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NSG 320 Exam 1 Study Notes, Study Guides, Projects, Research of Nursing

NSG 320 Exam 1 Study NotesNSG 320 Exam 1 Study Notes

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NSG 320 Exam 1 Study Notes
1. In respiratory alkalosis: - pH is high and PaCO2 is low
-Caused by:
*HYPERVENTILATION
*Hypoxemia from acute pulmonary disorders
*Pain
*Fear/anxiety
*Salicylate or Nicotine overdose
*Increased metabolism
-Compensation rarely occurs due to aggressive treatment for hypoxemia
2. In respiratory acidosis: "When you're on acid, you're relaxing and HYPOventi- lating"
-pH is low and PaCO2 is high
-Caused by:
*HYPOVENTILATION
*Respiratory failure
*Asthma attacks
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NSG 320 Exam 1 Study Notes

1. In respiratory alkalosis: - pH is high and PaCO2 is low

- Caused by:

* HYPERVENTILATION

* Hypoxemia from acute pulmonary disorders

* Pain

* Fear/anxiety

* Salicylate or Nicotine overdose

* Increased metabolism

- Compensation rarely occurs due to aggressive treatment for hypoxemia

2. In respiratory acidosis: "When you're on acid, you're relaxing and HYPOventi- lating"

- pH is low and PaCO2 is high

- Caused by:

* HYPOVENTILATION

* Respiratory failure

* Asthma attacks

* COPD

* Chest injury or trauma

* Pulmonary edema

* Fasting/starving

* Cardiac arrest

* Sepsis

*Trauma

* Seizures

* Renal failure

* Severe diarrhea

  • Compensation may occur during exhaling increase CO

5. Normal values for ABG: - pH: 7.35 - 7.

  • PaCO2: 35 - 45 mm Hg
  • HCO3 (Bicarbonate): 22 - 26 mEq/:
  • PaO2: 80 - 100 mm HG
  • SaO2: >95%
  • Base excess: +/- 2.0 meQ/L

6. Thyroid hormones: - TSH: Thyroid stimulating hormone

  • T3: Triiodothyronine hormone
  • T4: Thyroxine hormone

7. Euthyroid: - Normal functioning thyroid

Thyroid cannot make T3+T4 WITHOUT iodine

9. Primary hypothyroidism: - Caused by destruction of thyroid tissue or defective hormone synthesis

  • Most common cause is atrophy to thyroid gland which can be caused by Hashimo- to's thyroiditis or Graves' disease

10. Secondary hypothyroidism: - Caused by pituitary disease TSH secretion or

hypothalamic dysfunction with decreased-releasing hormone (TRH) secretion

11. Clinical manifestations of hypothyroidism: - Slow and low

  • Decreased body processes
  • Decreased cardiac contractility and output
  • Increased serum cholesterol and triglyceride levels
  • Anemia

12. Diagnostic studies consistent with hypothyroidism: - TSH higher than 4.

13. Interprofessional mgmt for hypothyroidism: - Thyroid replacement

  • Monitor for CV disease
  • Monitor HR, report higher than 100 BMP
  • Monitor for chest pain, weight loss, nervousness, tremors, and/or insomnia
  • Monitor thyroid levels and adjust dosage
  • Nutrition therapy for weight loss
  • Patient and caregiver teaching

* Comply with lifelong thyroid therapy

16. Hyperthyroidism: - Hyperactivity of the thyroid gland with sustained increase in synthesis and release

of thyroid hormones

  • Causes:

* Graves' disease

*Toxic nodular goiter

*Thyroiditis

* Excess iodine intake

* Pituitary tumors

*Thyroid cancer

17. Graves' disease: - An autoimmune disease of unknown etiology characterized by diffuse

thyroid enlargement and excess thyroid hormone secretion

  • May present with myasthenia gravis, DM, celiac disease, and pernicious anemia
  • Precipitating factors:

* Insufficient iodine supply

* Cigarette smoking

* Infection

* Stressful life events may interact with genetic factors

  • Hereditary

18. Clinical manifestations of hyperthyroidism: - Goiter (enlarged thyroid)

  • Exophthalmos (protrusion of the eyeballs)

* May cause corneal ulcers or loss of vision.

* Changes in the ocular muscles may result in muscle weakness causing diplopia

  • Early signs are weight loss and increased nervousness
  • Directly increases metabolism and tissue sensitivity to stimulation by the sympa- thetic nervous system

19. RAIU: - Used to distinguish Graves' disease from other forms of thyroiditis

20. Pathophysiology for goiter: - Antibodies bind to TSH and cause thyroid gland to overproduce T3 & T

  • However, goiter can be exhibited with hypothyroidism as well

21. Exophthalmos: - Forward protrusion of the eyes

  • Caused by inflammation byproducts accumulating in the retro-orbital tissues
  • Occurs in 1/
  • Can be unilateral
  • Accompanied by blurred vision, diplopia, pain, tearing, and photophobia
  • Resulting inability to close eyes completely increases risk of corneal dryness, irritation, infection and ulceration
  • Ocular muscle involvement can lead to paralysis of eyes
  • Usually not reversible

22. propylthiouracil (PTU) or methimazole (Tapazole): - Initial antithyroid therapy

  • Prevents formulation of thyroid hormones by inhibiting thyroid binding of iodine
  • Inhibits release of thyroid hormones
  • Side effects include depression, tremors, diabetes insipidus,
  • Drink plenty of fluids
  • Monitor for wt gain, slow HR, and cold intolerance

26. Radioactive iodine therapy (RAI): - Thyroid gland picks up the local radiation, which destroys

some of the cells that produce thyroid hormone

  • Not used in pregnancy
  • Encourage fluids as RAI is excreted through kidneys
  • May take 6-8 weeks for full symptom relief
  • Hypothyroidism major side effect

27. Pre DM: - Impaired glucose tolerance, impaired fasting glucose, or both

  • Typically occurs before DM 2
  • Typically do not have any symptoms
  • Education VITAL so pt does not develop type 2 DM

* Undergo screening

* Manage risk factors

* Monitor for symptoms of DM

* Maintain healthy weight, exercise, and diet

28. Metabolic syndrome: - Common condition that places patients at risk for pre DM

* Abdominal obesity

* Hyperglycemia fasting of more than 100

* Hypertension 130/

* Hyperlipidemia trig more than 150 HDL less than 40- 50

29. Type 1 DM: - Formerly known as juvenile-onset or insulin-dependent

  • Accounts for 5-10% of people
  • Affects people under age of 40, but can occur at any age
  • Osmotic effect of glucose products the manifestations of polydipsia and polyuria

30. Clinical manifestations for type 1 DM: - CLASSIC SYMPTOMS:

* Polyuria

* Polydipsia

* Polyphagia

  • Weight loss
  • Weakness
  • Fatigue
  • Rapid onset
  • Insulin dependent
  • Familial tendency
  • Peak incidence between 10 to 15 years