NURS 130 EXAM #4 | ACTUAL STUDY |
QUESTIONS WITH ANSWERS
Increase of Human Growth Hormone (HGH) could result in what two disorders?
Decrease of Human Growth Hormone (HGH) could result in what disorder? - ANSW-Increase of HGH
could result in acromegaly or gigantism.
Decrease of HGH could result in dwarfism.
What is acromegaly?
What causes it?
When does it occur? - ANSW-Acromegaly is an increased growth of body parts/extremities, without
increased height.
Acromegaly is typically caused by a tumor.
Acromegaly occurs after puberty.
What is gigantism?
When does it occur? - ANSW-Gigantism is an increased growth of body parts/extremities, as well as
height.
Gigantism occurs in childhood.
What is dwarfism?
Are there any complications associated with dwarfism? - ANSW-Dwarfism is disproportionate, limited
growth.
There are no associations with limited life, and no treatment available.
How are acromegaly and gigantism typically treated?
Detail nursing care associated. - ANSW-Acromegaly and gigantism are typically treated with a
hypophysectomy (removal of the pituitary gland).
Hemorrhage is a concern; patients will receive nasal packing that stays in place 2-4 days.
Bedrest for 24 hours; HOB at semi-fowlers or higher to decrease swelling and facilitate drainage.
Teach the patient not to sneeze, cough, vomit or strain.
Monitor for signs of CSF leaks.
What is diabetes insipidus (DI)?
What are the three primary symptoms? - ANSW-DI is the result of low ADH/vasopressin secretion.
The primary symptoms of DI are: polyurea, polydipsia, and electrolyte imbalances.
What is the quality of DI urine? SG?
About how many liters will a DI patient urinate in a day?
About how many liters will a DI patient consume in a day?
Which electrolytes are most impacted by DI? - ANSW-Urine is dilute; SG is very low (1.003).
DI patients will urinate 3-20 liters per day.
DI patients will consume 2-20 liters per day.
DI patients will experience high sodium levels, and low potassium due to dehydration.
,How will urine labs compare to blood labs in DI patients? - ANSW-Urine labs will be very dilute (low,
because of the high quantity), while blood labs will be very concentrated (high, because of the low
quantity).
What is the primary complication of DI?
Detail nursing care associated. - ANSW-The primary complication of DI is FVD, which leads to
hypovolemic shock and vascular collapse.
Treatment of DI includes:
Give fluids and vasopressors.
Replace ADH (vasopressin or desmopressin).
Identify the causative agent and correct it.
What is SIADH?
What are symptoms of SIADH?
What is the primary complication of DI?
Detail nursing care associated. - ANSW-SIADH is an increase in ADH production, resulting in urinary
retention.
Symptoms of SIAFH include: headache, LOC; weakness; anorexia with weight gain (due to excess fluid);
decreased sodium (which could cause ALOC, seizures, coma, death).
The primary complication of SIADH is low sodium due to FVE.
Treatment of SIADH includes:
Identify the causative agent and correct it.
Restrict fluid intake (500-1000 mL/day); administer diuretics (*monitor potassium status*); monitor QD
weights, I&Os, urine SG, neurological status, and pulmonary edema; administer hypertonic IV solution
(3% NS).
How will urine labs compare to blood labs in SIADH patients? - ANSW-Urine labs will be very
concentrated (high, because of the low quantity), while blood labs will be very dilute (low, because of
the high quantity).
What is Cushing's disease? What is it usually caused by? How is it diagnosed?
What are symptoms of Cushing's disease?
What is the treatment for Cushing's disease? - ANSW-Cushing's disease is an over-secretion of cortisol,
usually caused by tumors, head injuries or long-term steroid use; it is diagnosed off the dexamethasone
suppression test.
Symptoms of Cushing's disease are BIG:
Big face (moon face, truncal obesity, buffalo hump, stria/stretch marks, virilization/masculine traits);
increased BG; bone fractures; bruising (thin, fragile skin).
Increased risk of infection; increased BP; impaired immunity; impaired inflammation response.
Growth of hair (overgrowth in armpits, groin, chest, face; acne and low voice); GI disturbances
(increased gastric ulcers and increased gastric acid).
Treatment is a hypophysectomy.
What is Addison's disease? What is it usually caused by?
What are symptoms of Addison's disease?
, What is adrenal crisis/Addisonian crisis?
What is the treatment for ardenal crisis? - ANSW-Addison's disease is a decrease in cortisol, or the
abrupt cessation of steroids.
Symptoms of Addison's disease include: muscular weakness, fatigue; anorexia and weight loss;
hypotension, dizziness, orthostatic hypotension; low BG, low sodium (patient will crave sodium).
