PCCN 2025 EXAM REVIEW QUESTIONS
Diabetes Insipidus (Sip) - Answers -antidiuretic hormone is not secreted adequately, or
the kidney is resistant to its effect
Diabetes insipidus labs - Answers -1. hypernatremia
2. elevated BUN/Cr
3. increased serum osmo >295
4. decreased urine osmo < 200
5. decreased urine specific gravity < 1.005
6. Decreased ADH
7. Polydipsia
diabetes insipidus treatment - Answers -Desmopressin (vasopressin);
hydrochlorothiazide, hypotonic sol.
syndrome of inappropriate (increased) ADH (SIADH) - Answers -excessive secretion of
antidiuretic hormone producing water retention in the body
SIADH Labs - Answers -Urine chemistry: Think CONCENTRATED.
● Increased urine sodium
●Increased urine osmolarity
●Increased Urine Specific Gravity > 1.030
● As urine volume decreases, urine osmolarity increases. (decreased UOP)
Blood chemistry: Think DILUTE.
● Decreased serum sodium (dilutional hyponatremia)
● Decreased serum osmolarity (less than 270 mEq/L)
● As serum volume increases, serum osmolarity decreases.
- Increased ADH
SIADH Treatment - Answers -Fluid restriction, IV hypertonic saline, Loop Diuretics, , na
correction.
Diabetes Ketoacidosis Pathophysiology - Answers -- Too much glucose & too little
insulin.
- Body compensates w/ osmotic diuresis
- Leads the the 3Ps (Polyuria, polydipsia, polyphagia) & glycourisa, dehydration &
electrolyte imbalance.
- Leads to fat burning metabolism - ketone release - kussmaul breathing
diabetes ketoacidosis s/s - Answers -Neuro: Lethargic, confused, decreased DTR, n/v
, Cardio: Tachycardia & Hypotension
Pulmonary: Fruity breath & kussmaul breathing
3Ps (Polyuria, polyphagia, polydipsia
diabetes ketoacidosis labs - Answers -PH (acidotic - Increased ketones)
Urine Glucose
Blood Glucose 300 - 800
Decrease HCO3
Decrease Na
Elevated K
Increased Anion Gap
Diabetes Ketoacidosis Treatment - Answers --Hospitalization
-Correction of fluid (isotonic sol/hypotonic) and electrolyte balances
-Administer insulin
Hyperosmolar - Answers -a life threatening syndrome that can occur in the patient with
diabetes type 2 who is able to produce enough insulin to prevent DKA but not enough to
prevent severe hyperglycemia, osmotic diuresis, and extracellular fluid depletion.
Hyperosmolar Hyperglycemic Syndrome (HHS) Labs - Answers -- highest sugar over
600 - 2000
- higher fluid loss and extreme dehydration
(Increased Na, Decreased K, Mg, Phos).
- Neuro: head change level of consciousness, confusion neurological manifestations
- no ketones , no acid, no fruity breath/ketones
- Increased Urine Glucose
Hyperosmolar Hyperglycemic Syndrome (HHS) Treatment - Answers --
Isotonic/Hypotonic Sol
- Replenish electrolytes
Cardiac Blood Flow - Answers -1. Superior/Inferior Vena Cava
2. Right Atrium
3. Tricuspid Valve
4. RIght Ventricle
5. Pulmonic Valve
6. Pulmonic Artery - > Lungs
7. Pulmonic Veins
8. Left Atrium
9. Mitral Valve
10. Left Ventricle
11. Aortic Valve
12. Aorta
Preload - Answers -The myocardium stretch at the end of diastole.
Diabetes Insipidus (Sip) - Answers -antidiuretic hormone is not secreted adequately, or
the kidney is resistant to its effect
Diabetes insipidus labs - Answers -1. hypernatremia
2. elevated BUN/Cr
3. increased serum osmo >295
4. decreased urine osmo < 200
5. decreased urine specific gravity < 1.005
6. Decreased ADH
7. Polydipsia
diabetes insipidus treatment - Answers -Desmopressin (vasopressin);
hydrochlorothiazide, hypotonic sol.
syndrome of inappropriate (increased) ADH (SIADH) - Answers -excessive secretion of
antidiuretic hormone producing water retention in the body
SIADH Labs - Answers -Urine chemistry: Think CONCENTRATED.
● Increased urine sodium
●Increased urine osmolarity
●Increased Urine Specific Gravity > 1.030
● As urine volume decreases, urine osmolarity increases. (decreased UOP)
Blood chemistry: Think DILUTE.
● Decreased serum sodium (dilutional hyponatremia)
● Decreased serum osmolarity (less than 270 mEq/L)
● As serum volume increases, serum osmolarity decreases.
- Increased ADH
SIADH Treatment - Answers -Fluid restriction, IV hypertonic saline, Loop Diuretics, , na
correction.
Diabetes Ketoacidosis Pathophysiology - Answers -- Too much glucose & too little
insulin.
- Body compensates w/ osmotic diuresis
- Leads the the 3Ps (Polyuria, polydipsia, polyphagia) & glycourisa, dehydration &
electrolyte imbalance.
- Leads to fat burning metabolism - ketone release - kussmaul breathing
diabetes ketoacidosis s/s - Answers -Neuro: Lethargic, confused, decreased DTR, n/v
, Cardio: Tachycardia & Hypotension
Pulmonary: Fruity breath & kussmaul breathing
3Ps (Polyuria, polyphagia, polydipsia
diabetes ketoacidosis labs - Answers -PH (acidotic - Increased ketones)
Urine Glucose
Blood Glucose 300 - 800
Decrease HCO3
Decrease Na
Elevated K
Increased Anion Gap
Diabetes Ketoacidosis Treatment - Answers --Hospitalization
-Correction of fluid (isotonic sol/hypotonic) and electrolyte balances
-Administer insulin
Hyperosmolar - Answers -a life threatening syndrome that can occur in the patient with
diabetes type 2 who is able to produce enough insulin to prevent DKA but not enough to
prevent severe hyperglycemia, osmotic diuresis, and extracellular fluid depletion.
Hyperosmolar Hyperglycemic Syndrome (HHS) Labs - Answers -- highest sugar over
600 - 2000
- higher fluid loss and extreme dehydration
(Increased Na, Decreased K, Mg, Phos).
- Neuro: head change level of consciousness, confusion neurological manifestations
- no ketones , no acid, no fruity breath/ketones
- Increased Urine Glucose
Hyperosmolar Hyperglycemic Syndrome (HHS) Treatment - Answers --
Isotonic/Hypotonic Sol
- Replenish electrolytes
Cardiac Blood Flow - Answers -1. Superior/Inferior Vena Cava
2. Right Atrium
3. Tricuspid Valve
4. RIght Ventricle
5. Pulmonic Valve
6. Pulmonic Artery - > Lungs
7. Pulmonic Veins
8. Left Atrium
9. Mitral Valve
10. Left Ventricle
11. Aortic Valve
12. Aorta
Preload - Answers -The myocardium stretch at the end of diastole.
