NURS 4020 Complete Final Exam and
All Correct Answers.
Hypocalcemia - Answer less than 8.5
causes: hypoparathyroidism, malabsorption, renal failure, pancreatitis
s/sx: tachy, hypotension, bone pain cramps, parasthesias, tetany, chvostek, diarrhea, trousseau
tx: ca supplements, increased ca intake
Hypercalcemia - Answer greater than 10.5
causes: hyperparathyroidism, excessive ca supplementation, thiazide diuretic
s/sx: HTN, lethargy, polyuria, polydipsia, decreased DTR, constipation, confusion, muscle
weakness
Tx: dialysis, limit Ca intake, increase fiber
Hypomagnesemia - Answer less than 1.5
causes: prolonged gastric suctioning, uncontrolled DM
S/Sx: weakness, dysrhythmias, HTN, increased DTR, respiratory depression, tetany, trousseaus,
chvostek, parasthesias
Tx: oral Mg, increase oral intake
hypermanesemia - Answer more than 2.5
causes: renal insufficiency, excess consumption or IV intake
s/sx: hypotension, bradycardia, CNS depression, coma, respiratory distress, flushing, decreased
DTR
,Tx: dialysis, restrict Mg in diet, loop diuretics
Hypophosphatemia - Answer less than 2.5
reverse symptoms of calcium
s/sx: confusion, weakness, decreased DTRs
Hyperphosphatemia - Answer greater than 4.5
s/sx: tetany, chvostek, trousseau
Hypokalemia - Answer less that 3.5
causes: potassium wasting diuretics, vomiting and diarrhea, strenous activity
s/sx: confusion, hypoactive bowel, lethargy, weakness, limp, polyuria, constipation, cramps,
bradycardia, hypotension, PVCs, dysrhythmias
tx: increase in diet, oral potassium, parenteral
NEVER IV BOLUS POTASSIUM
Hyperkalemia - Answer greater than 5
causes: excessive intake, potassium-sparing diuretics, kidney failure
s/sx: muscle twitching, bradycardia, hypotension, PVCs, dysrhythmias, irritability, paresthesias,
oliguria, diarrhea, fatigue, cramping,
tx: IV dextrose with regular insuling, lasix, calcium gluconate kayexalate
hypervolemia - Answer HTN
bounding pulse
,JVD
oliguria
confusion
fatigue
dyspnea
edema
hypovolemia - Answer hypotension
weak, rapid pulse
flattened neck veins
n/v
confusion
lethargy
HA
dizziness
muscle cramps/ weakness
twitching
Hyponatremia - Answer less than 135
causes: burns, high ADH, excessive dilution with IV fluids
s/sx: seizures, abdominal distress (n/v, cramping), hypotension, tachycardia, hypothermia,
confusion, weak, lethargy
tx: treat underlying cause, loop diuretics, NaCl
Hypernatremia - Answer greater than 145
causes: kidney damage, excess IV fluids with NaCl, excess intake, hypertonic enteral feedings,
diarrhea, burns
s/sx:seizures, abdominal distress (n/v, cramps), hypotension, tachycarida, dehydration, agitated,
fluid retention, fever
Cushing's disease pathophysiology - Answer hypercortisolism
, excess secretion of cortisol from adrenal cortex
-caused by adrenal cortex, anterior pituitary, hypothalamus
increases total body fat from slow turnover of fatty acids
increase break down of tissue protein leads to decreased muscle mass
decreased lymphocytes leads to increased risk for infection
Cushing's disease s/sx - Answer moon face
buffalo hump
weight gain
HTN
dependent edema
muscle atrophy
osteoporosis
thinning skin
increased risk for infection
Addison's disease pathophysiology - Answer hypocortisolism
inadequate cortisol production
caused by inadequate ACTH, dysfunction of HPA, or direct dysfunction of adrenal gland
decreased aldosterone leads to hyperkalemia, hyponatremia, hypovolemia, acidosis
decreased cortisol leads to hypoglycemia, decreased gastric acid and GFR, increased BUN,
anorexia
decreased androgen leads to decreased body hair
Addison's disease s/sx - Answer muscle weakness
fatigue
All Correct Answers.
