Pee
Nicole presents at the ER with complaints of extreme thirst and reports excretion of large amounts of dilute urine (>250mL/hr). Her labs show a low urine specific gravity(1.001-1.005). The nurse suspects what condition?
Diabetes insipidus
This is the most crucial step in postoperative meningitis prevention.
What is oral care?
This condition is a clinical state of inappropriately high levels of circulating thyroid hormones (T3 and/or T4) in the body from any cause.
What is thyroid storm?
(aka thyrotoxicosis)
Parathyroid hormone is responsible for regulating the balance between these.
What are calcium and phosphorus?
What kind of levels would you see in lab work for a patient with cushing's disease? (mainly electrolytes)
Increased sodium and blood glucose; decreased potassium and calcium.
Bennett cannot excrete dilute urine, retains fluids, and has developed a sodium deficiency. Her labs show a high urine specific gravity (>1.030). The nurse suspects what condition?
SIADH
What are potential complications of this surgery?
- Transient diabetes insipidus
- CSF leak
- Visual disturbances
- Postoperative meningitis
- Pneumocephalus
- SIADH
This rare, life threatening condition is caused by an accumulation of mucopolysaccharides in subcutaneous and other interstitial tissues. Patient is hypothermic and unconscious. Typically requires intubation and mechanical ventilation.
What is myxedema coma?
This condition results in neurologic, cardiovascular, and kidney symptoms that can be life-threatening related to airway compromise.
What is hypercalcemic crisis?
Lenore presents at the ER with hypotension, cyanosis, fever, N/V, headache, abdominal pain, confusion, and restlessness. She says she has not had any water in 4 days (not unlikely for her). What is Lenore most likely experiencing?
Addisonian crisis
For this condition, you will restrict fluid intake, put the patient on seizure/fall precautions, administer hypertonic saline (3% NS in severe cases), and administer diuretics as ordered.
What is SIADH?
To prevent these (3) complications, patients are taught to avoid coughing, blowing their nose, sucking through a straw, and sneezing.
- ICP
- Incisional pressure
- CSF leak
She is experiencing acute coronary syndrome. The nurse should IMMEDIATELY discontinue the medication.
Prompt, aggressive treatment is needed to avoid morbid complications.
Deficiency of this is one of the causes of hypoparathyroidism.
What is vitamin D deficiency?
What are the “five Hs” of pheochromocytoma?
Hypertension
headache
hyperhidrosis (excessive sweating)
hypermetabolism
hyperglycemia
This condition occurs in SIADH patients due to water retention causing sodium to become diluted in the bloodstream.
What is dilutional hyponatremia?
Changes in these postoperative assessment results would indicate a hematoma.
What are visual acuity and visual fields?
This assessment is essential following a thyroidectomy because it may indicate increasing edema, damage to laryngeal nerve, or hemorrhage and should be reported immediately.
What is difficulty speaking/vocal quality changes?
This is a carpopedal spasm and is induced by occluding the blood flow to the arm for 3 minutes with a blood pressure cuff.
What is Trousseau sign?
What is the "triad of symptoms" of pheochromocytoma?
Headache, diaphoresis, and palpitations.
Other symptoms include tremor, headache, flushing, and anxiety.
These two medications are used in the treatment of SIADH.
What are demeclocycline and tolvaptan?
This is indicated by the presence of clear drainage with a yellow halo.
What is a CSF leak?
Bennett had a thyroidectomy and is experiencing hyperirritability of the nerves, with spasms of the hands and feet, and muscle twitching. What are these signs of and what imbalance is the cause?
Signs of tetany caused by hypocalcemia.
Monitor patient for laryngospasm. Must keep trach tray at bedside at all times.
This is a sharp tapping over the facial nerve just in front of the parotid gland and anterior to the ear causes spasm or twitching of the mouth, nose, and eye.
What is Chvostek sign?
What test can you run for Cushing's Disease?
Dexamethasone suppression test.