ATI Med-Surg Endocrine TEST QUESTIONS WITH CORRECT ANSWERS

ATI Med-Surg Endocrine TEST QUESTIONS WITH CORRECT ANSWERS /. Which hormone does the posterior pituitary gland secrete? - Answer-Vasopressin or ADH /.What is AHD's role in the kidneys? - Answer-ADH increases permeability of the renal distal tubules, causing the kidneys to reabsorb water. /.What is the result of ADH deficiency? - Answer-Diabetes Insipidus -Characterized by the excretion of large amounts of diluted urine. /.What is the result of excess ADH? - Answer-SIADH -kidneys retain water, urine becomes concentrated, urinary output decreases, and extracellular fluid volume is increased /.What is the diagnostic test for diabetes insipidus? - Answer-The water deprivation test -Measures the kidneys' ability to concentrate urine in light of an increased plasma osmolality and a low plasma vasopressin level. /.What are the indications for the water deprivation test? - Answer--only performed on pts who have a dx of diabetes insipidus -only conducted if pt's baseline serum Na+ level is WNL or the osmolality of urine is below 300 -should not be performed on pts w/ renal insufficiency, uncontrolled diabetes mellitus, hypovolemia, or untreated adrenal or thyroid hormone deficiency /.nursing actions for water deprivation test - Answer-Pre-procedure -tell pt not to smoke or drink caffeine before test -begin test by withholding fluids for 8-12 hr -- make sure that someone is w/ pt during test -obtain IV access Intraprocedure -place pt in recumbant position for 30 min and: -obtain 7-10 mL of heparinized blood in an iced tube and send to lab; -ask pt to empty his bladder, record amount, and send to lab; -weigh pt to nearest 10th of a kg (record wt and obtain BP and HR) -repeat THREE STEPS: WEIGH, MEASURE URINE, and OBTAIN SERUM -continue steps until serum Na+ concentration or osmolality rises complications -deyhdration r/t to decrease in vascular volume -monitor for indications of dehydration -- postural hypotension, tachycardia, and dizziness /.What are four tests that can be used to test for SIADH? - Answer-Serum ADH, serum electrolytes, urine electrolytes and osmolality, urine specific gravity /.What is the normal range for ADH? a) 7-9 b) 12-20 c) 1-5 d) 25-35 - Answer-C) 1-5 /.What does increased ADH indicate? - Answer-ADH Levels over 5 can indicate SIADH /.What are nursing actions for ADH collection? - Answer--Pt should fast and avoid stress for 12 hrs before -Review med list w/ provider -blood is obtained and taken to lab within 10min /.Normal ranges for Na+, K+, Chloride, and Mag - Answer-Na+: 135-145 K: 3.5-5.0 Chloride: 98-106 Mag: 1.3-2.1 /.What are the interpretation of findings in a serum electrolyte collection for SIADH? - Answer--Low serum Na+ and high urine sodium content are expected with SIADH -decreased serum osmolality and increased urine osmolality are indicative of SIADH /.Urine electrolyte and osmolality expected ranges - Answer--Urine Na+: 75-200 -Urine K+: 26-123 -Urine Chloride: 110-250 Urine osmolality: 200-800 /.Interpretation of findings for urine e- and osmolality - Answer--low serum Na+ and high urine sodium content are expected with SIADH -Decreased serum osmolality and increased urine osmolality are indicative /.Urine specific gravity normal range - Answer--1.010 to 1.025 /.interpretation of urine specific gravity findings: - Answer--a decrease in urine output and an increase in urine-specific gravity occur as a result of excess production of ADH /.What are Cushing's disease and Cushing's syndrome (hypercortisolism) characterized by? - Answer--hyperfunctioning adrenal cortex & excess production of cortisol /.What is Addison's disease characterized by? - Answer--hypofunctioning of adrenal cortex and consequent lack of adequate amounts of serum cortisol /.What are the diagnostic tests for the adrenal cortex? - Answer--dexamethasone suppresion test, plasma and salivary cortisol, 24 hr urine for cortisol, serum for adrenocorticotropic hormone, and ACTH stimulation test -CT scan and/or MRI /.What is the Dexamethasone suppression test? - Answer--determines if dexamethasone has an effect on cortisol levels -pt takes PO dose and blood sample is obtained next morning to determine if cortisol is present /.How is dosing determine for the dexamethasone suppression test? - Answer--low dose given to screen a pt for Cushings -high doses are given to determine cause of illness /.interpretation of findings for dexamethasone suppression test: - Answer--when decresaed amounts of ACTH are produced by pituitary gland, decreased amounts of cortisol are released by adrenal glands -when dexamethasone is given to a pt who has Cushings, there is no decrease in production of ACTH and cortisol /.Plasma cortisol test - Answer--high levels present in AM, lower levels occur around midnight -diurinal variations not seen in pts with Cushings -Plasma cortisol is usually collected at midnight /.Salivary cortisol - Answer--typical salivary coritsol level at might is less than 2.0 -high levels indicate hypercortisolism -usually collected at night; sample is obtained by placing a salivary cushion pan inside the pt's cheek /.urinary cortisol - Answer--normal range: 10-100 -higher levels indicate hypercortisolism urinary cotisol measured during 24-hr urine collection -pt empties bladder and then collects all urine excreted during next 24 hr period -urine must be kept in jug w/boric acid added and kept on ice