Review Topics Part 1
1) Diabetes Insipidus – page 1161-1162
• Caused by a deficiency of production of ADH or a decreased renal response to
... [Show More] ADH.
• Clinical Manifestations: Polydipsia and Polyuria.
• Diagnostic Studies: Water deprivation test (pt deprived of water for 8-12 hrs and then given desmopressin acetate subcut or nasally), Measure level of ADH after an analog of ADH is given.
• Types of Diabetic Insipidus: Central DI (results from an interference of ADH synthesis, transport, and release. Ex: brain tumor, head injury, brain surgery, CNS infection), Nephrogenic DI (results from inadequate renal response to ADH despite presence of adequate ADH. Ex: Drug therapy, renal damage, hereditary renal disease), Primary DI (Results from excessive water intake. Ex: Structural lesion in thirst center, psychological disorder).
• Nursing Management: Early detection, Maintaining adequate hydration, and patient teaching for long-term management.
2) Healthcare associated pneumonia
• Also known as nosocomial pneumonia, pneumonia in a non-intubated patient that begins 48 hours or longer after admission to hospital and was not present at the time of admission. Ventilator- associated pneumonia, also a type of HAP, refers to pneumonia that occurs more than 48 hours after endotracheal intubation.
• Treatment: Antibiotics that can be started as soon as sputum cultures identify the exact pathogen.
• Risks: In treatment of pneumonia, risk of developing multidrug-resistant organisms. Limits the available antibiotics that can be used as treatment.
3) Diabetes Mellitus long term complications
• Stroke
• Hypertension
• Dermopathy
• Atherosclerosis
• Nephropathy
• Peripheral neuropathy
• Neurogenic bladder
• Retinopathy, Cataracts, Glaucoma, Blindness
• Coronary Artery Disease
• Gastroparesis
• Islet Cell Loss
• Erectile Dysfunction
• Peripheral Vascular Atherosclerosis
• Gangrene
• Infections
• Examinations performed Daily, Annually, or when you visit HCP: Funduscopic, Fundus photography, Urinalysis, Feet Examination, and Stress Tests.
4) Renal dosing/ issues with drugs – page 1020 Box 44-3
ANTIBIOTICS OTHER DRUGS OTHER AGENTS
Amikacin Captopril Gold
Amphotericin B Cimetidine Heavy Metals
Bacitracin Cisplatin
Cephalosporins Cocaine
Gentamicin Cyclosporine
Neomycin Ethylene Glycol
Polymyxin B Heroin
Streptomycin Lithium
Sulfamidies Methotrexate
Tobramycin Nitrosoureas
Vancomycin NSAIDS
Phenacetin
Quinine
Rifampin
Salicylates
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