Test 1 Nursing the Adult

  1. What is the total average intake for 24hrs?
  2. The control of fluid balance is managed by what 4 things?
    • 1. The thirst mechanism
    • 2. ADH, causes reabsorption of water from the kidneys
    • 3. Aldosterone and atrial natriuretic peptide, (ANP), regulaters the reabsorption of water and sodium ions from the kidney tubules
    • 4. Baroreceptors in the carotid sinus and aortic arch, which detect pressure changes.
  3. The Intracellular fluid is high in what?
    Potassium K+
  4. The Extracellular Fluid is high in what?
    Sodium Na+
  5. This is fluid within the blood vessels. Consist of plasma, contain large amounts of protein and electrolytes
    Intravascular Fluid
  6. Fluid in the spaces surrounding the cells. High in Na+. Example Lymph.
    Intersitial Fluid
  7. Fluid in the aqueous humor, saliva, and CSF.
    Transcellular Fluid
  8. How much water is in Fat Cells?
  9. When substances move from a higer concentration to lower concentration until they are evenly distributed. This is possible due to kenetic motion. Glucose, carbon dioxide, water, and other small ions and molecules move by this.
  10. The movement of pure solvent (liquid) across the membrane. Goes from area of low concentration to high concentration.
  11. Equal solute concentration
  12. Greater solute concentration
  13. Lesser solute concentration
  14. Active transport requires what
    ATP/ Energy
  15. Pt ubalble to take in sufficient quanities of fluid because of impaired swallowing, extreme weakness, disorientation or coma, or the unavailability of water are at risk for
    Deficient Fluid Volume
  16. Pt who lose excessive amounts of fluids through prolonged vomiting, diarrhea, hemorrhage, diaphoresis (sweating), excessive wound drainage, or diuretic therapy are at risk for
    Deficiet Fluild Volume
  17. Pt. is presented with signs of THIRST, poor skin turgor, weight loss, weakness, postural hypotension, decreased urine production, dark concentrated urine, dry mucous membranes, rapid weak thready pulse, you would expect the Dr. to Dx this pt. with
  18. Pt present with weight gain, slow bounding pulse, elevated BP, crackles in lungs, decreased serum sodium, firm SubQ tissue, you would expect the Dr. to Dx this pt with
  19. What is the most accurate measure of fluid gain or loss for any age group
  20. The pt is Dx with fluid volume deficit what would you want to push to restore the fluid deficit
    Water and Electrolytes
  21. Prolonged vomiting can lead to what deficits
    • Na+
    • K+
    • Metabolic Acidosis
  22. What is the biggest loss of K+
  23. What does excessive fluid volume due to BP
    Jacks it up
  24. Discuss the tx for Excessive Fluid Volume
    • Bedrest
    • HOB up
    • O2 and Pulse Ox
    • Daily Wt
    • I & O
    • Fluid Restriction
    • Na+ restriction in diet
  25. What is the danger of Lasix?
    6hr Non-K+ sparing Diuretic
  26. The normal range for this is 135-145 mEq/L
    This is a major ation of the Extracellular Fluid
  27. The normal range for this is 3.5-5.0 mEq/L
    Major intracellular cation
  28. Alot of fluid intake will do what to Na+ levels
  29. No fluid intake will do what to Na+ levels in the body?
  30. Normal range is 21.5-4.5 mEq/L
    Necessary for the formation of ATP
    Phosphate PO4-
  31. The normal range is 8.4 - 10.6 mg/dL
    Necessary for Nerve transmission
  32. The normal range is 96-106 mEq/L
    Help maintain acid-base balance.
    Chloride Cl-
  33. Normal Range is 1.3-2.5 mEq/L
  34. The pH of body fluids is slightly
    Alkaline 7.35-7.45
  35. Name the 3 mechanisms that contal or try to rebalance pH
    • 1. Buffer pairs
    • 2. The respiratory system
    • 3. The kidneys
  36. What does hyperventilation result in?
    Respiratory Alkalosis
  37. What follows loss of hydrochloric acid from the stomach?
    Metabolic Acidosis
  38. A 28 yr old pt weighs 160 lbs. The pt body fluids account for about?

