NURS 3710 EXAM 4 QUESTIONS WITH ACCURATE
ANSWERS RATED A+
types of posterior pituitary disorders - ANSWER DI
SIADH
patho of DI - ANSWER decreased ADH --> decreased water absorption --> decreased
intravascular volume (AKA dehydration) --> increased serum osmolality (hypernatremia)
& excessive urine output (polyuria)
causes of DI - ANSWER recent head surgery, trauma
urine SPGR in DI - ANSWER < 1.005
key features of DI - ANSWER dehydration S/S, increased thirst, polyuria, weak
peripheral pulses, dilute clear urine, decreased cognition
if a person presents with signs of DI but no definitive diagnosis, what should the nurse
ask the patient? - ANSWER have you had any recent head surgery/injury or trauma?
what is the first diagnostic tests the nurse should anticipate for DI? - ANSWER 24hr
I&Os with no restrictions; UO = 4-30L
normal SPGR - ANSWER 1.005-1.030
what is the purpose of desmopressin acetate (DDAVP)? - ANSWER it's a synthetic form
of vasopressin
replaces ADH and decreases urination
,route of desmopressin - ANSWER oral, sublingual, intranasally
what disease is desmopressin used for? - ANSWER DI
what is the therapeutic response of desmopressin acetate? - ANSWER decreased
urination
for example, if a patient initially had a UO of 6L of dilute urine and after 6 days of taking
the drug, his UO was 1100 mL, the response would be considered therapeutic
what should the nurse be watching for when a patient is on desmopressin? - ANSWER
fluid overload due to water retention
so weigh the patient daily
what weight gain is considered fluid retention? - ANSWER > 2.2 lbs/1day
if a patient has DI, what should be a priority focus by the nurse? - ANSWER maintaining
hydration
--- monitor weight, I&Os, urine SPGR
what would be some indicators of the need to decrease a patient's dose of
desmopressin? - ANSWER weight gain = fluid retention
what should the nurse teach a patient taking desmopressin for DI before discharge? -
ANSWER weight
,(if n/v, go to ER due to water toxicity)
carry med alert bracelet
SIADH pathophysiology - ANSWER increased ADH --> increased water reabsorption -->
increased intravascular fluid volume (AKA fluid overload) --> dilutional hyponatremia
and decreased serum osmolality
S/S of SIADH - ANSWER decreased serum sodium (due to dilution) = increased urine
sodium --> disorientation
weight gain, decreased urination, hypertension, full & bounding pulse, hypothermia
what is the relationship between lung cancer and SIADH? - ANSWER lung malignancies
make more ADH
urine SPGR in SIADH - ANSWER > 1.030
because urine concentration is high
labs seen in SIADH - ANSWER decreased serum sodium
increased urine sodium
increased urine osmolarity
increased urine SPGR
decreased plasma osmolarity (b/c increased intravascular volume)
labs seen in DI - ANSWER large volumes of dilute urine
decreased urine SPGR
decreased urine osmolarity
, drug therapy for SIADH - ANSWER vasopressin receptor antagonists = tovaptan,
conivaptan
what are priority actions for a patient with SIADH? - ANSWER fluid restrictions, I&Os,
weight
why would conivaptan be prescribed? - ANSWER to promote water excretion without
sodium loss
therapeutic response of conivaptan - ANSWER increased urine output
increased sodium
decreased weight
decreased SPGR
why would conivaptan be used for SIADH instead of diuretics? - ANSWER conivaptan
are used when hyponatremia is present
diuretics are only used when sodium is near normal with heart failure
adrenal cortex hormones - ANSWER cortisol
aldosteron
functions of cortisol - ANSWER regulates metabolism
increases blood glucose
critical in physiologic stress response
what should the nurse monitor when giving conivaptan? - ANSWER sodium... there is a
concern for hypernatremia
ANSWERS RATED A+
types of posterior pituitary disorders - ANSWER DI
SIADH
patho of DI - ANSWER decreased ADH --> decreased water absorption --> decreased
intravascular volume (AKA dehydration) --> increased serum osmolality (hypernatremia)
& excessive urine output (polyuria)
causes of DI - ANSWER recent head surgery, trauma
urine SPGR in DI - ANSWER < 1.005
key features of DI - ANSWER dehydration S/S, increased thirst, polyuria, weak
peripheral pulses, dilute clear urine, decreased cognition
if a person presents with signs of DI but no definitive diagnosis, what should the nurse
ask the patient? - ANSWER have you had any recent head surgery/injury or trauma?
what is the first diagnostic tests the nurse should anticipate for DI? - ANSWER 24hr
I&Os with no restrictions; UO = 4-30L
normal SPGR - ANSWER 1.005-1.030
what is the purpose of desmopressin acetate (DDAVP)? - ANSWER it's a synthetic form
of vasopressin
replaces ADH and decreases urination
,route of desmopressin - ANSWER oral, sublingual, intranasally
what disease is desmopressin used for? - ANSWER DI
what is the therapeutic response of desmopressin acetate? - ANSWER decreased
urination
for example, if a patient initially had a UO of 6L of dilute urine and after 6 days of taking
the drug, his UO was 1100 mL, the response would be considered therapeutic
what should the nurse be watching for when a patient is on desmopressin? - ANSWER
fluid overload due to water retention
so weigh the patient daily
what weight gain is considered fluid retention? - ANSWER > 2.2 lbs/1day
if a patient has DI, what should be a priority focus by the nurse? - ANSWER maintaining
hydration
--- monitor weight, I&Os, urine SPGR
what would be some indicators of the need to decrease a patient's dose of
desmopressin? - ANSWER weight gain = fluid retention
what should the nurse teach a patient taking desmopressin for DI before discharge? -
ANSWER weight
,(if n/v, go to ER due to water toxicity)
carry med alert bracelet
SIADH pathophysiology - ANSWER increased ADH --> increased water reabsorption -->
increased intravascular fluid volume (AKA fluid overload) --> dilutional hyponatremia
and decreased serum osmolality
S/S of SIADH - ANSWER decreased serum sodium (due to dilution) = increased urine
sodium --> disorientation
weight gain, decreased urination, hypertension, full & bounding pulse, hypothermia
what is the relationship between lung cancer and SIADH? - ANSWER lung malignancies
make more ADH
urine SPGR in SIADH - ANSWER > 1.030
because urine concentration is high
labs seen in SIADH - ANSWER decreased serum sodium
increased urine sodium
increased urine osmolarity
increased urine SPGR
decreased plasma osmolarity (b/c increased intravascular volume)
labs seen in DI - ANSWER large volumes of dilute urine
decreased urine SPGR
decreased urine osmolarity
, drug therapy for SIADH - ANSWER vasopressin receptor antagonists = tovaptan,
conivaptan
what are priority actions for a patient with SIADH? - ANSWER fluid restrictions, I&Os,
weight
why would conivaptan be prescribed? - ANSWER to promote water excretion without
sodium loss
therapeutic response of conivaptan - ANSWER increased urine output
increased sodium
decreased weight
decreased SPGR
why would conivaptan be used for SIADH instead of diuretics? - ANSWER conivaptan
are used when hyponatremia is present
diuretics are only used when sodium is near normal with heart failure
adrenal cortex hormones - ANSWER cortisol
aldosteron
functions of cortisol - ANSWER regulates metabolism
increases blood glucose
critical in physiologic stress response
what should the nurse monitor when giving conivaptan? - ANSWER sodium... there is a
concern for hypernatremia
