Diabetes Insipidus Case Study (60 min)
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Study Tools For Diabetes Insipidus Case Study (60 min)
Diabetes Insipidus Pathochart (Cheatsheet)
Diabetes Insipidus (Mnemonic)
Diabetes Insipidus Assessment (Picmonic)
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Outline
Mrs. Ford is a 32 year old female who was admitted to the neuro ICU two days ago after a fall, which caused a large epidural hematoma over the left parietal lobe. She was intubated due to a low level of consciousness to protect her airway. An External Ventricular Drain (EVD) was placed to monitor her ICP. She also has an orogastric tube, and a Foley catheter in place
Critical Thinking Check
Bloom's Taxonomy: Application
You just started your shift, what nursing assessments will be your priority at this point?
VIEW ANSWER
Mrs. Ford’s vital signs are as follows:
BP 124/68 MAP 86
HR 84 Temp 98.9
RR 16 (ventilated)
ICP 12
She is not on any sedation. You determine her GCS is 6, she withdraws to pain, but does not open her eyes. Her pupils are equal and reactive bilaterally, 4mm. For this hour she has put out 120 ml of urine that is clear and yellow. She is receiving normal saline at 75 mL/hour as well as tube feeds at 40 mL/hour. Her EVD is open at 15 cmH2O and draining a clear pink fluid, 6 ml this hour.
faq lesson=”true” blooms=”Application” question=”Calculate her cerebral perfusion pressure.”]
- CPP = MAP – ICP
- 86 – 12 = 74 mmHg [/faq]
Critical Thinking Check
Bloom's Taxonomy: Analysis
Given the assessment information that you have, what are you most concerned for with this patient?
VIEW ANSWER
Hourly urine output for Mrs. Ford For the last 3 hours were 180 mL, 240 mL, and 440 mL. The urine is clear and barely pale yellow. Her blood pressure is 108/56, HR is 104. Her ICP is 15.
Critical Thinking Check
Bloom's Taxonomy: Analysis
What could be going on physiologically with Mrs. Ford?
VIEW ANSWER
Critical Thinking Check
Bloom's Taxonomy: Analysis
What further diagnostic testing do you expect the provider to order?
VIEW ANSWER
Lab Values:
Na+ 155 mg/dL
Serum osmo 310 mOsm/kg
Urine SG 1.005
Critical Thinking Check
Bloom's Taxonomy: Analysis
Explain the significance of these lab values considering the patient's diagnosis.
VIEW ANSWER
Critical Thinking Check
Bloom's Taxonomy: Analysis
What medications and or treatment changes do you expect the provider to order?
VIEW ANSWER
The provider orders the following:
Free water flush via OG Tube – 200 mL q4h
Change IVF to D5W at 125 mL/hr
Desmopressin (DDAVP) 2 mcg IV push q 12h
Daily weight
q4h Sodium and Serum Osmolality levels
You set the tube feeding pump to administer the free water and change the IV fluids while waiting for the DDAVP from the pharmacy
Critical Thinking Check
Bloom's Taxonomy: Analysis
What regular monitoring will need to be done for Mrs. Ford during this treatment?
VIEW ANSWER
After 2 days of treatment, misses Fords urine output and urine specific gravity return to Baseline. However, she continues to have a GCS between 4 + 6, and now her left pupil is 8mm and fixed. The nurse notes her respiratory rate is erratic, her ICP is 18, and her heart rate is dropping.
Critical Thinking Check
Bloom's Taxonomy: Analysis
What do you believe could be happening to Mrs. Ford at this time?
VIEW ANSWER
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Study Plan Lessons
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Acute Respiratory Distress Syndrome (ARDS) for Progressive Care Certified Nurse (PCCN)
AIDS Case Study (45 min)
Airway Suctioning
Anemia for Progressive Care Certified Nurse (PCCN)
Anesthetic Agents
Anesthetic Agents
ARDS Case Study (60 min)
ARDS causes Nursing Mnemonic (GUT PASS)
Artificial Airways
Aspiration for Certified Emergency Nursing (CEN)
Assessment for Myasthenic Crisis Nursing Mnemonic (BRISH)
Asthma for Certified Emergency Nursing (CEN)
AVPU Mnemonic (The AVPU Scale)
Azithromycin (Zithromax) Nursing Considerations
Barbiturates
Brain Death v. Comatose
Brain Tumors
Bronchoscopy
Carbon Dioxide (Co2) Lab Values
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Complications of Immobility
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Diabetes Mellitus Case Study (45 min)
Diabetic Ketoacidosis (DKA) Case Study (45 min)
Disseminated Intravascular Coagulation Case Study (60 min)
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Fractures (Open, Closed, Fat Embolus) for Certified Emergency Nursing (CEN)
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Head and Spinal Cord Trauma for Certified Emergency Nursing (CEN)
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Histamine 1 Receptor Blockers
Hyperthyroidism Case Study (75 min)
Hypothermia (Thermoregulation)
Infectious Diseases: Influenza for Progressive Care Certified Nurse (PCCN)
Intraoperative (Intraop) Complications
Leukemia Case Study (60 min)
