NUR 445 exam 1 labs UPDATED ACTUAL Questions and CORRECT Answers
Diabetes insipidus - DDVP/ Desmopressin - can lead to fluid retention, weight gain
go to ER/ notify provider if you gain more than 2 lbs in 24 hours - emergency
serious dehydration in DI if patient stopped meds (goes back to disease)
Take medications exactly as prescribed to mimic natural hormone release
DI High risk for dehydration - encourage to drink fluids!
Look at sodium levels- critical lab for DI
DI pee is diluted, pt is hypernatremic, and unable to concentrate urine
Lab that is a key indicator to fluid balance in DI - sodium
DDAVP - synthetic adh, why should you monitor urine tells us if desmopressin is working or not - urine returns to normal output if
output - working
DKA osmolality levels- urine output, serum glucose, serum osmolality - high. Dehydration and
hypernatremia expected. Metabolic acidosis.
HHS osmolality levels- urine output - initially low, serum glucose, serum osmolality - high. Profound
dehydration, hypernatremia expected. Metabolic acidosis.
DI osmolality levels - urine output and serum glucose - high, serum osmolality - low, dehydration and hypernatremia expected. Metabolic
alkalosis.
SIADH osmolality levels - urine output and serum glucose low, serum osmolality - high. Dehydration and
hypernatremia not expected. Metabolic acidosis.
What to report besides weight changes in DI- report persistent cough, edema, swelling, fluid overload signs
Sudden weight loss of two pounds- call and report to physician, if gained, go to ER - life-threatening
SIADH -pt history - high risk for developing SIADH - if history of cancer, falls, seizures
they have
Soaked inside What to monitor in labs - low sodium, hyponatremic
, Crackles in lungs with SIADH- serious, bc fluid overload - 3% sodium chloride, hypertonic solution
pulmonary edema can result, treat with
Drug to treat SIADH- vasopressin for vasoconstriction, but can cause adverse effects of chest pain,
tightness
First-line treatment for SIADH - fluid restriction
Thyroid storm- radioactive iodine - must maintain hydration, crucial in thyroid storm
Two med types for thyroid storm - beta blockers, anti- beta blockers to manage. Inhibit thyroid synthesis and reduce thyroid levels with
thyroid meds - pt might have tachycardia and anti-thyroid meds
hypertension, use
Thyroid storms are life-threatening. High T3/T4, low/ suppressed TSH, high glucose, calcium, and liver
enzymes
Med that addresses the root cause of thyroid storm is Methimazole, highest therapeutic effect in thyroid storm, directly reducing thyroid
production
Propylthiouracil PTU) inhibits the synthesis of thyroid hormones, more maintenance
Myxedema - severe resp depression, life-threatening, warm pt slowly
Levothyroxine, for hypothyroidism - best taken in the morning with water on an empty stomach
Methimazole, can cause bone marrow suppression - infection. Watch for fever, sore throat, report immediately
serious complication, results in
Thyroid meds - lifelong, can't stop suddenly. If not as dose increased or another med added if at max dose already
effective, they need to have
Thyroid surgery- lab crucial to check after thyroid calcium levels.
surgery?
Always have what at bedside after thyroid surgery Trach tray at bedside
Lip tingling after thyroid surgery can indicate low calcium/ hypocalcemia
Parathyroid might accidentally be cut in surgery, what affects calcium regulation
does it affect
Diabetes insipidus - DDVP/ Desmopressin - can lead to fluid retention, weight gain
go to ER/ notify provider if you gain more than 2 lbs in 24 hours - emergency
serious dehydration in DI if patient stopped meds (goes back to disease)
Take medications exactly as prescribed to mimic natural hormone release
DI High risk for dehydration - encourage to drink fluids!
Look at sodium levels- critical lab for DI
DI pee is diluted, pt is hypernatremic, and unable to concentrate urine
Lab that is a key indicator to fluid balance in DI - sodium
DDAVP - synthetic adh, why should you monitor urine tells us if desmopressin is working or not - urine returns to normal output if
output - working
DKA osmolality levels- urine output, serum glucose, serum osmolality - high. Dehydration and
hypernatremia expected. Metabolic acidosis.
HHS osmolality levels- urine output - initially low, serum glucose, serum osmolality - high. Profound
dehydration, hypernatremia expected. Metabolic acidosis.
DI osmolality levels - urine output and serum glucose - high, serum osmolality - low, dehydration and hypernatremia expected. Metabolic
alkalosis.
SIADH osmolality levels - urine output and serum glucose low, serum osmolality - high. Dehydration and
hypernatremia not expected. Metabolic acidosis.
What to report besides weight changes in DI- report persistent cough, edema, swelling, fluid overload signs
Sudden weight loss of two pounds- call and report to physician, if gained, go to ER - life-threatening
SIADH -pt history - high risk for developing SIADH - if history of cancer, falls, seizures
they have
Soaked inside What to monitor in labs - low sodium, hyponatremic
, Crackles in lungs with SIADH- serious, bc fluid overload - 3% sodium chloride, hypertonic solution
pulmonary edema can result, treat with
Drug to treat SIADH- vasopressin for vasoconstriction, but can cause adverse effects of chest pain,
tightness
First-line treatment for SIADH - fluid restriction
Thyroid storm- radioactive iodine - must maintain hydration, crucial in thyroid storm
Two med types for thyroid storm - beta blockers, anti- beta blockers to manage. Inhibit thyroid synthesis and reduce thyroid levels with
thyroid meds - pt might have tachycardia and anti-thyroid meds
hypertension, use
Thyroid storms are life-threatening. High T3/T4, low/ suppressed TSH, high glucose, calcium, and liver
enzymes
Med that addresses the root cause of thyroid storm is Methimazole, highest therapeutic effect in thyroid storm, directly reducing thyroid
production
Propylthiouracil PTU) inhibits the synthesis of thyroid hormones, more maintenance
Myxedema - severe resp depression, life-threatening, warm pt slowly
Levothyroxine, for hypothyroidism - best taken in the morning with water on an empty stomach
Methimazole, can cause bone marrow suppression - infection. Watch for fever, sore throat, report immediately
serious complication, results in
Thyroid meds - lifelong, can't stop suddenly. If not as dose increased or another med added if at max dose already
effective, they need to have
Thyroid surgery- lab crucial to check after thyroid calcium levels.
surgery?
Always have what at bedside after thyroid surgery Trach tray at bedside
Lip tingling after thyroid surgery can indicate low calcium/ hypocalcemia
Parathyroid might accidentally be cut in surgery, what affects calcium regulation
does it affect
