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Adult health 3 > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

glomerulonephritis CM

A

Chills, fever, leukocytosis, bacteriuria, pyuria, low back pain, flank pain, N, V, malaise, dysuria

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2
Q

Difference between acute and chronic glomerulonephritis

A

Acute: temporary and reversible kidney damage. Chronic: irreversible CKD

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3
Q

Risk factors for glomerulonephritis

A

Strep infection, endocarditis, HIV/Hep B or C, good pasture syndrome, Lupus, diabetic nephropathy, hypertension.

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4
Q

Describe how you get glomerulonephritis after strep

A

about 2-3 weeks after a strep infection, the antigens form a complex with the bodies antigens, these complexes trigger inflammation the glomerulus and prevent adequate filtering. `

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5
Q

specific CM of strep GN

A

periorbital edema, cola-colored urine, sodium retention, HTN

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6
Q

complication of strep GN

A

rapidly progressing GN (rapid loss of kidney function over a course of days or weeks)

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7
Q

`Teatment for rapidly progressing GN

A

correct fluid overload, manage BP, corticosteroids, cytotoxic drugs, plasmapheresis, dialysis

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8
Q

what is good pasture syndrome

A

autoimmune disease occurring in young male smokers, antibodies attack lungs and kidneys. presents as flu-like symptoms

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9
Q

treatment options for good pasture syndrome

A

corticosteroids, immunosuppressants, plasmapheresis, dialysis, transplant.

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10
Q

what is pyelonephritis

A

inflammation of renal tissue caused by infection or obstruction

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11
Q

what is important to remember about CT scans with kidney patients

A

no contrast dye

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12
Q

goals for Pyelonephritis

A

treat infection (culture and antibiotics) prevent dehydration (antiemetics and hydration)

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13
Q

what causes kidney stones

A

too much calcium/vitamins in the diet, immobility, hydronephrosis, infection

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14
Q

lithotripsy

A

shockwave therapy: be sure to strain all urine for stones, bleeding is normal but it should go away after a couple days

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15
Q

Medication for kidney stones

A

Flowmax - relaxes smooth muscles

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16
Q

cause of Prerenal AKI

A

reduced systemic cirrculation

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17
Q

cause of Intrarenal AKI

A

direct kidney damage

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18
Q

cause of post-renal AKI

A

obstruction

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19
Q

phases of AKI

A

oliguric, diuretic, recovery

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20
Q

what do we need to monitor in patients with renal issues

A

I&O, daily weight, fluid/ electrolyte levels (Na and K esp.)

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21
Q

cause of chronic kidney disease

A

diabetes and hypertension

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22
Q

creatinine normal values

A

0.6-1.3

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23
Q

normal BUN values

A

6-20

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24
Q

when do you start needing dialysis

A

with a GFR of 29 or lower, or acutely if fluid/electrolyte levels are imbalanced

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25
Q

ways to decrease your risk for CKD

A

control your blood sugar, control blood pressure, good diet, healthy weight, exercise, no tobacco use

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26
Q

best medications for CKD

A

ACE inhibitors and ARBs (they are renal protective)

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27
Q

CM for CKD

A

edema, back pain, oliguria, HTN

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28
Q

Complications of CKD

A

Anemia, Hyperkalemia, HF, and Mineral Bone Disorders

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29
Q

What level of K requires immediate intervention

A

> 6.5

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30
Q

What are treatment options for hyperkalemia

A
  1. Kayexalate (BS x4 and give with food, constipation as a S/E)
  2. Insulin and dextrose (shift K into the cells)
  3. IV gluconate (prevent V tach)
  4. dialysis
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31
Q

What causes bone issues in CKD

A

a decrease in Vitamin D in the body decreases calcium that is absorbed, the body then produces PTH to break down the bones for calcium.

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32
Q

Meds for bone disorders of CKD

A

Activated vitamin D, Phosphate binder (sevelamer, Calcium acetate - can cause CV issues and hypercalcemia, give with food)

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33
Q

what causes anemia in CKD

A

decreased erythropoetin

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34
Q

meds for anemia in CKD

A

hematopoietics (Epogen - S/E: HTN and thromboembolism)
Iron supplement (give between meals, S/E GI upset, constipation and
dark tarry stools)
folic acid

35
Q

What should we teach CKD patients

A

take daily weight and monitor I&O, Watch the signs of fluid overload and electrolyte imbalance. avoid NSAIDs, decongestants, or laxatives

36
Q

Complications of Hemodialysis

A

dysrhythmias, infection, disequilibrium syndrome

37
Q

types of vascular access

A

temporary JV catheter, fistula, graft. (DO NOT ACCESS)

38
Q

how often do you do hemodyalysis

A

3-4 hours, 3 days a week

39
Q

complications of Peritoneal dialysis

A

loss of protein, hyperglycemia, peritonitis

40
Q

risk factors for bladder cancer

A

cigarette smoking!
chemical exposure, radiation, chemo, chronic urinary irritation

41
Q

CM for bladder cancer

A

Hematuria!
irritable bladder

42
Q

types of urinary diversion device

A

incontinent type: ileal ostomy (constant output)
continent type: urinary “pouch”, still an ostomy, empties Q4-6
orthotopic type: new “bladder” formed from intestinal tissue, no urge
present

43
Q

treatment for bladder cancer

A

Chemo inserted with a catheter. pt should hold it for 2 hours and then urinate it out. (there a no systemic effects)

44
Q

Risk for Renal cancer

A

Cigarrette smoking!
obesity, chemical exposure, HTN, genetic predisposition or mutation

45
Q

CM for renal cancer

A

starts asymptomatic, hematuria, flank pain, palpable mass, vague sickness symptoms.

