Jeff Solheim CEN Course: Emergency Nursing Certification Review, Lectures, Study Materials &
Exam Prep Guide
Hyporeflexia is most commonly associated w/:
Hypokalemia
Hypocalcemia
Hypomagnesaemia
Hyperphosphatemia - correct answer ✔✔Hypokalemia
The ED nurse knows that a pt with azotemia... - correct answer ✔✔Has an increase in blood
urea nitrogen and creatinine level
Addison's disease/chrisis NEED Refined - correct answer ✔✔Adrenal glands produce insufficient
amounts of the hormone cortisol and sometimes aldosterone, too. When the body is under
stress (e.g. fighting an infection), this deficiency of cortisol can result in a life threatening
Addisonian crisis characterized by low blood pressure. NEED REFINED
Cushing Syndrome - correct answer ✔✔Type of Adrenal Emergency -- Excessive steroids, usually
from systemic exogenous admin, result in temporary hypernatremia (fluid retention),
hypokalemia, hyperglycemia, and hypocalcemia. Immunosuppression and appropriate
precautions required. If pt does not wean down the dose, an Addisonian crisis from insufficient
glucosteroids can result.
Acute Adrenal Insufficiency results from... - correct answer ✔✔I.e., Adrenal crisis, Addisonian
crisis), results from a sudden decrease in cortisol and aldosterone levels.
Acute Adrenal Insufficiency, types - correct answer ✔✔Primary adrenal insufficiency occurs in
individuals with preexisting chronic adrenal insufficiency (Addison dz). A common trigger is an
acute illness/stressor.
,Secondary (suppression of adrenal hormone release) is much more common. Long-term
glucocorticoid use (hydrocortisone, prednisone) causes adrenal gland suppression, primarily
reducing cortisol production. Consequently, abrupt d/x of those may precipitate acute adrenal
crisis.
S/Sx - Acute Adrenal Insufficiency - correct answer ✔✔Weakness, fatigue
Hypotension
Anorexia, Wt. Loss
N/V, abdominal pain, diarrhea, constipation
Hyperpigmentation
Diagnostic procedures - Acute Adrenal Insufficiency - correct answer ✔✔Complete Met Panel:
- Hypoglycemia
- Hyponatremia, hypochloremia, hyperkalemia (in pt's with primary adrenal insuff.)
Obtain creatinine level
Draw cortisol and adrenocorticotropic hormone levels
Therapeutic Interventions - Acute Adrenal Insufficiency - correct answer ✔✔- Stabilize
fluids/electrolytes
- IV Hydrocortisone
- Dexamethasone
Thrombocytopenia - correct answer ✔✔low platelet count
Aldosterone function - correct answer ✔✔- Facilitates sodium and water reabsorption
- Indirectly affects potassium excretion
, Cushing's Syndrome - adrenal emergency - correct answer ✔✔Elevated glucose
Decreased Potassium
Elevated Sodium
puffy/bloated appearance (fat), immunocompromised, poor wound healing
Addison's (Adrenal) Crisis - correct answer ✔✔Decreased glucose
Decreased sodium (can't reabsorb, thus water loss)
Elevated potassium (since Na low)
also, dehydration (weakness, fatigue, hypotension)
Cushing's Syndrome treatment - correct answer ✔✔Treatment for Cushing's Syndrome is
decrease corticosteroid doses (which may lead Secondary adrenal insufficiency if not weaned
down properly)
A decreased in which of the following is associated with effective tx of Addison's crisis?
- Sodium
- Glucose
- Potassium
- BP - correct answer ✔✔Potassium
Which of the following lab findings are most consistent with disseminated intravascular
coagulation?
Elevated d-dimer
elevated fibrgenogen
decrased
decreased - correct answer ✔✔
Exam Prep Guide
Hyporeflexia is most commonly associated w/:
Hypokalemia
Hypocalcemia
Hypomagnesaemia
Hyperphosphatemia - correct answer ✔✔Hypokalemia
The ED nurse knows that a pt with azotemia... - correct answer ✔✔Has an increase in blood
urea nitrogen and creatinine level
Addison's disease/chrisis NEED Refined - correct answer ✔✔Adrenal glands produce insufficient
amounts of the hormone cortisol and sometimes aldosterone, too. When the body is under
stress (e.g. fighting an infection), this deficiency of cortisol can result in a life threatening
Addisonian crisis characterized by low blood pressure. NEED REFINED
Cushing Syndrome - correct answer ✔✔Type of Adrenal Emergency -- Excessive steroids, usually
from systemic exogenous admin, result in temporary hypernatremia (fluid retention),
hypokalemia, hyperglycemia, and hypocalcemia. Immunosuppression and appropriate
precautions required. If pt does not wean down the dose, an Addisonian crisis from insufficient
glucosteroids can result.
Acute Adrenal Insufficiency results from... - correct answer ✔✔I.e., Adrenal crisis, Addisonian
crisis), results from a sudden decrease in cortisol and aldosterone levels.
Acute Adrenal Insufficiency, types - correct answer ✔✔Primary adrenal insufficiency occurs in
individuals with preexisting chronic adrenal insufficiency (Addison dz). A common trigger is an
acute illness/stressor.
,Secondary (suppression of adrenal hormone release) is much more common. Long-term
glucocorticoid use (hydrocortisone, prednisone) causes adrenal gland suppression, primarily
reducing cortisol production. Consequently, abrupt d/x of those may precipitate acute adrenal
crisis.
S/Sx - Acute Adrenal Insufficiency - correct answer ✔✔Weakness, fatigue
Hypotension
Anorexia, Wt. Loss
N/V, abdominal pain, diarrhea, constipation
Hyperpigmentation
Diagnostic procedures - Acute Adrenal Insufficiency - correct answer ✔✔Complete Met Panel:
- Hypoglycemia
- Hyponatremia, hypochloremia, hyperkalemia (in pt's with primary adrenal insuff.)
Obtain creatinine level
Draw cortisol and adrenocorticotropic hormone levels
Therapeutic Interventions - Acute Adrenal Insufficiency - correct answer ✔✔- Stabilize
fluids/electrolytes
- IV Hydrocortisone
- Dexamethasone
Thrombocytopenia - correct answer ✔✔low platelet count
Aldosterone function - correct answer ✔✔- Facilitates sodium and water reabsorption
- Indirectly affects potassium excretion
, Cushing's Syndrome - adrenal emergency - correct answer ✔✔Elevated glucose
Decreased Potassium
Elevated Sodium
puffy/bloated appearance (fat), immunocompromised, poor wound healing
Addison's (Adrenal) Crisis - correct answer ✔✔Decreased glucose
Decreased sodium (can't reabsorb, thus water loss)
Elevated potassium (since Na low)
also, dehydration (weakness, fatigue, hypotension)
Cushing's Syndrome treatment - correct answer ✔✔Treatment for Cushing's Syndrome is
decrease corticosteroid doses (which may lead Secondary adrenal insufficiency if not weaned
down properly)
A decreased in which of the following is associated with effective tx of Addison's crisis?
- Sodium
- Glucose
- Potassium
- BP - correct answer ✔✔Potassium
Which of the following lab findings are most consistent with disseminated intravascular
coagulation?
Elevated d-dimer
elevated fibrgenogen
decrased
decreased - correct answer ✔✔
