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disorders of PPG
pn 141 test i book:med surg nursing pg 336
| Question | Answer |
|---|---|
| disorders of the posterior pituitary gland are caused by what | too much or too little antidiuretic hormone (ADH) |
| what does ADH regulate | total body water by acting on the kidneys to retain or release water (not slutes- sodium) |
| what controls the release of ADH in resonse to serum osmolarity (concentration of particles of blood) | receptors in the hypothalamus |
| what happens when serum osmolarity increases (aka hyperosmolarity) | ADH secretion increases and renal water is reabsorbed which decreases urinary output |
| what happens when serum osmolarity decreases (aka hyposmolarity) | it suppresses the release of ADH, so urine output increases |
| diabetes insipidus: what is it | a condition that results from ADH insufficiency |
| diabetes insipidus: what are the two types | neurogenic and nephrogenic |
| diabetes insipidus- neurogenic: what can it result from | damage to the pituitary gland following a head injury or cranial surgery |
| diabetes insipidus- nephrogenic: when does it occur | when the kidneys fail to respond to ADH secretion, may be due to renal failure |
| diabetes insipidus: a deficient supply of ADH causes what amount of urinary output a day | 5-15 L |
| diabetes insipidus: s/s of it | extrem thirst (polydipsia), polyuria (5-15 L/day), urine specific gravity <1.005, very pale urine, weakness, dehydration (tachycardia, poor skin turgor, dry MM) |
| diabetes insipidus: tx of it | giving additional fluids by mouth, or 0.45% of normla saline IV, ADH replacemnt therapy, sodium restriction |
| diabetes insipidus: med given | vasopressin (pitressin), desmopressin (DDAVP), thiazide diuretics |
| Syndrome of inappropriate ADH secretion: what is it | a condition that results from excess production of ADH |
| Syndrome of inappropriate ADH secretion: cause of it | mung tumors, head injury, pituitary surgery, ar the use of barbiturates, anesthetics or diuretics |
| Syndrome of inappropriate ADH secretion: excess production of ADH leads to what | water retention, hyponatremia (low serum sodium levels), and serum hyposlolarity (excess dilution of the blood) |
| Syndrome of inappropriate ADH secretion: s/s of it | HA, anorexia, muscle weakness, decreased urine output, dark yellow urine, urine specific gravity >1.030, wt gain w/out edema |
| Syndrome of inappropriate ADH secretion: why do neurologic s/s develop | they appear as brain cells swell |
| Syndrome of inappropriate ADH secretion: why isn't edema present | b/c water is distributed between the intracellular and extracellular spaces |
| Syndrome of inappropriate ADH secretion: TX of it | by correcting the underlying cause, limit fluid intake, |
| Syndrome of inappropriate ADH secretion: MEds | diuretics (lasix) |
| diabetes insipidus: why is BP low in | b/c of dehydration (lost volume) |
| diabetes insipidus:why is HR high | bc it is trying to compensate for lost volume |
| diabetes insipidus: does this have anything to do with BG | NO |
| diabetes insipidus: are ADH levels high or low | High |
| what does ADH stand for | antidiuretic hormone |
| diabetes insipidus: normally ADH stops diuresing, but when the levels are low it doesn't stop diuresing causing | increased diuresing which causes dehydration |
| diabetes insipidus: first nursing intervention | give fluids, vasopresson to vasocontrict |
| diabetes insipidus: does this person sweat more or less | more |
| diabetes insipidus: do sodium levels increase or decrease | they increase >150 |
| SIADH: is there increased or decreased fluid volume | increased |
| SIADH: should fluid be restricted | yes |
| SIADH: are sodium levels elevated or decreased | decreased, because it is diluted from the extra volume |
| SIADH: will the extra fluid show as edema | no, because it is located inbetween the intra and extra cellular space |
| SIADH: does BP increase | only slightly |
| DI: does BG change | no |
| DI: nursing Dx | def. fluid volume tx: increase fluids |
| DI: does the salt need to be restricted; why or why not | yes; b/c it is more concentrated |
| Vasopressors- Vasopressin: action and use | a derivative of desmopressin. Regulates the reabsorbtion of water by the kidneys. it replaces the hormone in body and restores normal urination and thirst DI |
| Vasopressors- Vasopressin: adverse reactions | tremors, sweating, vertigo, nasal congestion, N/V, abdominal cramps, water intoxication |
| Vasopressors- Vasopressin: excessive amounts of this drug result in what | fluid overload |
| Vasopressors- Vasopressin: s/s of fluid overload (water intoxication) | drowsiness, listlessness, confusion, HA |
| SIADH: is ADH high or low | HIgh |
| SIADH: is sodium low or high; why | it is low; since there is fluid retention the sodium is dilutionally low |
| SIADH: S/S of low sodium | drowsiness, weakness, lethargy, HA |
| SIADH: is weight gained or lost | gained |
| SIADH: why is there HTN | b/c there is fluid overload |
| SIADH: Tx | fluid restriction, diuretics, |
Created by:
jmkettel
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