Tutoring Slides Unit 2 Med-Surg

Assessing Point of Maximum Impulse (PMI) Location

The PMI (apex of the heart) is located at the 5th intercostal space at the left midclavicular line.

Balloon Valvuloplasty Procedure for Mitral Valve Stenosis

A minimally invasive procedure in which a catheter with a balloon is inserted into the heart and inflated to widen a narrowed mitral valve.

Bradycardia Heart Rate

A heart rate less than 60 beats per minute caused by slowed electrical impulses from the sinoatrial (SA) node.

Cause of Peripheral Arterial Disease (PAD)

Most commonly caused by atherosclerosis, which narrows arteries and reduces blood flow to tissues.

Cause of Restrictive Cardiomyopathy (RCM)

Stiffening of the ventricles that decreases ventricular filling during diastole.

Cause of Tachycardia

Can result from fever, pain, anxiety, stress, fluid volume changes, myocardial infarction, shock, hyperthyroidism, medications, caffeine, nicotine, or stimulant drugs.

Discharge Teaching for Client with Valvular Heart Disease

Teach the client to monitor and report symptoms such as fatigue, dyspnea, edema, chest pain, palpitations, or dizziness and to keep follow-up appointments.

Disorders Originating from the Adrenal Glands

Include Addison's disease (decreased cortisol and aldosterone production) and Cushing's syndrome (excess cortisol production).

Addison's Disease

Adrenal insufficiency causing decreased cortisol and aldosterone levels, leading to hypotension, electrolyte imbalances, and hypoglycemia.

Cushing's Syndrome

Excess cortisol production causing hypertension, diabetes, osteoporosis, weight gain, and increased infection risk.

Myocardium

The thick muscular middle layer of the heart responsible for pumping blood throughout the body.

Normal Limits of Heart Rate

A normal adult heart rate ranges from 60 to 100 beats per minute.

Peripheral Venous Disease Signs and Symptoms

Varicose veins, brown ankle pigmentation, edema, pruritus, open sores, restless legs, and a feeling of heaviness in the lower extremities.

Priority Concern for Atrial Fibrillation Client

Increased risk for stroke due to blood clot formation in the atria.

Right Ventricle Anatomy

The right ventricle pumps deoxygenated blood to the lungs through the pulmonary arteries.

Risk Factors for Developing Pericarditis

Viral infections, recent cardiac procedures, bacterial infections, cancer, autoimmune disorders, and previous episodes of pericarditis.

Symptomatic Atrial Fibrillation Signs and Symptoms

Chest discomfort, shortness of breath, fatigue, anxiety, dizziness, lightheadedness, syncope, weight gain, and increased urination.

Valvular Heart Disease Signs and Symptoms

Heart murmur, palpitations, chest pain, fatigue, weakness, dizziness, dyspnea, arrhythmias, lower extremity edema, and abdominal discomfort from liver enlargement.

Atherosclerosis

Buildup of plaque inside artery walls that reduces blood flow and oxygen delivery to tissues.

Mitral Valve Stenosis

Narrowing of the mitral valve that restricts blood flow from the left atrium to the left ventricle.

Stroke Risk in Atrial Fibrillation

Irregular atrial contractions can cause blood pooling and clot formation, which may travel to the brain.

Heart Murmur

An abnormal heart sound caused by turbulent blood flow through the heart valves.

Dyspnea

Difficulty breathing or shortness of breath.

Edema

Excess fluid accumulation in body tissues causing swelling.

Palpitations

Awareness of an irregular, rapid, or forceful heartbeat.

Varicose Veins

Enlarged, twisted superficial veins caused by chronic venous insufficiency.

Pericarditis

Inflammation of the pericardial sac surrounding the heart.

Idiopathic Pericarditis

Pericarditis with no identifiable cause.

SA Node

The heart's natural pacemaker that initiates electrical impulses and regulates heart rate.

Pulmonary Arteries

Blood vessels that carry deoxygenated blood from the right ventricle to the lungs for oxygenation.

15-15 Rule

Treat hypoglycemia by giving 15 grams of fast-acting carbohydrates, waiting 15 minutes, and rechecking blood glucose; repeat if needed.

Client Risk for Developing Type 2 DM

Sedentary lifestyle, obesity, poor diet, family history, prediabetes, history of gestational diabetes, unhealthy sleep habits, and chronic stress.

Disorders Originating from the Adrenal Glands

Include Addison's disease and Cushing's syndrome.

Addison's Disease

Adrenal gland disorder causing inadequate cortisol and aldosterone production, resulting in hypotension, electrolyte imbalances, and impaired stress response.

Cushing's Syndrome

Excess cortisol production causing hypertension, osteoporosis, diabetes, weight gain, and increased infection risk.

Hemoglobin A1C (HbA1c)

Blood test that reflects average blood glucose levels over the previous 2–3 months.

Hemoglobin A1C Greater Than 6.5–7%

Indicates chronically elevated blood glucose levels and possible diabetes.

Hyperthyroidism

Excess thyroid hormone production causing increased metabolism and body system activity.

Hyperthyroidism Signs and Symptoms

Tachycardia, hypertension, weight loss, diarrhea, enlarged thyroid, warm moist skin, hair loss, muscle weakness, nervousness, insomnia, and irritability.

