Diabetes Insipidus
Diabetes insipidus is the result of injury to hypothalamus or pituitary gland which results in deficiency of this hormone.
What is ADH (vasopressin)
A patient with SIADH cannot excrete a dilute urine, and they retain fluid. Because of this, they develop this.
What is dilutional hyponatremia?
An early morning combined test of these two hormones will enable differentiation of primary adrenal insufficiency from secondary adrenal insufficiency and from normal adrenal function.
What is ACTH and cortisol?
The nurse caring for a Cushing’s patient is keen to anticipate these 2 electrolyte abnormalities.
What is hypernatremia and hypokalemia?
These are the three main causes of DKA.
What are missed insulin, illness/infection, and untreated/undiagnosed diabetes?
HSS is most common in this type of diabetic patient.
What is type 2?
This condition leads to bone decalcification and development of renal calculi.
What is hyperparathyroidism?
This is the primary treatment of hypothyroidism.
What is Levothyroxine?
The inability to increase these two lab indicators in the urine is the characteristic of DI.
What is specific gravity and osmolality?
Medication that may be given to an SIADH patient is this.
What is furosemide?
In a patient with Adrenal insufficiency, the nurse would expect to find these two electrolyte imbalances when analyzing blood chemistries.
What is hyponatremia and hyperkalemia?
The nurse does not forget to assess the Cushing patients stool because this population is at risk for this.
What is peptic ulcer?
This is the major electrolyte of concern when treating DKA.
What is potassium?
This can trigger HHS, resulting in an increased demand for insulin.
What is any illness?
This drug, an artificial hormone, is given to inhibit osteoclastic bone resorption and promotes renal excretion of calcium.
What is calcitonin?
In a patient experiencing a thyroid storm fever, this is the drug of choice to reduce the pyrexia because medications containing salicylates may result in higher levels of unbound thyroid hormone.
What is Acetaminophen?
This synthetic drug is the drug of choice for central DI because it does not have vascular effects of the natural hormone.
What is Desmopressin?
Because of the risk of hyponatremia, the SIADH patient may have this restriction.
What is fluid.
This drug is given to help manage sodium loss and hypotension in a patient with lifelong adrenal insufficiency.
What is fludrocortisone?
When patient has Cushing’s syndrome secondary to corticosteroid administration for treatment of an autoimmune disorder, the steroids should never be stopped abruptly but rather tapered off. Doing so may trigger this.
What is an Addison’s Crisis?
Before correcting hyperglycemia in a DKA patient, you must correct this first.
What is dehydration?
Unlike DKA, this is absent in the urine or serum in a patient with HHS.
What are Ketones?
This is positive when a sharp tapping over the facial nerve just in front of the parotid gland and anterior to the ear causes spasms or twitching of the mouth, nose, and eye.
What is Chvostek sign?
This drug used to treat hyperthyroidism works by blocking the synthesis of thyroid hormones (conversion of T3 and T4).
What is propylthiouracil?
DI can cause this and consequently decreased cardiac output and therefore decreased perfusion to vital organs.
What is dehydration?
As a nurse, monitoring of these is important on a patient with SIADH.
What are daily weights, I&O, urine/blood chemistries, and neurological status?
Patients are educated to avoid and recognize this in order to avoid an Addison’s crisis, and if they cannot avoid this, they are educated to increase their home steroid regimen.
What are physiological and/or psychological stressors?
The nurse frequently assesses the patient for subtle signs of infection because the anti-inflammatory effects of this may mask the common signs of inflammation and infection.
What are corticosteroids?
With 100 units of regular insulin mixed in a 500ml bag of NS, the rate in ml/hr will be this, when the order says to infuse 5 units per hour.
What is 25ml/hr?
The arterial pH is usually this in a patient with HSS.
What is normal?
This is positive when carpopedal spasm is induced by occluding the blood flow to arm for 3 minutes with a blood pressure cuff.
What is Trousseau sign?
This risk is most significant for a client that is within 12 hours post-op thyroidectomy surgery.
What is airway compromise by hematoma?
Limiting fluid intake on a DI patient will lead to this.
What is dehydration and hypernatremia?
These are common causes of SIADH.
What are head injury, brain surgery or tumor, or CNS infection (also sever pneumonia, pneumothorax, and other lung disorders and malignant tumors)?
When a patient is confirmed to be in an Addison’s crisis, the immediate treatment is directed towards combating this.
What is circulatory shock? (restoring blood circulation, administering fluids and corticosteroids, monitoring vital signs, and patient in recumbent/elevated legs position).
This drug may be given to reduce hyperadrenalism if Cushing’s is caused by ectopic ACTH secretion by a tumor that cannot be eradicated.
What is an Adrenal enzyme inhibitor (e.g., metyrapone, amino-glutethimide, mitotane, and ketoconazole).
Even if the blood glucose levels are decreasing, the insulin drip must not be stopped until this has been started/given.
What is subcutaneous insulin?
In a patient with HHS, electrolyte and BUN levels are consistent with the clinical picture of this.
What is severe dehydration?
A hypo- parathyroid client is educated to have a diet high in this and this, but low in this.
What is hi calcium/vita D and low phosphorus?
Due to its teratogenic side effects, this medication is not recommended for treatment of hyperthyroidism on a pregnant woman.
What is methimazole?