2-presentaion/videos Flashcards

Question 1

Q

what is endocrine system composed of

Answer

A

pituitary gland,

thyroid gland,

parathyroid glands,

adrenal glands,

pancreas, and

reproductive glands

Question 2

Q

pituitary gland
located
what does

Answer

A

located in skull-
”master”,

regulates many body functions woth hormones

Question 3

Q

anterior pituitary gland
+ hormones

Answer

A

several types of endocrine cells that secrete homrones

Growth Hormone,
prolactin hormone
, reproductive hormones
& Thyroid Stimulating Hormone

Question 4

Q

posterior pituitary gland

function
+
hormones function

Answer

A

nerve tissues//store and relase ADH and oxytocin

ADH & Oxytocin
ADH-decreases urine production
O-induces labor contractions in uterus

Question 5

Q

Thyroid gland

primary role

secretes

Answer

A

anterior of trachea and inferior to larnxyz

increase metabolism—made up of t3 and t4

secretes calcitonin-decreases excessive levels of calcium in blood

Question 6

Q

what is thyroid gland initated by and dependent on

Answer

A

Secretion of Thyroid hormone is initiated by the release of TSH by the pituitary gland

and is dependent on an adequate supply of iodine

Question 7

Q

Parathyroid Gland

secetes what

when released

what does

Answer

A

secretes parathyroid hormone

when calcium levels drop, parathyroid hormones secretions go up

phosphate’s metabolism

Question 8

Q

Adrenal Gland

sits where
produces what hormones

Answer

A

sits on top of kidneys

Produces hormones such as: epinephrine, norepinephrine & corticosteroids

Question 9

Q

where is cortisol produced and what does it do

Answer

A

adrenal gland

regulates stress response- controls fats, protiens and carbs/metabolism

Question 10

Q

Pancreas-what does

what its cells do

Answer

A

produced hormones and digestive enzymes

the cells it creates regulates carbohydrate metabolism

Alpha cells- glucagon produces

Beta cells-produces insulin

Question 11

Q

Reproductive
Testes & Ovaries

Answer

A

Cells within help source of steroid sex hormone,

Help promote growth cells and onset of puberty

Question 12

Q

Thyroid Tests-assessing function

RAI
Scan
Blood tests

Answer

A

Radioactive Iodine Uptake (RIA)-direct measure of thyroid activity- iodine uptake is measured

Thyroid Scan –looks for thyoif noduels

Thyroid-Stimulating Hormone (TSH)-blood tests- high or low levels
TSH > 3
t4 1.—2.3
T3 80-200

Question 13

Q

Assessing the Endocrine Function

Parathyroid tests

Answer

A

Calcium –blood test to look at calcium-
9-11 normal

hypocalcemia

Question 14

Q

Assessing the Endocrine Function

Pancreatic/endocrine tests
FBS
OGTT
HGBA1c

Answer

A

Fasting Blood Sugar (FBS)-measures trestment of diabetes//conforms diabetes

Oral Glucose Tolerance Testing (OGTT)-used if proior fasting blood glucose test were high//
dextroee solution is given and check back at 30-60-120 mins

Glycosylated hemoglobin (Hgb A1c)-results average blood glucse level from 120 days.
Nornal is 2-5/5.7-6.4=pre diabetec/ 6.5 or higher are diabetes

Question 15

Q

hypocalcemia
s/s

Answer

A

Muscle cramps

Numbness / tingling of the extremities (Trousseau Sign)

Twitching of facial muscles (Chvostek Sign) and eyelids when facial nerve is touched

Question 16

Q

hypercalcemia
s/s

Answer

A

ausea/Vomiting

Constipation

Bone Pain

Excessive Urination

Thirst

Confusion

Lethargy

Slurred Speech

Cardiac Arrest (SEVERE ONLY!!!!)