    D. 80 lbs
  39. In terms of planning for a pt body fluid needs the LPN should understand that throughout the life span, there is:
    A gradual decline in body water
  40. The componet of body fluid that provieds transportation of nutrients and waste products is:

    A. Water
  41. To plan care for a pt who has edema the LPN must know that the most important electrolyte in the retention of water in the body tissues is:

    D. Na+
  42. A pt is to be given aniemetic. The major side effects of antiemetics include:

    A. oversedation and hypotension
  43. What of the measures should be included in the care of a pt with severe vomiting and diarrhea?

    D. Correcting potassium deficit
  44. A pt is on a low Na+ diet. Which of the following foods are allowed on a low-sodium diet.

    D. Frest Fruit
  45. The pt has a blood pH of 7.45, which is considered
    slightly alkaline
  46. A pt lungs must be well ventilated because hypoventiliation of the lungs results in:

    C. acidosis due to decreased elimination of CO2.
  47. When a pt has vomiting, diuresis with K+ loss, or interinal fistulae, this can lead to :

    D. alkalosis from excessive loss of acids
  48. A pt is to have an infustion of an isotonic solution, which is one that has:

    B. the same osmotic pressure as that of body fluids.
  49. When a pt recieves a hypotonic solution IV. The LPN should expect the pt to receive:

    D. The cells begin to swell as water enters the intracellular compartment
  50. A pt. has a nursing diagnosis of Deficient fluid volume R/T vomiting and diarrhea. Which of the following measures is most likely to be implemented to correct this stituation:

    B. IV therapy
  51. A pt is instructed to eat foods high in K+, which include:

    B. bananas
  52. A 54 year old pt has been admitted to the unit with a K+ level of 2.6 mEq/L. The nurse would anticipate Mr. Hernandez to exhibit:

    A. Muscle faccidity
  53. A pt with Cushing disease will most likely exhibit signs and symptoms of

    A. hypernatremia, pt retains sodium and water
  54. Which of the following pt is most at risk for fluid volume overload?

    A. a 35 year old with renal disease
  55. A pt with a diagnosis of DM in metabolic acidosis has a blood glucose level of 250 mg/dl and has been admitted to your unit. Which symptom is most likely to accompany ketoacidosis:

