Excess ADH causes most of the filtered water to be reabsorbed from the kidneys

Excess adh causes most of the filtered water to be

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Excess ADH causes most of the filtered water to be reabsorbed from the kidneys back into central circulation Almost always acute **DARK urine bag, or nothing in it** S&S Water intoxication Decreased to no UOP ( urine output) Hyponatremia Nausea, vomiting Seizures Malaise Mental status changes Diagnostics High urine osmolarity (concentrated urine ) High urine specific gravity (URINE) o High specificity gravity, high concentration (concentrated ) BLOOD – diluted, decreased electrolytes Low serum osmolarity Low serum sodium Decreased BUN Decreased Hct Treatment and Nursing Considerations Treat underlying cause Careful I&O Weight Monitoring ( weight gain ) Fluid restriction ( no free water ) May need hypertonic NaCl Seizure precautions Education regarding these measures Diet high in protein and sodium o FRIED CHICKEN Frequent neuro checks o Finding the PROBLEM Disorder Serum Na+ Serum Osmo Urine Osmo SIADH Dehydration DInsipidus Disorders of Thyroid Thyroid Function o Thyroid Gland produces two types of hormones: Thyroid Hormone (TH) Thyroxine ( T4) Triiodothyronine ( T3) Calcitonin o The secretion of Thyroid Hormone is controlled by thyroid stimulating hormone ( TSH ), from the pituitary HYPO: low T3/T4, HIGH TSH ( trying to stimulate to get T3/T4 to work) HYPER: HIGH T3/T4 , low TSH ( just sits there because it isn’t doing anything ) o HYPOthyroidism Deficiency in secretion of Thyroid Hormone leading to decreased metabolic rate, decreased heat production, and other effects on body systems
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Congenital Spontaneous gene mutation An autosomal recessive genetic transmission of an enzyme deficiency Hypoplasia or aplasia of thyroid gland Acquired Idiopathic Autoimmune thyroiditis ( Hashimoto ) S&S Congenital (if not treated) o Thick, protruding tongue; thick lips o Hypotonia o Bradycardia o Larger posterior fontanel (closes at 2 months) that stays open longer o Prolonged neonatal jaundice o Difficulty feeding o Hypothermia Acquired o Decreased appetite o Thinning hair o Bradycardia o Depressed deep tendon reflexes o Growth slows o Fatigue o Constipation o Cold Sensitivity o May be asymptomatic Diagnosis Congenital o Newborn screening o T4 and TSH levels o EARLY detection key to prevent neurological and developmental delays o Those detected <3 months of age have best outcome with mental development Acquired o T4, TSH, anti-thyroid antibody tests o Thyroid scan or ultrasound to evaluate thyroid o Bone age X-ray to evaluate delayed growth Treatment Thyroid hormone levothyroxine (Synthroid) for life Dose will need to be adjusted as child grows Check apical pulse and blood pressure prior to administration Signs of toxicity/overdose?
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