Endocrine

1) What are some risk factors associated with GERD?

2.What are symptoms of GERD?

3.What medications are used to treat GERD?

4.What are lifestyle modifications for the client with GERD?

Gastro.

1.What are the two most common causes of diabetes insipidus (DI)?

2.What is the most common cause of syndrome of inappropriate antidiuretic hormone (SIADH)?

3.In DI, urine output may be as much as _________, and is accompanied by ________ and weight _______.

4.In SIADH, the client has oliguria. What are three other clinical manifestations?

5.A client who has scant urine, a urine specific gravity of greater than 1.025, increased urine Na+and K+, and decreased serum Na+and K+has what diagnosis?

6.A nurse is caring for a client who has fluid volume deficit related to diabetes insipidus. What are three nursing actions that should be taken?

ASTHMA

1.A nurse is providing medication education to a client who is prescribed prednisone for treatment of an asthma exacerbation. What information regarding this medication should the nurse provide?

2.What are potential triggering agents for a client with asthma?

AUTISM

1.What does the statement "learn the truth about autism" mean?

2.The treatment for autism is to control the symptoms. Why are antidepressants used in the treatment of autism? Why are anti psychotics used in the treatment of autism?

ENDOCRINE:

(1) Risk factors associated with GERD are:

• Obesity. (Due to excess belly fat causing pressure on the stomach)
• Pregnancy. (Increased intra-abdominal and gastric pressure)
• Aging process (Delayed gastric emptying and relaxed LES/lower esophageal sphincter)
• NGT (The tube passes through the lower esophageal sphincter)
• Hiatal hernia (LES displacement into the thorax and delays gastric emptying)
• Smoking. (Smoking increases stress, which increases acid production)

(2) Symptoms of GERD includes:

• Dyspepsia (Indigestion)
• Pyrosis (Burning sensation in the esophagus)
• Epigastric pain
• Eructation (belching)
• Regurgitation of food or sour bitter taste in the mouth.
• Atypical chest pain (Esophageal spasms)
• Laryngitis (Throat irritation)
• Dysphagia (Difficulty swallowing)
• Odynophagia (Painful swallowing)

(3) Medications used to treat GERD:

•  Antacids (neutralizes stomach acid).
• Histamine receptor antagonists (reduces acid production and provides longer relief)
• Proton pump inhibitors (block proton pump in acid producing cells)

(4) Lifestyle modifications for the client with GERD:

• Smoking cessation. Smoking increases stress, which increases acid production.
• Avoid the foods and beverages that trigger symptoms. Example, alcohol irritates the gastric mucosa. Coffee, citrus juices are direct irritants to esophageal mucosa.
• Maintain a healthy weight. If overweight or obese, take steps to lose weight with exercise and diet changes.
• Avoid tight-fitting clothes to decrease intra-abdominal pressure.

GASTRO:

(1) Most common cause of diabetes insipidus:

• Damage to the pituitary gland or hypothalamus from surgery, a tumor, a head injury or an illness. (central diabetes insipidus)
• Long-term lithium use (most common cause of acquired nephrogenic diabetes insipidus)

(2) The most common cause of SIADH is malignancy, especially small cell lung cancer. Self limiting when it is caused by head trauma or drugs and chronic when associated with tumors or metabolic diseases.

(3) In DI, urine output may be as much as (10-20L/day) and is accompanied by (excessive thirst) and (weight loss)

(4) Other clinical manifestations of SIADH includes muscle cramps, confusion, or seizures due to severe and rapid hyponatremia.

(5) A client who has scant urine, a urine specific gravity of greater than 1.025, increased urine Na+and K+, and decreased serum Na+and K+has what diagnosis?

• The client has (SIADH) Syndrome of inappropriate antidiuretic hormone secretion.

(6) Nursing action that should be taken in caring for a client who has fluid volume deficit related to diabetes insipidus includes:

• Ensure adequate fluid replacement through IV fluid administration as indicated. Rationale: To combat dehydration due to polyuria.
• Monitor vital signs. Rationale: To detect abnormalities in the baseline for rapid intervention. Polyuria causes decreased circulatory blood volume that may cause hypovolemic shock which is a life-threatening condition that needs immediate attention.
• Monitor intake and output. Rationale: To monitor for signs of dehydration.

ASTHMA

(1) A nurse is providing medication education to a client who is prescribed prednisone for treatment of an asthma exacerbation. What information regarding this medication should the nurse provide?

• Prednisone should not be used during pregnancy or lactation.
• Prednisone should be taken with food because they can irritate the lining of the stomach.
• Prednisone should be taken same time everyday, preferably in the morning because they can cause insomnia.
• The client should be instructed to monitor his/her blood sugar regularly because prednisone is a medication that can lead to spikes in blood sugar levels.

(2) What are potential triggering agents for a client with asthma?

• Environmental factors such as air pollutants, strong odors, seasonal and perennial allergens.
• Stress and emotional distress. Stress triggers the immune system to release certain chemicals that can lead to inflammation within the airways of the lungs, triggering an asthma attack.
• Viral respiratory tract infection. Upper respiratory infection can cause inflammation and narrowing of airways.
• Medications (aspirin, NSAIDS, beta blockers, cholinergics). Certain medications can generate asthma symptoms.

AUTISM

(1) What does the statement "learn the truth about autism" mean?

• People lack knowledge about autism. Most people probably heard lots of thoughts and ideas about it, but most people are not really informed. The statement "learn the truth about autism" is to make sure people know what is true and what is false in order to break any misconceptions about autism. For example, it is believe that people with autism can't feel emotions. This is such a misconception, for autism doesn't make an individual unable to feel the emotions, they just communicate emotions in different ways. To learn the truth about autism inspires people to look beyond what they can and to better understand these individuals as well as to break the stigma in the lives of families with children or family members with autism.

2.The treatment for autism is to control the symptoms. Why are antidepressants used in the treatment of autism? Why are anti psychotics used in the treatment of autism?

• Antidepressants: Antidepressant medications have demonstrated preliminary efficacy in targeting anxiety, which is common in autistic people. It is given to decrease: irritability, tantrums, aggressive behavior, frequency of repetitive stereotype behaviors in autistic people. SSRIs can be used to help regulate serotonin. Serotonin is an important chemical and neurotransmitter in the human body that is believed to help regulate mood and social behavior.
• Antipsychotics:  Antipsychotics are frequently used to treat variety of symptoms associated with autism as these drugs have sedative effect that can reduce aggression in children with disruptive behavior. It also helps in decreasing hyperactivity and irritability.