    A. Polydipsia
  56. List 3 tx or nursing measures that can lead to water intoxication:
    • 1. IV fluids too quickly
    • 2. Given water tap enemas
    • 3. Drink too much water and can't eliminate properly
  57. What hormones are secreted by the Thyroid Gland?
    • T3
    • T4
    • Calcitonin
  58. Intake of what is needed for the thyroid to secrete its hormones
    Iodine and Protein
  59. What is the most important day to day regulator of the metabolic rate?
  60. What is the function of hte Parathyroid gland?
    Secretes parathormone
  61. A low calcium level will stimulate the secretion of ?, which increases the plasma level of calcium
  62. What is the most important regulator of blood calcium levels?
  63. What 2 hormones are secreted by the adrenal medulla?
    Epinephrine and Norepinephrine
  64. Name the 3 hormones secreted by the adrenal cortex.
    • 1. Mineralcorticoids
    • 2. Glucocorticoids
    • 3. Gonadocorticoids
  65. The mineralcorticoids affect what 3 things
    • 1. Sodium
    • 2. Potassium
    • 3. Chloride
  66. The cheif mineralocorticoid is
  67. This hormone promotes conservation of water by acting on the kidneys to retain sodium in exchange for potassium
  68. The glucocorticoids are essential for proper utilization of what 3 things
    • Carbs
    • Protein
    • Fats
  69. The primary glucocorticoid is what
  70. What does cortisol do to glucose levels in the blood
  71. Both aldosterone and cortisol are controlled by
  72. The pancreas secretes what
  73. What cells secrete insulin
  74. What cells secrete glucagon
  75. This is needed for the cells of the body to be able to utilize glucose as fuel
  76. What are 5 affects of aging on the Endocrine System?
    • 1. Pit is smaller
    • 2. Thyroid becomes lumpy, metabolism declines
    • 3. Blood glucose levels rise
    • 4. Older adults experience hypoglycemia more quickly
    • 5. Immune system
  77. What 4 things may effect the result of a Serum T3, Serum T4 and TSH Test?
    • 1. Asprin
    • 2. Iodine containing meds
    • 3. Contrast Media
    • 4. Other meds
  78. What pt teaching should you given when you are doing a Radioactive Iodine Uptake or Thyroid Scan test?
    • 1. Must not be pregnant or lactating
    • 2. Radiacitve iodine is small
    • 3. 24hr specimen if required
  79. If a RAIU detects a Hot spot you could expect to tell the pt that they have a:
    Non Malignant Nodule
  80. If a RAIU detects a "Cold Spot" then you could expect to tell the pt:
    That they found a Malignant Nodule
  81. What test determines the degree of Diabetic control of blood sugar over the preceding 6-8 wks
    Glycosylated Hemoglobin or HbA1C
  82. What hormones are secreted by the Anterior Pituitary?
    • GH
    • TSH
    • ACTH
    • FSH
    • LH
    • Prolactin
  83. The adenohypophysis is also known as
    Anterior Pit
  84. The target tissue is most tissues in the body
    The principal action is it stimulates growth by promoting protein synthesis
    Growth Hormone
  85. The target tissue is Thyroid Gland
    The principal action is to increase secretion of thyroid hormone and increases the size of the thyroid gland
  86. The target tissue is Adrenal Cortex
    The principal action is to increase the secretion of the adrenocortical hormones
  87. The target tissue is Ovarian Follicles in female, and Seminiferous tubules in Males
    The principal action is follicle maturation (ova) and estrogen in the female, and sprematogenesis in the male
  88. The target tissue is Ovary in the females, and Testes in the Male
    The principal action is Ovulation, progesterone production in females, and Testosterone production in Males
  89. The target tissue is mammary gland
    The principal action is to stimmulates milk production
  90. What are the 2 hormones stored in the Posterior Pituitary Gland, and synthesized in the Hypothalamus?
    • ADH
    • Oxytocin
  91. What is the neruohypophysis also known as
    Posteior Pituitary
  92. The target tissue is Kidneys
    The principal action is to increase water reabsorption (decreases water loss in urine)
    Osmoreceptors detect increase in Na+ which send for signal to secrete....
  93. The target tissue is Uterus; mammary gland
    The principal action is to increase uterine contractions; stimulates ejection of milk from mammary gland
    Let Down Reflex
  94. What 3 hormones does the thyroid secrete
    • T3
    • T4
    • Calcitonin
  95. The target tissue is most body cells
    The principal action is to increase meatbolic rate
    • T3
    • T4
  96. The target tissue is Primarly Bone
    The principal action is to decrease bone calcium by inhibiting bone breakdown and release of calcium
  97. What hormone does the parathyroid secrete
  98. The target tissue is bone, kidney, digestive tract
    The principal action is to increase blood calcium by stimulation bone breakdown and release of calcium; increases calcium absorption in the digestive tract
  99. What hormones does the adrenal cortex secrete
    • Mineralocorticoids
    • Glucocorticoids
    • Gonadocorticoids
  100. The target tissue is Kidney
    The principal action is to increase Na+ reaborption and K+ excretion in kidney tubules, Increase water retension
  101. The target tissue is most body tissues, and the Liver
    The principal action is to increase blood glucose levels; inhibits inflammation and immune responses
  102. The target tissue is Heart, Blood vessels, liver and adipose
    The principal function is to help cope with stress, increases ht rt. and BP
    Epi and Norepi
  103. The target tissue is liver
    The principal action is to increase breakdown of glycogen ot increase blood glucose levles
  104. The target tissue is general, but especially liver, skeletal muscles, adipose
    The principal action is to decrease blood glucose level by facilitating uptake and utilization of glucose by cells
  105. The Pineal gland secretes what
  106. The target tissue is Hypothalamus
    The principal action it to inhibit gonadotropins-releasing hormone, regulates daily rhythms
  107. What does the thymus secreted
  108. The target tissue is tissues involved in the immune response
    The principal action is to delvelop the immune system
  109. What is the tempurature regulator
  110. A pt is admitted to the hospital with a suspected diagnosis of hyperthyroidism. She asks you about the throid scan for which she is scheduled this morning. You should tell her that the test is done to:

