GH deficiency in Adults can cause symptoms such as:
reduced bone density, insulin resistance, Increase in LDL/Cholesterol/triglycerides
polyuria dilute urine, tachycardia, fatigue
Increased temp, HR, BP; loose stools, increased apetite and consumption of food but loosing weight
Acromeagaly is a condition associated with what hormone? Too much of the hormone or too little?
ADH; too much
LH: too little
GH: too much
GH: too little
Select all approrpiate answers associated with ADH deficiency:
Medical Terminology: SIADH
Medical terminology: Diabetes Insipidus
Can be caused by head trauma/pituitary tumor
Is treated with iodine therapy
Symptoms include polyuria and polydipsia
If you were to compare the urine of a pt with diabetes insipidus and the urine of a pt with uncontrolled diabetes mellitus, the differences would be?
DI pt. would have more protein in urine
DI pt. would have extremely dilute urine and the DM pt. would have sugar in the urine
The DM pt. would have very concentrated urine and the DI pt. would have cloudy urine
The DI pt. would have concentrated urine while the DM pt. would have dilute urine
What would be the most likely specific gravity result of a pt. with Diabetes Insipidus?
Which lung sounds would be associated with Syndrome of Inappropriate ADH?
diminished in the bases
Select the test results that would be helpful in diagnosing SIADH
low specific gravity
high specific gravity
dilute serum osmolality
increased urine Sodium
Central pontine Myelinolysis is very serious iatrogenic reaction to what....
Potassium replacement that is too quick
Sodium replacement that is too quick
DDAVP administration in too high a dose
You are preparing a room for a pt. coming from the PACU after a thyroidectomy. What items, unique to this pt., should you make sure are in his room.
Signs and Symptoms of HyPERthyroid include:
Increased temp, BP, & HR
heat and exercise intolerance
Not eating a lot but still gaining weight
A 50yr old is admitted with thyrotoxicosis. His wife is asking you, the nurse, how you are going to help him. You reply
"I am going to give him DDVAP through his nose to help him retain water."
" I am going to make sure he is breathing well, and cool him down while we wait for the doctor to decide on medication."
" I am going to watch him, he will be fine with time."
" I am going to take his blood and then talk to the doctor about getting an antibiotic prescribed."
A pt you have is on the following list of medication:
benztropine mesylate (cogentin)
Which medication is being used to treat Grave's Disease?
benztropine mesylate (cogentin)
Radioactive Iodine Therapy (RAI) would be a poor treatment choice for a mother of 3 small children beacause....
it takes 4-6 weeks for effect
small children should be avoided for 2-4 days post therapy
oral contraceptives and RAI are contraindicated
She may become depressed and not have enough energy to take care of her kids
You are on a mission trip to Zambia and do not have the resources to test blood. How would you assess a pt. for acute hypocalcemia
Ask the pt. about how much calcium they get in there diet
Check capillary refill in there toes
tap zygomatic arch between the corner of the mouth and ear and watch for chvostek's sign
Ask pt. to flex half and watch for trousseau's sign
Which of the following is NOT a symptom of HypOthyroidism
decreased body temp
In a pt. with hashimoto's you would expect to see a ________ in TH and a(n) _______ in TSH
hypoparathyroidism manifests: (4 correct)
blood calcium falls
blood calcium rises
All of the following are autoimmune disease associated with the endocrine system EXCEPT:
Primary adrenal insufficiency is also known as Addison's Disease and its odd symptom is hyperpigmentation
A student nurse is trying to find something to do a teaching plan on besides a incentive spriometer. A nurse overhears her bitching and lets her know there is a pt. with a new diagnosis of Addison's Disease on the floor. What are all the things a student nurse could teach this pt?
High salt diet, no fasting
Hydrocortisone (cortef) Side effects
levothyroxine (synthroid) therapy
call the doctor to get a medication increase in times of stress
How to properly administer Nasal spray DDAVP
A young girl with Cushing's Disease could be a risk for body image issues because cushing's is known for the visible symptoms of: (pick 4)
abnormal distribution of fat, trunkal fat and thin limbs
excessive hair growth
After a transphenoidal hypophysectomy for the treatment of pituitary tumor causing Cushing's Disease... nasal drainage should be monitored for the presence of what substance?
A nurse is taking care of a pt who has been on countless medications for hypertension. Nothing has worked. The pt. verablized to the nurse that when she came in for surgery and received morphine sulfate for pain control she felt much worse also she became very sick last year after drinking red wine at her sons wedding. What rare condition should the pt. be assessed for...
