NRNP 6540F Advanced Practice Care of Older
Adults
What are signs & symptoms of SIADH (Syndrome of inappropriate antidiuretic hormone)? -
Increased production of ADH (antidiuretic hormone), hyponatremia, concentrated urine (from
excess water resorption), elevated urine osmolality, mental status changes from cerebral edema.
\a Diabetes insipidus is associated with what sodium level? - Hypernatremia
\a Psychogenic polydipsia results in urine that is: - diluted with low osmolality and hyponatremia
\a How would you determine the cause of a patient's AKI who presents with decreased urine output,
history of neurogenic bladder, chronic foley, dark urine, and Cr increase from 1.3 to 2.1 over 3
months? - Flush the foley catheter to see if urine comes out and assess the patency of the catheter.
This action will unblock clogged sediment or biofilm from chronic bacteriuria.
\a When a female patient presents to the ER after sexual assault, what medications should be
offered prior to discharge? - Ceftriaxone, azithromycin, Plan B, and Metronidazole.
\a Manifestations of Conn syndrome (hyperaldosteronism)? - hypernatremia, hypokalemia, and
hypertension
\a What causes Cushing syndrome? - Increased levels of glucocorticoids, can be exogenous (from
therapy) or endogenous (from adenoma or neoplasm).
\a Manifestations of Cushing syndrome? - hypertension, truncal obesity, osteoporosis, skin fragility,
and hyperglycemia.
\a What differentiates primary adrenocortical insufficiency from secondary adrenocortical
insufficiency? - Skin hyperpigmentation is present in primary adrenocortical insufficiency
\a What is Trousseau's sign? - A carpal spasm elicited by compression of the upper arm with a BP
cuff that indicates hypocalcemia.
, \a What is Chovstek's sign? - A hemifacial tic that is induced by tapping the facial nerve below the
maxilla that indicates hypocalcemia.
\a What is Babinski's sign? - An upward response (extension) of the hallux when the sole of the foot
is stimulated with a blunt instrument. Can identify spinal cord disease in adults.
\a What is Romberg's sign? - Loss of balance in standing when eyes are closed. Usually indicating a
loss of proprioception or lesion in the cerebellum.
\a What is Homan's sign? - pain on passive dorsiflexion of ankle, associated with DVT.
\a What is the clinical presentation of Goodpasture's syndrome? - Urinalysis: Specific gravity: 1.020.
pH 5.5, 1+ albumin and large blood present.
Chest XR positive for bilateral diffuse infiltrates.
BUN 30, Cr 3.0
Symptoms: dyspnea with hemoptysis
\a What is Goodpasture syndrome? - Damage to alveolar and renal glomerular basement
membranes by cytotoxic antibody.
\a Initial treatment for Goodpasture's syndrome? - Hospitalization, pulse dose of steroids, begin
plasmapheresis and cyclophosphamide therapy.
\a Characteristics of Grave's disease - Ophthalmopathy (lid retraction, scleral show, proptosis) and
hyperthyroidism
\a What organism causes the formation of a staghorn calculus? - Proteus mirabilus
\a What organism causes Toxic shock syndrome? - Staphylococcus aureus
\a What electrolyte disturbance is most likely to lead to tetany and neuromuscular irritability? -
Hypocalcemia
\a Features of hypercalcemia include? - "Stones, groans, moans, and bones."
Adults
What are signs & symptoms of SIADH (Syndrome of inappropriate antidiuretic hormone)? -
Increased production of ADH (antidiuretic hormone), hyponatremia, concentrated urine (from
excess water resorption), elevated urine osmolality, mental status changes from cerebral edema.
\a Diabetes insipidus is associated with what sodium level? - Hypernatremia
\a Psychogenic polydipsia results in urine that is: - diluted with low osmolality and hyponatremia
\a How would you determine the cause of a patient's AKI who presents with decreased urine output,
history of neurogenic bladder, chronic foley, dark urine, and Cr increase from 1.3 to 2.1 over 3
months? - Flush the foley catheter to see if urine comes out and assess the patency of the catheter.
This action will unblock clogged sediment or biofilm from chronic bacteriuria.
\a When a female patient presents to the ER after sexual assault, what medications should be
offered prior to discharge? - Ceftriaxone, azithromycin, Plan B, and Metronidazole.
\a Manifestations of Conn syndrome (hyperaldosteronism)? - hypernatremia, hypokalemia, and
hypertension
\a What causes Cushing syndrome? - Increased levels of glucocorticoids, can be exogenous (from
therapy) or endogenous (from adenoma or neoplasm).
\a Manifestations of Cushing syndrome? - hypertension, truncal obesity, osteoporosis, skin fragility,
and hyperglycemia.
\a What differentiates primary adrenocortical insufficiency from secondary adrenocortical
insufficiency? - Skin hyperpigmentation is present in primary adrenocortical insufficiency
\a What is Trousseau's sign? - A carpal spasm elicited by compression of the upper arm with a BP
cuff that indicates hypocalcemia.
, \a What is Chovstek's sign? - A hemifacial tic that is induced by tapping the facial nerve below the
maxilla that indicates hypocalcemia.
\a What is Babinski's sign? - An upward response (extension) of the hallux when the sole of the foot
is stimulated with a blunt instrument. Can identify spinal cord disease in adults.
\a What is Romberg's sign? - Loss of balance in standing when eyes are closed. Usually indicating a
loss of proprioception or lesion in the cerebellum.
\a What is Homan's sign? - pain on passive dorsiflexion of ankle, associated with DVT.
\a What is the clinical presentation of Goodpasture's syndrome? - Urinalysis: Specific gravity: 1.020.
pH 5.5, 1+ albumin and large blood present.
Chest XR positive for bilateral diffuse infiltrates.
BUN 30, Cr 3.0
Symptoms: dyspnea with hemoptysis
\a What is Goodpasture syndrome? - Damage to alveolar and renal glomerular basement
membranes by cytotoxic antibody.
\a Initial treatment for Goodpasture's syndrome? - Hospitalization, pulse dose of steroids, begin
plasmapheresis and cyclophosphamide therapy.
\a Characteristics of Grave's disease - Ophthalmopathy (lid retraction, scleral show, proptosis) and
hyperthyroidism
\a What organism causes the formation of a staghorn calculus? - Proteus mirabilus
\a What organism causes Toxic shock syndrome? - Staphylococcus aureus
\a What electrolyte disturbance is most likely to lead to tetany and neuromuscular irritability? -
Hypocalcemia
\a Features of hypercalcemia include? - "Stones, groans, moans, and bones."
