Exam 3 Misc Flashcards
What is the most reliable indicator of kidney funciton?
creatinine levels
A Patient has a high BUN, what is the next best nursing action?
Check the creatinine. If normal start to explore. Look at H&H. Is there a GI bleed?
What diagnostics are bowel preps ordered for?
KUB
IVP
Retro IVP
What medications do you want to check before renal biopsy
ASA or warfarin.
Three reasons to use Retrograde Pyelogram vs Intravenous Pyelogram
IVP results are not good
Allergic to iodine
Elevated creatinine
Renal Biopsy Post Procedure
Apply pressure dressing
Keep on affected side for 30 min - 1hr
Bed rest Q24 hrs
VS Q 5/15 min x 1 hr
No heavy lifting for 1 week
UTI: First quick dipstick will be postive for
Nitrites (indicating bacteria)
WBC (Pyuria)
Leukocyte esterase (Pyuria)
Urinalysis vs Urine culture
Urinalysis is looking at all the different things
Urine culture is trying to identify the bacteria type
4 Reasons a urine culture might be done
- Complicated or nosocomial UTI
- Frequent UTI
- Unresponsive to therapy
- Questionable diagnosis
If a patient has there bladder removed and has significant comorbidities and a shorter life expectancy, what urinary diversions might be expected?
Ileal Conduit
AKI phases
Oliguric
Diuretic
Recovery
Clinical Manifestations of Oliguria phase of AKI
<400 ml/24 hr
Begins 1 day after hypotensive event and last 1-3 weeks
Nephrotoxic Drugs
NSAIDS
Aminoglycosides
Potassium Binders
Patiromer (Veltassa)
Sodium zirconium (lokelma)
Sodium polystyrene (Kayexalate)
We do not give potassium binder to which type of patients
Patients with a paralytic ileus
IV calcium gluconate MOA
Does not lower K. Just raises threshold for excitation
Best way to prevent CKD is to control
HTN
DM
Nursing Problem CKD: Excess Fluid Volume
Monitor for FVE
Weigh Daily
Fluid restrictions
Nursing Problem CKD: Malnourishment
Monitor N/V
Weight trends
Serum protein levels
H&H
Nursing Problem CKD: Risk For Injury
Monitor electrolyte levels
Administer prescribed supplements
Hemodialysis Complications
Infection
Decreased CO
Cardiac Dysrhythmias
Disequilibrium syndrome
Air embolism
Disequilibrium syndrome
Complication of HD. Manifest as disorientation, seizures, HA agitation, N/V
Peritoneal Dialysis Complicaitons
Infection
Decreased CO
Fluid overload
Respiratory insufficiency (Pressure)
Abd Pain
Advantages and Disadvantages of HD
ADV: Rapid removal of fluid. Can help change electrolyte problems quickly
DISADV:
Vascular access
Heparin
Dietary restriction (less often)
Hypotension
Advantages and Disadvantages of PD
ADV: Less complicated and few dietary restrictions. Less CV stress
DISADV:
PERITONITIS
BODY IMAGE ISSUES
PD: NSG considerations
Turn side to side to facilitate drainage prn
Observe color of dialysate
PD: HD considerations
No BP, injections, IV insertions of affected limb
AIDS defining cancers
Pneumocysitsi jirovecii
Kaposi sarcoma
Wasting syndrome
Pervasive candidiasis
Aids dementia complex
Stage 1 of HIV
Early Acute Infection
Not detectable
No symptoms
Infections
Seroconversion HIV
Part of stage one
Antibodies become detectable and you have the worst flu like symptoms
HIGH INFECTIONS
Usually around week 3/4
Stage 2 HIV
Clinical Latency
Virus levels stabilized and body is fighting infection
Last 3-12 years without treatment
Last decades with treatment
Asymptomatic
persistent drop in CD4 with increase in virus production
Stage 3 HIV
AIDS
How often does CD4 and Viral load need to be checked with HIV postive patients
Every 3 - 4 months
Factors that affect wound healing: ODD
Skin fragility and loss of turgor
Overall wellness
Chemo
Anti inflammatory
Steroids
Obesity
Diet for wound healing
HIgh protein, carbs, vitamines
Moderate fat intake
Hydrogel is for _______, __________, ___________, and helps to ….
Infected - deep wounds - necrotic tissue
helps promotes autolytic debridement, rehydrate, and fill dead space
Complications of wound healing: ODD
Adhesions
Contractions
Fistulas
Excessive granulation tissue
Keloid formation
What does eGFR take into consideration?
Age
Sex
Weight
Race
Bun
Creatinine
Albumin
What is drawn in the middle of 24 hour clearance?
Serum creatinine
Urinalysis for a kidney stone is looking at?
Hematuria
Crystalluria
pH