Question 17

Q

Assessing the Endocrine System

Health Assessment Interview
Sub/obj
Physical assessment

Answer

A

Subjective & Objective Data –medical/social/family gistoy/diet/eating habits,urinsting

Physical Assessment
Skin Changes: inspecting color, should be even and apporpate for age and race

Nail & Hair Assessment: should be normal and distrubted evenly

Facial Assessment:
Acromegaly-abnormal bone growth from hypersectretion
Exophthalmos –protruding eyes seen with hyperthyroidism

Thyroid Gland Assessment: size and consistency
Goiter

Motor/sensory: DTR and nurepathy and altered sensations//increase DTR is hyperthyrisond?decreased is hypothyroidism

Musculoskeletal: size and propertions of patients body structure

Question 18

Q

Trousseau’s & Chvostek’s sign

Answer

A

T- , tetany muscle spasm, inflating BP cuff above AC levels, cause contraction in hands/fingers and produces muscle spasms /

/C-, tapping fingers on jawline, repeated facial muscle contractions that causes twitching

Tests for hypocalcemia

Question 19

Q

Hyperthyroidism
AKA
what does

Answer

A

AKA Thyrotoxicosis

Excessive delivery of thyroid hormone to tissues –increased circulating thyroid hormone

Question 20

Q

what does excessive TH do to the body

alterations in

common etiologies of hyperthyroidism

Answer

A

Excess TH = increased metabolic rate-

alterations in cardiac output, peripheral blood flow, oxygen consumption, and body temperature

The common etiologies are Graves disease and toxic multinodular

Question 21

Q

manifestations of hyperthyroidism

Answer

A

Hyperactive bowels/ diahhrea

Hyper metabolism/increased appetite/weight loss

Heat intolerance

Hand tremors

Insomnia; emotional liability

Smooth/warm skin, might lose hair

exopthalamus

Question 22

Q

Causes of Hyperthyroidism:

Graves’ Disease

Answer

A

Most common cause of hyperthyroidism

Autoimmune disorder-more common in women

Question 23

Q

Graves disease

Patho

Answer

A

Antibodies that bind to TSH receptors causes thyroid cells to hyperfunction, leads to over secretion and enlargement of gland

Question 24

Q

Graves disease

manifestations

Answer

A

enlarged thyroid (goiter),

poptosis/exophthalmos-forward protrusion of eyeballs-sclera may also be visible above iris/bilateral-blurred vision, diplopia,eye pain, lacrimation and photophobia

Fatigue/difficulty sleeping,/weight loss,/heat intolerance /changes in menstruation

Question 25

Q

Toxic Multinodular Goiter–Causes of hyperthyroidism

thyroid tumor
manifest
etiology

Answer

A

Thyroid tumor–small nodules that secrete excessive amounts of th

Manifest-similar to hyperthyroidism

etiology-lack of iodine, increased iodine filtration, presence of immunilgobulans

Question 26

Q

thyroidotis -what is
manifestation

acute/chronic
causes of hyperthyroidism

Answer

A

viral infection of thyroid glands

causing inflammaation and increased TH effects

normally acute-when chronic can cause hashimotos

Question 27

Q

Thyroid Crisis
AKA
Extreme
Occurs d/t
Threatening

Answer

A

AKA thyroid storm

Extreme state of hyperthyroidism occurs less now dt treatments

Occurs due to untreated hyperthyroidism, or extreme stressor (infection, trauma, untreated DKA, manipulation of thyroid gland”

Life Threatening if not treated- rpaid icnrase in metabolic rate–MEDICAL EMERGENCY

Question 28

Q

manifestations of thyroid crisis

Answer

A

Hyperthermia(102-106),

tachycardia//HTN,

dyspnea,

GI distress,

seizures,

anxiety,

agitation

Question 29

Q

treatment of thyroid crisis

treatment

intrevnetions

stablaizes

Answer

A

cooling w/out aspirin , replacing fluids-checking glucose,electrolyes,

stabilizes cardiac function and repository function and reducing thyroid hormone secretions

maintaing vital organs

Question 30

Q

how to diagnose thyroid crisis

Answer

A

TH (T3 t4) levels

increased RAI intake

Question 31

Q

Hyperthyroidism: Diagnosis

Answer

A

Presentation of manifestations

Diagnostic Tests:
Elevated TH (t3 & t4)