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Local Anesthesia
Lung Cancer
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Miscellaneous Nerve Disorders
Moderate Sedation
Montelukast (Singulair) Nursing Considerations
Morphine (MS Contin) Nursing Considerations
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Nephrotic Syndrome Case Study (Peds) (45 min)
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Noncardiac Pulmonary Edema for Certified Emergency Nursing (CEN)
Nursing Care and Pathophysiology for Acquired Immune Deficiency Syndrome (AIDS)
Nursing Care and Pathophysiology for Anaphylaxis
Nursing Care and Pathophysiology for Asthma
Nursing Care and Pathophysiology for Influenza (Flu)
Nursing Care and Pathophysiology for Myasthenia Gravis
Nursing Care and Pathophysiology for Psoriasis
Nursing Care and Pathophysiology for Scleroderma
Nursing Care and Pathophysiology for Sepsis
Nursing Care and Pathophysiology for SIRS & MODS
Nursing Care and Pathophysiology of Acute Respiratory Distress Syndrome (ARDS)
Nursing Care and Pathophysiology of Chronic Kidney (Renal) Disease (CKD)
Nursing Care and Pathophysiology of Diabetic Ketoacidosis (DKA)
Nursing Care and Pathophysiology of Glomerulonephritis
Nursing Care and Pathophysiology of Pneumonia
Nursing Care Plan (NCP) & Interventions for Increased Intracranial Pressure (ICP)
Nursing Care Plan (NCP) for Activity Intolerance
Nursing Care Plan (NCP) for Acute Bronchitis
Nursing Care Plan (NCP) for Acute Kidney Injury
Nursing Care Plan (NCP) for Acute Respiratory Distress Syndrome
Nursing Care Plan (NCP) for Anaphylaxis
Nursing Care Plan (NCP) for Anemia
Nursing Care Plan (NCP) for Angina
Nursing Care Plan (NCP) for Aortic Aneurysm
Nursing Care Plan (NCP) for Aspiration
Nursing Care Plan (NCP) for Asthma / Childhood Asthma
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Nursing Care Plan (NCP) for Bowel Obstruction
Nursing Care Plan (NCP) for Brain Tumors
Nursing Care Plan (NCP) for Bronchoscopy (Procedure)
Nursing Care Plan (NCP) for Cardiogenic Shock
Nursing Care Plan (NCP) for Chronic Kidney Disease
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Nursing Care Plan (NCP) for Congestive Heart Failure (CHF)
Nursing Care Plan (NCP) for Cushing’s Disease
Nursing Care Plan (NCP) for Diabetes Insipidus
Nursing Care Plan (NCP) for Diabetic Ketoacidosis (DKA)
Nursing Care Plan (NCP) for Disseminated Intravascular Coagulation (DIC)
Nursing Care Plan (NCP) for Diverticulosis / Diverticulitis
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Nursing Care Plan for Nasal Disorders
Nursing Care Plan for Pulmonary Edema
Nursing Care Plan for Restrictive Lung Diseases (Pulmonary Fibrosis, Neuromuscular Disorders)
Nursing Care Plan for Scleroderma
Nursing Case Study for Breast Cancer
Nursing Case Study for Cardiogenic Shock
Nursing Case Study for Hepatitis
Nursing Case Study for Pneumonia
Nursing Case Study for Type 1 Diabetes
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Obstructive Sleep Apnea for Progressive Care Certified Nurse (PCCN)
Ondansetron (Zofran) Nursing Considerations
Opioids
Pancreatitis For PCCN for Progressive Care Certified Nurse (PCCN)
Patient Positioning
Pentobarbital (Nembutal) Nursing Considerations
Peritonitis for Certified Emergency Nursing (CEN)
Pleural Space Complications (Pneumothorax, Hemothorax, Pleural Effusion, Empyema, Chylothorax) for Progressive Care Certified Nurse (PCCN)
Positioning (Pressure Injury Prevention and Tourniquet Safety) for Certified Perioperative Nurse (CNOR)
Post-Anesthesia Recovery
PPE Precautions (Personal Protective Equipment) for Certified Perioperative Nurse (CNOR)
Propofol (Diprivan) Nursing Considerations
Respiratory A&P Module Intro
Respiratory Alkalosis
Respiratory Course Introduction
Respiratory Depression (Medication-Induced, Decreased-LOC-Induced) for Progressive Care Certified Nurse (PCCN)
Respiratory Distress Syndrome for Certified Emergency Nursing (CEN)
Respiratory Failure (Acute, Chronic, Failure to Wean) for Progressive Care Certified Nurse (PCCN)
Respiratory Infections (Pneumonia) for Progressive Care Certified Nurse (PCCN)
Respiratory Infections Module Intro
Respiratory Procedures Module Intro
Respiratory Trauma for Certified Emergency Nursing (CEN)
Respiratory Trauma Module Intro
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Shock States (Anaphylactic, Hypovolemic) For PCCN for Progressive Care Certified Nurse (PCCN)
Spinal Cord Injury Case Study (60 min)
Stroke Assessment (CVA)
Surgical Wound Classification Documentation for Certified Perioperative Nurse (CNOR)
Systemic Lupus Erythematosus (SLE)
The Medical Team
Thoracentesis
Trach Suctioning
Tuberculosis for Certified Emergency Nursing (CEN)
Vaccine-Preventable Diseases (Measles, Mumps, Pertussis, Chicken Pox, Diphtheria) for Certified Emergency Nursing (CEN)
Ventilator Settings
Wound Dressing Maintenance for Certified Perioperative Nurse (CNOR)