Hypocalcemia - Answer less than 8.5
causes: hypoparathyroidism, malabsorption, renal failure, pancreatitis
s/sx: tachy, hypotension, bone pain cramps, parasthesias, tetany, chvostek, diarrhea, trousseau
tx: ca supplements, increased ca intake
Hypercalcemia - Answer greater than 10.5
causes: hyperparathyroidism, excessive ca supplementation, thiazide diuretic
s/sx: HTN, lethargy, polyuria, polydipsia, decreased DTR, constipation, confusion, muscle
weakness
Tx: dialysis, limit Ca intake, increase fiber
Hypomagnesemia - Answer less than 1.5
causes: prolonged gastric suctioning, uncontrolled DM
S/Sx: weakness, dysrhythmias, HTN, increased DTR, respiratory depression, tetany, trousseaus,
chvostek, parasthesias
Tx: oral Mg, increase oral intake
hypermanesemia - Answer more than 2.5
causes: renal insufficiency, excess consumption or IV intake
s/sx: hypotension, bradycardia, CNS depression, coma, respiratory distress, flushing, decreased
DTR
,Tx: dialysis, restrict Mg in diet, loop diuretics
Hypophosphatemia - Answer less than 2.5
reverse symptoms of calcium
s/sx: confusion, weakness, decreased DTRs
Hyperphosphatemia - Answer greater than 4.5
s/sx: tetany, chvostek, trousseau
Hypokalemia - Answer less that 3.5
causes: potassium wasting diuretics, vomiting and diarrhea, strenous activity
s/sx: confusion, hypoactive bowel, lethargy, weakness, limp, polyuria, constipation, cramps,
bradycardia, hypotension, PVCs, dysrhythmias
tx: increase in diet, oral potassium, parenteral
NEVER IV BOLUS POTASSIUM
Hyperkalemia - Answer greater than 5
causes: excessive intake, potassium-sparing diuretics, kidney failure
s/sx: muscle twitching, bradycardia, hypotension, PVCs, dysrhythmias, irritability, paresthesias,
oliguria, diarrhea, fatigue, cramping,
tx: IV dextrose with regular insuling, lasix, calcium gluconate kayexalate
hypervolemia - Answer HTN
bounding pulse
,JVD
oliguria
confusion
fatigue
dyspnea
edema
hypovolemia - Answer hypotension
weak, rapid pulse
flattened neck veins
n/v
confusion
lethargy
HA
dizziness
muscle cramps/ weakness
twitching
Hyponatremia - Answer less than 135
causes: burns, high ADH, excessive dilution with IV fluids
s/sx: seizures, abdominal distress (n/v, cramping), hypotension, tachycardia, hypothermia,
confusion, weak, lethargy
tx: treat underlying cause, loop diuretics, NaCl
Hypernatremia - Answer greater than 145
causes: kidney damage, excess IV fluids with NaCl, excess intake, hypertonic enteral feedings,
diarrhea, burns
s/sx:seizures, abdominal distress (n/v, cramps), hypotension, tachycarida, dehydration, agitated,
fluid retention, fever
Cushing's disease pathophysiology - Answer hypercortisolism
, excess secretion of cortisol from adrenal cortex
-caused by adrenal cortex, anterior pituitary, hypothalamus
increases total body fat from slow turnover of fatty acids
increase break down of tissue protein leads to decreased muscle mass
decreased lymphocytes leads to increased risk for infection
Cushing's disease s/sx - Answer moon face
buffalo hump
weight gain
HTN
dependent edema
muscle atrophy
osteoporosis
thinning skin
increased risk for infection
Addison's disease pathophysiology - Answer hypocortisolism
inadequate cortisol production
caused by inadequate ACTH, dysfunction of HPA, or direct dysfunction of adrenal gland
decreased aldosterone leads to hyperkalemia, hyponatremia, hypovolemia, acidosis
decreased cortisol leads to hypoglycemia, decreased gastric acid and GFR, increased BUN,
anorexia
decreased androgen leads to decreased body hair
Addison's disease s/sx - Answer muscle weakness
fatigue
