Med SURG 2 Final HESI review 2020 Latest Graded A
Med SURG 2 Final HESI review 2020 Med surg 1 review/Med surg 2 review: Renal assessment Bun 8 – 25 Creatinine 0.6 – 1.3 Uric acid 2.5 – 8 Potassium 3.5 - 5 GFR 125/min (60 is good for kidney pt) Specific gravity – 1.003 – 1.02 AST: 0 – 35 ALT: 10 – 35 Albumin: 3.5 – 5.5 (same as potassium) Bilirubin: 0.1 – 1.2 mg/dl Amylase: 25-150 Lipase: 10 – 140 Thyroid • Hypothyroid- high TSH (trying to stimulate thyroid to work), low T3 and T4 o Everything slows down (bowel movements), hair falls out, dry skin, fat, fatigue, Puffy face o Give synthroid in morning before meals (at same time) o Myxedema (opposite of thyroid storm) – decrease mental status, hypothermia, slowing of organ function o After a thyroidectomy, a client is at risk for developing hypocalcemia. Trousseau sign (carpal spasm w BP cuff) • Hyperthyroid- TSH is low (thyroid already working too much) o Thyroid storm, inc BP, diarrhea, weight loss, exopthalamous, heat intolerance, nausea o Thryorid storm - fever, hyperreflexia, abdominal pain, diarrhea, dehydration rapidly progressing to coma, severe tachycardia, extreme vasodilation Radioactive iodine- stay away from pregnant people and chidren for 24 hours Thyroidectomy- watch for hypothyroid, HOB raised (incision), watch for blood. Watch for thyroid storm. Graves disease is the result of increased thyroid, not parathyroid, activity. • Hyperparthyroidism o calcium = too high bone pain (kidney stones, concentration problems) o Elevated serum calcium levels produce osmotic diuresis and thus polyuria. This diuresis leads to dehydration (weight loss rather than weight gain). Calcium is being pulled from the bones aka excess bone reabsorption bone pain • Hypoparathyroidism (hypo LOW calcium) o Parathyroid removed- calcium will drop (brittle nails, cataracts, dry skin) Pituitary Gland • Impaired Posterior pituitary gland ADH & oxytocin • Impaired Anterior pituitary gland G, LH and FSH SIADH - edema, fluid volume overload, • give diuretics, replace fluids (keep a balance so not dehydrated) • doctors restrict fluids, not nurses • SS: 1. High urine osmolality 2. Low serum osmolality 3. Hypotonicity of body fluids 4. Continued release of antidiuretic hormone 5. hyponatremia Diabetes Insipidis – not enough ADH; pee a lot; super thristy • s/s- low specific gravity of urine, dehydration • Treatment: desmopressin • give them an antidiuretic increase urine concentration
Información del documento
- Subido en
- 19 de marzo de 2021
- Número de páginas
- 26
- Escrito en
- 2020/2021
- Tipo
- Examen
- Contiene
- Preguntas y respuestas
