HURST REVIEW NCLEX-RN READINESS EXAM 1-WITH
100% VERIFIED SOLUTIONS-
How can HF lead to Hypervolemia? - ANSWER: If the heart is weak - Cardiac output
goes down - Kidney perfusion decreases - Urinary output decreases - so the volume
stays in the vascular space
Aldosterone - ANSWER: Think Sodium & Water
"salt-retaining hormone"
Aldosterone promotes the retention of sodium by the kidneys.
Sodium retention promotes water retention
Watter retention promotes a higher blood volume and pressure
What diseases are caused by TOO MUCH Aldosterone? - ANSWER: Cushing's
Hyperaldosteronism (Conn's disease)
What diseases are caused by TOO LITTLE Aldosterone? - ANSWER: Addison's disease
ADH Think ? - ANSWER: H2O
Anti - Diuretic Hormone (ADH) - ANSWER: Makes you RETAIN WATER
Too Much ADH problems - ANSWER: - Retain water
- Fluid Volume Excess
= SIADH
Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
saying...? - ANSWER: Too Many Letters = (retaining) Too Much Water
SIADH urine characteristics - ANSWER: Urine output is decreased
Urine sodium is increased
Urine concentration is increased
Urine specific gravity is increased
SIADH serum (blood) characteristics - ANSWER: Serum sodium is Diluted
(because of the increase of water in the body)
Hematocrit is low
Signs and symptoms of Fluid Volume Excess (FVE) - ANSWER: Distended neck
veins/peripheral veins (veins are full)
,Peripheral edema/third spacing (vessels can't hold any more, so they start to leak)
Central Venous Pressure (CVP) numbers go up
Lung sounds: wet, crackles (heard in lower lungs first) ->SOB
Polyuria (kidneys are trying to get fluid off to help diuresis)
Pulse increases (can be full/bounding)
BP increases (more volume more pressure)
Weight increases (any acute gain or loss isn't fat, it's fluid)
CVP (central venous pressure) - ANSWER: A direct measurement of the blood
pressure in the right atrium and vena cava. CVP reflects the amount of blood
returning to the heart and the ability of the heart to pump blood from the right heart
into the pulmonary system.
Normal CVP = 2-6 mmHg
Fluid Retention think... - ANSWER: Heart Problems First!
Treatment for Fluid Volume Excess - ANSWER: -Reduce fluid retention by salt and
fluid restriction
-Diuretics to increase fluid excretion
-I&O and Daily weights (can be delegated to UAP)
-Treat underlying cause
Furosemide (Lasix) - ANSWER: loop diuretic
Can cause loss of Potassium = hypokalemia
Can cause BP to drop = hypotension
(withhold med if bp or potassium is too low)
What loop diuretic can be given if furosemide does not work? - ANSWER:
Bumetanide (Bumex)
Hydrochlorothiazide (Thiazide) - ANSWER: Diuretic: blocks sodium and potassium
reabsorption in the distal tubules
(Watch lab work for all diuretics for dehydration and electrolyte problems)
Spiralactone (Aldactone) - ANSWER: Potassium-sparing diuretic (Retains Potassium)
, Can cause HYPERkalemia
Not enough ADH problems - ANSWER: - Lose Water (diuresis)
- Fluid Volume Deficit (shock)
= Diabetes Insipidus
"D in DI think D for Diurese"
DI urine characteristics - ANSWER: Urine output is increased (a lot)
Urine sodium is decreased
Urine concentration is decreased (diluted)
Urine specific gravity is decreased
DI serum (blood) characteristics - ANSWER: Blood is concentrated
Patient is extremely dehydrated
Hematocrit is elevated
Concentrated makes these #s go up
&
Dilute makes these #s go down - ANSWER: Urine specific gravity
Sodium
Hematocrit
ADH is found where? - ANSWER: pituitary gland
Which key words should make you think potential ADH problems? - ANSWER:
Craniotomy
Head injury
Sinus surgery
Transsphenoidal hypophysectomy
or any condition that can lead to increased ICP
What's another name for anti-diuretic hormone (ADH) that can be utilized as an ADH
replacement in diabetes insipidus? - ANSWER: vasopressin (Pitressin)
or
desopressin acetate (DDAVP)
How does bed rest induce diuresis? - ANSWER: it causes the release of ANP and the
decreased production of ADH.
