Module 7
If a patient doesn’t show ST elevation on the ECG and doesn’t have positive troponin but is still showing cardiac signs what is the next step?
Serial EKGS and troponin to look for changes
Stress test if those are negative
What is acute coronary syndrome?
Atherosclertoic plaque in coronary artery ruptures resulting in platelet aggregation (clumping)
Leads to clot
Leads to vasoconstriction
Treatment of Addison's crisis?
Aggressive Fluid replacement
IV hydrocortisone
IV vasopressors
Treat the hyperkalemia
What is the test for diabetes insipidus?
Hypertonic saline test
Dehydration assessment
Treatment for SIADH?
Hypertonic saline
Demeclocycline
What is stable chronic angina?
Chest pain that relieve with rest
Signs of addisons?
Hyperkalemia
Hyponatremia
Muscle weakness
Hypoglycemia
Diarrhea
Orthostatic hypotension
What is the treatment for hyperkalemia?
Dextrose and insulin
What might a nurse give to a patient who has diabetes insipidus?
Replace fluid and electrolytes
Oral Chlorpropamide
Demopressin acetate
What does the nurse want to monitor/prompt with a patient who has SIADH?
Restrict fluids
Monitor for fluid overload
Safe environment
Neuro changes
What is unstable angina?
Chest pain with rest or exertion
Causes severe activity limitation
Patient education with addisons disease?
Lifelong hormone replacement
Prednisone and Fludrcortisone
Regular feedings
Adequate rest
Avoid stress
What are the nursing interventions for addisons?
Monitor for arrhythmias
Check vitals frequently
Monitor labs
Glucose Hourly
What might a nurse monitor with a patient who has diabetes insipidus?
I and Os
Vitals
Daily weights
Signs of cushing disease?
Moon face
hump back
enlarged abdomen
thin extremities
bruises easily
What do you want to monitor for post op with PCI, If any of these signs occur what do you want to do next?
Chest pain
ST elevation
Bleeding at insertion site
Reaction to contrast
Hypotension
Hypokalemia
Dysrhythmias
NEXT: Call provider/Rapid response
When can addisons crisis happen?
when patient stop taking their steroids'
Signs of Diabetes insipidus?
Polyuria
Polydipsia
weakness
fatigue
Patient education with diabetes insipidus?
Teach them to weigh themselves
Monitor weight
Lifelong vasopressin therapy
Early detection of dehydration
Interventions for cushing disease?
Restore fluid balance
Prevent injury
Prevent infection
Prevent acute adrenal insufficiency
What medications will the patient be sent home with who had a PCI?
Two antiplatelet
Symptoms of addisons crisis?
Abdominal, Flank or leg pain
Tachycardia
Nausea
Changes in LOC
If a patient with Diabetes insipidus starts to show signs of hypovolemia what can happen next?
Shock and coma
Signs of SIADH?
Confusion
Seizures
LOC
Weight gain/edema
Muscle cramps/weakness- hyponatremia
Oliguria
What are hyperpituitarism disease?
Cushings
SIADH