Decreased TSH-low bc pit gland will try to overcompensate for high thyroid hormone-stop producing tsh in attempt to stop t3 t4

Increased radioactive iodine (RAI) uptake

Thyroid Scan- nodules, tumors

Question 32

Q

medications for hyperthyroidism

theraptuc results

Answer

A

Anti-thyroid medication –reduce thyroid hormone production

Cardiac manifestations –beta blocker ‘olol’

RAI-only if severe issues with swallowing/cany undue

TR -Takes several weeks because it demonstrate efect already made hormones

Question 33

Q

Hyperthyroidims treatments

RAI– how works
how long
contraindicated
devlops/requuires

Answer

A

Tyroid gland takes in iodine in any form, radioactive iodine damdages thyroid cells and less thyroid hormone is produces

Oral administration; 6-8 weeks result time

Contraindicated in pregnancy –crosses placenta

develop hypothyroidism-require liofelong thyroid replacement-becuase tissues cannot be replaced

Question 34

Q

thyroidectomy

indication of use
subtotal
total

hyperthyroidism

Answer

A

Indication - so englarged, pressure on esophagus or trachea casuing swallowing issues

Subtotal thyroidectomy: leaves enough of gland to still produces TH

Total: removal of thyroid; lifelong hormone replacement

Question 35

Q

Prior to surgery-thyroidectomy

Answer

A

pt should be in Euthyroid state- normal thyroid function

using antithyroid drugs or iodine preperations.

Reduces vascularity and size of gland and reducsing risk of hemorrahge

Question 36

Q

antithyroid meds

Answer

A

carbimazole,

methimazole,

propylthiouracil

Question 37

Q

pre operative care of hyperthyroidism

state
reduces
admisnter
support
eexpect
answer

Answer

A

euthyroid state,

reduces risk of complications-

administer antithyroid meds/

support neck by placing both hands on neck

/expect hoarsness/

answer questions

Question 38

Q

post operative care
hyperthyroidism

resp assess

hemorrhage

tetany

lanrygel

Answer

A

Resp- Assess rr, rhythm, depth,, maintain humidification, assist w/cDB, suction equipment viable/

/Hemorrhage- assess drainage from dressing, assess bp and pulse for shock/

/Laryngeal- assess for ability to speak aloud/

/assess for tetany d/t calcium deficiency-twingling toes, fingers and lips, mascular twitches, potives c and t signs iv calcium for immediate

Question 39

Q

Nursing care- Hyperthyroidims

Reduce risk of Hf

Monitor Visual changes

limit weight loss

monitor anxiety

teaching

Answer

A

Reduce risk of HF- Monitor Bp,p,rr breath/keep distraction free environment/rest periods

Monitor vision changes-monitor visual acuity, intergity and closure, protect eye using glasses, artificial tears, moist compressors, reporting pain

Limit weight loss-daily weights, diet high is carbs and protein, in between meal snacks, small more frequent meals, montir labs

Monitor anaxiety-ask questions-body

Teaching-lifelong treatment, wound care, manifestaions of hypothyroisim, refereal to agencies

Question 40

Q

transitions of care hyperthyroidism

mistaken

severe–inc

reabostption

dementia

provider

Answer

A

soemtiems mistaken for cardiac problems

severe wight loss inc risk for falls

bone reabostion inc leading to inc broken bones

palpations.tremors/anxiety are misateken for dementia

recignize/report palpations,tremor, heat intolernce, sweating, nervous, anxiety to provider

