Acute Respiratory Distress Syndrome and Endocrine Disorders
45 Questions
0 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What characterizes the exudative phase of acute respiratory distress syndrome (ARDS)?

  • Refractory hypoxemia and bilateral infiltrates (correct)
  • Fluid accumulation in the interstitial space and alveoli (correct)
  • Diffuse fibrosis and scarring of lung tissue
  • Hypercarbia and worsening oxygenation

    • Which clinical manifestation is associated with the fibrotic phase of ARDS?

  • Hyperventilation
  • Worsening hypoxemia
  • Tachycardia
  • Decreased left-heart preload (correct)

    • What diagnostic feature is commonly seen on a chest X-ray for ARDS?

  • Ground-glass appearance (correct)
  • Consolidation with air bronchograms
  • Normal lung volumes
  • Dilation of bronchial tubes

    • Which treatment method is primarily used for refractory hypoxemia in ARDS?

    <p>Mechanical ventilation</p> Signup and view all the answers

    What is a characteristic feature of airway pressure release ventilation (APRV) used in ARDS treatment?

    <p>Inverse inspiratory/expiratory ratio</p> Signup and view all the answers

    What is the primary clinical manifestation of diabetes insipidus?

    <p>Polyuria</p> Signup and view all the answers

    What is a common clinical manifestation of pheochromocytoma?

    <p>Severe headaches</p> Signup and view all the answers

    Which of the following indicates nephrogenic diabetes insipidus?

    <p>Kidney resistance to ADH</p> Signup and view all the answers

    What is the primary focus in the preparation for an adrenalectomy in patients with pheochromocytoma?

    <p>Reducing blood pressure and heart rate</p> Signup and view all the answers

    Which diagnostic test would be most relevant for assessing hypopituitarism?

    <p>ACTH stimulation test</p> Signup and view all the answers

    Which imaging studies are used for diagnosing pheochromocytoma?

    <p>CT and MRI</p> Signup and view all the answers

    What is a major risk during an adrenalectomy for pheochromocytoma?

    <p>Hypertensive crisis</p> Signup and view all the answers

    What treatment is commonly used for managing symptoms of diabetes insipidus?

    <p>Desmopressin</p> Signup and view all the answers

    Which medication is administered to manage hypertensive crisis in pheochromocytoma?

    <p>Sodium nitroprusside</p> Signup and view all the answers

    Which condition may result from hyperpituitarism due to increased prolactin levels?

    <p>Hypogonadism</p> Signup and view all the answers

    What autoimmune condition is the most common cause of hypothyroidism?

    <p>Hashimoto's thyroiditis</p> Signup and view all the answers

    What type of fluid management is beneficial in treating diabetes insipidus?

    <p>Hypotonic solutions</p> Signup and view all the answers

    Which of the following is NOT a clinical manifestation of hypothyroidism?

    <p>Increased energy</p> Signup and view all the answers

    Which clinical manifestation is not typically associated with diabetes insipidus?

    <p>Oliguria</p> Signup and view all the answers

    Who is most at risk for developing hypothyroidism?

    <p>Females aged 30 to 60</p> Signup and view all the answers

    What medication is used to inhibit the release of anterior pituitary hormones?

    <p>Bromocriptine</p> Signup and view all the answers

    Which type of trauma is characterized by a sharp object penetrating the chest?

    <p>Penetrating trauma</p> Signup and view all the answers

    What common assessment tool is used for emergency situations to quickly evaluate chest trauma?

    <p>Ultrasonography (FAST)</p> Signup and view all the answers

    Which complication is specifically related to the accumulation of air in the pleural space?

    <p>Tension pneumothorax</p> Signup and view all the answers

    What is a primary goal during the treatment of chest trauma?

    <p>Maintain airway, breathing, and circulation</p> Signup and view all the answers

    Which of the following is a clinical manifestation of chest trauma?

    <p>Shortness of breath</p> Signup and view all the answers

    What medication type is often used to assist with ventilation in mechanically ventilated patients?

