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Final Exam Review Nurs 6531 Deck 1 Questions and Answers

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What are signs & symptoms of SIADH (Syndrome of inappropriate antidiuretic hormone)? - ANSWER Increased production of ADH (antidiuretic hormone), hyponatremia, concentrated urine (from excess water re... sorption), elevated urine osmolality, mental status changes from cerebral edema. Diabetes insipidus is associated with what sodium level? - ANSWER Hypernatremia Psychogenic polydipsia results in urine that is: - ANSWER diluted with low osmolality and hyponatremia How would you determine the cause of a patient's AKI who presents with decreased urine output, history of neurogenic bladder, chronic foley, dark urine, and Cr increase from 1.3 to 2.1 over 3 months? - ANSWER Flush the foley catheter to see if urine comes out and assess the patency of the catheter. This action will unblock clogged sediment or biofilm from chronic bacteriuria. When a female patient presents to the ER after sexual assault, what medications should be offered prior to discharge? - ANSWER Ceftriaxone, azithromycin, Plan B, and Metronidazole. Manifestations of Conn syndrome (hyperaldosteronism)? - ANSWER hypernatremia, hypokalemia, and hypertension What causes Cushing syndrome? - ANSWER Increased levels of glucocorticoids, can be exogenous (from therapy) or endogenous (from adenoma or neoplasm). Manifestations of Cushing syndrome? - ANSWER hypertension, truncal obesity, osteoporosis, skin fragility, and hyperglycemia. What differentiates primary adrenocortical insufficiency from secondary adrenocortical insufficiency? - ANSWER Skin hyperpigmentation is present in primary adrenocortical insufficiency What is Trousseau's sign? - ANSWER A carpal spasm elicited by compression of the upper arm with a BP cuff that indicates hypocalcemia. What is Chovstek's sign? - ANSWER A hemifacial tic that is induced by tapping the facial nerve below the maxilla that indicates hypocalcemia. What is Babinski's sign? - ANSWER An upward response (extension) of the hallux when the sole of the foot is stimulated with a blunt instrument. Can identify spinal cord disease in adults. What is Romberg's sign? - ANSWER Loss of balance in standing when eyes are closed. Usually indicating a loss of proprioception or lesion in the cerebellum. What is Homan's sign? - ANSWER pain on passive dorsiflexion of ankle, associated with DVT. What is the clinical presentation of Goodpasture's syndrome? - ANSWER Urinalysis: Specific gravity: 1.020. pH 5.5, 1+ albumin and large blood present. Chest XR positive for bilateral diffuse infiltrates. BUN 30, Cr 3.0 Symptoms: dyspnea with hemoptysis What is Goodpasture syndrome? - ANSWER Damage to alveolar and renal glomerular basement membranes by cytotoxic antibody. Initial treatment for Goodpasture's syndrome? - ANSWER Hospitalization, pulse dose of steroids, begin plasmapheresis and cyclophosphamide therapy. Characteristics of Grave's disease - ANSWER Ophthalmopathy (lid retraction, scleral show, proptosis) and hyperthyroidism What organism causes the formation of a staghorn calculus? - ANSWER Proteus mirabilus What organism causes Toxic shock syndrome? - ANSWER Staphylococcus aureus What electrolyte disturbance is most likely to lead to tetany and neuromuscular irritability? - ANSWER Hypocalcemia Features of hypercalcemia include? - ANSWER "Stones, groans, moans, and bones." Delerium and renal stones When you see hypochloremia, the patient may have? - ANSWER Metabolic Alkalosis Hyperkalemia is associated with what cardiac abnormalities? - ANSWER peaked T-waves, wide QRS, and ventricular arrhythmias. A patient presents with arcus cornea, LDL 285, TG 110, HDL 45, and father died of an MI at age 45. What is his most likely diagnosis? - ANSWER Heterozygous familial hypercholesterolemia A fasting blood glucose level of 130 mg/dL indicates: - ANSWER Diabetes What are risk factors for ectopic pregnancy? - ANSWER smoking, previous tubal surgery, previous ectopic pregnancy, exposure to diethylibestrol, current IUD, PID, advanced maternal age, infertilitiy for more than 2 years. What hormones are most critical to replace in a patient at risk for anterior pituitary insufficiency? - ANSWER Glucocorticoids, and thyroid hormone What is diabetes insipidus? - ANSWER a disorder caused by inadequate amounts of ADH which causes excessive water loss CKD Stage 1 - ANSWER GFR >90 with evidence of renal damage, as