NURS 3628: Med Surg 2 -Final HESI Review. Questions & Answers.

Med surg 1 review/Med surg 2 review: Renal assessment Bun 8 – 25 Creatinine 0.6 – 1.3 Uric acid 2.5 – 8 Potassium 3.5 - 5 GFR 125/min (>60 is good for kidney pt) Specific gravity – 1.003 – 1.02 AST: 0 – 35 ALT: 10 – 35 Albumin: 3.5 – 5.5 (same as potassium) Bilirubin: 0.1 – 1.2 mg/dl Amylase: 25-150 Lipase: 10 – 140 Thyroid  Hypothyroid- high TSH (trying to stimulate thyroid to work), low T3 and T4 o Everything slows down (bowel movements), hair falls out, dry skin, fat, fatigue, Puffy face o Give synthroid in morning before meals (at same time) o Myxedema (opposite of thyroid storm) – decrease mental status, hypothermia, slowing of organ function o After a thyroidectomy, a client is at risk for developing hypocalcemia.  Trousseau sign (carpal spasm w BP cuff)  Hyperthyroid- TSH is low (thyroid already working too much) o Thyroid storm, inc BP, diarrhea, weight loss, exopthalamous, heat intolerance, nausea o Thryorid storm - fever, hyperreflexia, abdominal pain, diarrhea, dehydration rapidly progressing to coma, severe tachycardia, extreme vasodilation  Radioactive iodine- stay away from pregnant people and chidren for 24 hours  Thyroidectomy- watch for hypothyroid, HOB raised (incision), watch for blood. Watch for thyroid storm.  Graves disease is the result of increased thyroid, not parathyroid, activity.