Graves' Disease

Autoimmune form of hyperthyroidism often associated with exophthalmos (bulging eyes) and goiter.

Exophthalmos

Protrusion or bulging of the eyes commonly seen in Graves' disease.

Goiter

Enlargement of the thyroid gland.

Hypoglycemic Episode Education

Teach clients to recognize symptoms of low blood sugar, monitor glucose levels, carry glucose sources, and know how to use glucagon.

Glucagon

Emergency medication used to raise blood glucose during severe hypoglycemia.

Insulin Hormone Deficiency

Lack of insulin prevents glucose from entering cells, resulting in hyperglycemia.

Levothyroxine

Synthetic thyroid hormone replacement used to treat hypothyroidism.

Levothyroxine Administration

Take 1 hour before meals or 3 hours after meals to maximize absorption.

“Master Gland”

The pituitary gland, which controls and regulates many other endocrine glands.

Pituitary Gland

Endocrine gland located below the hypothalamus that secretes hormones controlling growth, metabolism, reproduction, and fluid balance.

Myxedema Coma

Life-threatening complication of severe untreated hypothyroidism causing hypothermia, hypotension, decreased consciousness, and organ dysfunction.

Primary Function of the Endocrine System

Hormone secretion and regulation of body processes.

Random Blood Glucose Level for Hyperglycemia

A random blood glucose level greater than 200 mg/dL is considered diagnostic of hyperglycemia.

Normal Adult Blood Glucose Range

Approximately 74–106 mg/dL.

Type 1 Diabetes Mellitus (T1DM)

Autoimmune disease that destroys pancreatic beta cells and results in little or no insulin production.

Cause of Type 1 DM

Autoimmune destruction of insulin-producing beta cells in the pancreas.

Beta Cells

Cells located in the islets of Langerhans that produce insulin.

Complication of Thyroid Storm

Life-threatening cardiac complications including severe tachycardia, heart failure, dysrhythmias, and cardiac arrest.

Desmopressin (DDAVP) for Central Diabetes Insipidus

Synthetic form of vasopressin used to replace deficient antidiuretic hormone (ADH) and decrease urine output.

Desmopressin (Lab Value to Watch)

Monitor serum sodium levels closely because desmopressin can cause hyponatremia.

Diabetes Insipidus from Pituitary Tumor Removal

Can occur after neurosurgery due to damage to the hypothalamus or pituitary gland, resulting in ADH deficiency.

Diabetes Insipidus (DI)

Disorder caused by inadequate ADH resulting in excessive dilute urine production and dehydration.

Diabetes Insipidus Signs and Symptoms

Polyuria, polydipsia, dry mucous membranes, poor skin turgor, hypotension, tachycardia, weakness, irritability, and low urine specific gravity.

Diabetic Ketoacidosis (DKA)

Acute diabetic emergency characterized by hyperglycemia, ketosis, dehydration, and metabolic acidosis.

DKA Signs and Symptoms

Altered mental status, fatigue, polydipsia, tachypnea, Kussmaul respirations, hypotension, tachycardia, nausea, vomiting, abdominal pain, polyuria, and fruity-smelling breath.

Kussmaul Respirations

Deep, rapid respirations that occur as the body attempts to compensate for metabolic acidosis.

Hypernatremia in Relation to Diabetes Insipidus

Elevated sodium levels caused by excessive water loss and dehydration.

Hyponatremia Related to SIADH

Low sodium levels caused by excessive ADH secretion and water retention.

Hyponatremia Signs and Symptoms in SIADH

Headache, confusion, tremors, muscle cramps, nausea, vomiting, decreased urine output, and concentrated urine.

Severe Hyponatremia

May progress to respiratory failure, seizures, coma, and death.

Priority Intervention for DKA Client

Initiate IV fluid replacement to correct hypovolemia and restore circulation.

Fluid Resuscitation in DKA

Administration of isotonic IV fluids to restore hydration and tissue perfusion.

Priority Intervention to Prevent Complications in SIADH Client

Implement fluid restriction.

Additional SIADH Intervention

Administer prescribed medications, encourage sodium intake, and provide frequent oral care.

Sign of SIADH Worsening Condition

Increasing confusion, headache, neurological deterioration, seizures, cerebral edema, or coma.

Thyroid Storm

Life-threatening exacerbation of hyperthyroidism causing severe metabolic and cardiovascular instability.

Thyroid Storm Signs and Symptoms

High fever (104–106°F), tachycardia greater than 140 bpm, severe hypertension, dysrhythmias, enlarged thyroid, bulging eyes, tremors, hyperreflexia, diarrhea, vomiting, agitation, psychosis, and coma.

ADH (Antidiuretic Hormone)

Hormone responsible for regulating water balance by promoting water reabsorption in the kidneys.

SIADH (Syndrome of Inappropriate Antidiuretic Hormone)

Disorder characterized by excessive ADH secretion, water retention, and dilutional hyponatremia.

Polyuria

Excessive urine output.

Polydipsia

Excessive thirst.

Low Urine Specific Gravity

Dilute urine commonly seen in diabetes insipidus.

High Urine Specific Gravity

Concentrated urine commonly seen in SIADH.