ACTH-secreting pituitary adenoma
The ductus arteriosus is...
where the blood bypasses the liver in fetal circulation
fistula between the aorta and pulmonary artery in fetal circulation
a connection through the right and left atria that allows for blood to bypass the nonfunctional lungs in fetal circulation
Something i would like to feed to Mary's cat
All of the following are characteristics of a normal newborn that make the newborn more at risk for injury/illness than adults.... EXCEPT
low ability to excrete drugs and process fluid
Presence of surfactant maintaining respiratory stability
bacteria are not normally found in the digestive tract, bacteria that produce Vit K not found (blood coagulation)
large body surface to body mass, thin layer subq fat
You are performing the 5 min after birth APGAR for baby Ellen. She is crying and squawking her brains out while breathing well, has a heart rate of 96, has pink trunk but cyanosis evident fingers and toes, good reflexes, and spontaneously moves all limbs. Baby Ellen's APGAR Score would be?
annoying, i fucking hate APGAR
8: infant do well in normal newborn nursery
10: prognosis is grave
7: infant do well in normal newborn nursery
If a newborn weighs 8.8lbs at birth, the newborn's stomach capacity would be approximately
(step 1 find weight in kg
Step 2 find capacity in mls
Step 3 convert mls to ounces)
In which state should the nurse encourage the parents to hold the infant to increase bonding
Light sleep State: eyes closed, may fuss briefly, easy to startle and wake
Drowsy Alert State: eyes are closed, wake with more stimulus or go back to sleep
Quiet Alert State: minimal body movements but gazes at things/environment
Crying State: continous and lust cries, active body movements, resp irregular and rapid
An umbilical cord should have 2 veins and 1 artery if it doesnt it may be associated with chromosomal anomalies and renal defects
Which of the following are used when trying to assess gestational age and completing a Ballard Score (pick 4)
genitals: rugae, labia
Presence of lanugo
A nurse is reading report and finds the following conflicting results on a Ballard Score: square window (wrist bend) is 45 degrees, Popliteal angle (thigh on abdomen) fully extends; scarf sign fails to reach midline, plentiful lanugo, plantar creases over entire foot, ears do not keep stiff nature, clitoris and minora are greater than the majora.
Which results are consistent with a preterm infant
square window (wrist bend) is 45 degrees
Popliteal angle (thigh on abdomen) fully extends
scarf sign fails to reach midline
plantar creases over entire foot
clitoris and minora are greater than the majora
Ears do not keep stiff nature
37.7 degrees Celsius is what temperature in Fahrenheit ?
A nurse can initiate warming interventions such as a radiant warmer or skin to skin for a newborn with a below than normal temperature. Based on temperature all taken 4 hours after birth which baby should the nurse consider implementing these interventions on?
Baby A: 35.6 C
Baby B: 36.6 C
Baby C: 38.9 C
An LNA takes a newborns vital signs who was born 4 hours ago.
HR: 150 BPM
Respirations: 50 breaths/min
Which results are normal?
HR, Respirations and temperature are normal
Respirations, temperature and BP are normal
Only BP is normal
All finding are within normal ranges
A mother is asking you how much weight her baby is expected to lose within the first few days of life. Her baby weighed 8 lbs at birth and was a normal height of 20 inches. You tell her...
Your baby shouldnt lose any weight and should gain 1/2oz per day
Your baby was a AGA and should lose about a pound
Your baby may loose as much .8 lbs in the first few days and still be healthy
Your baby may loose as much as 1.6 lbs in the first few days and still be healthy
Bowel sounds should be auscultated 1 hour after birth.
Vitamin K (aquamephyton) injections and erythromycin opthalmic ointment should be administered within ________ after birth/
A is ? B is ?
A is Caput succedaneum (localized edema )
B is Cephalhematoma (collection of blood)
A is Cephalhematoma (collection of blood)
B is Caput Seccedaneum (localized edema)
The placement of the urethra is......
Which of the following are used to check for hip dysplasia?
A baby on the first day of birth has a blood sugar of 38. What should the nurse do?
Feed and recheck in 30 min
Give sugarwater in a bottle and recheck in 60 min
feed and recheck in 2 hours
Let baby rest and recheck in an hour
Appropriate treatment for a neonate with early breastfeeding jaundice would be
switch to formula
increase feedings so baby can eliminate meconium
do genetic testing
Use donor milk instead of mother's milk
Your pt. assigned for the day has Bipolar 1. You know that the difference between bipolar 1 and bipolar 2 is that...
Bipolar 1 alternates between major depressive episodes and mania while bipolar 2 clients have never had full blown mania
Bipolar 2 pts have only had symptoms for 1-2 months
Bipolar 1 clients meet all the criteria for depression and mania at the same time
Bipolar 1 pts have never experience mania
Symptoms of Mania include which of the following (pick 4)
agitation, activity increased
flight of ideas
A highly agitated pt. paces the unit and states, "I could buy and sell this place." The client's mood fluctuates from fits of laughter to outbursts of anger. Which is the most accurate documentation of this client's behavior?
Pt won't sit still and is experiencing magical thinking.
Mood labile. Exhibiting delusions of reference. Hyperactive
Mood euthymic. Exhibiting magical thinking. Restless
Pt appears agitated and is pacing the unit. Mood labile, exhibiting grandiosity.