Question 41

Q

hypothyroidism

common in

decrease in

Answer

A

Insufficient amount of TH

-common In women 30—60

Decrease metabolic rate & heat production-affects all body systems

Question 42

Q

chronic untreated state of hypothyroidism

Answer

A

myxedema

edema throughout body-result of water retention-puffy face and enlarged tongue and horse voice

Question 43

Q

primary/secondary hypothyroidism

Answer

A

Primary:- common, congenital defects, loss of tissue dt surgery or meds

Secondary: slow onset, tsh deficiency, resistance to hormones

Question 44

Q

hypothyroidism

how does a goiter work
increased risk

Answer

A

TH production decreases so thyroid gland enlarges to attempt to produce more hormone- makes a Goiter

Patients are at increased risk for atherosclerosis and cardiac disorders, hyponatremia

Question 45

Q

Hypothyroidism: Manifestations

Answer

A

Goiter

Fluid retention; edema

Decreased appetite/weight gain

Fatigue, lethargy, listlessness

Constipation

Pallor//Dry skin

Hoarseness of voice

Abnormal lipids-high cholesterol levels

intolerance to cold

dec tast/smell

slow pulse

menstrusl, anemia, cardiac enlargment

slow onset of years or months

Question 46

Q

what to do with hypothyroidism when pateint cannot close eyes

Answer

A

eye drops or eye pathces

Question 47

Q

Iodine Deficiency
why is iodine necessary
meds that cause

Causes of Hypothyroidism

Answer

A

Iodine is necessary for TH synthesis

meds can cause iodine deficiency (goitrogenic// lithium carbonate //bipolar drugs//antithyroid drugs

Question 48

Q

Hashimotos Thyroiditis
what is
what happens
decreases
progresses

Causes of Hypothyroidism

Answer

A

Most common cause of goiter & Hypothyroidism-common in women

Autoimmune antibodies destroy thyroid tissue, replaced with fibrous,

TH levels decreases

Originally causes goiter to enlarge, but as progresses will shrink

Question 49

Q

Myxedema Coma
what is it
severe disorders
what can happen

Causes of Hypothyroidism

Answer

A

Life threatening Complication of long standing, untreated hypothyroid

Severe metabolic disorders: hyponatramia, hypoglycemia, acidosis

cardic collapse, impaired cognition and coma

Question 50

Q

Diagnosis of hypothyroidism

Answer

A

Clinical manifestations

Decrease in TH(esp 4)

TSH is increased

Elevated LDL, triglycerides

Question 51

Q

Medications
hypothyroidism-whats purpose
examples

Answer

A

Replace TH

Levothyroxine (Synthroid, levothroid, levoxyl

may need surgery to reduce goiter size

Question 52

Q

What do you need to know for med admisteration
hypothyroidism

meals
watch
heighten
treatment
alter
monitor

Answer

A

1 hr before meals or 2 hrs after 

watch for toxicity –severe anxiety,

heighten affects of anticoagulants monitor for bleeding and bruising/

/ lifelong treatments/

/can alter amount of insulin required in diabetics

/monitor bp+pulse-report over 100

Question 53

Q

surgery
hypothyroidism

Answer

A

Goiter

Resp issues, dysphagia

Question 54

Q

Hypothyroidism: Nursing Care

reduce risk of HF

reduce risk of constipatoin

maintain skin intebgry

Answer

A

Reduce risk of heart failure-monitor bp/hr/apical pulse, suggest avoiding chilling-increasing room temp and using covers, alternate activity with rest

Reduce risk of constipation-fluids of 2000 ml day, high fiber diet, walking as tolerated

Maintain good skin intergrity-monitor surfaces for redness or lesions, turning schedule, limit time in one position, ROM, take warm not hot baths, alc free oils

Question 55

Q

hypothyroidism

/education-diet

lifetime continuity of care

Answer

A

education-Dietary intake adequate iodine intake, low fat,

medications and provider checks lifelong–
follow up with provider,
some dosage readjustments over time

