Endocrine and Metabolic Crises Flashcards

A nurse correcting hyponatremia is careful to raise serum sodium slowly to avoid which serious complication?

Answer: Osmotic demyelination syndrome (central pontine myelinolysis)

Overly rapid correction of chronic hyponatremia causes osmotic demyelination, leading to irreversible neurologic injury.

Central diabetes insipidus is most appropriately treated with which medication?

Answer: Desmopressin (DDAVP)

Central DI results from ADH deficiency, so synthetic ADH (desmopressin) replaces the missing hormone.

A postoperative neurosurgical patient develops urine output of 800 mL/hr with rising serum sodium. What condition should the nurse suspect?

Answer: Diabetes insipidus

High-volume dilute urine with hypernatremia after pituitary/brain surgery strongly suggests central diabetes insipidus.

Which finding indicates effective treatment of DKA?

Answer: Closure of the anion gap and resolution of ketosis

Resolution of DKA is defined by closure of the anion gap and clearing of ketones, not glucose alone.

A patient in adrenal crisis is most likely to display which electrolyte pattern?

Answer: Hyponatremia and hyperkalemia

Aldosterone deficiency in adrenal crisis causes sodium loss and potassium retention, producing hyponatremia and hyperkalemia.

Which precipitating factor most commonly triggers adrenal crisis in a patient on chronic corticosteroids?

Answer: Abrupt withdrawal of steroids or acute stress without dose increase

Suddenly stopping steroids or failing to increase the dose during stress leaves the suppressed adrenal axis unable to meet cortisol demand.

A beta-blocker such as propranolol is used in thyroid storm primarily to address which problem?

Answer: Tachycardia and adrenergic symptoms

Propranolol controls the severe tachycardia and other adrenergic effects of thyroid storm and also reduces T4-to-T3 conversion.