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Adult Health 2 > Final exam test 2 :)\ > Flashcards

Final exam test 2 :)\ Flashcards

1
Q

What labs are increased in CKD?

A

-BUN, Cr, potassium, phosphate, urine protein

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2
Q

What labs are decreased in CKD?

A
  • Calcium, H&H, Cr clearance, GFR
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3
Q

Normal level Cr

A

0.5-1.2

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4
Q

Normal BUN level

A

10-20

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5
Q

Normal sodium level

A

135-145

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6
Q

normal potassium level

A

3.5-5.0

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7
Q

Normal phosphate level

A

2.4-4.5

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8
Q

Normal calcium level

A

8.2-10.2

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9
Q

normal pH

A

7.35-7.45

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10
Q

Normal HgB in women vs men

A

women : 12-16
males: 14-18

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11
Q

Normal HCt in women vs men

A

women: 38-44
men: 43-49

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12
Q

Normal urine protein

A

6-8

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13
Q

Normal Cr clearance

A

88-137

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14
Q

Normal GFR

A

125

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15
Q

What are foods high in potassium?

A

oranges bananas, melons, tomatoes, deep green veggies, beans, etc.

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16
Q

What drugs can we give in hyperkalemia?

A
  • IV Ca gluconate
    -Kayexalate
  • IV glucose/insulin
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17
Q

What are some foods high in phosphorus?

A

-milk, cheese, ice cream, yogurt

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18
Q

What can be given to decrease phosphurus? and what do you educate the pt about these?

A
  • calcium acetate and calcium carbonate (phosphate binders)
    -Administer with each meal, watch for constipation!
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19
Q

What drug can we give for hyperparathyroidism?

A

-calcimimetic agents

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20
Q

What can we give to help with pt anemia in CKD?

A
  • erythropoietin
  • folic acid supplementation
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21
Q

What vitamin can we also give for hyperphosphatemia to increase phosphate binding?

A

-Vitamin D

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22
Q

What drugs should you not give in CKD?

A

-digoxin
-Demerol
-NSAIDS
-watch for nephrotoxic meds
like aminoglycosides
penicillin
tetracyclines

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23
Q

What may you need to hold prior to dialysis?

A
  • antihypertensives, water soluble meds
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24
Q

What are ways to treat CKD?

A

-kidney transplant
-Renal replacement therapies
hemodialysis
peritoneal dialysis
continuous renal replacement therapy (CRRT)

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25
Q

What do we assess for pre-op kidney transplant?

A
  • assess for ureteral reflux
    to make sure there is no issues of urine backflow
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26
Q

What should we educate our patients who just had a kidney transplant??

A
  • Immunosuppressive meds 4 life = cyclosporine
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27
Q

Hyperacute stage of kidney transplant rejection occurs how long after transplant?

A
  • min-hours after transplant
    -requires graft removal
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28
Q

Accelerated kidney transplant rejection occurs how long after transplantation.?

A

-2-4 days
-requires graft removal

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29
Q

Acute kidney transplant occurs how long after transplant?

A
  • 1st 3 months after transplant
    -manage with increased dose of immunosuppressants
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30
Q

What are s/s of kidney rejection?

A

-fever, swelling, tenderness, pain of transplanted kidney
-oliguria,edema, weight gain, fever, HTN

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31
Q

Chronic rejection s/s of kidney transplant include?

A

-progressive azotemia, proteinuria, and HTN

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32
Q

What is a fistula?

A
  • surgical connection of an artery and a vein (nothing artificial!)
  • must mature before beginning use for dialysis/ can take weeks/months
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33
Q

What is a graft?

A

-PROSTHEITC graft inserted between an artery and vein.
- can be used more quickly, doesn’t last as long, prone to infection

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34
Q

A person is having restlessness, twitching, n/v, some confusion during dialysis what do we ?think is going on and what do we do?

A
  • Disequilibrium syndrome
    -stop/slow dialysis, infuse HYPERTONIC saline, albumin or mannitol to draw fluid from the brain.
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35
Q

What is our goal weight gaining between dialysis

A
  • no more than 3 llbs
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36
Q

What are some contraindications for peritoneal dialysis?

A
  • hx of abd surgery, diverticulitis, pancreatitis
  • recurrent abdominal wall/inguinal hernias
  • obesity
    -pre-exsiting back problems/vertebral disease
    -COPD
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37
Q

What do you do if peritoneal dialysis is not flowing well?

A

-REPOSITION PT

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38
Q

What diet to people with peritoneal dialysis want to be on?

A
  • high protein
    -increase fiber
  • limit carbs if gaining weight
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39
Q

What foods do you want to limit with oxalate stones?

A

-chocolate, tea, peanuts , spinach, strawberries

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40
Q

What can you give for uric acid stones?

A

allopurinol

41
Q

How do you manage calcium stones?

A

-restrict Ca
- restrict protein and sodium
- thiazide diuretics

42
Q

What should you expect after an ESWL?

A

-hematuria

43
Q

What type of education would we give to pt that have stones?

A
  • TRIAL OF PASSAGE
    -low sodium, low oxalate, high citrus diet
44
Q

First sign you see with bladder cancer?

A

PAINLESS HEMATURIA

45
Q

What are some general s/s of prostatitis?

A

-pain with/after ejaculating
-burning/urgency/frequency

46
Q

What drug should a pt with prostatitis be on?

