Tracheostomy tray =2 swelling, tetany
(muscle spasms), laryngeal damage
Suctioning equipment, supplemental
oxygen
Adrenal Insufficiencv Causes: Labs to Look For: Assessment: Normal
(Addisonian Crisis) Infection J Salt Vital signs (decreased BP + increased adrenal cortex
Destruction of adrenal gland, Cancer M potassium HR) function
decreased ACTH, CRH, Trauma J, cortisol Yie) Normal vital
glucocorticoids and Females ages 30-50 e | glucose Serum sodium, potassium, and signs
mineralocorticoids D/C abruptly Complications: glucose Emotional
corticosteroids e Severe hypovolemia BUN and Hematocrit stability
Manifestations: e Hypotension Cardiac rhythm Increased
Dark, bronzed e Hyperkalemia Change in muscle strength corticosteroids
hyperpigmentation Change in skin color during periods
Decreased cortisol and of stress
aldosterone: weakness, Actions/Interventions:
weight loss, fatigue, Ensure vascular access and administer
nausea, abdominal pain, IV fluids with sodium and glucose
gastroenteritis € Administer corticosteroid (IV
Decreased pubic and Cortisone)
armpit hair € Administer aldosterone (Chronic
Dehydration adrenal insufficiency)
Hypotensive Safety precautions due to risk of falls
(postural hypotension): bed at lowest
position
Wearing a medical alert bracelet
Salt intake in hot weather
tushing Syndrom] Causes: Labs to Look For: Assessments: Stabilization of
e Cortisol Vital signs vitals
Spring 2026 - Arizona College.
NUR 445: Module 1 (Exam 1) Endocrine Disorders
Priority Assessments Critical Cues Priority Actions/Interventions Outcomes
Diabetes Insipidu] Causes: Labs to Know: GOAL = prevent dehydration + replace e normalization
A decrease of ADH production e Central [decreased ADH e | USG<1.005 deficient ADH of urine
leads to water reabsorption from the posterior e | Urine Osmolality | Assess: output, USG,
back into circulation pituitary gland] e HCT e BP (hypotension) serum
e Nephrogenic [kidneys e Sodium Level e |/O electrolytes
Pee out very dilute urine are resistant to ADH =2 Major Complications: e Daily Weight (decrease in weight) e vital signs
d/t renal insufficiency, e Hypovolemia e Visual Acuity normalize
hypercalcemia, e Hypernatremia: e Serum Sodium and Osmolality e body weight is
hypokalemia] confusion, seizures, (hypernatremia) stable
e Head injury or coma, USG (low)
craniotomy neuromuscular Actions/Interventions:
Manifestations: excitability Decreased LOC (Emergent Situation):
e Primary: Polyuria, IV Fluids are indicated
polydipsia, nocturia o Ensure IV access is
e FVD: thirst, skin tenting, established (if they are
fatigue hypotensive, it can be hard
e Hypotension to getin an V)
e Hypernatremia o Hypotonic fluids: 0.45% NS,
D5 In Water
Awake & Alert + Intake Gag Reflex:
PO Hydration
QDesmopressin or Vasopressin
o DDAVP: intranasal, SUBQ,
oral
o Synthetic analog of ADH
o Monitor: fluid status, serum
electrolytes, urine output
Mouth Care:
o d/t FVD pt mucous
membranes can be dry
ES.
, NUR 445: Module 1 (Exam 1) Endocrine Disorders
§yndrome of Inappropriatg Causes: Labs to Know: Assess: Stable body
Antidiuretic Hormone (SIADH) e CNS disorders: tumors, M USG + Urine Neurological status (hyponatremia weight
Increase in ADH causing water medications, carcinoma Osmolality can lead to confusion, headache, Increased
overload = dilutional Manifestations: J Sodium change in LOC) sodium levels
hyponatremia e Primary: hyponatremia J, Urine output Intake and output (decreased urine Equal I/O
Water reabsorption in the e Early: anorexia, nausea, J, Serum output) Labs return to
kidneys malaise Osmolality Serum sodium and osmolality normal
e Others: headache, J HCT (Decreased)
irritable, confused, weak Major Complications: USG + urine osmolality (increased)
e Hyponatremia Sodium <120 = Skin integrity
seizures and coma Actions/Interventions:
Cerebral edema Restrict Fluids
Increased ICP ) Demeclocycline (increases
excretion of water from the kidneys)
3% Saline via Central IV Line (increase
serum sodium)
SEIZURE PRECAUTIONS
€ Medications:
o Vasopressin antagonists
(Tolvaptan) = increase water
excretion and increase serum
sodium
o Tetracycline (demeclocycline)
— promotes urine
production
= Avoid if pt has
kidney disease
o Loop Diuretics (furosemide)
- inhibit reabsorption of
sodium and chloride
o Osmotic Diuretics (Mannitol)
— promotes diuresis
Surgery: transsphenoidal
hypophysectomy to remove pituitary
tumors
ES.
