NU185 Exam 4 review COMPREHENSIVE
QUESTIONS AND VERIFIED SOLUTIONS
Hyperpituitary - ✔✔Agromegaly Gigantism (never fuse) Growth plate
distinguish one never fuse Gigantism - ✔✔Never fuses (elongated bones)
Acromegaly (enlarged bones) - ✔✔enlargement of the extremities Hypopituitary
- ✔✔Dehydration Addison (secondary) amenorrhea Headaches Visual
disturbances - ✔✔S/S of hyperpituitary Test to diagnose Cushing disease -
✔✔Dexamethasone suppression test Steps for a dexamethasone test - ✔✔NPO
Blood specimen collected (1st thing) Pheochromcytoma - ✔✔tumor of the
adrenal medulla S/S of pheochromcytoma - ✔✔Severe HTN & tachycardia
Catecholamine (EPI & NONEPI) - ✔✔What is secreted from a pheochromcytoma
SIADH (soaked inside) - ✔✔Excessive amounts ADH (fluid overload) S/s of fluid
over load due SIADH - ✔✔JVD, crackles, ABD distention Increased specific
gravity - ✔✔Fluid overload Drop in urine specific gravity - ✔✔Fluid overload
Treatment for SIADH - ✔✔Tolvaptan DI (dry inside) (primary DI) - ✔✔Decreased
production of ADH (dilute urine) Secondary DI - ✔✔TBI Neurosurgery Trauma
Infection Sx Dipsogenic DI - ✔✔Excessive fluid intake Nephrogenic DI -
✔✔kidneys don't respond properly to ADH Drug related DI - ✔✔Lithium,
demeclocycline S/S OF DI - ✔✔Dehydration For someone with DI, check vital
signs for - ✔✔Tachycardia and hypotension Treatment for DI - ✔✔DDAVP
(desmopressin) Therapeutic response for DI - ✔✔Decrease urine output
Hallmark sign of DI - ✔✔polyuria (increased urine) When a pt receives regular
insulin when to check to hypoglycemia (remember peak hours so check in 3
hours) - ✔✔1000 Why are DM patients prone to infection - ✔✔Elevated glucose
increase the chance for bacteria growth Normal HgbA1c - ✔✔Less than 7 is
good PRIORITY for someone with retinopathy - ✔✔Make sure BG is maintained
Things to do for those with retinopathy - ✔✔Eye exam Adequate light to see Do
you apply heat or cold to skin if you have neuropathy - ✔✔No! What does a
person who is stressed expect - ✔✔Hyperglycemia Addison therapeutic
treatment - ✔✔Hypernatremia With hypernatremia remember - ✔✔Everything
is decreased except K+ Cushing is at risk of infection due to - ✔✔Low cortisol
What do you do if the pt has bloody mucus after transhypophysectomy -
, ✔✔Notify PCP What position do you put someone in for transhypophysectomy -
✔✔Semi Fowler What do you avoid when you a have transhypophysectomy -
✔✔No brushing your teeth No coughing What should you do when you are
doing a renal scan - ✔✔Handle urine safely Precautions for taking HTN meds
while on dialysis - ✔✔Check with PCP (hold eliquis) What do you do if near an
doesn't work - ✔✔Give another dose of narcan Who comes first in the ER -
✔✔Chest pain patients What do you do if you have had a snake bite - ✔✔Go to
ER Immediately Sit in a low dependent position What do you do for a pt with
frostbite present with numb, discolored, blisters - ✔✔Cover with sterile gauze
What do you do if a patient has a bright red arterial blood from wound -
✔✔Apply pressure Difference between small pox and chicken pox - ✔✔Small
pox has lesions on the soles of hands and feet When do you discontinue
precautions for the plague - ✔✔After 48 hours of antibiotics You need 3
negative tests How do you handle a patients clothes with toxic waste on them -
✔✔With tongs What do you do if someone with peritoneal dialysis has slow
outflow - ✔✔Check tubing for kinks Reposition pt Make sure more fluids are
going in the out 1200ml broke up - ✔✔500, 500, 200 S/S of End of chronic
renal failure - ✔✔Respiration assessment Fluid overflow Carcinogenic
pulmonary edema Treatments for dry skin and pruritis - ✔✔Luke warm water
Mild soap Pat dry What would you report when coming back k from dialysis -
✔✔Temp (ex:99.4) Temp indicates infection What statement about water safety
needs further teaching - ✔✔I can go swimming my myself When you have
retinopathy maker sure to control - ✔✔Blood sugar What will be high with BG -
✔✔Cortisol Is sodium low or high with SIADH - ✔✔low S/S of SIADH (soaked
inside) - ✔✔seizures fluid overload weight gain Lab values of SIADH - ✔✔low
BUN low Hgb low Hct low Creatine meds for SIADH - ✔✔Tolvaptan s/s of
diabetes insipidus - ✔✔diuresis dehydration hypovolemia seizures polydipsia
Trx for DI - ✔✔Replace fluids and electrolytes Meds for DI - ✔✔DDVAP What
does tolvaptan do? - ✔✔increases uprine output what does DDVAP do -
✔✔decreases urine output central DI - ✔✔after trauma or sx Nephrogenic DI -
✔✔high calcium in system high lithium in system Pituitary tumors -
✔✔abnormal growths that develop in the pituitary gland s/s of pituitary
adenoma - ✔✔headache visual disturbances trx for pituitary tumors -
✔✔hypophysectomy hypophysectomy - ✔✔removal of the pituitary gland What
position should you be in when you have a hypophysectomy - ✔✔semi fowler
