MED SURG II – MASTER HESI REVIEW LATEST UPDATE 2023 | VERIFIED

1) Diabetes Insipidus – page • Caused by a deficiency of production of ADH or a decreased renal response to ADH. • Clinical Manifestations: Polydipsia and Polyuria. • Diagnostic Studies: Water deprivation test (pt deprived of water for 8-12 hrs and then given desmopressin acetate subcut or nasally), Measure level of ADH after an analog of ADH is given. • Types of Diabetic Insipidus: Central DI (results from an interference of ADH synthesis, transport, and release. Ex: brain tumor, head injury, brain surgery, CNS infection), Nephrogenic DI (results from inadequate renal response to ADH despite presence of adequate ADH. Ex: Drug therapy, renal damage, hereditary renal disease), Primary DI (Results from excessive water intake. Ex: Structural lesion in thirst center, psychological disorder). • Nursing Management: Early detection, Maintaining adequate hydration, and patient teaching for long-term management. 2) Healthcare associated pneumonia • Also known as nosocomial pneumonia, pneumonia in a non-intubated patient that begins 48 hours or longer after admission to hospital and was not present at the time of admission. Ventilator- associated pneumonia, also a type of HAP, refers to pneumonia that occurs more than 48 hours after endotracheal intubation. • Treatment: Antibiotics that can be started as soon as sputum cultures identify the exact pathogen. • Risks: In treatment of pneumonia, risk of developing multidrug-resistant organisms. Limits the available antibiotics that can be used as treatment.