    B. detect abnormal areas of growth or tissue in the thyroid
  111. Three of the following are signs or symptoms of hyperthyroidism. Which one is not?

    C. mental sluggishness
  112. Immediately after a pt has a thyroidectomy, the pt should be placed in which of the following positions?

    A. Fowler's
  113. During the immediate postoperative period, a pt who has had a thyroidectomy should be watched for:

    C. edema, hoarness, and increase in VS
  114. Muscular twitching and cramps in the muscles following thyroidectomy may indicate:

    B. damage to the parathyroid glands during surgery
  115. In the postoperative period, you should observe a pt who has had a thyroidectomy for evidence of thyroid crisis. Two common signs of thyroid crisis are:

    B. extreme temperature elevation and rapid pulse rate
  116. The LPN can expect thyroid crisis to be tx by:

    A. reducing the body temperature and lowering the pulse rate
  117. When you evaluate the tx of a hyperthyroid pt who has received oral radioactive iodine, the pt describes bieng very tired and lethargic. You should know that this indicates that:

    D. the treatment is working
  118. A 42 year old pt complains that she has been losing a lot of her hair, is fatigued, and is cold all the time. You should recognize that these symptoms are indicative of:

    A. Hypothyroidism
  119. A pt is dx as having Addison's Disease. This condition is the result of :

    B. insufficiencies of the mineralocorticoids and glucocorticoids
  120. In addition to generalized malaise and muslce weakness, three of the following symptoms are also common when a pt has Addison's disease. Which one in not a symptom:

    B. Headache
  121. When caring for a pt with Addison's disease, you should observe for and report which of the following findings?

    D. a sudden drop in BP
  122. Three of the following are symptoms of Cushings syndrome. Which one is not?

    B. Hypotension
  123. When doing a discharge teaching for a pt with Addison's disease, you should explain to the pt that getting an infection may:

    B. precipitate crisis
  124. A pt has DI. You should anticipate giving which of the follwoing drugs:

    B. Pitressin
  125. A pt who has hyperthyroidism has a nursing diagnosis of "anxiety R/t nervousness and agitation. Because of this nursing diagnosis, which of the following interventions should be included in the pt's care?

    B. keeping the environmental stimuli to a minimum
  126. If a pt has hypoparathyroidism, the pt's chief symptoms is likely to be:

    A. tetany
  127. Aldosterone's major function is to:

    D. conserve water and sodium in the body
  128. A pt is at risk for developing osteoporosis if she is producing abnormal:

    B. calcitonin
  129. A pt is admitted with a suspected endocrine disorder. His symptoms include changes in blood glucose levles, weakness, and irritability. Diagnostic procedures to determine etiology of the problem would include:

    B. lab studies
  130. A pt with deficiency of which of the following hormones will exhibit symptoms of DI?
    a. insulin
    b. glucagon
    c. estrogen
    d. ADH
    D. ADH
  131. When a pt has alterations in serum Ca+ and PO4-, which of the following is dysfunctional?