    <p>Neuromuscular blocking agents</p> Signup and view all the answers

    What is the result of a hemothorax?

    <p>Blood in the pleural space</p> Signup and view all the answers

    Which of the following lab tests is essential to assess for potential oxygenation issues?

    <p>ABGs</p> Signup and view all the answers

    What is the primary treatment for thyroid cancers?

    <p>Surgical excision</p> Signup and view all the answers

    What condition is primarily associated with hypoparathyroidism?

    <p>Hypocalcemia</p> Signup and view all the answers

    What is administered to a patient presenting with acute hypocalcemia?

    <p>Calcium gluconate</p> Signup and view all the answers

    Which diagnostic test is essential for identifying hypoparathyroidism?

    <p>Low serum calcium levels</p> Signup and view all the answers

    After a total thyroidectomy, what medication must the patient take for life?

    <p>Levothyroxine</p> Signup and view all the answers

    What clinical manifestation is associated with hypoparathyroidism?

    <p>Prolonged QT interval</p> Signup and view all the answers

    Which of the following treatments is specifically used for locally advanced or metastatic differentiated thyroid cancer that has progressed?

    <p>Cabozantinib</p> Signup and view all the answers

    What nursing action is crucial postoperatively for a patient who has had a thyroidectomy?

    <p>Monitor for signs of tetany</p> Signup and view all the answers

    What is the primary function of insulin pumps?

    <p>To provide rapid-acting insulin in continuous incremental dosages</p> Signup and view all the answers

    Which of the following is a clinical manifestation of diabetic ketoacidosis (DKA)?

    <p>Ketonuria</p> Signup and view all the answers

    What should be monitored before administering insulin in cases of hyperglycemia?

    <p>Potassium levels and electrolytes</p> Signup and view all the answers

    What is defined as hypoglycemia?

    <p>A blood glucose level of less than 65 mg/dL</p> Signup and view all the answers

    What is the effective route for insulin administration during DKA treatment?

    <p>Intravenous delivery</p> Signup and view all the answers

    What is a common cause of diabetic ketoacidosis (DKA)?

    <p>Missed or reduced insulin doses</p> Signup and view all the answers

    Which of the following is part of the prevention strategy for diabetes management regarding DKA?

    <p>Patient education on signs and symptoms of DKA</p> Signup and view all the answers

    What breathing pattern is associated with diabetic ketoacidosis (DKA)?

    <p>Kussmaul respirations</p> Signup and view all the answers

    Study Notes

    Diabetes Insipidus

    • Classified as either central (ADH deficiency) or nephrogenic (kidney resistance to ADH)
    • Central DI is caused by decreased ADH secretion from the posterior pituitary gland.
    • Nephrogenic DI occurs when the kidneys are resistant to ADH.
    • Chronic renal insufficiency, hypercalcemia, hypokalemia, and interstitial renal tubule disease can cause nephrogenic DI.
    • Key symptoms include polyuria, polydipsia, and nocturia.
    • Other symptoms include hypotension, tachycardia, and hypovolemia.
    • Diagnosis involves serum and urine electrolytes, serum and urine osmolality, urine specific gravity (decreased), and imaging (CT or MRI) of the head.
    • Hematocrit and serum sodium are typically elevated.
    • Treatment involves fluid management with hypotonic solutions (0.45% NS). and desmopressin (synthetic ADH analogue).

    Hypopituitarism

    • Hyposecretion of hormones from the anterior pituitary gland.
    • In children, before epiphyseal closure, it can lead to dwarfism.
    • Osteoporosis may develop.
    • Diagnosis involves ACTH stimulation testing to measure TSH, FSH, LH, prolactin, and growth hormone.

    Hyperpituitarism

    • Oversecretion of hormones from the anterior pituitary gland.
    • Increased prolactin can lead to hypogonadism, galactorrhea, and increased body fat.
    • Acromegaly is characterized by thickening of bones (especially hands, feet, and facial bones).
    • Diagnosis includes ACTH stimulation test, measurements of TSH, FSH, LH, prolactin, and growth hormones.

    Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH)

    • Disorder related to an increase in ADH.
    • Characterized by water overload and resultant hyponatremia and hypoosmolality.
    • Urine output is decreased, but concentration (specific gravity) and osmolality are increased.
    • Clinical manifestations include hyponatremia, anorexia, nausea, and malaise.

    Adrenal Insufficiency

    • Decreased secretion of ACTH from the anterior pituitary gland (secondary insufficiency) or hypothalamus (tertiary insufficiency).
    • Symptoms include weakness, weight loss, fatigue, nausea, abdominal pain, and darkened/bronzed skin.
    • Diagnosis includes cortisol, glucose, and potassium measurements, and CT/MRI scans.
    • Treatment/management includes cortisol administration, IV fluids, and glucose.

    Adrenal Cortex Hyperfunction (Cushing's Syndrome)

    • Caused by excessive hormone production, often from a pituitary tumor (70%) or adrenal tumor (15%).
    • Excess circulating cortisol (from adrenal glands) is a key feature.
    • Virilization (male sexual characteristics in females) and hyperglycemia are common symptoms.
    • Other symptoms include increased risk of infection, emotional disturbances, moon face, cardiac hypertrophy, breast atrophy, adrenal tumors, obesity, abdominal striae, amenorrhea, and decreased muscle mass.
    • Diagnosis involves cortisol level assessment.

    Pheochromocytoma

    • Catecholamine-secreting tumors of the adrenal medulla (usually unilateral).
    • Symptoms include tachycardia, hypertension, severe headaches, palpitations, hyperhidrosis, hypermetabolism, and hyperglycemia.
    • Paroxysmal (sudden onset) hypertension is a key manifestation.
    • Diagnosis relies on measuring urine and plasma catecholamine levels and imaging studies (CT or MRI).
    • Treatment involves lowering blood pressure and surgically removing the tumor.

    Hypothyroidism

    • Hashimoto's thyroiditis is the most common type, involving an autoimmune response that destroys the thyroid gland.
    • Characterized by decreased energy, increased sleep, fatigue, weight gain, decreased appetite, and cold intolerance.
    • Myxedema (a type of edema) is a common feature.
    • Diagnosis typically confirms low T3/T4 and elevated TSH levels.
    • Treatment involves levothyroxine (thyroid hormone replacement).

    Hyperthyroidism

    • Graves' disease is the most common cause, involves antibodies stimulating thyroid hormone production.
    • Characterized by increased energy, decreased sleep, fatigue, weight loss, increased appetite, and heat intolerance.
    • Common symptoms include increased heart rate ("elevated heart rate"), cardiac dysrhythmias, a thyroid bruit, high bowel activity, increased appetite, weight loss, nervousness, insomnia, light or absent menses, hair loss, and exophthalmos (eyeball protrusion).
    • Diagnosis involves measuring elevated T3/T4 and decreased TSH levels.

    Hypoparathyroidism

    • Hypocalcemia (low calcium) is a central aspect due to lack of PTH (parathyroid hormone).
    • Calcium is not mobilized from bone, conserved in the kidneys or absorbed in the small intestines.
    • Numbness, tingling (around mouth/hands/feet), muscle cramps, spasms, and tetany are common manifestations.
    • Diagnosis includes low serum calcium, high serum phosphate levels, and low serum PTH levels.
    • Treatment involves intravenous calcium administration followed by oral calcium and vitamin D supplements.

    Hyperparathyroidism

    • Hypercalcemia (high calcium) is the key feature due to excessive PTH.
    • PTH affects bone, kidneys, and the bowel, causing osteoclastic bone activity.
    • Symptoms might be asymptomatic, but may include elevated ionized and serum calcium levels, decreased serum phosphorus levels, muscle weakness, and low-back pain.