Question 56

Q

hyperparathyroidism
typically present in

results from

typically have issues with

increased risk of

Answer

A

older adults and 3x more in women

Results from an increased secretion of : parathyroid hormone-PTH-regulates calcium

Issues with hypercalcemia and bone problems

increased risk of kidney stones

Question 57

Q

Diagnosis: hyperparathyroidism

Answer

A

6 month history of:

parathyroid levels,

serum calcium levels

Question 58

Q

manifestations of hyperparathyroidism

many are

__calcemia
what happens to Bone
whats elevated
met/ren/pol

Answer

A

many are asymptomatic

hypercalemia

bone reaboprtion leadinf to pathologic fractures

elevated calcium altering musclar and nueral acrivity

metabolic acidosis, renal caluli, poluria

Question 59

Q

Hyperparathyroidism
Meds+goal
drink/keep
what to avoid/

Answer

A

alendronate and Calcitonin—Decreasing serum calcium

drink fluid and keep active

/ avoid immobilization, thiazide diuretics, large doses of vitamins A,D, calcium antacids and supplement

Question 60

Q

Hypo parathyroidism

what is it-how would it present
what tests can you run

Answer

A

Low levels of PTH- low calcium levels- hypocalciam

Numbness, tingling around mouth & fingers, foot hand and larygenal spasms, tetany(continuous spasm) /

What Tests? Trassaus and chovseks//brittle nails, hair loss, dry scaly skin

Question 61

Q

How are you diagnose

how treated with

what does it do
hypoparathyroidism

Answer

A

Diagnosed Low serum calcium

T-Increasing Ca+ levels by: calcium gluconate iv/ inc calcium/ inc vit D

reduce tetnay

Question 62

Q

Diabetes Mellitus

what is it
what does it result from
differnce between type 1 and 2

Answer

A

Metabolic disease characterized by hyperglycemia

Results from : Defects in secretion of insulin and/or action of insulin

Type 1
Insulin deficient- Beta Cells destroyed-doesn’t make insulin

Type 2
Insulin resistance, body rejects insulin

Question 63

Q

hyperglycemia sstuff

Answer

A

DKA-fruity breath

BG>200

Long term complication of parethesia

polydypsia

polyuria

Question 64

Q

hypogylcemia stuff

Answer

A

BG> 50

slurred speech

decerased LOC

irratable

headache

shakiness

Answer 65

A

Aplha cells produce glucagon,breakdwpons lipids inro glucose, increasing glucose levels

Beta cells produce insulin, moves glucose into cells, decreasing glucose levels//delta cells do both

Answer 66

A

Keeping the blood glucose levels controlled at or near normal levels

People with DM are 2-4 more times likely to die from heart disease

Answer 67

A

Genetic predisposition –most often occurs before 30

Environmental factors –viral or chemical toxin

Appears when 90% of beta cells are destroyed

Require an external source of insulin Without – ketosis

Answer 68

A

Polyuria inceasd urine output-loss of electrolyes”glucosuria”-glucose in urine

Polydipsia increases thirst

Polyphagia glucose enters cells w/out insulin—increased hunger

Weight loss, fatigue, malaise,

Result from the lack of insulin-destruction o beta cells

Answer 69

A

Hyperglycemia despite insulin: insulin is available but impaired function

Risk Factors
Heredity in siblings
Obesity-BMI of at least 27 and lack of exercise, poor diet

Answer 70

A

impaired glucose tolerance

occurs 10-20 yeaers before effect of insulin

characetrized by-central obesity, hypertenstion, high trugylceride level, high fasting blood glucose, hyperinsulemina

Answer 71

A

gradual osnet , hyperglycemia,

polyura, polydyspia,

blurred vision
, fatigue,
skin infections

Answer 72

A

Best glycemic control

diet/ excercise

oral medcitons- maybe insulin

Answer 73

A

Hemoglobin A1c-average blood glucose over 120 days
Normal 2-5%
5.7-6.4% pre-diabetes- high risk
6.5% or higher-diagnostic for diabetes

