Adult Care 3 Exam 3

Question 1

Name the causes for prerenal AKI

Answer 1

Sepsis, shock, hypovolemia, renal vascular obstruction

Question 2

Name the causes for intrarenal AKI

Answer 2

Trauma, hypoxic, medication (abx)

Question 3

Name the causes for postrenal AKI

Answer 3

BPH, kidney stones, tumor

Question 4

4 stages of AKI

Answer 4

1. Onset (sudden loss b/c of pre/intra/postrenal problem)
2. Oliguria, edema, HTN, electrolyte imbalance.
3. Diuresis (increase urine)
4. Recovery phase

Question 5

Causes of Kidney injury or CKD

Answer 5

Leading causes are HTN and diabetes

Other causes: Lupus, rheumatoid arthritis, infections, medications, and smoking

Question 6

Medication to decrease Potassium in acute kidney injury?

Answer 6

Sodium polystyrene, calcium gluconate, sorbitol

Question 7

Treatment for AKI

Answer 7

Diuretics, dialysis, epoetin alfa, antihypertensive, seizure precaution,

Question 8

Complication on CKD

Answer 8

Pericarditis, HF, anemia, cognitive impairments, tremors (asterixis), uremic symptoms, renal osteodystrophy
Uremic symptoms: uremic halitosis (ammonia breath) and uremic frost (urea crystals on skin - itchy)

Question 9

Hemodialysis post procedure complication

Answer 9

Complications (hypotension, clotting of vascular access, headache, muscle cramps, bleeding)
Indications of bleeding or infection at the access site
Findings of disequilibrium syndrome (nausea and headache)
Findings of hypovolemia (hypotension, dizziness, tachycardia)

Question 10

Sign of MS

Answer 10

MS is hard to diagnose early on bc of it its mild and vague early symptoms of fatigue or muscle weakness/ataxia
Other s/s: nystagmus, cognitive changes (memory loss, impaired judgment), changes is visual acuity, pain, dysphagia, dysarthria, muscle spasticity, etc
Most common signs are dysphagia, dysarthria, muscle spasticity, and vertigo
Changes in cognition are usually seen late in the course

Question 11

MS diagnostics

Answer 11

MRI (Most definitive diagnostic)
Reveals plaques of the brain and spine, which is most diagnostic.
CSF
Elevated protein level and a slight increase in WBCs.
Evoked protein testing
Measure the electrical activity in the brain and spinal cord in response to stimuli

Question 12

Medication for MS

Answer 12

Natalizumab: binds WBC and prevents damage to myelin.
Given at clinic b/c of allergic reaction
Risk for progressive multifocal leukoencephalopathy (PML).
PML:Viral disease that causes inflammation and damage to the brain’s white matter
Monitor changes in LOC

Mitoxantrone (chemo drug): resolve relapses but with risks for leukemia and cardiotoxicity.

Glatiramer acetate: synthetic myelin-based
protein.

Interferon-beta

Medical marijuana

Question 13

C2 and C5

Answer 13

Paralysis of some/all muscle for breathing and extremities. Need ventilator

Question 14

C5 to C6

Answer 14

Paralysis of extremities and trunk
weakness of shoulder and elbow muscle

Question 15

C6-C8

Answer 15

Paralysis of extremities and trunk

Question 16

T11-L1

Answer 16

Paralysis of and loss of sensation in the hips and legs

Question 17

Onset and time of Spinal schok

Answer 17

48 hours onset and continue for several weeks

Question 18

Neurogenic shock indications

Answer 18

Check every hour Oxygen <95% or aspiration, bradycardia, SBP<90 or MAP <65

Question 19

Medication for Spinal injury

Answer 19

PPI to prevent ulcers
Tizanidine or baclofen

Question 20

Long term complication of SCI

Answer 20

Pressure injuries is the major one
They are also at risk for venous thromboembolism (VTE), contractures, orthostatic hypotension (especially in patients with high SCI), and fractures related to osteoporosis

Question 21

S/S of autonomic dysreflexia

Answer 21

Key features
Significant rise in systolic and diastolic blood pressure
Profuse sweating above lesion, goosebumps, flushing, blurred vision, spots in patient’s vision, nasal congestion, severe headache, feeling of apprehension

Question 22

Intervention for Autonomic dysreflexia

Answer 22

Sitting position
Call for help
Treat cause
Nifedipine or nitrates
Monitor BP

Question 23

Composition of bile

Answer 23

Bile salt, bilirubin, cholesterol

Question 24

Chronic Cholecystitis S/S

Answer 24

Jaundice, clay-colored stools, icterus (yellowing of eye), steatorrhea

Question 25

Acute Cholecystitis s/s

Answer 25

RUQ pain (especially after fatty meal - may radiate to the right shoulder), flatulence, dyspepsia, eructation, N/V

Question 26

Risk factors of cholicystitis

Answer 26

4 F’s and high cholesterol

Question 27

Diagnostics labs

Answer 27

Increase bilirubin, WBC, AST, LDH, amylase, and lipase