CCRN- Endocrine Concepts (Barron's) Questions and Answers well Explained Latest 2024/2025 Update 100% Correct.

what are 3 treatments for DI? - 1) give ADH (pitressin, DDAVP), use cautiously in those with heart disease, may cause coronary artery ischemia 2) give fluids to replenish intravascular volume 3) monitor urinary output/specific gravity what is the pathophysiology of SIADH? (figure 10-1 pg 204) - too much ADH--> water retention--> decrease in serum Na+ (dilutional hyponatremia-CARDINAL SIGN); decreased urinary output; decreased osmolality (hypo-osmolality) measure of the number of particles in a solution; expressed as milliosmoles - serum osmolality (osmolality of body fluids) what is the normal osmolality of body fluids? - 275-295 mOsm/kg (hypo-osmolar <275 hyper-osmolar >295) true or false: cell membranes are permeable to water, therefore serum osmo will affect the intracellular fluid (ICF) osmo - true note that serum sodium, BUN, and glucose each play a role in the calculation of serum osmolality. 2(Na+) + BUN/5 + glucose/20 = 275-295 mOsm/kg. According to the formula above, an increase in serum sodium, BUN, and/or glucose will affect the serum osmo, increasing or decreasing the serum osmolality? - increase where is the hypothalamus located? - pituitary glandthe endocrine "monitoring central" and regulates temperature, intake drives, autonomic nervous system (sympathetic/parasympathetic) - hypothalamus what two parts of the body release hormones that are NOT controlled by the hypothalamus? - 1) pancreas 2) parathyroid what are three things that the hypothalamus regulates? - 1) temperature 2) intake drives 3) autonomic nervous system (sympathetic/parasympathetic) where is ADH formed? - hypothalamus where is ADH stored? - posterior pituitary this works on the distal convoluted and collecting tubule of kidney to REABSORB WATER (prevents diuresis) and concentrates urine (normal urine osmolality (1.010-1.020) - ADH what are 5 etiologies of SIADH? - 1) oat cell carcinoma (most common) 2) viral pneumonia (most common) 3) head problems (most common) 4) increased osmolality, anesthesia, analgesia, stress 5) thiazide diuretics (esp elderly) what is the biggest danger of hyponatremia?** - SEIZURE*** what are 4 treatments of SIADH? - 1) address etiology -oat cell carcinoma, viral pneumonia, head problems 2) fluid restriction3) 3% saline (generally reserved for serum Na+ less than 120 mEq/L) 4) NO hypotonic solutions or free water what is the pathophysiology of diabetes insipidus (DI)? - not enough ADH--> WATER loss--> increased serum Na+ (hypernatremia), UO 6-24 L/day** (low urine S.G.), increased serum osmolality (hyper-osmolality) what is a cardinal sign of SIADH?*** - dilutional hyponatremia (decreased serum Na+) what is a major symptom of DI?*** - DILUTE urine (specific gravity 1.001-1.005) what are 2 etiologies of DI? - 1) head problems (surgery, trauma) 2) phenytoin (Dilantin) what is a complication of DI? - hypovolemia, hypovolemic shock Diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS)?*** pts are typically younger - DKA Diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS)?*** usually associated with type I diabetes or new onset of type I - DKA Diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS)?*** an etiology may be infection - DKA Diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS)?*** an etiology may be stress - DKADiabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS)?*** an etiology may be noncompliance - DKA Diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS)?*** pts are typically older - HHS Diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS)?*** usually associated with type II diabetes - HHS