ANP (atrial natriuretic peptide) - ANSWER: Produce by atrial auricles
Target: kidneys
Effect:
- Makes the body LOSE WATER
100% VERIFIED SOLUTIONS-
How can HF lead to Hypervolemia? - ANSWER: If the heart is weak - Cardiac output
goes down - Kidney perfusion decreases - Urinary output decreases - so the volume
stays in the vascular space
Aldosterone - ANSWER: Think Sodium & Water
"salt-retaining hormone"
Aldosterone promotes the retention of sodium by the kidneys.
Sodium retention promotes water retention
Watter retention promotes a higher blood volume and pressure
What diseases are caused by TOO MUCH Aldosterone? - ANSWER: Cushing's
Hyperaldosteronism (Conn's disease)
What diseases are caused by TOO LITTLE Aldosterone? - ANSWER: Addison's disease
ADH Think ? - ANSWER: H2O
Anti - Diuretic Hormone (ADH) - ANSWER: Makes you RETAIN WATER
Too Much ADH problems - ANSWER: - Retain water
- Fluid Volume Excess
= SIADH
Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
saying...? - ANSWER: Too Many Letters = (retaining) Too Much Water
SIADH urine characteristics - ANSWER: Urine output is decreased
Urine sodium is increased
Urine concentration is increased
Urine specific gravity is increased
SIADH serum (blood) characteristics - ANSWER: Serum sodium is Diluted
(because of the increase of water in the body)
Hematocrit is low
Signs and symptoms of Fluid Volume Excess (FVE) - ANSWER: Distended neck
veins/peripheral veins (veins are full)
,Peripheral edema/third spacing (vessels can't hold any more, so they start to leak)
Central Venous Pressure (CVP) numbers go up
Lung sounds: wet, crackles (heard in lower lungs first) ->SOB
Polyuria (kidneys are trying to get fluid off to help diuresis)
Pulse increases (can be full/bounding)
BP increases (more volume more pressure)
Weight increases (any acute gain or loss isn't fat, it's fluid)
CVP (central venous pressure) - ANSWER: A direct measurement of the blood
pressure in the right atrium and vena cava. CVP reflects the amount of blood
returning to the heart and the ability of the heart to pump blood from the right heart
into the pulmonary system.
Normal CVP = 2-6 mmHg
Fluid Retention think... - ANSWER: Heart Problems First!
Treatment for Fluid Volume Excess - ANSWER: -Reduce fluid retention by salt and
fluid restriction
-Diuretics to increase fluid excretion
-I&O and Daily weights (can be delegated to UAP)
-Treat underlying cause
Furosemide (Lasix) - ANSWER: loop diuretic
Can cause loss of Potassium = hypokalemia
Can cause BP to drop = hypotension
(withhold med if bp or potassium is too low)
What loop diuretic can be given if furosemide does not work? - ANSWER:
Bumetanide (Bumex)
Hydrochlorothiazide (Thiazide) - ANSWER: Diuretic: blocks sodium and potassium
reabsorption in the distal tubules
(Watch lab work for all diuretics for dehydration and electrolyte problems)
Spiralactone (Aldactone) - ANSWER: Potassium-sparing diuretic (Retains Potassium)
, Can cause HYPERkalemia
Not enough ADH problems - ANSWER: - Lose Water (diuresis)
- Fluid Volume Deficit (shock)
= Diabetes Insipidus
"D in DI think D for Diurese"
DI urine characteristics - ANSWER: Urine output is increased (a lot)
Urine sodium is decreased
Urine concentration is decreased (diluted)
Urine specific gravity is decreased
DI serum (blood) characteristics - ANSWER: Blood is concentrated
Patient is extremely dehydrated
Hematocrit is elevated
Concentrated makes these #s go up
&
Dilute makes these #s go down - ANSWER: Urine specific gravity
Sodium
Hematocrit
ADH is found where? - ANSWER: pituitary gland
Which key words should make you think potential ADH problems? - ANSWER:
Craniotomy
Head injury
Sinus surgery
Transsphenoidal hypophysectomy
or any condition that can lead to increased ICP
What's another name for anti-diuretic hormone (ADH) that can be utilized as an ADH
replacement in diabetes insipidus? - ANSWER: vasopressin (Pitressin)
or
desopressin acetate (DDAVP)
How does bed rest induce diuresis? - ANSWER: it causes the release of ANP and the
decreased production of ADH.
ANP (atrial natriuretic peptide) - ANSWER: Produce by atrial auricles
Target: kidneys
Effect:
- Makes the body LOSE WATER