    Type 1 Diabetes Mellitus

    • Autoimmune destruction of insulin-producing beta cells in the pancreas causes insulin deficiency.
    • Common symptoms involve increased urination (polyuria), increased thirst (polydipsia), increased appetite (polyphagia) fatigue, and weight loss.
    • Glucosuria (presence of glucose in urine) is also a symptom.
    • Diagnosis relies on H1AC, fasting blood glucose, and oral glucose tolerance tests.

    Type 2 Diabetes Mellitus

    • Insulin resistance or insufficient insulin production leads to high blood glucose.
    • Common symptoms involve increased urination (polyuria), increased thirst (polydipsia), increased appetite (polyphagia) fatigue, and weight loss.
    • Risk factors include obesity and physical inactivity.
    • Diagnosis involves H1AC, fasting blood glucose, and oral glucose tolerance tests.

    Diabetic Ketoacidosis (DKA)

    • Inadequately low insulin causes an excessive breakdown of fats, producing excess ketones in the blood.
    • Common symptoms include high blood glucose above 250 mg/dL (although DKA can sometimes present below 250 mg/dL), ketones in the urine (ketonuria), low blood pH (less than 7.3), low serum bicarbonate (less than 18 mEq/L), and Kussmaul respirations (rapid, deep, compensatory respirations).

    Hyperosmolar Hyperglycemic State (HHS)

    • Extremely high blood glucose (>600 mg/dL) without significant ketoacidosis.
    • Common features include dehydration, neurological changes, and extremely high blood osmolality (often above 320 mOsm/kg).

    Pulmonary Embolism (PE)

    • Blood clot in the lungs (typically from deep vein thrombosis.)
    • Common features include chest pain, dyspnea (shortness of breath), tachypnea (rapid breathing), tachycardia (fast heartbeat), and hypoxemia (low blood oxygen).
    • Diagnosis typically involves ECG, CT scans (with IV contrast), and blood tests (e.g., D-dimer).
    • Treatment typically includes anticoagulants.

    Acute Respiratory Distress Syndrome (ARDS)

    • Respiratory failure characterized by fluid buildup in the lungs, severe hypoxemia (low blood oxygen) and reduced gas exchange.
    • Common features include shortness of breath, reduced oxygenation, and fluid buildup in the lungs.
    • Multiple underlying causes are possible, ranging from aspiration pneumonia to severe sepsis.
    • Diagnosis often involves chest x-ray for appearance, blood gas analysis (ABGs) for oxygen levels, and other tests (e.g, CBC.)
    • Treatment includes mechanical ventilation and sometimes extracorporeal membrane oxygenation (ECMO).

    Chest Trauma

    • Chest trauma can occur from blunt-force or penetrating injuries; resulting in damage to organs, broken ribs, and other harm.
    • Common symptoms involve shortness of breath, decreased oxygenation, decreased level of consciousness, reduced lung sounds, asymmetrical chest movement (flail chest), subcutaneous emphysema (air under the skin), and possibly blood in the pleural space (hemothorax).
    • Diagnosis often relies on a chest X-ray, ultrasonography (FAST exams), CT scan, and blood gas analysis (ABGs), coagulation studies, and complete metabolic profiles.
    • Treatment often involves airway management, breathing support (e.g., ventilation), possible surgery, and pain management.

    Other

    • Relevant medications, diagnoses, complications, and nursing actions/teachings for many of these conditions. Specific, crucial aspects are included when necessary.

    Studying That Suits You

    Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

    Quiz Team

    Related Documents

    NUR 445 Exam 1 PDF

    Description

    Test your knowledge on the exudative phase of acute respiratory distress syndrome (ARDS) and its clinical manifestations. This quiz also covers key aspects of endocrine disorders such as diabetes insipidus and pheochromocytoma. Challenge yourself with questions about diagnosis, treatment methods, and risk factors associated with these conditions.

    More Like This

    Use Quizgecko on...
    Browser
    Open
    Browser
    Browser