Adult Care 3 Exam 3 Flashcards
Name the causes for prerenal AKI
Sepsis, shock, hypovolemia, renal vascular obstruction
Name the causes for intrarenal AKI
Trauma, hypoxic, medication (abx)
Name the causes for postrenal AKI
BPH, kidney stones, tumor
4 stages of AKI
- Onset (sudden loss b/c of pre/intra/postrenal problem)
- Oliguria, edema, HTN, electrolyte imbalance.
- Diuresis (increase urine)
- Recovery phase
Causes of Kidney injury or CKD
Leading causes are HTN and diabetes
Other causes: Lupus, rheumatoid arthritis, infections, medications, and smoking
Medication to decrease Potassium in acute kidney injury?
Sodium polystyrene, calcium gluconate, sorbitol
Treatment for AKI
Diuretics, dialysis, epoetin alfa, antihypertensive, seizure precaution,
Complication on CKD
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)
Hemodialysis post procedure complication
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)
Sign of MS
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
MS diagnostics
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
Medication for MS
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
C2 and C5
Paralysis of some/all muscle for breathing and extremities. Need ventilator
C5 to C6
Paralysis of extremities and trunk
weakness of shoulder and elbow muscle
C6-C8
Paralysis of extremities and trunk
T11-L1
Paralysis of and loss of sensation in the hips and legs
Onset and time of Spinal schok
48 hours onset and continue for several weeks
Neurogenic shock indications
Check every hour Oxygen <95% or aspiration, bradycardia, SBP<90 or MAP <65
Medication for Spinal injury
PPI to prevent ulcers
Tizanidine or baclofen
Long term complication of SCI
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
S/S of autonomic dysreflexia
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
Intervention for Autonomic dysreflexia
Sitting position
Call for help
Treat cause
Nifedipine or nitrates
Monitor BP
Composition of bile
Bile salt, bilirubin, cholesterol
Chronic Cholecystitis S/S
Jaundice, clay-colored stools, icterus (yellowing of eye), steatorrhea
Acute Cholecystitis s/s
RUQ pain (especially after fatty meal - may radiate to the right shoulder), flatulence, dyspepsia, eructation, N/V
Risk factors of cholicystitis
4 F’s and high cholesterol
Diagnostics labs
Increase bilirubin, WBC, AST, LDH, amylase, and lipase