Fasting Plasma Glucose greater then 126

Oral Glucose Tolerance Test given 75 gramd of glucose, glucose should be abpve 200

Urine test looking for glucose, keotnes and albumin

Answer 74

A

SM- goal to achieve metabolic control & decrease complications by testing levels

Medications
Insulin: In class chart activity pg. 612

Anti-Diabetic Medication: Glipizide, glimepiride (), metformin

Medication goal – see imrovment of glucose, decrease in a1c-if not imrovinf suggest insulin changes

Answer 75

A

insulin-pharm

nutrion

healthy eating

Answer 76

A

admisnter food,
administer glucagon

simple carbs/protine
check back in 15 minutes

Answer 77

A

signs and symptoms of low blood glucose /

/Biguinide or metformin are not given in hospital or held 48 hrs before ct dt due to risk of kidney damage

asprin Therapy – cardiovaular disease is most common cause of mornbiltiy and moritlity-given once a day as promar prevention for pts woth heart disease

Answer 78

A

Nutrition
Carbs, protein, Fats, Fiber, Sodium, Sweeteners, alcohol –balance.no excess

Exercise –decrease amount of insulin when excercising

Answer 79

A

requires use of insulin even without eating,

sickness causes stress to body, glucose may raise even without insulin

insulin still needs to be taken even with no eating

mintor ever 4 hrs or more frequently dur to risks for shifting glucoses

Answer 80

A

Hyperglycemia above normal blood glucose levels- caused by-steroids,sickenss-

Hypoglycemia –lower glucose levels,pts with rapid pulse, irabiltoy,dif thinking, hedacheache// get glucose quick so iv or im

Diabetic Ketoacidosis –hypergylcemia-breaks down fats for energy, pts have kussmaluls and ftuiry brath,dehydration, dry mucous, weakness, n/v//replace fluids, balace electrolytes

Macrovascular Complications –peripheral vascular insufficenty/ ulcerations./gangrene of legs

Microvascular Complications –parethesia, capillary leak, decreased transport of oxygen to cells

Increased susceptibility to infection

Delayed/non- healing wounds

Answer 81

A

Hyperglycemic state-type 2

urination
thirst
nausua
dry skin
disoratation/drowsiness

Answer 82

A

Renal system: Kidneys, ureters, bladder, and urethra

Answer 83

A

contains nephrons which process the blood to make urine

Filtration system

Located outside peripternieal cavity

Highly vasucular

Three regions- each regions has 1 mill nephorons-process blood to make urine

Answer 84

A

Urine is formed through 3 processes-filteration,reabsirbtion,secteion

Urine is 95% water, 5%solutes—(urea)

Answer 85

A

Transport urine from kidney to bladder to excrete from body

Urinary bladder serves as sortage site for urine/males is infront rectum, females is in uterus

Openings are inside bladder, healthy adult can hold 300-500 before urge to void

Urethra is musulcar tube that channels out to body

Answer 86

A

Diagnostic Tests  used to support diagnosis,detemrain treatmetns and nsuring iunterventions

Genetic Considerations  family history, kidney function, diabetes, genetic testing,

Health History Interview  chief complains, asses elim status, pattern freuwncy changes in urine, color, odor, bleeding, assessing pain during urination, lifesytkle diets, exposure to pathogens, medicaitons, history of:bladder cancer, polsytic kindey disease, diabetes,polysistic kindey disease

Physical Assessment  percussion, external structures and overall skin assesmwnt //pain, what kind, kindey pain and renal pain, bladder pain, pain from distended bladder

Answer 87

A

Nocturia-night urination

Decreased Bladder Capacity

Urinary Retention–Behavior changes –Suspect uti

Weakened Sphincter muscles & shortened urethra in women

Incontinence

Answer 88

A

Inflammation of urinary bladder, caused by uti

patho- mucosa of bladder becomes red, hemorage and bleed, inflammatory response causes pus to form