46
Q

treatment for renal cancer

A

partial nephrectomy, simple total nephrectomy, radical nephrectomy

47
Q

how to screen for prostate cancer

A

Annual digital rectal exam starting at age 50
biopsy, US, prostate antigen test

48
Q

how to treat someone with prostate cancer

A

radical prostatectomy
hormone therapy
internal radiation

49
Q

screening for BPH

A

annual digital rectal exam starting at age 50

50
Q

treatment for BPH

A

lifestyle changes (non-irritating diet, scheduled voiding, avoid anticholinergics/decongestants)
Medications (Proscar, Flowmax)
Surgery (either a laser, or TURP: transurethral resection of the prostate,
bleeding common, need continuous catheter irrigation)

51
Q

Medications for BPH

A

Proscar to shrink the prostate ( takes 6mo. to take effect, evaluate with post-void residual)
Flowmax - (smooth muscle relaxer - S/E hypotension, dizziness)

52
Q

CM of testicular cancer

A

firm lump in the scrotum, scrotal swelling, dull abdominal ache

53
Q

long term side effects of testicular cancer

A

infertility, ejaculatory dysfunction

54
Q

risk factors for skin cancer

A

Light colored skin and eyes

55
Q

prevention of skin cancer

A

always wear sunscreen, try to be in the shade during the most sunny times of the day 10-4

56
Q

3 side effects of Leukemia

A

anemia, thrombocytopenia, immunosuppresion

57
Q

most common type of leukemia

A

Chronic lymphocytic leukemia

58
Q

Doxorubicin

A

common drug for Acute Myelogenous Leukemia. can cause cardiac dysfunction!

59
Q

CM of lymphoma

A

B symptoms
swollen lymph nodes
fatigue

60
Q

What are B symptoms

A

unexplained weight loss, fever, night sweats

61
Q

Hodgkins vs Non hodgkins lymphoma

A

H: displays B symptoms and is localized
NH: no/less B symptoms, spread throughout body

62
Q

what is multiple myeloma

A

cancer of the plasma cells. decrease production of antibodies, results in production of dysfunctional proteins. these proteins infiltrate the bone marrow.

63
Q

CM of multiple myelomas

A

anemia, neutropenia, thrombocytopenia, weakened bones, bone pain, bone pain, fractures, hypercalcemia.

64
Q

how to prevent hypercalcemia complications of multiple myeloma

A

weight bearing exercises, continuous IV hydration, monitor I&O, lasix

65
Q

Important factors to know about external radiation

A

causes skin damage.
protect skin by cleansing it daily, and avoiding extreme temperatures or other irritants. Dry radiation burns (keep clean and lubricated with aloe) Wet desquamation (keep clean and covered with a dressing)

66
Q

important factors to know about internal radiation

A

the patient is radioactive - so limit time at the bedside. 3’ away, cluster care, wear lead apron, wear a badge to measure exposure.

67
Q

administration concerns for chemo

A

if a port of venous access is broken the chemo can leak into surrounding tissues leading to extravasation (stop the infusion and aspirate all of the chemo from the catheter)

68
Q

what to do for nausea and vomiting from chemo

A

take antiemetic(ondansetron) before chemo and scheduled for 24-48 hours after

69
Q

what is tumor lysis syndrome

A

a rapid release of cells d/t destruction from chemo (24-48 hours later)
causes hyperuricemia, hyperphosphatemia, hyperkalemia, and hypocalcemia

70
Q

how to best prevent Tumor Lysis syndrome

A

take Allopurinol daily(bind to uric acid), increase fluid intake, take sodium bicarb acutely

71
Q

Superior Vena Cava Syndrome

A

obstruction of the SVC by tumor or thrombosis

72
Q

CM of Superior Vena Cava Syndrome

A

periorbital edema, Distended Neck veins, headaches, seizures, mediastinal mass

73
Q

Why would someone have a side effect of Anemia during cancer

A

chemo destroying proliferative cells, malnutrition, or bleeding

74
Q

medication for Anemia (and S/E)

A

Sub-Q Erythropoietin. can cause HTN, thrombosis, or headache

75
Q

Risk of thrombocytopenia, what precautions will we take?

A

high bleeding risk, need to be on fall precautions.
hold blood thinners and any other drugs that promote bleeding. careful of bruising and cuts (BP cuff, soft tooth brush, electric razor)

76
Q

What platelet levels quantify thrombocytopenia, prolonged bleeding, and spontaneous bleeding

A

<150,000 =thrombocytopenia
<50,000 = prolonged bleeding
<20,000 = spontaneous bleeding

77
Q

at what level is someone under neutropenic precautions, and will we perform chemo with this patient

A

<1000 ANC (no chemo performed)

78
Q

What is a neutropenic fever

A

a fever >100.4 and an ANC <500. requires immediate hospitalization

79
Q

What does a Neutropenic precaution entail?

A

no raw or uncooked food, no live plants, strict hand washing, close infection monitoring, screen all visitors

80
Q

what is Pegfilgrastim

A

it is a 1-dose, long-lasting colony-stimulating factor for neutropenia. Used to keep dialysis on schedule

81
Q

What is Vincristine

A

this is a specific chemotherapy agent. It is a very powerful vesicant so you need to constantly monitor for extravasation. also causes neuropathy

82
Q

what is Cisplatin

A

this is a nonspecific chemotherapy agent. causes terrible vomiting, and is nephrotoxic, myelosuppression, ototoxicity, peripheral neuropathy

83
Q

What is finasteride

A

a BPH medication used to shrink the prostate, it may take up to 6 months to be effective, and will be evaluated by post-void residual

Adult health 3 (2 decks)

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