signs & symptoms
High urine output
low specific gravity (1.005)
dehydrated
thirsty
low osmolarity
What is Diabetes Insipidus
Head trauma
tumors
cancer
meningitis
What is SIADH
Interventions for DI
vasopressin
push fluids
daily weight
I & O's
Explain the Pathophysiology of Hyperaldosteronism
increased secretion of aldosterone with mineralocortcoid excess.
excessive secretion of aldosterone from one or both adrenal glands
A nurse cares for a client who has SIADH. Serum sodium level is 114. What nursing action would be appropriate?
a. consult with the dietitian about increased dietary sodium
b. restrict the client's fluid intake to 600ml/day
c. handle the client gently by using turn sheets for repositioning
d. instruct assistive personnel to measure intake and output
cushingoid features
hyperglycemia
thin extremities
purple striae
susceptibility to infections
What is Cushing disease
catecholamine-producing tumors in the adrenal medulla
What is pheochromocytoma
Interventions for SIADH
fluid restriction
replacing lost sodium
drug therapy (diuretics, hypertonic saline, demeclocycline)
measure I & O's, daily weights
Explain the pathophysiology of hypercortisolism (Cushing disease)
excess secretion of cortisol from the adrenal cortex.
affects metabolism and all body systems
increase in total body fat
reduce lymphocyte production
The nurse is caring for a client who is diagnosed with DI. For what common complication will the nurse monitor?
a. hypertension
b. bradycardia
c. dehydration
d. pulmonary embolus
hypernatremia
hypokalemia
metabolic alkalosis
What is Hyperaldosteronism
abrupt withdrawal of long-term steroids
infection
autoimmune disorders
chronic or extreme stress
What is Addison's disease (hypoadrenalism)
Interventions for Adrenal Gland Hypofunction
(addison's disease)
fluid balance
prevent hypoglycemia
assessing cardiac function
daily weight
i & o's
hormone replacement therapy
Pathophysiology of Adrenal Gland Hypofunction
(addison's disease)
inadequate secretion of adrenocorticotropic hormone (ACTH)
dysfunction of hypothalamic-pituitary control mechansim
loss of aldosterone and cortisol
A nurse assesses a client who potentially has hyperaldosteronism. Which serum lab values would the nurse associate with this disorder?(select all that apply)
a. sodium 150
b. sodium 130
c. potassium 2.5
d. potassium 5.0
low urine output
hypo osmolality
hyponatremia
headache
seizures
severe high blood pressure
What is SIADH
long-term, high-dose use of the cortisol-like glucocorticoids.
noncancerous tumor of the adrenal cortex
What is Cushing's Disease
Interventions for Hyperaldosteronism
BP monitoring
removal of one or both adrenal glandsglucocorticoid replacement
spironolactone therapy until surgery
Pathophysiology of SIADH
ADH (vasopressin) is secreted even when plasma osmolarity is low or normal, resulting in water retention and fluid overload
A nurse assesses a client with Cushing disease. Which assessment findings would the nurse expect?(select all that apply)
a. moon face
b. weight loss
c. hypotension
d. petechiae
e. muscle atrophy
hyperkalemia
hyponatremia
hypovolemia
weightloss
bronze pigmentation
weakness
What is Addison's disease ( Adrenal Gland Hypofunction)
drug related- lithium carbonate,
head trauma
infectious process
What is Diabetes Insipidus
Interventions for cushing syndrome
restore fluid balance
prevent injury
prevent infection
prevent acute adrenal insufficiency
removal of tumors
Pathophysiology of DI
disorder of the posterior pituitary gland in which water loss is caused by either an ADH deficiency or an inablility of the kidneys to respond to ADH
A client is being treated for DI with synthetic vasopressin (desmopressin). What is the priority health teaching that the nurse provides regarding drug therapy?
a. the need to check the client's urinary specific gravity
b, the need to take blood pressure at least twice a day
c. the need to monitor blood glucose daily
d. the need to weigh every day and report weight gain