Usually uncomplicated and responds to treatment well

however, when untreated may be spread to kidney and cause ulcer formatuion

Urethritis: Inflammation of urethra

Answer 89

A

Dysuria: -painful uraination

Urgency: sudden need to void

Nocturia: void 2 or more times a ngiht

Pyuria: foul order cloudy utine

Hematuria: bloody urine

Super pubic pain, tenderness

Answer 90

A

Lab Testing for UTI,

Urinalysis - assement of pyurai ,bacetria and blood cells

Urine Culture & sensitivity –identifies infecting orgnims and most imacful antibotc

WBC –loukocytosis, associated with infection

IVP structural issues

Cystoscopy: Endoscopy of the bladder via the urethra
Visualizes bladder and for bladder neck obstructions

Post procedure assessment Complications or abnormals Assess and notify MD

Answer 91

A

older adults-nocturia, incontience, confusion, behavioral change, lethargy and anoerixa, hypothermia

older men enlarged protate can impede urine flow, leading to incomlete bladder emptying

Answer 92

A

Antibiotics:
Ciprofloxacin, levofloxacin, sulfamethoxazole-trimethoprim –finish entore course

Urinary Analgesic
Phenazopyridine used for relief of pain, burning–

Answer 93

A

BPH and cystitis

if you give this then dont need to take narcotics dt dizziness

Answer 94

A

can turn urine orange, red,and can stay in underwear

Follow up urine cultire, 10 days to 2 weeks after antibiotics

Complementary Therapies
Cranberry products, blueberry juice, herbal supplements (Saw palmetto)

Answer 95

A

Teach measures to reduce UTI

Emptying bladder

Be alert to manifestations of UTI

Answer 96

A

Stones in the urinary tract

Lithiasis- means stone formation

Stone in kidney- nephrolithiasis

Stone anywhere else in urinary tract- urolithiasis

Answer 97

A

family history,
genetic predisporiton
, dehydration and immobility

ingesting meal high in salt, decreasing urine volume, concentration develops salt. when fluid intake is adequate no stone growth occurs

Answer 98

A

High temp

pain

N/v

Answer 99

A

Manifestations:
Symptoms vary with size and location
Renal colic-severe pain on side of stone
UTI– chills, frequency, urgency –N/V,

Complications
Obstruction of urine flow; impairs renal function –treat so no failure

Answer 100

A

kindeys producing mroe urine, causinf increased pressure and distention

if not treated this pressure can cause kidney failure

urinary stasis can cause inc uti

Answer 101

A

Medications(nsaids, tamsulosin),

positioning,

relaxation techniques and

hydration

Strain urine: Passing of stone is possible-look for blood in urine(hemotorria)

Answer 102

A

sodium-restricted protien

calcium

caffiene

aniaml fats

increase fluid intake to 2.5-3 l

Answer 103

A

-use of sound waves to crush stones- preferred treatment.

Noninvasive, don’t cause damage,

takes 30 mins to 2 hrs/

/Pre-withhold fluids and foods/

post-monitor vitals, monitor urine,maintain placement of catheter, administer fluids

pregnacy is contraindacted

Answer 104

A

-thin plastic tubes, placed between kindey and bladder. Allows urine to flow through stones, can break a stone/

Answer 105

A

can cause pain and blatter frequenct, pain in kindey when passing urine//normal to have discomfort and blood,

stent can be removed with local anathetic

Answer 106

A

Pre Care: – vitals and assessment, knowledge, signed consent, NPO to reduce risk of aspiration

Post Care:- vitals, assesmnts, montoring urine, some bleeding is normal, encourage and increase to drink fluids, use pain meds

Answer 107

A

Remove excess fkuid and metabolic waste prodcuts when a pt acute kifney injury ot renal failiure

Answer 108

A

gradual decrease in kindey fnuntion, leads to metabolic waste being collevte fin blood, Bun and creatine are diagnosed for disorders,

hypertension, diabetes, infection, overdose, nephrotoxic drugs

Answer 109

A

blood passes through filter outisde of body, and filters and puts blood back in body

Vascular access is needed -

Temporary (mahurkar) or permanent (AV fistula)

–AV Fistula development: Surgical procedure- connecting an artery and vein-long term vascular access

Palpable pulsation and bruit on auscultation

Avoid vein punctures, BPs or lab draws on this side ( Limb Alert!)

