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CH2 Exam 2
Glomerulonephritis Assessment
Mechanism
Group A Beta-Hemolytic Streptococcal Infection
Signs and Symptoms
Hypertension
Hematuria
Proteinuria
Oliguria
Generalized Edema
Increased BUN and CR
Flank Pain
2 mins
Acute Glomerulonephritis Interventions
Rest
Restrict Salt and Fluid Intake
Restrict Protein
Antihypertensives
Diuretics
Antibiotics
2 mins
Renal Calculi Assessment
Cause/Mechanism
Hypercalcemia (Most Commonly)
Signs and Symptoms
Flank Pain
Radiates Toward Bladder
Renal Colic
Urinary Tract Infection
Urinary Retention
Hematuria
Considerations
Stone Recurrence
2 mins
Renal Calculi Interventions
Interventions
Increase Fluid Intake
Opioids
NSAIDs
Antibiotics
Lithotripsy
Surgical Stone Removal
Considerations
Identify Type CT-KUB
Low Sodium Diet
2 mins
Pyelonephritis Assessment
Cause/Mechanism
Ascending Urethral Bacteria
Assessment
Dysuria
Fever
Fatigue
Flank Pain
Costovertebral Tenderness
Nausea and Vomiting
1 min
Pyelonephritis Interventions
Urinalysis
NSAIDs
Antibiotics
Increase Fluid Intake
Avoid Catheterization
Consideration
Urosepsis
1 min
Hypothyroidism Assessment
Assessment
Weight Gain - Edema
Lethargy
Cold Intolerance
Bradycardia
Hypertension
Brittle Nails and Dry Skin
Constipation
Goiter
Prolonged Menses
Slowed Thinking
Diagnostic Tests
Decreased Free T4
Increased TSH
2 mins
Hypothyroidism Intervention
Medications
Levothyroxine (Synthroid)
Liothyronine (Cytomel)
Complication
Myxedema Coma
Nursing Considerations
Lifelong Replacement Hormone
Monitor Vital Signs
Fluids and Fiber
Low Calorie, Low Fat Diet
Medication Education
No Switching Brands
2 mins
Hashimoto's Thyroiditis
Symptoms
Hypothyroidism with Bouts of Hyperthyroidism
Enlarged, Nontender Thyroid
Mechanism
Autoimmune
Anti-Thyroid Peroxidase (TPO)
Anti-Thyroglobulin
Lab Findings
Hurthle Cells
Lymphoid Follicles
Associations
HLA-DR5 and HLA-DR3
Increased Risk Of Non-Hodgkin Lymphoma
2 mins
Sheehan's Syndrome
Postpartum Pituitary Gland Necrosis
Agalactorrhea
Amenorrhea
Secondary Hypothyroidism with Cold Intolerance
1 min
Hyperthyroidism Assessment
Assessment
Heat Intolerance
Exophthalmos
Warm, Moist Skin and Silky Hair
Tremors
Goiter
Diarrhea
Weight Loss
Tachycardia
Hypertension
Amenorrhea
Diagnosis
Decreased TSH with Elevated Free T4
Radioactive Iodine Uptake (RAIU)
2 mins
Hyperthyroidism Interventions
Drug Therapy
Propylthiouracil (PTU)
Methimazole (Tapazole)
Iodine
Beta Blockers
Other Therapies
Radioiodine Ablation
Thyroidectomy
Complications
Thyrotoxicosis
Post-Surgery Hypocalcemia
2 mins
Graves' Disease Characteristics
Women 20-40 years old
Pathophysiology
Anti-TSH Receptor Antibodies
Symptoms
Ophthalmopathy
Exophthalmos
Hyperthyroidism
Goiter
Pretibial Myxedema
1 min
Propylthiouracil (PTU) and Methimazole (MMI)
Indications
Hyperthyroidism
Mechanism
Inhibits Thyroid Peroxidase
PTU Blocks Peripheral Conversion of T4 to T3
Side Effects
Agranulocytosis
Skin Rash
Hepatotoxicity (PTU)
Teratogen (MMI)
1 min
Graves' Disease Labs and Treatment
Labs
Decreased TSH
Increased T3
Increased T4
Radioactive Iodine Uptake (RAIU)
Treatment
Beta blocker
Methimazole
Radioiodine Ablation
1 min
Adrenal Gland (Basic)
Characteristics
Adrenal Cortex
RAAS Stimulates Aldosterone
CRF (CRH) acts on Anterior Pituitary Gland to Release ACTH
Cortisol Released
Androgens Released
Adrenal Medulla
Epinephrine & Norepinephrine
2 mins
Adrenal Gland (Advanced)
Characteristics
Adrenal Cortex
Zona Glomerulosa
Aldosterone
Zona Fasciculata
Cortisol
Zona Reticularis
Androgens
Adrenal Medulla
Chromaffin Cells
Epinephrine & Norepinephrine
2 mins
Pheochromocytoma
Cause/Mechanism
Adrenal Medulla Tumor
Increased Catecholamines
Assessment
Episodic Hypertension
Diaphoresis
Abdominal or Chest Pain
Interventions
Surgery
Antihypertensives
Phenoxybenzamine
Metyrosine (Demser)
Considerations
Do Not Palpate Abdomen
3 mins
Addison's Disease Assessment
Assessment
Deficiency of Cortisol and Aldosterone
Irritability
Hyperkalemia
Muscle Weakness
Skin Hyperpigmentation
Hyponatremia
Hypotension
Hypoglycemia
Considerations
Addisonian Crisis
2 mins
Addisonian Crisis
Assessment
Severe Symptoms
Shock
Interventions
High-Dose Hydrocortisone
Large Volumes of IV Fluid
Insulin with Dextrose
Kayexalate
Loop or Thiazide Diuretics
2 mins
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