    C. parathyroid
  132. The nurse would monitor a pt for signs and symptoms of glucose intolerance when a pt is dx with which of the following disorders? (select all that apply)

    a. acromegaly
    b. cushings syndrome
    c. pheochromocytoma
    d. graves disease
    • b. cushings
    • c. pheochromocytoma
  133. A pt is scheduled for thyroid function tests in the morning. Pt preparation for the diagnostic procedure includes: (select all that apply)

    a. keeping the pt NPO after Midnight
    b. asking the pt if she has recently eaten shrimp or clams
    c. explaining to the pt that the dose of radioactivity she will be exposed to during the test is very small
    d. ascertaining if the pt is claustrophobic
    e. instructing her to discard her first mornings urine
    b and C
  134. A pt is dx with a thyroid disorder. You should anticipate that the pt is mostly likely to have problems with:

    C. metabolic rate
  135. The dr orders a dexamethasone suppression test to assist in the dx of cushings syndrome. An appropriate nursing action would be to:

    B. check orders for drugs to withheld
  136. Which of the following is at greatest risk for injury related to bone fracture:

    D. pt with a parathyroid disorder
  137. This tumor secretes GH leading to continued growth of bones and soft tissue
    Tumor of the pituitary usually a genign pituitary adenoma.
  138. Excessive secretion of GH caused what in children
  139. Excessive secretion of GH in adults
  140. What is tx for a pituitary tumor
    Hormone Therapy
  141. Removal of the pituitary gland
  142. A post op hypophysectomy pt is kept in what position
    Semi Fowlers
  143. A rare disorder characterized by a decrease in the level of one or more pituitary hormones
    hypofunction of the pit gland
  144. What is the most common cause of pituitary hypofunction
  145. What is used to replace GH
    Somatropin via SubQ Injection
  146. Decreased muscle mass, pathologic fractures is shown in what diminished hormone secretion
  147. Menstrual irregularities, diminished libido, decreased breast size, testicular atrophy, impotence, decreased facial hair is shown when what hormone diminishes
    • FSH
    • LH
  148. Weakness, fatigue, headache, postural hypotension, decreased tolerance for stress, susceptibility to infection is shown when which hormones are diminished
    • ACTH
    • Cortisol
  149. Cold intolerance, constipation, fatigue, lethargy, weigh gain is shown when which hormone is diminished
  150. Your pt is experiencing profound diuresis, thirst, weakness, fatigue from nocturia, wt loss, and poor skin turgor. What do you expect the dr to dx this pt with
  151. List the 3 primary mechanisms of DI:
    • 1. Central DI
    • 2. Nephrogenic DI
    • 3. Dispogenic DI
  152. This mechanism of DI is associated with brain tumors, and head injury
  153. This mechanism of DI is caused by drug therpay or kidney disease
    Nephrogenic DI
  154. This mechanism of DI is caused by excessive water intake and is sometimes associated with schizophrenia
    Dispogenic DI
  155. Explain the Tx for DI
    Replacement of fluid and electrolytes, along with hormone therapy.
  156. This is oppisite of DI. Excessive amounts of ADH are produced, resulting in fluid retention
    Syndrome of Inappropriate ADH or SIADH
  157. You pt is experiencing symptoms of confusion, loss of consciousness, wt gain, and edema. Her urine output is diminished. She is experiening muscle cramps and weakness.When you listen to her lungs you notice crackling. You would expect the dr to dx this pt with
  158. Explain the tx for SIADH
    Restricting fluid to 500-1000 ml per day. Admin sodium chloride, diuretics, and demeclycyline to increase free water clearance.
  159. Your pt has an enlargement on the front of her neck. She is complaining that she is having difficulty swallowing. What would you expect the dr to dx this pt with.
  160. Explain the tx for a goiter
  161. What nursing considerations should you be aware of when tx a person with a goiter.
    Iodine preparations should be well diluted and given through a straw because they can cause staining to the teeth.
  162. What is another name for Graves Disease
  163. Your pt is a 45 yr old woman. She is present with symptoms of wt loss, nervousness, weakness, insomina, tremulousness, agitation, tachycardia, palpitations, ankle edema, difficulty concentrating, diarrhea, increased thirst, decreased libido. Upon assessment you notice exophthalmos. What would you expect the dr to dx this pt with.