, NUR 445: Module 1 (Exam 1) Endocrine Disorders
[hyroid Storm (Thyrotoxicosis] Causes: Complications: Priority: airway management and fluid Stabilize pt
e Hyperthyroidism e Respiratory resuscitation Stable weight
Manifestations: e Cardiac Interventions: Adjustments
e Tachycardia dysrhythmias e € Antithyroid medications + iodine in thyroid
e Fever e Seizures preparations medications
Systolic hypertension e Tachycardia: © beta-blockers Healthy, active
Abdominal pain e Hyperthermia: cooling blankets lifestyle
Tremors o € Glucocorticoids: decrease the
Change in LOC release of TSH
e Eye lubricant to decrease corneal
irritation
Myxedema Com! Manifestations: Interventions: Stabilization of
Characterized by hypoxia and e Bradycardic e Thyroid replacement therapy labs, weight,
carbon dioxide retention, fluid Hypotensive o © Synthroid: take in the skin turgor,
and electrolyte imbalances. Hypoglycemic morning energy
Hyponatremia e Use sedatives and narcotics with Medication
Sensitivity to sedatives, caution adherence
narcotics, hypnotics e Warming blankets
e Nonpitting edema, e Turn and reposition to promote skin
edema of tongue and integrity d/t myxedema
larynx
[hyroid Surger] For patients with Complications: Postoperative Priorities:
hyperthyroidism a total or e Removal of all e Monitoring for airway compromise,
subtotal thyroidectomy is parathyroid tissue hemorrhage, hypocalcemia, and
performed e Hypoparathyroidism damage to the laryngeal nerve
e Damage to the e Assess for damage to the laryngeal
laryngeal nerve that nerve
affects swallowing o Hoarseness or husky tone
and voice o Q1-2 hours
Normal Subtotal Thyroidectomy Total Thyroidectomy
Interventions:
e Sandbags help keep the head in
proper alignment
ES.
, NUR 445: Module 1 (Exam 1) Endocrine Disorders
Position semi-fowler’s to ease the
work of breathing, decrease
aspiration risk
Humidified air 2 secretions
Tracheostomy tray =2 swelling, tetany
(muscle spasms), laryngeal damage
Suctioning equipment, supplemental
oxygen
Adrenal Insufficiencv Causes: Labs to Look For: Assessment: Normal
(Addisonian Crisis) Infection J Salt Vital signs (decreased BP + increased adrenal cortex
Destruction of adrenal gland, Cancer M potassium HR) function
decreased ACTH, CRH, Trauma J, cortisol Yie) Normal vital
glucocorticoids and Females ages 30-50 e | glucose Serum sodium, potassium, and signs
mineralocorticoids D/C abruptly Complications: glucose Emotional
corticosteroids e Severe hypovolemia BUN and Hematocrit stability
Manifestations: e Hypotension Cardiac rhythm Increased
Dark, bronzed e Hyperkalemia Change in muscle strength corticosteroids
hyperpigmentation Change in skin color during periods
Decreased cortisol and of stress
aldosterone: weakness, Actions/Interventions:
weight loss, fatigue, Ensure vascular access and administer
nausea, abdominal pain, IV fluids with sodium and glucose
gastroenteritis € Administer corticosteroid (IV
Decreased pubic and Cortisone)
armpit hair € Administer aldosterone (Chronic
Dehydration adrenal insufficiency)
Hypotensive Safety precautions due to risk of falls
(postural hypotension): bed at lowest
position
Wearing a medical alert bracelet
Salt intake in hot weather
tushing Syndrom] Causes: Labs to Look For: Assessments: Stabilization of
e Cortisol Vital signs vitals
