34 Questions
What is the recommended dosing schedule for glucocorticoids like Cortisone and Hydrocortisone in patients with low cortisol levels?
Give 2/3 of the dose in the morning and 1/3 in the afternoon
Which of the following is NOT a nursing intervention for patients with low cortisol levels?
Promoting exposure to infections for immunity boost
What is the emergency condition that results in low blood pressure, low blood sugar levels, and high blood potassium levels?
Addisonian crisis
Which of the following hormones is used in hormonal replacement therapy as a mineralocorticoid?
Fludrocortisone acetate
In hormonal replacement therapy, what is the importance of never omitting prescribed medications?
To ensure lifelong hormone replacement
What is the proper way to administer glucocorticoids to simulate cortisol release?
Give 2/3 of the dose in the morning, 1/3 in the afternoon
What is a common cause of secondary hyperparathyroidism?
Vitamin D deficiency
Which diagnostic test would show increased bone density in a patient with hypoparathyroidism?
X-ray examination
How can secondary hyperparathyroidism be managed medically?
Administering vitamin D supplements
What nursing intervention is recommended to prevent injury in patients with hyperparathyroidism?
Providing a safe environment to prevent fractures
Which clinical manifestation is NOT typically associated with hyperparathyroidism?
Cataracts
What is a common symptom of hypoparathyroidism?
Weakened tooth enamel
What is the primary reason for asking the client to stay awake the night before a sleep EEG exam?
To induce sleep deprivation for specific brain activity patterns
What is the main purpose of a myelography/myelogram procedure?
To visualize the spinal cord and vertebrae
What should a nurse do if a patient is found to be allergic to contrast agents before a radiographic procedure?
Stop the procedure and inform the healthcare provider immediately
What is a possible consequence of increased intracranial pressure (ICP)?
Impairment of nerve cell functioning
What does increased ICP refer to in the context of neurological conditions?
An increase in any of the intracranial components like brain tissue, CSF, or blood
Why is it important to encourage fluid intake after a myelography/myelogram procedure?
To help excrete the contrast material from the body
What is a serious side effect of Valium administration?
Yellowing of the skin or eyes
How is Liquid Valium typically absorbed when administered rectally?
Immediately within seconds
Why should Valium not be used on a daily basis?
To avoid addiction and withdrawal symptoms
What are some nursing interventions recommended during seizure activity?
Placing the individual in a side-lying position
What kind of diagnostic tests may be performed to rule out infections or trauma related to seizures?
Lumbar puncture
What are some cognitive signs mentioned during the ictal phase of seizures?
'Déjà-vu' symptoms
What is a common manifestation of an allergic reaction to the iodine contained in a contrast agent?
Numbness of extremities
What is the immediate intervention recommended in case of an allergic reaction to contrast media?
Administering epinephrine
What is a nursing responsibility before a Computed Tomography (CT) scan involving contrast media?
Withholding food for 4-6 hours
What is the purpose of a Positron Emission Tomography (PET) scan?
To assess brain function
What does a Single-Photon Emission Computed Tomography (SPECT) aim to overcome?
The limitation of PET scans
Which guideline should a nurse follow after a patient undergoes an angiography procedure?
Monitor vital signs and neurovascular checks as ordered
Why do patients have to remove metallic materials before undergoing a CT scan?
To prevent interference with x-ray beams
What is the purpose of using contrast media in some CT scans?
To enhance visualization of internal structures
Why do patients need to remain as still as possible during a CT scan?
To minimize radiation exposure and ensure clear images
What is the role of deoxyglucose in a Positron Emission Tomography (PET) scan?
To provide information about brain function by emitting positrons
Study Notes
Diagnostic Tests
-
Angiography
- Uses iodine-containing contrast agent
- Risks: allergic reaction to iodine, vessel injury, bleeding, and CVA
- Pre-procedure: NPO 4-6 hours, well-hydrated, clear liquids permitted
- Post-procedure: monitor VS and neuro signs, bedrest, keep extremity straight and immobilized
-
Computed Tomography (CT) Scan
- Uses ionizing radiation to detect intracranial and spinal cord lesions
- Pre-procedure: signed consent, notify physician if client has risk factors, withhold food 4-6 hours
- Post-procedure: check for delayed allergic response, increase fluid intake if contrast medium used
-
Positron Emission Tomography (PET) Scan
- Provides information on brain function, glucose metabolism, and cerebral blood flow
- Pre-procedure: signed consent, withhold caffeine, alcohol, and tobacco 24 hours prior
- Post-procedure: increase fluid intake to eliminate radioisotope
-
Single-Photon Emission Computed Tomography (SPECT)
- Overcomes limitations of PET
- No additional information provided
Endocrine Disorders
-
Hypocortisolism
- Causes: adrenal insufficiency, Addison's disease
- Symptoms: low cortisol levels, hyponatremia, hypovolemia, hyperkalemia, acidosis, hypoglycemia
- Nursing interventions: administer HRT, monitor VS, provide rest periods, prevent fatigue and infection
-
Hyperparathyroidism
- Causes: parathyroid adenoma, congenital hyperparathyroidism, multiple endocrine neoplasia
- Symptoms: hypercalcemia, kidney stones, bone pain, osteoporosis
- Medical management: surgery, increased fluids, dietary restrictions, medications
-
Hypoparathyroidism
- Causes: congenital absence, autoimmune disease, removal of parathyroid glands
- Symptoms: hypocalcemia, neuromuscular symptoms, tetany, psychosis
- Medical management: vitamin D and calcium supplements
Other Conditions
-
Increased Intracranial Pressure (ICP)
- Causes: trauma, hemorrhage, abscesses, growths or tumors, hydrocephalus, edema or inflammation
- Symptoms: headache, vomiting, seizures, papilledema
- Nursing interventions: monitor ICP, manage pain, prevent increased ICP
-
Seizures
- Causes: lead poisoning, hypoglycemia, infection, electrolyte imbalances
- Symptoms: aura, twitching, loss of consciousness
- Nursing interventions: protect from injury, decrease external stimuli, keep airway open
Test your knowledge on nursing interventions for patients with low cortisol levels presenting symptoms like hyponatremia, hypovolemia, hyperkalemia, acidosis, and hypoglycemia. Learn about administering Hormonal Replacement Therapy (HRT) with glucocorticoids and mineralocorticoids according to diurnal rhythm patterns.
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