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Related Concept Videos

Nursing Diagnosis01:22

Nursing Diagnosis

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Following assessment, a nursing diagnosis is the next step in the nursing process. It begins after the nurse has collected and recorded the patient data. The purpose of diagnosing is to identify how the client responds to actual or potential health processes, identify factors that bestow or that cause health problems, the etiologies, and identify resources or strengths the individual, group, or community can draw on to prevent or resolve problems.
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Formulating and Validating Nursing Diagnosis I01:26

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A nursing diagnosis is written when the nurse recognizes a cluster of essential patient data indicating health problems treated with independent nursing interventions. The standardized terminologies of a nursing diagnosis help nurses identify and treat patients' problems. Every electronic health record that uses nursing diagnosis must employ standard diagnostic terminology. Developing an efficient, individualized care plan begins with accurate nursing diagnoses.
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Documentation of Nursing Diagnosis01:10

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The nurse documents nursing diagnoses and enters them into the patient record. The identified patient's nursing diagnosis is either written out with a plan of care or entered into the electronic health record.
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Vascular plants, which account for over 90% of the Earth’s vegetation, all undergo primary growth—which lengthens roots and shoots. Many land plants, notably woody plants, also undergo secondary growth—which thickens roots and shoots.
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Formulating and Validating Nursing Diagnosis II01:25

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Nursing diagnoses represent a problem validated by major defining characteristics. There are four categories of nursing diagnoses: problem-focused, risk, health promotion or wellness, and syndrome. The anatomy of a nursing diagnosis includes three components: problem statement or diagnostic label, defining characteristics, and related factors.
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Diabetes: Symptoms, Diagnosis, and Complications01:15

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For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
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Differentiated Mouse Adipocytes in Primary Culture: A Model of Insulin Resistance
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Differential diagnosis in primary aldosteronism

G Opocher1, S Rocco, G Carpenè

  • 1Institute of Semeiotica Medica, University of Padova, Italy.

The Journal of Steroid Biochemistry and Molecular Biology
|April 1, 1993
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Primary aldosteronism (PA) diagnosis involves identifying elevated aldosterone and suppressed renin in hypertensive patients. This review details PA subsets, distinguishing surgically remediable forms like aldosterone-producing adenomas from idiopathic hyperaldosteronism.

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Area of Science:

  • Endocrinology
  • Nephrology
  • Internal Medicine

Background:

  • Primary aldosteronism (PA) is a common cause of secondary hypertension, often underdiagnosed.
  • Accurate subtyping of PA is crucial for identifying patients who may benefit from surgical intervention.
  • Existing diagnostic criteria require refinement for precise differentiation of PA subtypes.

Purpose of the Study:

  • To review diagnostic methods and findings in a series of 113 primary aldosteronism patients.
  • To differentiate between subtypes of PA, particularly aldosterone-producing adenoma (APA) and idiopathic hyperaldosteronism (IHA).
  • To evaluate the effectiveness of various diagnostic tests in identifying surgically remediable PA.

Main Methods:

  • Analysis of clinical data, including blood pressure, potassium levels, and hormonal assays (aldosterone, renin, 18-hydroxy-corticosterone).
  • Assessment of hormonal responses to posture changes, angiotensin II infusion, and captopril challenge.
  • Correlation of functional tests with morphological imaging (CT scan, scintiscan) and adrenal vein catheterization.

Main Results:

  • Aldosterone-producing adenoma (APA) and idiopathic hyperaldosteronism (IHA) were the most common PA subtypes (51% and 44%).
  • APA patients showed more frequent hypokalemia, while IHA patients had lower supine aldosterone levels.
  • Hormonal responses to posture and angiotensin II differed between APA and IHA, with captopril showing variable efficacy. Higher 18-hydroxy-corticosterone and ANP levels were noted in adenoma patients.
  • Imaging techniques like CT and scintiscan had 85% accuracy, with adrenal vein catheterization clarifying most remaining cases.
  • Dexamethasone-suppressible hyperaldosteronism and aldosterone-producing carcinoma were identified as rare PA variants.

Conclusions:

  • Accurate subtyping of PA is achievable through a combination of clinical, hormonal, and imaging assessments.
  • Distinctive hormonal profiles and responses aid in differentiating APA from IHA.
  • Adrenal vein catheterization remains valuable for confirming lateralization in ambiguous cases, guiding surgical decisions for remediable PA.