Answer 110

A

Pre vitals
Weight
Vascular access

Answer 111

A

Vitals, weight

Monitor labs BUN, Creat, electrolytes and CBC ( NA, K+, Ca)

Assess site for bleeding

Asses for headache, n/v,dehydration,muscle cramps,bleeding and provide support

Answer 112

A

3-4 hrs a day 3-4 times a week

complications
hypotension
bleeding
infections

CRRT
if cardiac status is unstable, contious renal replacement may be needed. more gradual removal=helps remain stable

Answer 113

A

Peritoneal membrane serves as a dialyzing membrane-warmed sterile dialystate is instilled

Fluid shift of solutes are more gradual is comparison

Less risk for unstable patients

If the stuff is coming back cloudy it could mean infecetion

Dextrsoe as osmotic agent to draw water into dialsytle

drained with gravity

Answer 114

A

Vitals, weight

Abdominal girth -measure

Empty bladder prior /note bun, serum electrolye, creatinine, ph and hemaatocirt

Dialysate is warmed to prevent hypothermia

Answer 115

A

Access vitals, temp, weight

Educate patient on self administration –can do at home-risk for infection, looking for cloudy retirn of dialotae soluton

Time meals tp correspond with dialysis outflow

Answer 116

A

restore fluid/electrolyte balance-,manitain hourly I and o, weigh daily, assess vitals every 4 hrs, place in semi fowlers, restrict fluids If ordered, turn frequently

Maintain adequate nutrition- monitor food record intale, weogh daily,arrangrfor dietary conislation

Answer 117

A

Age related, enlargement of prostate gland-common in aging male-40 ish starts

Risk factors- beong over 40,testiserone,diet high in meat/fats

Complications-diverticula on bladder wall, may obstruct ureters and ascend from bladder to kidneys

Answer 118

A

Partial or complete obstruction of urine flow

Decreased bladder compliance and contractibility

Urine retention –may become chronic

Catheter is hard to put in because of enlargement

Answer 119

A

Physical examination and PSA levels (Prostate-specific antigen)

Increasing levels of PSA- need further investigation and review of symptoms

Urine is examined for WBC,RBC and bacteria

Answer 120

A

Med-goal: decrease prostate size
Finasteride (Proscar)
Dutasteride (Avodart)

Med- goal: relieve obstruction and help increase urine flow
Terazosin (hytrin)
Tamsulosin (Flomax)

Answer 121

A

Transurethral Surgery (TURP) Resection of Prostate –

Obstructing tissue removed using wire loop instead through urethra

-risks of postoperative hemorrhage or clot retention, inability to void and uti

Open Procedures: For more invasive concerns

Answer 122

A

Eduacte in urinary cather

Drains near incision site-if open

Wear teds and scd-up and walking

Bed rest until morning

Ensure signed form

Bowel prep

Education on questions

NPO

Answer 123

A

Assesmtnes/vitals

check bleeding/ dressing

Diet modications-inc fiber

Adequete I and o

Irreate cath

Mange pain

Supostory for spams-
investagte what pain

Anagesic

Fluid intake

Contious bladder irragtion

Answer 124

A

Foely cahter

Intruct on some dribbling, some pain, some buering, some blood–normal until infamatory pricess decresed

Diet with fiber

Laxatives-no straining

No sexual acitivy for 6 week

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