indicated by proteinuria. CKD Stage 2 - ANSWER GFR 60-89 CKD Stage 3a - ANSWER GFR 45-59 CKD Stage 3b - ANSWER GFR 30-44 What is the diagnosis and initial treatment of a patient with history of nonfunctional pituitary macroadenoma with severe retro-orbital headache, nausea, vomiting, mental status change, right third nerve palsy with stiff neck, and pituitary adenoma (enlarged) hemorrhage? - ANSWER Pituitary apoplexy dexamethasone 2mg IV q 6hr then surgery if mental status change present. What causes hypocalcemia in patients with end stage renal disease? - ANSWER Decreased conversion of Vitamin D. What condition is associated with recurrent nephrolithiasis? - ANSWER Primary hyperparathyroidism What stabilizes the cardiac membrane in treatment of hyperkalemia? - ANSWER Calcium gluconate What medication acts rapidly to antagonize the membrane effects of potassium in hyperkalemia? - ANSWER Calcium is cardioprotective What is the most common cause of euvolemic hyponatremia? - ANSWER SIADH (syndrome of inappropriate antidiuretic hormone secretion) What causes are associated with hypervolemic hyponatremia? - ANSWER Cirrhosis and CHF What is a long-term complication of radio-active iodine therapy? - ANSWER Hypothyroidism 80% of acute pyelonephritis cases in women are caused by what pathogen? - ANSWER E coli Most common cause of acute scrotal pain in adults? - ANSWER epididymitis What are predisposing factors for hypocalcemia? - ANSWER hypoparathyroidism, pancreatitis, vitamin D deficiency, chronic alcohol use disorder, and medications such as phenytoin, cisplatin, and estrogen. What are prerenal causes of AKI? - ANSWER decrease in extracellular fluid volume, decreased renal blood flow, or altered intrarenal hemodynamics. Post-renal causes of AKI - ANSWER benign prostatic hyperplasia, bladder cancer, nephrolithiasis, neuromuscular disorders, prostate cancer, strictures, trauma What is are intrinsic causes of renal failure? - ANSWER Acute glomerulonephritis, ischemic injury, nephrotoxins, malignant hypertension What classification of drugs cause urinary retention? - ANSWER anticholinergics (ipratropium) Common secondary causes of nephrotic syndrome - ANSWER lupus and diabetes Presenting symptoms of nephrotic syndrome - ANSWER loss of appetite, fatigue, ascites, lower extremity edema, proteinuria, low blood albumin, and hyperlipidemia. What is the initial insulin loading dose for a patient in DKA? - ANSWER 0.1 to 0.15 units/kg/hr with hourly glucose monitoring What is Hashimoto's thyroiditis? - ANSWER autoimmune destruction of thyroid gland, Anti-thyroid stimulating hormone (TSH) receptor antibodies inhibit release of thyroid hormone. What would you do first for an incidental finding of an adrenal mass? - ANSWER Overnight dexamethasone suppression test. Clinical signs of PCOS - ANSWER oligomenorrhea, infertility, hirsutism, obesity, and 2/3 Rotterdam criteria: oligo-ovulation or anovulation clinic of biochemical signs of hyperandrogenism polycystic ovaries on US Treatment for simple cystitis - ANSWER 5 days of nitrofurantoin Define the acronym MUDPILES - ANSWER Acronym for identifying a high anion gap metabolic acidosis: Methanol Uremia Diabetic ketoacidosis Paraldehyde Iron, isoniazid Lactate Ethanol, ethylene glycol Salicylates First-line evaluation of vulvovaginal candidiasis - ANSWER wet mount Prolonged nausea and vomiting can result in: - ANSWER Metabolic alkalosis loss of gastric acid Clinical signs/symptoms of uremic pericarditis - ANSWER worsening anemia, absence of diffuse ST-segment T-wave elevations, fever, pleuritic chest pain, pain that increases in recumbent position. Hemodialysis treatment should be heparin free. What is hepatorenal syndrome? - ANSWER chronic or acute renal disease with advanced hepatic failure and portal hypertension. What complaint is common with patients who have acute on chronic urinary retention? - ANSWER urinary incontinence Aside from potassium chloride as a supplement, what can be used to treat hypokalemia? - ANSWER Magnesium For a patient who is lethargic and hyperkalemic, what is the first line therapy? - ANSWER Calcium gluconate or calcium chloride Priapism is a known side effect of what medication? - ANSWER Trazodone What is the maximum compensation of PaCO2 in metabolic acidosis? - ANSWER 26 signs of preeclampsia - ANSWER BP > 140/90 proteinuria >300 mg of protein in urine in 24 hours headache visual changes 2+ pitting edema [Show More]

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