    • Graves Disease
    • Hyperthyroidism
  164. Explain the tx for Graves Disease
    • Radio active iodine
    • Antiythyroid drugs
  165. When a pt in not responding to iodine tx or antithyroid meds they may have to undergo a
  166. Your pt who is post op from recieving a thyroidectomy is presenting with symptoms of increased pulse, increased respiration rate, tetany, and rise in body temp. What should you do STAT
    Report to charge nurse or dr
  167. What is a complication in thyroidectomy that is caused by a sudden increase in the output of thyroxine caused by the manipulation of the thyroid as it is being removed
    Thyroid Storm
  168. Your post op pt from a thyroidectomy is present with 106 degree fever, 200 bpm, rapid respirations, apprehension and restlelessness, what do you anticipate
    Thyroid storm which must be tx quickly
  169. Myxedema is also known as
  170. Your pt is a 8 wk old infant. The infant is presenting with signs of delayed physical growth, mental growth, sluggish. What do expect the dr. to dx this infant with
  171. Your pt is a 32 year old presenting with a decreased appetite, wt gain, bagginess under the eyes, swelling of the face, lethargic, slurred speach, abdominal distention, depression, husky voice, dry scaly skin, brittle nails, easy brusing, and nonpitting edema. What do you expect the dr. to dx this pt. with
  172. What is the tx for myxedema
    Replacement of thyroid hormones
  173. What should you keep in mind when dealing with pt that have been dx with myxedema
    • 1. Cold intolerence
    • 2. Dont rush pt
  174. A pt who presents with painless enlargement of the thyroid gland, and dysphagia is most likely to be suffering from what
    Thyroiditis or Hasimotos
  175. Explain the tx for hosimoto's disease
    Given thyroid hormone to prevent hypothyroidism and suppress TSH secretion.
  176. What is the most common form of thyroid cancer
    Papillar carcinoma.
  177. Your pt presents with muscle tetany, positive chvosteks and trousseaus sign, mild tingling, muscle cramps, and irritability. What do you expect the dr. to dx this pt with
  178. Explain the tx for hypoparathyroidism
    Raise the calcium levels to a normal range. Milk, yogurt, and chese are high in phosphorus and therefore not advised.
  179. Your pt is a 62 year old postmenopausal woman. She is presenting with adenoma, dehydration, confusion, lethargy, N & V, wt. loss, thirst, hypertension. Upon assessment you notice that she has a right fractured femur. What do you expect the dr to dx this pt with
  180. Explain the tx for hyperparathyroidism
    • Infusion of isotonic sodium chloride
    • admin of diuretic
    • Phosphate Therapy
  181. Your pt is presenting with intermittent unstable hypertension, diaphoresis, anxiety, severe headache, and palpations. What do you expect the dr to dx this pt with
  182. This is a rare tumor of the adrenal medulla that secretes catchcholamines (epi and norepi).
  183. Explain the tx for pheochromocytoma
  184. Your pt is presenting with signs of generalized malaise, muscle weakness, muscle pain, othrostatic hypotension, cardiac dysrythmia, anorexia, flatulence, and diarrhea. You would expect the dr to dx with pt with
    • Adrenocortical Insufficiency
    • Addisons Disease
  185. What is also known as Adernocortical Insufficiency
    Addisons Disease
  186. Explain the tx for Addisons disease
    • Life long therapy replacement
    • hydrocortisone
    • fludrocortisone
  187. Physical stress form the flu or other infection can tip the scales for a pt with Addison's disease and send them into
  188. Excess Adrenocortical Hormone is also known as
    Cushings Syndrome
  189. A pt presents with painful fatting swellings in the intrascapular space (buffalo hump) and facial area (moon face), enlarged abdomen with thin extremities, easily brusing, impotence, amenorrhea, hypertension, hirsutism, streaked purple markings in the abdominal area. You would expect the dr to dx this pt with
    Cushings Syndrome
  190. Explain tx of cushings syndrome
    • microsurgy on the pituitary gland
    • radiation
    • keocanazole
  191. The most common cause of cushings is
    prolonged use of corticoids for chronic inflammatory disorders such as COPD, RA, Crohns Disease
  192. What is oversecreting in cushings sydrome
  193. A pt has been admitted for management of hypoparathyroidism. The nurse should anticipate an order for:

