CCRN Latest 2023 with Certified Solutions

CCRN Latest 2023 with Certified Solutions SIADH too much water, dilutional hyponatremia. Decreased osmolarity=hypoosmolar. Decreased urinary output. CSF normal protein, glucose, WBCs, specific gravity, Protein <100, Glucose: 70 WBCs: 4 cells/mm2 Specific gravity 1.007 Poikothermia fluctuation of core body temperature of more than 2° C due to changes in ambient room temperature pathophysiology of a seizure neurons in the cerebral cortex fire at the same time in a paroxysmal burst. System driven outcome include length of stay, readmission rate, and resource utilization. Arterial supply to the brain: vertebrobasilar, common carotid, meningeal arteries The vertebrobasilar arteries supply the posterior portion of the brain. The common carotid arteries supply the anterior area of the brain. The meningeal arteries supply the superior portion of the brain. Pheochromocytoma adrenal medulla,hi epi/norepi. s/s: hypertension, sweating, headache, palpitations, apprehension, nausea/vomiting, tremor, pallor, abdominal pain, chest pain, and hyperglycemia. Acute radiation syndrome large doses of ionizing radiation , Circulatory collapse, increased intracranial pressure, vasculitis, and meningitis causing death within 3 days Complications of SIADH seizure activity Treatment of SIADH (avoid what solutions?) Fluid restriction 3% nacl (1500 osmolarity over 25cc/hr or less) Dont do hypotonic solutions! Asses for fluid overload hypertonic solutions D5LR; D5 1/2 NS; D5NS hypotonic solutions 0.5% NS (HNS or 0.45% NS); 2.5% dextrose in 0.45% NS (D2.5 45% NS) Osmolality and Sodium 275-295= normal osmolality. Sodium=135-145. Usually 2X of Na Causes of SIADH Viral PNA Oat cell carcinoma Head problems Increased serum osmolality Anesthesia and analgesics Stress Diabetes insipidus (urine specific gravity?) No ADH, can't keep water, increased UOP. Hypernatremic, hyperosmolar, increased urinary output