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NUR 410 Med-Surg: Exam 3 Latest Update Questions with Excellent Solution Graded A+ Guaranteed Pass $7.39   Add to cart

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NUR 410 Med-Surg: Exam 3 Latest Update Questions with Excellent Solution Graded A+ Guaranteed Pass

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NUR 410 Med-Surg: Exam 3 Latest Update Questions with Excellent Solution Graded A+ Guaranteed Pass - *ACTH* (nl to inc; or dec depending on cause) - If it stops sending messages then they know the problem is not the pituitary gland, but in the adrenal gland - You need a lot of cortisol in the...

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  • August 17, 2024
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NUR 410 Med-Surg: Exam 3 Latest Update
Questions with Excellent Solution Graded
A+ Guaranteed Pass
- *ACTH* (nl to inc; or dec depending on cause)

- If it stops sending messages then they know the problem is not the pituitary gland, but in the adrenal
gland

- You need a lot of cortisol in the morning when you wake up and then at night it drops

- W/ Cushing syndrome it is always high and there is not a regulatory - Answer -What is there to
know about DST in cushing syndrome?

- *fludrocortisone (Florinef)

- Given am

- monitor BP - Answer -What is there to know about mineralocorticoid in addison disease?

- *Head trauma* (self limiting and transient)

- CVA

- Guillian-Barre

- SLE

- Pituitary surgery - Answer -What is their to know about the CNS causes of SIADH?

- *High fever*

- *tachypnea*

- *profound weakness*

- *severe abd, back & leg pain*

- severe N/V

- confusion

- *low Na+*

- *high K+*

- low BS

- *dehydration*

,- *severe hypotension*

- tachy

- *circulatory collapse* (lack of perfusion/pallor)

- coma - Answer -What are the CM of addison's crisis?

- *Inc Na*

- especially with excess heat/humidity

- careful potassium - Answer -What is the diet in addison disease?

- *Polydipsia and Polyuria* (up to 12 liters/day, reports of 20 L/day)

- *Low urine specific gravity* (<1.005) dilute urine (low solute)

- *Low urine osmolality* (<100 mOsm) dilute

- *Elevated serum osmolality*(hyperosmolality >295 mOsm/kg; involving serum Na)

- *Fluid volume deficit/electrolyte abnormalities*, particularly if pt stops drinking (i.e.Dehydration &
Hypernatremia)

- Weight loss

- Constipation

- Poor skin turgor

- Hypotension

- Tachy

- Hypovolemic shock

- CNS manifestations: irritability, mental dullness, coma - Answer -What are the CM of diabetes
insipidus?

- *Severe hypertension*

- *Resistant to treatment*

- *May be very labile*

- *Severe pounding H/A*

- *Tachy/palpitations/angina/EKG changes* (BP can be persistent, fluctuating, intermittent (episodic),
paroxysmal)

- *Profuse diaphoresis*

- Hyperglycemia

- Weight loss

, - Anxiety

- provoked by many meds: antiHTN, opioids, radiologic contrast media, Tricyclic antidepressants -
Answer -What are the CM of pheochromocytoma?

- 24 hr Urinary: free cortisol (dec/low) (better than a blood test)

- Serum cortisol (dec)

- Serum ACTH: *Inc* in Primary (adrenal gland doesn't make cortisol); *Dec* in secondary (Pituitary
doesn't produce ACTH adequately)

- ACTH stimulation test

- Serum glucose, Na (dec)

- potassium, BUN (inc)

- Anemia

- CT/MRI - Answer -What is the diagnostic tests for addison disease?

- 285-295 mmol/kg

- <265 is hypo-osmolality

- >320 is hyper-osmolality - Answer -What is the normal serum osmolality?

- ACTH deficit resulting in lack of glucocorticoids & androgens

- Disorder of pituitary function

- Overuse or abrupt w/drawal of exogenous corticosteroids (AIDS, TB can destroy adrenals) -
Answer -What is the secondary disease of addison disease?

- Adequate ADH but decreased renal response to ADH

- Onset & fluid losses less significant than with central

- Causes: drug therapy, renal damage/renal failure, hereditary, electrolyte imbalances (Drugs, i.e. Lithium
therapy is one common drug cause

- other causes: hypokalemia, hypercalcemia, pregnancy-gestational

- Vasopressin receptors (V) on kidney, kidney does not respond to ADH, or damage of receptors -
Answer -What is there to know about Nephrogenic DI?

- ADH (vasopressin) is synthesized in the hypothalamus & transported/stored in posterior pituitary gland
- Answer -What does the posterior pituitary gland store?

- Adrenal & Pituitary for inoperable tumors

- aka drug induced Medical Adrenalectomy

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