Nur 104

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Nur 104
2012-02-20 00:52:11

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  1. Hormones - what do they do
    • regulate metabolism
    • growth and development
    • sexual and reproductive processes
  2. Diabetes insipidus - Etiology
    • Characterized by the production of copious amounts of Urine ( usually moer that 2.5L/day) of dilute urine.
    • Occurs as a result of decreased ADH (antidirectic hormone)
    • Causes:
    • Centeral DI - brain tumors,head injury, neurosugery, CNS infections
    • Nephrogenic DI - drug therapy or kidney disease
    • Dispogenic DI - exessive water intake (sometimes associated w/schizophrenia.
  3. Dibetes insipidus - S/S
    • profound diuresis (production of large amts. of urine)
    • 15 - 20 L in 24 hrs
    • thirst, weakness, fatigue - from nocturia.
    • deficient fluid volume: tachycardia, hypotension, weight loss, constipation, poor skin turgor
  4. Diebetes insipidus - diagnoses
    Lab test...urine adn plasma osmolality urine specific gravity (a water deprivation test)
  5. Diabetes insipidus - Treatment
    • Fluide and Electrolyte replacement
    • hormone therapy
    • v/s - to establish baselien
  6. Hypoparathyroidism
    caused by atrophy or traumatic injury to parathyroid glands

    S/S mild tingling, numbness, muscle cramps, mental changes such as irritabilty. tetany (a muscular twitchin and spasm - serious)

    treated by measures to raise serum calcium levels to normal...oral parenteral admin of calcium salts

    chronic: vidamin d
  7. Hyperparathyroidsm
    Cause postmenopausal women...excessive synthesis of parathoromne...high calcium

    S/S: mild or severe: dehydration, confusion, lethargy, anorexia, nausea, vomiting, weight loss, consitipation, thirst, frequent urination, hypertension.

    treatment: infusion of isotonic sodium chloried and admin of diuretic agents, phosphate therapy, milthramycin. surgical removal of thyroid...thyroidectomy
  8. Post-op for Thyroidectomy
    • Fowlers position
    • head may be supported with sandbags torelieve tension on sutures
    • V/S continuously progressing to hourly once pt is stable
    • watch for signs of bleeding and swelling at site
    • rise in temp, pulse, r/r - sould report immediately as may indicate a high level thyroxine in bloodstream.
  9. Thyroid Storm - throid crisis
    • complicaiton following a thyroidectomy.
    • or od of levothyroxine

    • Sudden andextreme elevation of all body processes temp may rise to 106
    • pulse 200 beats
    • respiration rapid - marked apprehension/restlellness
    • pt cna quicky go from delirum,, coma, dealth from heartfailure.
    • Treatment must be immediate, reduce temp, cardiac drugs, sedatives
  10. Transsphenoidal - surigical approach for hypophysectomy
    hypophsectomy...removal of the pituitary gland

    transsphenoidal - via the nose
  11. Addison's Disease
    • Expected findings during assessment:
    • Generlized malaise, muscle weakness, muscle pain, orthostatic hypotension adn dysrhthmias.
  12. Cortisol - hydrocortisone (glucocorticoid)
    • acts to increase glucose levels in the blood...helps counteract inflammatory response
    • helps the body respond to stress
  13. Pheochromacytoma
    • rare tumor of the adrenal gland causes too much epinephrine/norepinephrine
    • treatment: removal of the tumor
  14. Maxedema
    • low level of thyroid...can result in coma
    • hypotension, hpyothermia, respiratory failure, hyponatremia, hypoglycemia
  15. Acromegaly
    Inspection: tall, huge facial features, enlared ft, hands, thichened skin, fatigure, weakness, enlarged heart, and organs chest size

    remove turmor - transsphenoidal