NURSING TEST
Posterior Pituitary
Diabetes Insipidus/DI
When there is a deficiency in the release of ADH/vasopressin the body losses the ability to hold
water resulting in a fluid volume deficit/dehydration. Remember that ADH tells the kidneys to
reabsorb water, so if no ADH you pee everything out. DI is commonly caused by head trauma or
craniotomy.
S/S- Polyuria (piss like a horse), polydipsia (thirst), hypotension (from fluid loss), specific
gravity decrease (1.005-1.010), tachycardia, weight loss, dry mucous membranes, hypernatremia
(salt and fish bowel situation), and mental changes.
Nursing- Fluid volume deficit is main concern. Pt should be given Desmopressin (DDAVP) or
vasopressin (ADH). Remember if to much ADH given pt may develop SIADH.
Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
Occurs when there is an excessive amount of ADH/vasopressin released into the body causing
the kidneys to reabsorb fluid and results in fluid volume overload. Clients with small cell/Oat-
cell carcinoma are at most risk.
S/S- Hyponatremia (deep tendon reflexes, fatigue, HA, anorexia, nausea, decreased mental
status, seizures, coma), oliguria, increased specific gravity, and hypertension.Remember the S/S
for fluid volume excess (weight gain, JVD, tachycardia, tachypnea,rales). Complications may
include coma, seizures, and brain damage.
Nursing- Fluid volume excess is primary concern and can lead to pulmonary edema from third
spacing so respiratory (lung sounds) is a priority! Patient should be given diuretics and
hypertonic saline solution (draws fluid into cells).
, Parathyroid
Hypoparathyroidism
Occurs when the parathyroid gland produces low levels or no parathyroid hormone (PTH), which
results in decreased bone resorption (osteoclasts do not break down bone and release Ca+).
Because of this serum calcium levels become abnormally low, and phosphate levels become high
(there inversely related). Patient will have a risk of pronounced neuromuscular irritability
(tetany). Remember patients with ESRD will have increased phosphate levels, which will
decrease Ca+ levels resulting in hypoparathyroidism.
S/S- Decreased bone resorption, Ca+ <8.5, phosphate >3, hypocalciuria (low Ca+ in pee),
hypophosphaturia (low phosphate in pee), and signs of tetany (Chvostek’s (touching cheek) and
Trousseau’s (B/P cuff causes arm bend) signs, cardiac dysrhythmias).
Nursing- DOC for hypoparathyroidism/tetany is 10% calcium gluconate IV. Remember the
major complication of tetany is laryngospasms, which can obstruct the airway!
Sliding Filament Theory- This is basically how a muscle contracts. Calcium is released by the
sarcoplasmic reticulum and binds with troponin, which triggers tropomyosin and flexion occurs.
There’s a lot more steps but just know without Ca+ muscles will not work smoothly and patient
will cramp and twitch.
Hyperparathyroidism
Occurs when the parathyroid gland releases excessive amounts of PTH, this causes increased
bone resorption or bone break down, which increases the amount of Ca+ in the blood. Just like
hypoparathyroidism, when the Ca+ levels increase the phosphate levels will drop.
S/S- Patient will have increased bone resorption, Ca+ >10.5, phosphate <1.2, hypercalciuria,
hyperphosphaturia, and decreased neuromuscular irritability.
Nursing- Patient must have fluids increased and give diuretics. Give infusion of normal saline,
furosemide (Lasix), loop diuretics, calcitonin (Calcimar), and glucocorticoids (lowers GI
absorbtion of Ca+ into body). Because of hypercalcemia in body, monitor for nephrolithiasis
Posterior Pituitary
Diabetes Insipidus/DI
When there is a deficiency in the release of ADH/vasopressin the body losses the ability to hold
water resulting in a fluid volume deficit/dehydration. Remember that ADH tells the kidneys to
reabsorb water, so if no ADH you pee everything out. DI is commonly caused by head trauma or
craniotomy.
S/S- Polyuria (piss like a horse), polydipsia (thirst), hypotension (from fluid loss), specific
gravity decrease (1.005-1.010), tachycardia, weight loss, dry mucous membranes, hypernatremia
(salt and fish bowel situation), and mental changes.
Nursing- Fluid volume deficit is main concern. Pt should be given Desmopressin (DDAVP) or
vasopressin (ADH). Remember if to much ADH given pt may develop SIADH.
Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
Occurs when there is an excessive amount of ADH/vasopressin released into the body causing
the kidneys to reabsorb fluid and results in fluid volume overload. Clients with small cell/Oat-
cell carcinoma are at most risk.
S/S- Hyponatremia (deep tendon reflexes, fatigue, HA, anorexia, nausea, decreased mental
status, seizures, coma), oliguria, increased specific gravity, and hypertension.Remember the S/S
for fluid volume excess (weight gain, JVD, tachycardia, tachypnea,rales). Complications may
include coma, seizures, and brain damage.
Nursing- Fluid volume excess is primary concern and can lead to pulmonary edema from third
spacing so respiratory (lung sounds) is a priority! Patient should be given diuretics and
hypertonic saline solution (draws fluid into cells).
, Parathyroid
Hypoparathyroidism
Occurs when the parathyroid gland produces low levels or no parathyroid hormone (PTH), which
results in decreased bone resorption (osteoclasts do not break down bone and release Ca+).
Because of this serum calcium levels become abnormally low, and phosphate levels become high
(there inversely related). Patient will have a risk of pronounced neuromuscular irritability
(tetany). Remember patients with ESRD will have increased phosphate levels, which will
decrease Ca+ levels resulting in hypoparathyroidism.
S/S- Decreased bone resorption, Ca+ <8.5, phosphate >3, hypocalciuria (low Ca+ in pee),
hypophosphaturia (low phosphate in pee), and signs of tetany (Chvostek’s (touching cheek) and
Trousseau’s (B/P cuff causes arm bend) signs, cardiac dysrhythmias).
Nursing- DOC for hypoparathyroidism/tetany is 10% calcium gluconate IV. Remember the
major complication of tetany is laryngospasms, which can obstruct the airway!
Sliding Filament Theory- This is basically how a muscle contracts. Calcium is released by the
sarcoplasmic reticulum and binds with troponin, which triggers tropomyosin and flexion occurs.
There’s a lot more steps but just know without Ca+ muscles will not work smoothly and patient
will cramp and twitch.
Hyperparathyroidism
Occurs when the parathyroid gland releases excessive amounts of PTH, this causes increased
bone resorption or bone break down, which increases the amount of Ca+ in the blood. Just like
hypoparathyroidism, when the Ca+ levels increase the phosphate levels will drop.
S/S- Patient will have increased bone resorption, Ca+ >10.5, phosphate <1.2, hypercalciuria,
hyperphosphaturia, and decreased neuromuscular irritability.
Nursing- Patient must have fluids increased and give diuretics. Give infusion of normal saline,
furosemide (Lasix), loop diuretics, calcitonin (Calcimar), and glucocorticoids (lowers GI
absorbtion of Ca+ into body). Because of hypercalcemia in body, monitor for nephrolithiasis
