NR 120.516 MODULE 5,6,7 AND 8 KEY CONCEPT
2025/2026 LATEST EXAM JOHNS HOPKINS
UNIVERSITY (SUMMARY)
NR 120.516 Complex: Module 5: Endocrine
Antidiuretic Hormone:
Produced by hypothalamus
Stored and released by posterior
pituitary gland
Acts on collecting ducts and tubules of kidneys
Antidiuretic Hormone:
Response to
High serum osmolality
Low plasma volume
Low BP
*conserves water to maintain BP
Diabetes Insipidus
No enough ADH= Polyuria (3-20L/day)
Nephrogenic:: kidneys resistant to ADH
Central: decrease secretion (idiopathic, brain injury, surgery)
Diabetes Insipidus
Clinical Manifestation
,"high and dry"
Urine specific gravity < 1.005
Serum sodium > 145
High urine output
Nocturia
Increased Hct
Increased serum osmolality
Decreased urine osmolality
Dehydration- HypoTN, tachy
Thirst
Diabetes Insipidus
Diagnostic test
Water deprivation test
SC vasopressin to differentiate central from nephrogenic cuase
Diabetes Insipidus
Fluid Replacement
Hypotonic IV fluid (D5 1/2 NS)
PO- water at bedside
Diabetes Insipidus
Medications
Pitressin (vasopressin)- synthetic ADH
Desmopressin (DDAVP)
ADH analog
,Diabetes Insipidus
Nursing Care/Assessment
Fluid intake
Urine output
Weights- fluid balance
Assess BP- HypoTN, tachy
Labs
Diabetes Insipidus
Labs
Serum Na & K
Serum osmolality > 287
Urine osmolality < 200
Urin SG < 1.005
Thyroid Hormones
Thyroxine (T4)- abundant
Triiodothyronine (T3)- potent
Thyrocalcitonin- dec Ca and P
What do thyroid hormones do?
incr metabolic activity
incr protein synthesis
incr glucose intake by cells
incr glycolysis
incr mobilization of fatty acids
incr O2 utilization
incr rate & strength of heart
incr rate & depth of resp.
Hypothyroidism
, result form thyroid surgery or treatment for hyperthyroid or cancer
Diagnosis: elevated TSH
Hashimoto's thyroiditis
Hypothyroidism
Clinical Manifestation
Decr metabolism
Sluggish/fatigue
Constipation (decr motility)
Weight gain
Decr heat production
Cold sensitivity
Bradycardia
Coarse dry skin/hair loss
Decr fertility
Goiter
Hypothyroidism
Treatment
thyroid hormone replacement
Hypothyroidism
Safety Alert
Decreased metabolism of sedatives, hypnotics, narcotics
Pt may need decreased dosages or increased time between doses
2025/2026 LATEST EXAM JOHNS HOPKINS
UNIVERSITY (SUMMARY)
NR 120.516 Complex: Module 5: Endocrine
Antidiuretic Hormone:
Produced by hypothalamus
Stored and released by posterior
pituitary gland
Acts on collecting ducts and tubules of kidneys
Antidiuretic Hormone:
Response to
High serum osmolality
Low plasma volume
Low BP
*conserves water to maintain BP
Diabetes Insipidus
No enough ADH= Polyuria (3-20L/day)
Nephrogenic:: kidneys resistant to ADH
Central: decrease secretion (idiopathic, brain injury, surgery)
Diabetes Insipidus
Clinical Manifestation
,"high and dry"
Urine specific gravity < 1.005
Serum sodium > 145
High urine output
Nocturia
Increased Hct
Increased serum osmolality
Decreased urine osmolality
Dehydration- HypoTN, tachy
Thirst
Diabetes Insipidus
Diagnostic test
Water deprivation test
SC vasopressin to differentiate central from nephrogenic cuase
Diabetes Insipidus
Fluid Replacement
Hypotonic IV fluid (D5 1/2 NS)
PO- water at bedside
Diabetes Insipidus
Medications
Pitressin (vasopressin)- synthetic ADH
Desmopressin (DDAVP)
ADH analog
,Diabetes Insipidus
Nursing Care/Assessment
Fluid intake
Urine output
Weights- fluid balance
Assess BP- HypoTN, tachy
Labs
Diabetes Insipidus
Labs
Serum Na & K
Serum osmolality > 287
Urine osmolality < 200
Urin SG < 1.005
Thyroid Hormones
Thyroxine (T4)- abundant
Triiodothyronine (T3)- potent
Thyrocalcitonin- dec Ca and P
What do thyroid hormones do?
incr metabolic activity
incr protein synthesis
incr glucose intake by cells
incr glycolysis
incr mobilization of fatty acids
incr O2 utilization
incr rate & strength of heart
incr rate & depth of resp.
Hypothyroidism
, result form thyroid surgery or treatment for hyperthyroid or cancer
Diagnosis: elevated TSH
Hashimoto's thyroiditis
Hypothyroidism
Clinical Manifestation
Decr metabolism
Sluggish/fatigue
Constipation (decr motility)
Weight gain
Decr heat production
Cold sensitivity
Bradycardia
Coarse dry skin/hair loss
Decr fertility
Goiter
Hypothyroidism
Treatment
thyroid hormone replacement
Hypothyroidism
Safety Alert
Decreased metabolism of sedatives, hypnotics, narcotics
Pt may need decreased dosages or increased time between doses
