Exam 2- AKI and HIV/AIDS

Question 1

What are the causes of prerenal AKI?

Answer 1

** hypoperfusion**
volume depletion (burns, hemorrhage, GI loss), hypotension (shock, sepsis), and renal artery stenosis

Question 2

What are the causes of intrarenal AKI?

Answer 2

parenchymal damage to the glomeruli or kidney tubules; acute tubular necrosis

Question 3

What are the causes of postrenal AKI?

Answer 3

obstruction distal to the kidney by conditions (renal calculi, strictures, blood clots, BPH, malignancies, and pregnancy)

Question 4

Diagnostics for AKI?

Answer 4

• 50% or more increase in serum creatinine above baseline (normal creatine is 800 mL/day
• anuria 800 mL/day
• oliguria

Question 5

What is the most immediate life-threatening imbalance seen in AKI?

Answer 5

hyperkalemia

Question 6

Nursing care for AKI patients?

Answer 6

• monitor serum level
• daily weight
• Intake and Output
• reduce metabolic rate– bed rest
• turn, cough, take deep breaths
• AVOID catheter due to high UTI risk
• bath in cool water if patient is itchy
• AVOID excess fluids
• treat underlying problem (burn, UTI, obstruction)

Question 7

Adverse effects for HIV/AIDS meds?

Answer 7

• hepatotoxicity, nephrotoxicity and osteopenia, along with increased risk of cardiovascular disease and myocardial infarction
• cause fat redistribution syndrome and metabolic alterations such as dyslipidemia and insulin resistance which put the patient at risk for early-onset heart disease and diabetes

Question 8

What education do we teach HIV/AIDS patients?

Answer 8

understand transmission, course of disease, symptoms of opportunistic infections, treatments, and medications

Question 9

What are some opportunistic infections related to HIV/AIDS?

Answer 9

Pneumocystis carinii pneumonia, CMV, TB, toxoplasmic encephalitis, cryptococcal meningitis, disseminated histoplasmosis, coccidioidomycosis, progressive neuro diseases (HIV associated dementia, CNS lymphoma, and progressive polyradiculopathy)

Question 10

What is HIV/AIDS?

Answer 10

retrovirus
reverse transcriptase
AIDS is the final stage of HIV
AIDS is a chronic condition

Question 11

Clinical features of 3rd degree heart block?

Answer 11

slow pulse, confusion, syncope, signs and symptoms of decreased cardiac output (decreased BP, chest pain, SOB, agitation, apathy)

Question 12

Causes of 3rd degree heart block?

Answer 12

ischemic heart disease, acute MI, conduction system disease

Question 13

What is the treatment of 3rd degree block?

Answer 13

PPM

Question 14

What happens during 3rd degree heart block?

Answer 14

• atrial and ventricles are blocked– no communication b/t atria and ventricles
• block can occur in AV node, bundle of His, or bundle branches

Question 15

What is 1st degree heart block?

Answer 15

impulse originates in SA node and conduction is prolonged in AV node

Question 16

How does 1st degree present?

Answer 16

PR interval >0.20, always constant and P wave is upright

Question 17

What medication can cause first degree heart block?

Answer 17

digoxin

Question 18

Diagnostics associated with HIV/AIDS?

Answer 18

EIA- antibodies are detected, resulting in positive results and marking the end of the window period
Western blot- also detects antibodies to HIV; used to confirm EIA
Viral load- measures HIV RNA in the plasma
CD4/CD8- markers found on the lymphocytes. HIV kills CD4+ cells, which results in a significantly impaired immune system
OraQuick- in home HIV test

Question 19

What are possible nursing diagnoses for AIDS? (5)

Answer 19

Risk for infection, impaired tissue integrity, altered nutrition, activity intolerance, and pain.