Adult Care

Question 1

How much kidney damage must be done to see creatinine levels rise?

Answer 1

50% of damage

Question 2

What do the s&s of AKI occur?

Answer 2

Due to retention of nitrogenous wastes, fluids and inability to regulate electrolytes.

Question 3

What are the S&S of AKI?

Answer 3

Decreased urine output, increased fluid volume (HTN, edema and CHF), changes in LOC, uremia (N&V, pruritus, anorexia).

Question 4

What is the priority care for AKI?

Answer 4

1. Monitor electrolytes
2. Monitor BP
3. Monitor I+O plus daily weights
4. Renal diet (low protein and high carb)
5. Dialysis if needed.

Question 5

What is priority care during dialysis?

Answer 5

Monitor for hypovolemic shock, monitor for bleeding, hold anti HTN and meds during dialysis, monitor for arterial seal syndrome, palpate thrill or auscultate for bruit to ensure fistula is patent.

Question 6

What is normal GFR?

Answer 6

> 90%

Question 7

What indicates end stage kidney disease?

Answer 7

<15%

Question 8

How is HIV spread?

Answer 8

Blood, breast milk, semen and vaginal secretions.

Question 9

What precautions are needed for HIV client?

Answer 9

Contact only

Question 10

What is scleroderma?

Answer 10

Inflammation, fibrosis and sclerosis of connective tissue = no cure.

Question 11

Main complications of scleroderma?

Answer 11

Renal crisis = causes HTN due to narrowing of blood vessels to kidneys.

Question 12

S&S of scleroderma?

Answer 12

Pain, stiff muscles, pitting edema, tight/shiny/thick skin, dysphagia, contractors.

Question 13

How does Lyme disease present?

Answer 13

Ring shaped rash at any part of the body.

Question 14

S&S of lupus?

Answer 14

Butterfly shaped rash, dry rash on upper body, fever, weakness, weight loss, photosensitivity, joint pain, red palms, anemia.

Question 15

Priority care for client with lupus?

Answer 15

Mild soap on skin, frequent oral care, high vitamin/iron diet, conserve energy, avoid sun, topical corticosteroids.

Question 16

Who is at high risk for HIV/AIDS?

Answer 16

Hetero or homosexuals involved with high risk person, IV drug user, receiving blood products, healthcare workers, babies born to infected mom.

Question 17

What does IgA protect against?

Answer 17

Viral protection

Question 18

What does IgE protect against?

Answer 18

Allergy & parasites.

Question 19

What does IgG protect against?

Answer 19

Secondary antibody protection

Question 20

What does IgM protect against?

Answer 20

Primary antibody protection.

Question 21

What occurs in sickle cell crisis?

Answer 21

RBC cannot carry oxygen.

Question 22

What worsens sickle cell crisis?

Answer 22

Inadequate O2 or hydration worsens this by making the RBC’s clump together = vaso-occlusion.

Question 23

What is priority care for sickle cell crisis?

Answer 23

IV fluids and oxygen

Question 24

What are warning signs of cancer?

Answer 24

Sore that doesn’t heal, indigestion, hoarseness, obvious change in wart or mole, lump in breast, unusual bleeding.

Question 25

What are considerations for post-mastectomy?

Answer 25

DO NOT use limb, elevate to avoid lymphedema, avoid sun, avoid any type of constriction to that arm.

Question 26

What are considerations for after radiation therapy?

Answer 26

Wash irritated area with water and soap daily, do not remove markings for radiation beam, do not use powders/lotions or creams, avoid any friction or tensions at the area, avoid exposure to sun.

Question 27

When is it best for testicular self exam? How do you do it

Answer 27

Right after shower, gently lift each testicle and role between fingers to assess for abnormalities. Repeat in q1 month.

Question 28

What is the purpose of continuous bladder irrigation?

Answer 28

To remove clotted blood from bladder.

Question 29

What S&S do we report with use of continuous bladder irrigation?

Answer 29

Pain and spasm (indicates obstruction) or decreased output versus input (indicates clot or kink).