QUESTIONS AND VERIFIED SOLUTIONS
Hyperpituitary - ✔✔Agromegaly Gigantism (never fuse) Growth plate
distinguish one never fuse Gigantism - ✔✔Never fuses (elongated bones)
Acromegaly (enlarged bones) - ✔✔enlargement of the extremities Hypopituitary
- ✔✔Dehydration Addison (secondary) amenorrhea Headaches Visual
disturbances - ✔✔S/S of hyperpituitary Test to diagnose Cushing disease -
✔✔Dexamethasone suppression test Steps for a dexamethasone test - ✔✔NPO
Blood specimen collected (1st thing) Pheochromcytoma - ✔✔tumor of the
adrenal medulla S/S of pheochromcytoma - ✔✔Severe HTN & tachycardia
Catecholamine (EPI & NONEPI) - ✔✔What is secreted from a pheochromcytoma
SIADH (soaked inside) - ✔✔Excessive amounts ADH (fluid overload) S/s of fluid
over load due SIADH - ✔✔JVD, crackles, ABD distention Increased specific
gravity - ✔✔Fluid overload Drop in urine specific gravity - ✔✔Fluid overload
Treatment for SIADH - ✔✔Tolvaptan DI (dry inside) (primary DI) - ✔✔Decreased
production of ADH (dilute urine) Secondary DI - ✔✔TBI Neurosurgery Trauma
Infection Sx Dipsogenic DI - ✔✔Excessive fluid intake Nephrogenic DI -
✔✔kidneys don't respond properly to ADH Drug related DI - ✔✔Lithium,
demeclocycline S/S OF DI - ✔✔Dehydration For someone with DI, check vital
signs for - ✔✔Tachycardia and hypotension Treatment for DI - ✔✔DDAVP
(desmopressin) Therapeutic response for DI - ✔✔Decrease urine output
Hallmark sign of DI - ✔✔polyuria (increased urine) When a pt receives regular
insulin when to check to hypoglycemia (remember peak hours so check in 3
hours) - ✔✔1000 Why are DM patients prone to infection - ✔✔Elevated glucose
increase the chance for bacteria growth Normal HgbA1c - ✔✔Less than 7 is
good PRIORITY for someone with retinopathy - ✔✔Make sure BG is maintained
Things to do for those with retinopathy - ✔✔Eye exam Adequate light to see Do
you apply heat or cold to skin if you have neuropathy - ✔✔No! What does a
person who is stressed expect - ✔✔Hyperglycemia Addison therapeutic
treatment - ✔✔Hypernatremia With hypernatremia remember - ✔✔Everything
is decreased except K+ Cushing is at risk of infection due to - ✔✔Low cortisol
What do you do if the pt has bloody mucus after transhypophysectomy -
, ✔✔Notify PCP What position do you put someone in for transhypophysectomy -
✔✔Semi Fowler What do you avoid when you a have transhypophysectomy -
✔✔No brushing your teeth No coughing What should you do when you are
doing a renal scan - ✔✔Handle urine safely Precautions for taking HTN meds
while on dialysis - ✔✔Check with PCP (hold eliquis) What do you do if near an
doesn't work - ✔✔Give another dose of narcan Who comes first in the ER -
✔✔Chest pain patients What do you do if you have had a snake bite - ✔✔Go to
ER Immediately Sit in a low dependent position What do you do for a pt with
frostbite present with numb, discolored, blisters - ✔✔Cover with sterile gauze
What do you do if a patient has a bright red arterial blood from wound -
✔✔Apply pressure Difference between small pox and chicken pox - ✔✔Small
pox has lesions on the soles of hands and feet When do you discontinue
precautions for the plague - ✔✔After 48 hours of antibiotics You need 3
negative tests How do you handle a patients clothes with toxic waste on them -
✔✔With tongs What do you do if someone with peritoneal dialysis has slow
outflow - ✔✔Check tubing for kinks Reposition pt Make sure more fluids are
going in the out 1200ml broke up - ✔✔500, 500, 200 S/S of End of chronic
renal failure - ✔✔Respiration assessment Fluid overflow Carcinogenic
pulmonary edema Treatments for dry skin and pruritis - ✔✔Luke warm water
Mild soap Pat dry What would you report when coming back k from dialysis -
✔✔Temp (ex:99.4) Temp indicates infection What statement about water safety
needs further teaching - ✔✔I can go swimming my myself When you have
retinopathy maker sure to control - ✔✔Blood sugar What will be high with BG -
✔✔Cortisol Is sodium low or high with SIADH - ✔✔low S/S of SIADH (soaked
inside) - ✔✔seizures fluid overload weight gain Lab values of SIADH - ✔✔low
BUN low Hgb low Hct low Creatine meds for SIADH - ✔✔Tolvaptan s/s of
diabetes insipidus - ✔✔diuresis dehydration hypovolemia seizures polydipsia
Trx for DI - ✔✔Replace fluids and electrolytes Meds for DI - ✔✔DDVAP What
does tolvaptan do? - ✔✔increases uprine output what does DDVAP do -
✔✔decreases urine output central DI - ✔✔after trauma or sx Nephrogenic DI -
✔✔high calcium in system high lithium in system Pituitary tumors -
✔✔abnormal growths that develop in the pituitary gland s/s of pituitary
adenoma - ✔✔headache visual disturbances trx for pituitary tumors -
✔✔hypophysectomy hypophysectomy - ✔✔removal of the pituitary gland What
position should you be in when you have a hypophysectomy - ✔✔semi fowler