    A. calcium
  194. A pt with addisons disease will most likely exhibit which of the follwoing symptoms:

    C. bronae skin pigment
  195. A pt with Cushings disease should be instructed to :

    B. litmit dietary sodium
  196. A pt with a pituitary tumor will most likely exhibit symptoms of:

    A. alteration in visual activity
  197. Which electrolyte is directly affected by the hormone secreted by the parathyroid:

    D. calcium
  198. A pt with acromegaly will most likely exhibit which of the following symptoms:

    C. bone pain
  199. You are caring for a pt with Graves Disease.Which of the following findings would indicate a complication of this pts disease process:

    A. SOB
  200. You are caring for a pt after a thyroidectomy. Your priority should be to:

    B. maintain the pt in a semi-fowlers position
  201. What type of Diabetes does the body's immune system destroy the beta cells
    Type 1 IDDM
  202. Which type of DM requires injections of Insulin to maintain life because they produe little or no insulin on their own
    Type 1
  203. People that have type 1 DM are more prone to what
  204. What type of DM is related to insulin resistence
    Type 2
  205. A pt is presented to you with symptoms of polyuria, polydipsia, polyphagia, rapid wt loss, irritability, weakness, fatigue and N & V. What do you expect the dr to dx this pt with
    Type 1 DM
  206. A pt is presented to you with wt gain, poor healing of wounds, blurred vision, increased fatigue, numbness in the feet. Upon getting a hx, he tells you that his mother and grandfather have DM. What do you expect the dr to dx this pt with
    Type 2 Dm
  207. What 4 factors influence the pt development of DM
    • 1. Genetics
    • 2. Metabolic
    • 3. Microbiologic
    • 4. Immunologic
  208. Explain the wt loss in a pt with Type 1 DM
    • 1. the loss of body fluid
    • 2. in the absence of sufficient insulin the body begins to metabolize its own protein and fat.
  209. What is the cure for DM
    No Cure
  210. What is the goal for DM pt
    maintain blood glucose levels
  211. What is the number 1 tx for DM
    Insulin Therapy
  212. What is Type 2 Dm tx
    • Diet
    • Exercise
    • OHA's
    • Insulin
  213. Oral Hypoglycemic agents
  214. explain the precautions you take with NPH
    • Cloudy
    • Roll in hands
  215. Which routes can insulin be taken by
    • Injection
    • Inhaled
  216. Why can insulin not be taken by PO
    Gastric juices destroy it
  217. Are OHA's a form of insulin
  218. If your pt is taking an OHA should you advise them to stop their diet and exercise program
  219. Explain the cautions used with Lantix and Levomere
    Cant be mixed with anything
  220. Name 3 problems with Insulin Therapy
    • Allergic reaction
    • Lipodystrophy
    • Somogy Effect and Dawn phenomenon
  221. What should you do when taking Metgormin and need a contrast dye
    Hold metformin 48-72 hrs
  222. You have a pt that is presenting with symptoms of 3 P's, Flu like symptoms, Kussmauls Respirations, Fruity acetone breath, and dehydration. What do you expect the dr to dx this pt with
    Diabetic Ketoacidosis
  223. This is a serious condition caused by incomplete metabolism of fats due to the absence or insufficienty supply of insulin. The body breaks down protein and fat for energy. This produces an abundance of ketones
    Diabetic Ketoacidosis
  224. A pt presents with the following symptoms polyuria, lethargy, BS of 1,00-1,500 and no N & V. What would you expect the dr. to dx this pt with
    • HNKS
    • Hyperglycemic Hyperosmolar Nonketotic syndrome
  225. This occurs in type 2 DM who experience high blood glucose levels because of illness or added stress, such as infection.
    Hyperglycemic hyperosmolar nonketotic syndrome
  226. This is encountered with type 1 diabetes. This follows a period of hypoglycemia.
    Rebound Hyperglycemia
  227. this is characterized by elevated blood glucose in the morning, but is not related to hypoglycemia. This is caused by a release of GH, glucagons and epinephrine during the night. These are all counterregulatory hormones which act to raise the bodys blood sugar. This is why most DM can't tolerate carbs in the morning
    Dawn Phenomenon
  228. When does the Somogi Effect need to have BS checked
  229. Your pt presents with symptoms of tremulousness, hunger, headache, pallor, sweating, palpitations, blurred vision, weakness, confusion. You would expect the dr to dx this pt with
  230. This is a syndrome whereby a pt has insulin resistance, hypertension, increased LDLs and decreased HDLs.
    Insulin Resistence Syndrome
  231. Disease of the kidney occurs directly from changes in the renal blood circulation.
  232. Very poor circulation in feet and lower extremities.
    peripheral vascular disease
  233. Visual impairment and blindness due to Dm
  234. The three most common visual disturbances
    • Diabetic Retinopathy
    • Cataracts
    • Glaucoma
  235. Pathologic changes in the NS causes deterioration of nerves
  236. Your pt is presented with rapid heart beat, weakness, anxiety, nervousness, and hunger. What can you expect the dr to dx this pt with
  237. A pt recently diagnosed as having hypoglycemia says, "Hypoglycemia! I can't live with that. My neighbor had that and acted crazy!" Which of the following responses should you give him:

    C. Hypoglycemia has been succussfully tx by diet modifications
  238. DM is best defined as a (n):

    A. disturbance in utilization of glucose
  239. Three of the following are early signs of hypoglycemia. Which one is not:

    A. polyuria
  240. When teaching a pt with type 1 diabetes about home care, you assure her that she can recognize the early signs of Diabetic Ketoacidosis, which are:

    A. thirst dry mucous membranes and dry skin
  241. When drawing up a long-acting insulin and regular insuling in one syringe, which of these actions should you take:

    C. draw up the reglular insulin first
  242. Which of the following is most likely to occur if hypoglycemia is not tx properly?

    B. Loss of consciousness
  243. A pt may be at risk for developing hyperglycemic hyperosmolar nonketotic syndrome if three of these conditions are present. Which condition is not considered a factor?

    A. drinking too much water
  244. A pt with Dm has been maintained on Meformin (glucophage) for reglulation of her blood glucose levels. Which of the following issues should be included in this pt's teaching?

    B. report changes in voiding pattern
  245. A pt with DM is taking Lantus insulin. The nurse is aware that this insulin will most likely be admin:

    D. at night
  246. A pt presents in the ER with Polyuria, polydipsia, and polyphagia related to diabetes. You should expect these symptoms are related to :

    B. hyperglycemia
  247. A pt newly dx with DM is learning to admin his injections of NPH and regular insulin. Which statment indicates that the pt understands your teaching regarding proper insulin admin?

    • C. I will draw up the regular before the NPH
    Inhalation powder=Exubera
    Aspart Injection=NovoLog
    Lispro injection=Humalog
    Glulisine injection=Apidra
    Rapid Acting Insulin
    Regular human insulin injection=Humulin R
    Buffered regular human insulin injection= Velosulin BR
    Short acting Insulins
  251. What does metformin have an effect on and what should you keep in mind
    Liver and No contrast dyes
  252. What are acarbose (precose)
    Startch blockers, Intestine
  253. pioglitazone (Actos) does what
    Decreases liver production of glucose, making muscle more sensitive to insulin
  254. What does Starlix and Prandin do
    stimulates insulin secretion Pancreas
  255. Januvia does what
    enhances natural body systems, regulates glucose Pancreas`
Card Set
Test 1 Nursing the Adult
Nursing the Adult