N314 EXAM 3 REVIEW

19endocrine (Aldosterone/Adrenal/few Thyroid/Parathy)

18Renal
13Urinary

Elevated Ca level: Weight bearing activities help deposit Ca from

serum to bone.
Addisons disease s/s
darkened skin
muscle weakness
back pain
diarrhea
anxiety
Sources of iodine
DI
fluid expectancy
Risk factors for developing hypothyroidism
age
female
having surgery (thyroidectomy)
Thyroid storm
management of patient:
temperature control (stimulated-high vitals)
Dont intervene = patient may die.
medications of tx include: anti-thyroid, beta-blockers help with
decreasing vitals
usually unstable, in ER setting (medical emergency)
Steroids: affecting immune system = decrease = prone to infection
Cushings syndrome:
buffalo hump
moon face
abdominal swelling
elevated blood glucose
brittle bones
Nursing Diagnosis: Body Image!!!!
Levothyroxine (Synthroid)
dont stop taking abruptly
take on empty stomach (before meals)
Hypothyroidism medication caution
any sedatives (more sensitive to these drugs)
Patients need teaching about valium and contraindications with
hypothyroidism
Ways to assess for full bladder
palpation
percussion (dull sound)
Remember normal changes in older patients related to urinary system:

weakened pelvic floor muscles

decreased kidney functions (decrease in GFR)
Intercostal vertebral angle
palpation of kidney
Difficulty voiding, retention, possible obstruction = UTI
most in males related to urinary retention/enlarged prostate gland
Wheres the pain with kidney stone?
flank pain> in ureter
Hemodialysis (Watch videos)
graft/fistula
Most common reason for diagnosis for glomerulonephritis
untreated STREP infection
Keigal exercises
Bladder retraining
Beginning the program, first, leave the catheter in place but clamp it.
Try to train the patient to collect the urine in bladder so they can see if
they feel the need to void
Sign of urinary retention: >100mL left in the bladder is after voiding =
urinary retention
Things that contribute to dietary, family history, risk factors for
developing stones.
Bladder cancer intravescial BCG (therapy) procedure
patient education includes:
do not urinary for 2 hours.
Prevent recurrence of Kidney stones
stop any medications that may cause increase in Ca
increase water intake (8-10 fl.oz or 2-3 L /day)
Diet: reducing dairy or high Ca foods