Finall Exam:l NSGl 430/l NSG430l (Latestl
2025/l 2026l Update)l Adultl Healthl Nursingl IIl Completel Guide|l Questionsl &l Answers|l Gradel A|l 100%l Correctl (Verifiedl Solutions)-l GCU
Q:l endl ofl life
Answer:
TYPESl OFl CAREl 1.l palliative:l inl personl withl lifel limitingl illness.l canl bel donel withl orl withoutl curative.l focusl onl symptoms 2.l hospice:l whenl personl hasl 6l mol orl lessl tol live,l determinedl byl 2l certifiedl physicians BRAINl DEATH -canl bel calledl byl 2l RNs -irreversiblel brainl damagel ENDl OFl LIFEl MANIFESTATIONS
1.l Respiratory:l
-firstl tol go -initiallyl fastl RRl thenl slowedl RR,l apnea,l cheynel stokes,l deathl rattle 2.l Sensory -hearingl isl lastl tol gol -decreasedl taste,l smell,l touch
3.l skin:
-mottled,l cyanosis -cool,l waxlike
4.l urinary:
-decreasedl UO -incontinence
5.l GI:
-constipation,l hypoactivel bowell sounds -incontinence -decreasedl appetite 6.l Musculoskeletal -decreasedl mobility,l diffl tol positionl selfl -needsl tol bel turned
7.l Cardiovascular:
-initiall increasedl HRl thenl decreasedl 1 / 4
-weakl pulses ENDl OFl LIFEl CARE
-painl management:l nol fearl ofl addiction
-educatel familyl aboutl whatl tol expect -chaplainl services -encouragel touch
-SOB:l keepl HOBl elevated,l anxiolytics,l benzosl
POSTl MORTEMl CARE -neverl sayl thel body -handsl atl side,l eyesl closed,l removel linesl andl dressings,l cleanl body,l incontinencel pad,l brushl hair
Q:l DKA
Answer:
profoundlyl highl glucosel levels->breakl downl fatl forl energy->l ketones->metabolicl acidosisl -rapidl onset -occursl inl typel 1,l notl typel 2l
CAUSES
-infection -illness -poorl management -undiagnosedl DM1l
MANIFESTATIONS
-polyuria,l ketonuria -hot,l dry,l dehydration,l tachycardia -kussmualsl breathing,l fruityl odorl -BGl >250,l pHl <7.3 -n/v,l abdominall pain!
TREATMENT
-oxygen
-fluids:l 0.9l orl 0.45l NS,l whenl BGl reachesl 250l addl inl 5-10%l dextrosel
-regularl insulinl dripl -monitorl Kl bcl insulinl reducesl levels,l alwaysl checkl Kl beforel givingl insulin
Q:l hyperglycemicl hyperosmolarl syndrome
Answer:
cannotl makel enoughl insulinl tol preventl hyperglycemial andl osmoticl diuresisl -graduall onset 2 / 4
-occursl inl typel 2 CAUSE -newlyl diagnosedl typel 2 -illness -mentall illness -impairedl thirstl sensation
MANIFESTATIONS
-hypotension,l decreasedl renall perfusion,l hemoconcentrationl (clotting) -BGl >l 600
-neurol changes:l aphasia,l hemiparesis,l coma,l seizure
TREATMENT
-fluids -insulinl drip
Q:l hypoglycemia
Answer:
-belowl 70
MANIFESTATIONS
-cool,l clammy,l tachycardia,l confusion,l tremor,l seizure,l coma,l nervousl
TREATMENT
-concoius:l 15l gl carb
-unconcious:l IVl 50%l Dl orl IMl glucagon
Q:l SIADHl andl DI
Answer:
SIADH -pitl issuel causesl tool muchl ADH->fluidl retention,l dilutionall hyponatremia,l urinel concen -manifestations:l wl gain,l decreasedl UO,l edema,l cerebrall edema,l hyponatremial (HA,l musclel cramps),l vomiting -treatment:l fluidl restriction,l Kl andl Nal replacements,l canl givel hypertonicl solutionl slowly,l loopl diureticl (furosemide),l demeclocyclinel andl vasopressorl antagonistl tol inhibitl thel effectsl ofl ADH,l seizurel precautions DIABETESl INSIPIDUSl -notl enoughl ADHl productionl (centrall DI)l orl nol responsel (renall issue) -manifestations:l polyurial andl polyphagia,l nocturia,l hypernatremia,l urinel specificl gravityl <1.005,l urinel osmolarityl <100,l seruml osmolarityl >295
-Dx:l waterl deprivationl test 3 / 4
>nol fluidsl forl 8-12l hours,l thenl givel desmopressin,l ifl urinel concenl increasesl thenl itl isl centrall DIl ifl itl doesntl thenl itl isl nephrogenicl -treatment:l Nal restriction,l fluidsl (hypotonicl ifl acute),l desmopressin,l thiazidel diuretics,l NSAIDSl
PITUITARYl SURGERY -pituitaryl tumorl canl causel bothl DIl andl SIADH -surgeryl goesl throughl nosel intol brainl rightl byl thel eyesl sol postl opl monitorl pupilsl andl visuall acuity -canl increasel ICPl sol takel measuresl tol avoidl this -checkl bandagel forl CSF,l ifl glucosel isl greaterl thanl 30l itl isl CSF >riskl forl meningitis
Q:l cushingsl syndrome
Answer:
adrenall issue -eitherl al tumorl causingl excessivel releasel ofl Hl orl prolonged/excessl intakel ofl corticosteroids
MANIFESTATIONS
-moonl face,l thinl redl skin -weightl gain,l truncall obesity,l buffalol hump,l striae -dyspnea,l fatigue 1.l glucocorticoids:l hyperglycemia,l delayedl woundl healing,l musclel wasting,l lossl ofl bonel matrix,l lossl ofl collagen
2.l mineralocorticoids:l hypokalemia,l hypertension
3.l androgens:l acne,l virilizationl inl women,l feminisml inl menl
TREATMENT
-surgeryl isl causedl byl tumor -slowlyl taperl offl medsl ifl causedl iatrogenically -riskl forl thromboembolisml bcl hyperglycemia->hypercoag -educatel theml thatl theirl moodl labilityl willl gol awayl whenl thel issuel isl fixed
-postl opl surgery:
>adrenalectomy:l riskl ofl bleedingl bcl itsl highlyl vascularized
>increasel corticosteroidsl tol handlel thel stressl ofl thel surgeryl >willl bel onl lifelongl corticosteroidl replacementl therapy -avoidl stressl andl extremes
Q:l addisons
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