Adrenal crisis is a progression of the disease with severe hypotension (leads to shock), profound low BG
(leads to seizures and death), and pallor and cyanosis.
Treatment during adrenal crisis includes:
Fluid resuscitation
IV steroids
Monitor BP, electrolytes, and BG.
Educate the patient to: administer lifelong steroid replacement; increase dosage during times of stress;
orthostatic hypotension safety; have small, but frequent meals, with high protein; take rest periods.
What three hormones does the thyroid produce? What do they do?
What element is essential for thyroid hormone production? What physiological manifestation occurs if
there is not enough of that element? - ANSW-The thyroid produces thyroxine (T4), triiodothyronine (T3),
and thyrocalcitonin. T3 and T4 regulate the metabolism of cholesterol, protein, and fats. Thyrocalcitonin
lowers the levels of calcium and phosphate in the blood and promotes the formation of bone.
Iodine is essential for thyroid hormone production. If a patient lacks iodine, they may have a goiter.
What is the relationship between T3, T4, and TSH? - ANSW-Thyroid hormones are regulated through
negative feedback; when T3 and T4 are low, TSH increases.
What is Grave's disease? What is it usually caused by?
What are symptoms of Grave's disease?
What is the treatment for Grave's disease?
What is thyroid storm?
What is the treatment for thyroid storm? - ANSW-Grave's disease is an autoimmune disorder with an
unknown cause. It is an increased T3 and T4, with a decrease TSH.
Symptoms of Grave's disease are all related to hyperactivity of the metabolism: insomnia; lack of ability
to concentrate; ALOC; muscle weakness, hyperreflexia, exercise intolerance; weight-loss, anorexia; heat
intolerant; increased temperature; goiter, dyspnea; exophthalmos, photophobia and blurred vision; thin
hair, hair loss, fine and silky texture; increase GI frequency, abdominal cramping, nausea and vomiting;
increased BP, increased HR.
Assist with activity and rest; create a calm environment; I&Os, QD weight, increased calories and
proteins; use cooling measures; avoid excessive palpation of the thyroid; eye protection (exophthalmos
prevents eyelid from full closure); give IV fluids.
Thyroid storm is a life-threatening complication. Begins with increased CO, that becomes decreased CO
when the body cannot compensate. Characterized by: high HR, atrial fibrillation,
True or False.
An increase of temperature one degree warrants a call to the doctor for patients with with Grave's
disease. - ANSW-True.
QUESTIONS WITH ANSWERS
Increase of Human Growth Hormone (HGH) could result in what two disorders?
Decrease of Human Growth Hormone (HGH) could result in what disorder? - ANSW-Increase of HGH
could result in acromegaly or gigantism.
Decrease of HGH could result in dwarfism.
What is acromegaly?
What causes it?
When does it occur? - ANSW-Acromegaly is an increased growth of body parts/extremities, without
increased height.
Acromegaly is typically caused by a tumor.
Acromegaly occurs after puberty.
What is gigantism?
When does it occur? - ANSW-Gigantism is an increased growth of body parts/extremities, as well as
height.
Gigantism occurs in childhood.
What is dwarfism?
Are there any complications associated with dwarfism? - ANSW-Dwarfism is disproportionate, limited
growth.
There are no associations with limited life, and no treatment available.
How are acromegaly and gigantism typically treated?
Detail nursing care associated. - ANSW-Acromegaly and gigantism are typically treated with a
hypophysectomy (removal of the pituitary gland).
Hemorrhage is a concern; patients will receive nasal packing that stays in place 2-4 days.
Bedrest for 24 hours; HOB at semi-fowlers or higher to decrease swelling and facilitate drainage.
Teach the patient not to sneeze, cough, vomit or strain.
Monitor for signs of CSF leaks.
What is diabetes insipidus (DI)?
What are the three primary symptoms? - ANSW-DI is the result of low ADH/vasopressin secretion.
The primary symptoms of DI are: polyurea, polydipsia, and electrolyte imbalances.
What is the quality of DI urine? SG?
About how many liters will a DI patient urinate in a day?
About how many liters will a DI patient consume in a day?
Which electrolytes are most impacted by DI? - ANSW-Urine is dilute; SG is very low (1.003).
DI patients will urinate 3-20 liters per day.
DI patients will consume 2-20 liters per day.
DI patients will experience high sodium levels, and low potassium due to dehydration.
,How will urine labs compare to blood labs in DI patients? - ANSW-Urine labs will be very dilute (low,
because of the high quantity), while blood labs will be very concentrated (high, because of the low
quantity).
What is the primary complication of DI?
Detail nursing care associated. - ANSW-The primary complication of DI is FVD, which leads to
hypovolemic shock and vascular collapse.
Treatment of DI includes:
Give fluids and vasopressors.