A manic pt with a lithium level of .4 is... What other labs would you want to look at for this pt because they are taking lithium? ( 4 answers)
Within therapeutic range
at risk for toxicity
Select all the Side effects associate with lithium therapy (not toxicity) (pick 4)
fine hand tremors
A pt comes into the ED with confusion, psychomotor retardation, excessive urine output and tremors (ataxia). The client is on Lithium therapy what would you expect the Lithium level to be?
Anticonvulsants used to treat bipolar disorder that need to have blood levels drawn include
divalproex sodium (depakote)
Depakote is to alopecia as Lamictal is to __________
Steven's Johnson Syndrome
Which Medication is not an antipsychotic?
A pt. is on benzotropin mesylate (cogentin), Fluoxetine (prozac), thioridazine (mellaril) and aripiprazole (abilify). The pt asks you which medication is helping make his voices quieter... the best answer would be?
Cogentin helps the most
Prozac makes you not as depressed so you dont hear voices
Mellaril is a atypical antipsychotic that helps make all your voices go away
Abilify is a medication that treats both the positive symptoms like hearing voices and the negative symptoms of schizophrenia.
Dystonia and pseudo-parkinsonism are both side effects of antipsychotics that can be treated with anticholinergic medication
A shizophrenic pt. on holoperidol comes into the office and is moving his mouth repetitvely like he is chewing on his tongue. When asked about it he says he can't stop. You would document this Side effect as?
neuroleptic malignant syndrome
Physostigimine (antilirium) is to anticholenergics as ________________ is to benzodiazepines
Which antipsychotic is associated with agranulocytosis : high fever, sore throat, lethargy, necrosis
olanzapine (zyprexa) would not be a good choice for a pt. with what condition?
pt who is a night owl
You know the pt. understood you explanation on insulin resistance when she said which of the following
"If i just stop eating all carbs i will be cured"
"insulin resistance is when i don't make enough insulin"
"insulin resistance is when i make too much insulin but my body doesn't use it right"
Select which types of diabetes are always treated with insulin therapyT
The hallmark symptoms of both type 1 and type 2 diabetes include:
Low serum sodium
polyphagia which means the desire to keep moving all the time
Polyphagia which means increased apetite
To get the best clinical picture of the average blood sugars over the past 90 days for pt. a healthcare professional would look at ?
Glucose tolerance Testing
Fasting blood sugar
A pt.had a fasting blood sugar of 160 and a Glucose Tolerance Test result of 204 at 2 hours. What is the appropriate action ....
Tell the pt. he has diabetes and let him express his feelings r/t diagnosis
Run each test for a second time and if the results are congruent with the first set of results make a diagnosis of prediabetes
Get a hbA1c
Run each test for a second time and if the results are congruent with the first set of results make a diagnosis of diabetes
Goal of an adult for fasting blood sugar is _______ goal for a1c is < _______
An example of a good 12-15g carb snack for a diabetic would be 1 cup of 1%milk or a small banana
Check all that are associated with hypoglycemia: (pick 4)
low and wet
Blood sugar <65
Symptoms: rapid pulse + RR
Tx: rule of 15 (15g carb recheck in 15 min)
Select all that are associated with hyperglycemia (pick 6)
High and dry
Cause: glucagon, skipped insulin, infection
Blood sugar >250
Tx: rule of 15
faintness, cold clammy sweats,
excessive urination, thirst, hunger
kussmaul, ketones in urine
Tx: insulin, increase activity
A type 1 Diabetic is presenting in the ER with symptoms that started 6 hours ago. Pt is tachycardia, hypotensive and is experiencing palpitations. Last blood sugar was 380 and urine dip was positive for ketones. What is this condition? What does this pt need for tx? (pick 3)
Hyperglycemic- Hyperosmokar nonketotic syndrome
blood sugars every hour
blood sugars every 15 min till stable
Type 2 Diabetic presents in the ER with a blood sugar of 840. Blood tests show high serum osmolality, normal electrolytes, increase PH and increased Bicarb. Urine dip shows no ketones. What is happening with this pt? what does this pt need? (pick 4)
IV insulin slowly decrease serum glucose
vitals and blood sugars every 15-60 min
fluid therapy with 1/2 NS
Biguanide drug, choice for type 2 diabetes, stops liver from releasing extra glucose and makes muscle cells more sensitive to insulin
Insulin Detemir (levemir)
NPH ( Isophate Insulin Suspension)
Long acting insulins such as lantus and levemir can be mixed with shorter acting insulins to be injected at one time...
Insulin Lispro (humalog) should be given when?
in the morning before breakfast and again 24 hours later so it can provide steady long term coverage
When the pt. calls down for the tray since it is intermediate and takes 2-4 hours to start working
When dietary gets on the floor because it is very rapid acting and only takes <15 min to start working
In a hypoglycemic Emergency what can be administered to an unconscious pt.?