COI 2 Test 1

Know the treatment for Addison's disease.

(occurs when adrenal glands don't make enough cortisol and aldosterone)
Fluid and electrolyte balance
Steroids: cortisone and hydrocortisone.
Hormone replacement therapy.

Know the classical signs of increased intracranial pressure

Changes in LOC
Change in Vital signs
Ocular Signs
Severe headache
Confusion/changes in behavior
As the ICP continues to increase the patient will manifest changes on the contralateral (opposite side of mass)
With painful stimuli the patient will

Know the signs signifying neurological change in a patient

Altered level of consciousness
Muscle weakness/involuntary muscle contractions

Rapid acting insulin:

Lispro, Aspart, Glulisin
Onset (hours): <0.5
Peak: 0.5-2.5
Duration: 3-4.5

Intermediate acting insulin:

Isophane (NPH), lente
Onset (hours): 1-3
Peak: 3-8
Duration: 7-14

Long acting insulin:

bovine ultralente
Onset (hours): 2-4
Peak: 6-12
Duration: 12-30
Glargine, detemir
Onset: 1-2
Peak: none
Duration: 18-24

Know the basic functions of each of the endocrine glands covered in class

Thyroid: affects metabolism
Pituitary: secretes many different hormones, some of which affect other glands
Parathyroid: help regulate level of calcium in blood
Adrenal: help trigger the fight-or-flight response
Pancreas: regulates the level of sugar in bl

Know the teaching/education for a patient in Addisonian crisis

Avoid stress

Know the common diagnostic neurological studies and indications

Lumbar Puncture (Insertion of needle under sterile technique into subarachnoid space): Cerebrospinal Fluid Analysis
Electroencephalography (EEG): Seizure
Electromyography (EMG) and Nerve Conduction Study: Neuromuscular disorders
Computed Tomography (CT)

Know your basic stroke emergency assessment

Face: Is one side of the face drooping? Ask the person to smile
Arms: does one arm drift downward? Have to person raise both arms
Speech: Are they slurring their speech or having difficulty getting the words out right? Have the person try to repea

Know the different presentations for the ischemic and hemorrhagic strokes

Ischemic: inadequate blood flow to a part of the brain
Hemorrhagic: bleeding into the brain that results in death of brain cells
Transient Ischemic Attack (TIA) transient episode of neurologic dysfunction caused by focal brain, spinal cord, or retinal isc

Know the interventions for the Alzheimer patient

Alzheimer's Disease: Chronic progressive, degenerative disease. Common form of dementia. Cause unknown but genetic plays a role in certain cases.
Nursing Intervention: Assess mental status, re-orientation, safety, assistive with ADL and self-care

Know the expected lab and diagnostic findings in Cushing's disease

Elevated serum cortisol levels
Elevated blood glucose
Elevated sodium (Na+) or hypernatremia
Decreased serum potassium (k+) or hypokalemia
Hint: Extra "Cush" for Cushing's a disorder of excess therefore almost all labs elevated
Dexamethasone suppression t

Know the important objective and subjective data collection for Cushing's disease

Subjective data:
Past medical and medication history (steroids)
Rheumatology patients, asthmatics, history of neuro-endocrine tumors
Body Image
Objective data:
Vital signs
Skin integrity


Health history
Hyperthyroidism treatment
Iodine-containing medications
Changes in appetite
Weight gain
Activity level
Speech, memory, or skin changes
Physical examination
Cold intolerance
Signs of depression
Heart rate
Gland tenderness


Subjective data:
heat intolerance
weight loss
objective data:
increase T3 and T4
decreased or undetectable TSH

Type 1

Absent or minimal insulin production
More common in young people but can be at any age

Type 2

Pancreas continues to produce some endogenous insulin but not enough insulin is produced OR body does not use insulin effectively

Know the causes of type 1 and type 2 diabetes

Type 1: Genetics, autoimmune, environment
Type 2: lifestyle, disease, medications

S/S for hypoglycemia:

shakiness, palpitations, nervousness, diaphoresis, anxiety, hunger, pallor
Altered mental functioning: difficulty speaking, visual disturbances, stupor, confusion, coma
Check blood glucose 1st: If < 70 mg/dL, immediately begin treatment
If >70

S/S for hyperglycemia:

Diabetic Ketoacidosis (DKA)
Clinical manifestations
Poor skin turgor
Dry mucous membranes
Orthostatic hypotension
Lethargy and weakness early
Skin dry and loose; eyes soft and sunken
Clinical manifestations
Abdominal pain, anorexia

Know the care of the patient with Myasthenia gravis

Drug therapy: anticholinesterase drugs (Pyridostigmine (Mestinon) is the most successful drug of this group), alternate-day corticosteroids (Prednisone), and immunosuppressants
Up to 80% of patients who receive corticosteroids have complete cessation of s

Know the presentation of the patient with Parkinson's disease

Gradual degeneration of the midbrain affecting control and regulation of movement.
Attributed to a combination of environmental and genetic factors.
Symptoms: Slow shuffling gait, mask-like facial expressions, pill-rolling movements of hands, stooping pos

Know the care of the patient with Lou Gehrig's disease

Progressive, degenerative disorder involving both the upper and lower motor neurons. Coordination and muscle strength get progressively worse.
Usually no change in mental status or sensory function. Eventual paralysis of the motor system, except the eyes.

Know the nursing education for the patient with Multiple Sclerosis

Autoimmune disease that results in demyelination of the white matter of the nervous system.
Diplopia (double vision)
Blurred vision
Muscle weakness and unsteady gait,
Slurred speech,
Memory loss
Intolerance of temperature extreme

Know the assessment of the patient with Huntington's disease

Degenerative disease with gradual onset of involuntary, jerking movements(chorea), and progressive decline in mental ability, resulting in dementia and behavioral changes.
Chorea: Abnormal involuntary movements-constant writhing, twisting, uncontrollable

Frontal lobe:

controls speech articulation, behavior, moral decision making and emotional outbursts (Broca's area)

Parietal lobe:

interprets sensory stimuli, pain, and touch

Temporal lobe:

auditory processing, language interpretation (wernicke's area), memory formulation and storage

Occipital lobe:

contains the visual cortex and is involved in interpreting visual stimuli


relays ascending sensory information from the body to the brain; and descending messages from the brain to the body
Integrates sensory impulses: recognition, variations in touch and temperature, sense of movement and position, size, shape and quality reco


works with the pituitary gland to maintain homeostasis. Site of hunger center. Regulates sleep, blood pressure, aggressive and sexual behavior, emotional responses

Basal ganglia:

keeps the contractile tone of every muscle in the trunk and extremities in a constant state to control highly skilled movements that require precision without intentional thought


Situated between the midbrain and medulla and is a bridge between the halves of the cerebrum as well as between the medulla and the cerebrum. Contains sensory and motor pathways.


Connects the pons and the cerebrum with the cerebral hemispheres. Contains sensory and motor pathways and is the center for auditory and visual reflexes.

Medulla Oblongata:

Transmits motor fibers from the brain to the spinal cord and sensory fibers from the spinal cord to the brain. Contains centers for controlling heart, respiration and blood pressure.