Endocrine
This endocrine disorder is characterized by:
What is DI?
A child presents with:
The nurse suspects this neurologic infection and knows antibiotics should not be delayed if it is suspected.
What is Bacterial Meningitis?
A patient with cirrhosis becomes increasingly confused and develops:
The nurse recognizes this complication of liver failure.
What is hepatic encephalopathy?
A 4-week-old infant presents with:
The nurse recognizes this pediatric GI disorder.
What is pyloric stenosis?
The nurse receives report on four patients.
Which patient should the nurse assess FIRST?
A. A patient with hypothyroidism reporting constipation
B. A patient with Crohn's disease reporting abdominal pain 7/10
C. A patient with SIADH whose sodium is 118 mEq/L and who is becoming confused
D. A patient with pyelonephritis reporting flank pain 8/10
What is C - A patient with SIADH whose sodium is 118 mEq/L and who is becoming confused?
A patient with Type 1 Diabetes presents with:
The nurse knows the acid-base imbalance is caused by this physiologic process.
What is the breakdown of fat producing ketones? (ketogenesis)
A child with croup was admitted with:
Two hours later the nurse notices the child is now:
The nurse recognizes this change most likely indicates:
What is respiratory deterioration progressing toward respiratory failure?
A patient with acute appendicitis suddenly develops:
The nurse recognizes the patient is most likely developing this complication.
What is peritonitis secondary to appendiceal rupture?
A 3-year-old presents with:
The nurse recognizes this pediatric condition and knows the greatest danger is bowel ischemia.
What is Intussusception?
The nurse receives report on four patients.
Who should the nurse assess FIRST?
A. A patient with DKA whose blood glucose is 480 mg/dL and potassium is 2.9 mEq/L while receiving insulin
B. A patient with ulcerative colitis reporting 8 bloody stools today and Hgb 9.6 g/dL
C. A patient with cirrhosis and ammonia level 102 mcg/dL who is mildly confused
D. A patient with pyelonephritis and a temperature of 102.1°F
What is A - A patient with DKA whose blood glucose is 480 mg/dL and potassium is 2.9 mEq/L while receiving insulin?
A patient arrives in the ED with:
The nurse recognizes this life-threatening endocrine emergency and anticipates IV fluids and corticosteroid administration.
What is an Addisonian Crisis (Adrenal Crisis)?
A patient with bacterial meningitis is becoming:
The nurse knows the most dangerous physiologic threat is:
What is increased intracranial pressure (ICP) leading to decreased cerebral perfusion?
A patient with cirrhosis suddenly develops:
The nurse recognizes the patient is most likely experiencing this life-threatening complication.
What is esophageal variceal hemorrhage causing hypovolemic shock?
A newborn has:
During a rectal examination, the infant suddenly passes a large amount of stool.
The nurse recognizes this condition is caused by:
What is Hirschsprung Disease caused by absence of ganglion cells in the bowel?
The nurse receives report on four patients.
Who should the nurse assess FIRST?
A. A child with RSV who has mild retractions and is drinking fluids
B. A patient with appendicitis reporting pain 9/10
C. A child with gastroenteritis who has not voided in 8 hours and has dry mucous membranes
D. A patient with hypothyroidism reporting fatigue
What is C - A child with gastroenteritis who has not voided in 8 hours and has dry mucous membranes?
A patient with Graves' disease suddenly develops:
The nurse recognizes this endocrine emergency, which can rapidly lead to cardiovascular collapse if untreated.
What is Thyroid Storm?
A 7-year-old child is admitted with suspected sepsis.
Assessment findings:
The nurse recognizes the child is most likely experiencing this stage of shock.
What is compensated septic shock (early septic shock)?
A patient with advanced cirrhosis has:
The nurse recognizes these findings are occurring because the liver can no longer adequately perform this normal function.
What is clotting factor production (synthesis)?
A 6-week-old infant is brought to the clinic with:
Laboratory findings:
The nurse recognizes this disorder and knows the infant is at risk for deficiencies of fat-soluble vitamins.
What is Biliary Atresia caused by obstruction/absence of the bile ducts?
The nurse receives report on four patients.
Who should the nurse assess FIRST?
A. A patient with hepatic encephalopathy who is increasingly difficult to arouse
B. A patient with ulcerative colitis reporting 10 bloody stools in 24 hours and Hgb 8.9 g/dL
C. A patient with SIADH whose sodium is 122 mEq/L and reports a headache
D. A patient with pyelonephritis who has a fever of 103°F and flank pain
What is A - A patient with hepatic encephalopathy who is increasingly difficult to arouse?
A patient is being treated for DKA.
Current assessment:
A new graduate nurse states:
"The glucose is almost normal, so the DKA is resolved."
The experienced nurse knows the MOST important indicator that DKA is resolving is:
What is resolution of the metabolic acidosis/closure of the anion gap?
A patient with suspected bacterial meningitis arrives in the ED.
The provider orders:
The new graduate nurse says:
"Let's wait until after the lumbar puncture and cultures are completed before starting the antibiotic."
The experienced nurse immediately recognizes the most serious problem with this plan is:
What is delaying antibiotic administration in suspected bacterial meningitis?
A patient with cirrhosis is admitted with hepatic encephalopathy.
Assessment:
Four hours later the nurse finds:
The nurse recognizes the patient's MENTAL STATUS is WORSENING because of this physiologic process.
What is increased ammonia production from GI bleeding?
A 2-year-old is admitted with RSV.
Initial assessment:
Four hours later the nurse notes:
The new graduate nurse states:
"The respiratory rate is better now because it went from 44 to 20."
The experienced nurse immediately recognizes the child is actually experiencing:
What is respiratory deterioration leading to respiratory failure
The nurse receives report on four patients.
A.
A patient with DKA is receiving insulin.
B.
A patient with SIADH
C.
A child with septic shock
D.
A patient with cirrhosis
Who do you see first?
What is C - A child with septic shock?