Endocrine Nursing ADN VTC Program Exam
Questions and Answers
Cholelithiasis (gallstones) - ✅✅Fat, Female, Forty, Fertile = risk factors
Stones in the gallbladder of gallbladder duct
*if not bothersome no treatment, when bothersome can do laprascopic or open cholecystectomy.
*Can also do extracorporeal shock wave lithotripsy (ESWL)
*May also have percutaneous transhepatic biliary catheter to open blocked duct.
*If not surgical candidate may be prescribed meds such as Urosodiol or Chenodal to break up the
stones.
SX: same as cholecystitis
Cholecystitis - ✅✅Inflammation of gallbladder, can be with or without stones
SX: upper abdominal pain, can radiate to shoulder, pain triggered by high-fat or high-volume meal,
anorexia, N/V, dyspepsia, eructation, flatulence, feeling of abdominal fullness, REBOUND TENDERNESS
(Blumberg's sign), fever, jaundice, clay-colored stools, dark urine, steatorrhea.
Labs: elevated WBC, elevated ALP, AST, LDH, serum bilirubin levels
Imaging: abdominal xray, ultrasound, hepatobiliary scan
Obesity BMI - ✅✅BMI of 30-39.9
*Increases risk for CAD, vascular disease, stroke, diabetes, negative aspects of immobility, DM2, HTN,
hyperlipidemia, obstructive sleep apnea, depression and other mental health/behavior problems,
urinary incontinence, gout, cholielithiasis, chronic back pain, decreased wound healing, prone to yeast
infections in folds.
*Consult about how they feel about weight, interest in losing weight, whether they have tried losing
weight in the past, nutrition, lifestyle habits including exercise. Can also be prescribed anoretic drugs
short term.
*In order to have bariatric surgery they must do certain things first including losing a certain amount of
weight.
orexins - ✅✅appetite stimulants (neuropeptides)
, anorexins - ✅✅appetite suppressants (neuropeptides)
icteric phase - ✅✅a stage of liver disease marked by jaundice
diabetes insipidus (DI) - ✅✅antidiuretic hormone (ADH---AKA vasopressin) is not secreted, or there is
a resistance of the kidney to ADH which leads to excess fluid volume loss and hypernatremia, and low
specific gravity of urine.
*Can lose 4-30L urine in 24 hours
*GIVE THEM FLUIDS
Tx: DDAVP (desmopressin acetate)
*Daily weight, if up more then 2.2.lbs call MD
water toxicity= HA, confusion, N/V (watch for this)
**SX: hypotension, tachycardia, weak peripheral pulses, hemoconcentration, increased urine output.
low specific gravity, poor turgor, dry mucous membranes, decreased cognition, ataxia, increased thirst,
irritability. **
SIADH - ✅✅Syndrome of Inappropriate ADH in which there is too much ADH secreted causing the
body to retain the fluid as well become hyponatremic and high specific gravity..
Early Sx: anorexia, N/V. Progresses to lethargy, HA, hostility, disorientation, change in level of
consciousness, seizures, and coma, DECREASED DEEP TENDON REFLEXES.
**FULL BOUNDING PULSES, HYPOTHERMIA**
Tx: Fluid restriction, IV hypertonic saline, conivaptan/tolvaptan (vasopressin receptor antagonists which
encourages water excretion without sodium), demeclocycline.
*I/O, daily weight, fluid restriction, dilute tube feeds and mix meds with saline solution rather than
water, may also administer diuretics.
**Monitor for neuro checks and LOC as severe hyponatremia (110mEq) can cause seizures and death**
complications of bariatric surgery - ✅✅Decreases volume capacity of the stomach
-can be band, sleeve, or stapling
*Causes malabsorption syndrome
Questions and Answers
Cholelithiasis (gallstones) - ✅✅Fat, Female, Forty, Fertile = risk factors
Stones in the gallbladder of gallbladder duct
*if not bothersome no treatment, when bothersome can do laprascopic or open cholecystectomy.
*Can also do extracorporeal shock wave lithotripsy (ESWL)
*May also have percutaneous transhepatic biliary catheter to open blocked duct.
*If not surgical candidate may be prescribed meds such as Urosodiol or Chenodal to break up the
stones.
SX: same as cholecystitis
Cholecystitis - ✅✅Inflammation of gallbladder, can be with or without stones
SX: upper abdominal pain, can radiate to shoulder, pain triggered by high-fat or high-volume meal,
anorexia, N/V, dyspepsia, eructation, flatulence, feeling of abdominal fullness, REBOUND TENDERNESS
(Blumberg's sign), fever, jaundice, clay-colored stools, dark urine, steatorrhea.
Labs: elevated WBC, elevated ALP, AST, LDH, serum bilirubin levels
Imaging: abdominal xray, ultrasound, hepatobiliary scan
Obesity BMI - ✅✅BMI of 30-39.9
*Increases risk for CAD, vascular disease, stroke, diabetes, negative aspects of immobility, DM2, HTN,
hyperlipidemia, obstructive sleep apnea, depression and other mental health/behavior problems,
urinary incontinence, gout, cholielithiasis, chronic back pain, decreased wound healing, prone to yeast
infections in folds.
*Consult about how they feel about weight, interest in losing weight, whether they have tried losing
weight in the past, nutrition, lifestyle habits including exercise. Can also be prescribed anoretic drugs
short term.
*In order to have bariatric surgery they must do certain things first including losing a certain amount of
weight.
orexins - ✅✅appetite stimulants (neuropeptides)
, anorexins - ✅✅appetite suppressants (neuropeptides)
icteric phase - ✅✅a stage of liver disease marked by jaundice
diabetes insipidus (DI) - ✅✅antidiuretic hormone (ADH---AKA vasopressin) is not secreted, or there is
a resistance of the kidney to ADH which leads to excess fluid volume loss and hypernatremia, and low
specific gravity of urine.
*Can lose 4-30L urine in 24 hours
*GIVE THEM FLUIDS
Tx: DDAVP (desmopressin acetate)
*Daily weight, if up more then 2.2.lbs call MD
water toxicity= HA, confusion, N/V (watch for this)
**SX: hypotension, tachycardia, weak peripheral pulses, hemoconcentration, increased urine output.
low specific gravity, poor turgor, dry mucous membranes, decreased cognition, ataxia, increased thirst,
irritability. **
SIADH - ✅✅Syndrome of Inappropriate ADH in which there is too much ADH secreted causing the
body to retain the fluid as well become hyponatremic and high specific gravity..
Early Sx: anorexia, N/V. Progresses to lethargy, HA, hostility, disorientation, change in level of
consciousness, seizures, and coma, DECREASED DEEP TENDON REFLEXES.
**FULL BOUNDING PULSES, HYPOTHERMIA**
Tx: Fluid restriction, IV hypertonic saline, conivaptan/tolvaptan (vasopressin receptor antagonists which
encourages water excretion without sodium), demeclocycline.
*I/O, daily weight, fluid restriction, dilute tube feeds and mix meds with saline solution rather than
water, may also administer diuretics.
**Monitor for neuro checks and LOC as severe hyponatremia (110mEq) can cause seizures and death**
complications of bariatric surgery - ✅✅Decreases volume capacity of the stomach
-can be band, sleeve, or stapling
*Causes malabsorption syndrome
