Final Exam Review Nurs 6531 Deck 1

Final Exam Review Nurs 6531 Deck 1 What are signs & symptoms of SIADH (Syndrome of inappropriate antidiuretic hormone)? - ANSWER Increased production of ADH (antidiuretic hormone), hyponatremia, concentrated urine (from excess water resorption), elevated urine osmolality, mental status changes from cerebral edema. Diabetes insipidus is associated with what sodium level? - ANSWER Hypernatremia Psychogenic polydipsia results in urine that is: - ANSWER diluted with low osmolality and hyponatremia How would you determine the cause of a patient's AKI who presents with decreased urine output, history of neurogenic bladder, chronic foley, dark urine, and Cr increase from 1.3 to 2.1 over 3 months? - ANSWER Flush the foley catheter to see if urine comes out and assess the patency of the catheter. This action will unblock clogged sediment or biofilm from chronic bacteriuria. When a female patient presents to the ER after sexual assault, what medications should be offered prior to discharge? - ANSWER Ceftriaxone, azithromycin, Plan B, and Metronidazole. Manifestations of Conn syndrome (hyperaldosteronism)? - ANSWER hypernatremia, hypokalemia, and hypertension What causes Cushing syndrome? - ANSWER Increased levels of glucocorticoids, can be exogenous (from therapy) or endogenous (from adenoma or neoplasm). Manifestations of Cushing syndrome? - ANSWER hypertension, truncal obesity, osteoporosis, skin fragility, and hyperglycemia. What differentiates primary adrenocortical insufficiency from secondary adrenocortical insufficiency? - ANSWER Skin hyperpigmentation is present in primary adrenocortical insufficiency What is Trousseau's sign? - ANSWER A carpal spasm elicited by compression of the upper arm with a BP cuff that indicates hypocalcemia. What is Chovstek's sign? - ANSWER A hemifacial tic that is induced by tapping the facial nerve below the maxilla that indicates hypocalcemia. What is Babinski's sign? - ANSWER An upward response (extension) of the hallux when the sole of the foot is stimulated with a blunt instrument. Can identify spinal cord disease in adults. What is Romberg's sign? - ANSWER Loss of balance in standing when eyes are closed. Usually indicating a loss of proprioception or lesion in the cerebellum. What is Homan's sign? - ANSWER pain on passive dorsiflexion of ankle, associated with DVT. What is the clinical presentation of Goodpasture's syndrome? - ANSWER Urinalysis: Specific gravity: 1.020. pH 5.5, 1+ albumin and large blood present. Chest XR positive for bilateral diffuse infiltrates. BUN 30, Cr 3.0 Symptoms: dyspnea with hemoptysis What is Goodpasture syndrome? - ANSWER Damage to alveolar and renal glomerular basement membranes by cytotoxic antibody. Initial treatment for Goodpasture's syndrome? - ANSWER Hospitalization, pulse dose of steroids, begin plasmapheresis and cyclophosphamide therapy. Characteristics of Grave's disease - ANSWER Ophthalmopathy (lid retraction, scleral show, proptosis) and hyperthyroidism What organism causes the formation of a staghorn calculus? - ANSWER Proteus mirabilus What organism causes Toxic shock syndrome? - ANSWER Staphylococcus aureus What electrolyte disturbance is most likely to lead to tetany and neuromuscular irritability? - ANSWER Hypocalcemia Features of hypercalcemia include? - ANSWER "Stones, groans, moans, and bones." Delerium and renal stones When you see hypochloremia, the patient may have? - ANSWER Metabolic Alkalosis Hyperkalemia is associated with what cardiac abnormalities? - ANSWER peaked Twaves, wide QRS, and ventricular arrhythmias. A patient presents with arcus cornea, LDL 285, TG 110, HDL 45, and father died of an MI at age 45. What is his most likely diagnosis? - ANSWER Heterozygous familial hypercholesterolemia A fasting blood glucose level of 130 mg/dL indicates: - ANSWER Diabetes What are risk factors for ectopic pregnancy? - ANSWER smoking, previous tubal surgery, previous ectopic pregnancy, exposure to diethylibestrol, current IUD, PID, advanced maternal age, infertilitiy for more than 2 years. What hormones are most critical to replace in a patient at risk for anterior pituitary insufficiency? - ANSWER Glucocorticoids, and thyroid hormone What is diabetes insipidus? - ANSWER a disorder caused by inadequate amounts of ADH which causes excessive water loss CKD Stage 1 - ANSWER GFR 90 with evidence of renal damage, as indicated by proteinuria. CKD Stage 2 - ANSWER GFR 60-89 CKD Stage