Replace ADH (vasopressin or desmopressin).
Identify the causative agent and correct it.
What is SIADH?
What are symptoms of SIADH?
What is the primary complication of DI?
Detail nursing care associated. - ANSW-SIADH is an increase in ADH production, resulting in urinary
retention.
Symptoms of SIAFH include: headache, LOC; weakness; anorexia with weight gain (due to excess fluid);
decreased sodium (which could cause ALOC, seizures, coma, death).
The primary complication of SIADH is low sodium due to FVE.
Treatment of SIADH includes:
Identify the causative agent and correct it.
Restrict fluid intake (500-1000 mL/day); administer diuretics (*monitor potassium status*); monitor QD
weights, I&Os, urine SG, neurological status, and pulmonary edema; administer hypertonic IV solution
(3% NS).
How will urine labs compare to blood labs in SIADH patients? - ANSW-Urine labs will be very
concentrated (high, because of the low quantity), while blood labs will be very dilute (low, because of
the high quantity).
What is Cushing's disease? What is it usually caused by? How is it diagnosed?
What are symptoms of Cushing's disease?
What is the treatment for Cushing's disease? - ANSW-Cushing's disease is an over-secretion of cortisol,
usually caused by tumors, head injuries or long-term steroid use; it is diagnosed off the dexamethasone
suppression test.
Symptoms of Cushing's disease are BIG:
Big face (moon face, truncal obesity, buffalo hump, stria/stretch marks, virilization/masculine traits);
increased BG; bone fractures; bruising (thin, fragile skin).
Increased risk of infection; increased BP; impaired immunity; impaired inflammation response.
Growth of hair (overgrowth in armpits, groin, chest, face; acne and low voice); GI disturbances
(increased gastric ulcers and increased gastric acid).
Treatment is a hypophysectomy.
What is Addison's disease? What is it usually caused by?
What are symptoms of Addison's disease?
, What is adrenal crisis/Addisonian crisis?
What is the treatment for ardenal crisis? - ANSW-Addison's disease is a decrease in cortisol, or the
abrupt cessation of steroids.
Symptoms of Addison's disease include: muscular weakness, fatigue; anorexia and weight loss;
hypotension, dizziness, orthostatic hypotension; low BG, low sodium (patient will crave sodium).
Adrenal crisis is a progression of the disease with severe hypotension (leads to shock), profound low BG
(leads to seizures and death), and pallor and cyanosis.
Treatment during adrenal crisis includes:
Fluid resuscitation
IV steroids
Monitor BP, electrolytes, and BG.
Educate the patient to: administer lifelong steroid replacement; increase dosage during times of stress;
orthostatic hypotension safety; have small, but frequent meals, with high protein; take rest periods.
What three hormones does the thyroid produce? What do they do?
What element is essential for thyroid hormone production? What physiological manifestation occurs if
there is not enough of that element? - ANSW-The thyroid produces thyroxine (T4), triiodothyronine (T3),
and thyrocalcitonin. T3 and T4 regulate the metabolism of cholesterol, protein, and fats. Thyrocalcitonin
lowers the levels of calcium and phosphate in the blood and promotes the formation of bone.
Iodine is essential for thyroid hormone production. If a patient lacks iodine, they may have a goiter.
What is the relationship between T3, T4, and TSH? - ANSW-Thyroid hormones are regulated through
negative feedback; when T3 and T4 are low, TSH increases.
What is Grave's disease? What is it usually caused by?
What are symptoms of Grave's disease?
What is the treatment for Grave's disease?
What is thyroid storm?
What is the treatment for thyroid storm? - ANSW-Grave's disease is an autoimmune disorder with an
unknown cause. It is an increased T3 and T4, with a decrease TSH.
Symptoms of Grave's disease are all related to hyperactivity of the metabolism: insomnia; lack of ability
to concentrate; ALOC; muscle weakness, hyperreflexia, exercise intolerance; weight-loss, anorexia; heat
intolerant; increased temperature; goiter, dyspnea; exophthalmos, photophobia and blurred vision; thin
hair, hair loss, fine and silky texture; increase GI frequency, abdominal cramping, nausea and vomiting;
increased BP, increased HR.
Assist with activity and rest; create a calm environment; I&Os, QD weight, increased calories and
proteins; use cooling measures; avoid excessive palpation of the thyroid; eye protection (exophthalmos
prevents eyelid from full closure); give IV fluids.
Thyroid storm is a life-threatening complication. Begins with increased CO, that becomes decreased CO
when the body cannot compensate. Characterized by: high HR, atrial fibrillation,
True or False.
An increase of temperature one degree warrants a call to the doctor for patients with with Grave's
disease. - ANSW-True.
