Professional Documents
Culture Documents
MS HESI Study Guide
MS HESI Study Guide
o Manifestations
dehydration or electrolyte loss: polyuria, polydipsia, polyphagia, weight
loss, dry skin, sunken eyes, soft eyeballs, lethargy and coma
nausea, vomiting, abdominal pain
fruity breath (ketones)
high blood sugar >240 mg/dL
weakness; Hyperkalemia
altered mental status
shock; coma
Ketone levels , buffering of body , blood pH and acidosis occurs.
Kussmaul respiration (ketones) causes respiratory alkalosis to correct
metabolic acidosis by exhaling CO2.
o Priority treatment monitor manifestations of DKA
First assess the airway, LOC, hydration status, electrolytes, and
hypertension and blood glucose level.
pt is dehydrated , closely assess the pt.s fluid status fluid therapy, first
things you need to prioritize in order.
Drug therapy regular insulin by continuous IV infusion continuous
insulin is used instead of SubQ because of 4min half-life of IV insulin and
because of delayed onset of action and prolonged half-life of subQ regular
insulin.
acidosis management
Epigastric pain additional assessment; cause for concern
Carpal tunnel clinical manifestations/symptoms, interventions
Raynauds clinical manifestations/symptoms, interventions
UTI - clinical manifestations/symptoms, assessment, interventions
Complications from flu assessment
Seizures (tonic clonic) interventions
Hypo/hyperthyroidism labs, assessment
o Clinical manifestations
TachyC
tachypnea
insomnia
diaphoresis
double vision
HTN, stroke volume, palpitations
weight loss
irritability
hyperglycemia
heat intolerance
tremors
muscle weakness
exophthalmos
goiter- diff. swallowing
o lab values
T3 and T4 (70-205 ng/dL)
T3RU (24%-34%)
Antibodies to TSH (TSH-RAb) high in graves dz.
TSH Low in graves dz. High in secondary or tertiary hyperthyroidism
Thyroid scan- checks position, size, and function of the thyroid gland.
Radioactive iodine is given by mouth and the uptake of iodine by the
thyroid gland is measured.
Ultrasound- determines the size and general composition of
masses/nodules. painless and quick procedure
ECG- usually shows TachyC. May also show A-fib, dysrhythmias, and
changes in P and T waveforms
o treatment
Monitor v/s
reduce stimulation
anti-thyroid drugs
lithium
beta-adrenergic blockers
thionamides
Radioactive iodine therapy (not used in pregnant women)
Promote comfort- Reducing room temperature
thyroidectomy- total or partial
Monitor V/S q 15 min. postop
Pt. will be on thyroid replacement hormone therapy synthroid for
rest of their life.
hemorrhage
respiratory distress- laryngeal stridor heard in acute resp.
obstruction
Hypocalcemia and tetany- occur if the parathyroid glands are
removed or damaged. Inadequate blood flow to the
o Patho- life threatening event where cortisol and aldosterone is greater than the
available supply.
o Clinical manifestations
Calculations