47
Q

What do you need to educate pt with prostatitis ab?

A

-avoid alc,coffee,tea,chocolate, caffeine
-avoid intercourse
-avoid sitting for long periods of time

48
Q

Clinical manifestations of BPH

A

-dribble,urinary frequency, nocturia, decreased volume/force of stream.

49
Q

How do we diagnose BPH

A

DRE- recommended for older men around 50

50
Q

What are some risk factors for prostate cancer?

A

-age >50
-diet high in red meat, dairy, or fat
-family hx
-africans

51
Q

Clinical manifestations of prostate cancer?

A
  • blood in urine/semen
    -painful ejaculation
52
Q

How do you diagnose prostate cancer?

53
Q

What should educate the pt on if they are on brachytherapy?

A

-avoid infants and pregnant women for 2 months
-strain urine -lost beads
-condom for 2 weeks
-may cause inflammation of the rectum, bowel, and bladder

54
Q

What do we want to educate our pt who just had prostate surgery?

A

-avoid straining/heavy lifitng
-avoid long trips/strenous exercise
-avoid spicy foods, alc, and coffee

55
Q

Clinical manifestations of testicular cancer?

A
  • painless enlargement
  • backache, abdominal pain, weight loss, weakness
55
Q

Clinical manifestations of testicular cancer?

A
  • painless enlargement
  • backache, abdominal pain, weight loss, weakness
56
Q

How do we diagnose testicular cancer?

A
  • TSE
    -TUMOR MARKERS
57
Q

A person just got a suprapubic cath and is complaining of yellow crusty buildup what do we tell them to do?

A

-increase fluid intake.

58
Q

What do we use for catheter care for a suprapubic cath?

A

soap and water BID

59
Q

How long does the pt have to void after d/c suprapubic cath?

60
Q

Can we clamp a nephrostomy tube?

61
Q

What do we want to assess for after getting a nephrostomy tube?

A

-bleeding!

62
Q

Pet scan pre-op care=?

A

-NPO 6-12 hours
-no caffeine, alc, or tobacco 24 hours before

63
Q

Pre-procedure things for cerebral angiography = ?

A
  • NPO @ MN, CONSENT
    -assess for allergies to iodine, contrast dye, seafood
  • assess for anticoagulant use = HOLD!!
64
Q

Post-procedures for cerebral angiography?

A

-pulses distal to cath site q 15 min for first hour then hourly
-bedrest 6-12 hours/legs straight
-pressure on site for 15-20 min

65
Q

EEG pt education prior to procedure?

A
  • no caffeine 8-12 hours
    -wash hair the night before and the morning of the test
  • don’t use hair products the day of the test to help with electrode attachment.
66
Q

Lumbar puncture pre-procedure :
Post-procedure:

A
  • anticoagulant/antiplatelet med are being help
    -dont hold BP med!!
    -obtain consent
    -check pt,inr platelets
    postprocedure: lay flat 4-6 hours
67
Q

Decerebrate = what?

A
  • extension, externally rotated
68
Q

What are things to avoid in transsphenoidal surgery?

A
  • vigorous coughing
    -blowing the nose
    -Sucking through a straw
    -sneezing
69
Q

What are some post op education for transsphenoidal surgery?

A
  • elevate HOB 30-45 degrees 2 weeks after surgery
    -avoid tooth brushing until incision healed
    -room humidifier PRN
  • Monitor nasal packing for blood or CSF drainage (Halo effect)
70
Q

What signs do you see with meningitis?

A

+Kernig’s sign: with thigh flexed, leg can’t completely extend.
+Brudzinski’s: as the neck is flexed, the knees flex involuntarily.

71
Q

What are clinical manifestations of parkinsons?

A

-resting temor/pillrolling
- rigidity
-Bradykinesia
-postural instability

72
Q

CSF of meningitis include

A
  • increase WBC/protein
    -decrease glucose
    cloudy CSF
73
Q

What are some clinical manifestations of cholecystitis?

A
  • Pain (RUQ) = onset 30-1 hours after eating
    • murphy sign = pain on palpation of RUQ
      -Steatorrhea= clay colored, oily stools
74
Q

What are the risk factors for cholelithiasis??

A

-5 f’s = fair, fat, over 40, fertile, female

75
Q

Which stones can dissolve?

A

Cholesterol
PIGMENT STONES WILL NOT DISSOLVE

76
Q

What happens in a cholecystography?

A

-pt takes PO dye 12 hours prior tot he study.
-ASK AB ALLERGIES!

77
Q

What happens in an ERCP?

A

-diagnostic and treatment option
- NPO the night before
-take cardiac/HTN meds

78
Q

What do we want to monitor for in a percutaneous transhepatic cholangiography?

A

-peritonitis

79
Q

UDCA/CDCA does what?

A
  • decreases large CHOLESTEROL STONES, DISSOLVES SMALL ONES, PREVENTS NEW STONES
    -not for pt with frequent symptoms, duct obstruction, or PIGMENT STONES
80
Q

How does MTBE work?

A

it is infused via a catheter directly into the gallbladder
-DISSOLVES CHOLESTEROL STONES

81
Q

What are some clinical manifestations of acute pancreatitis?

A

-LUQ pain that can radiate to the back/shoulder blades
- deep and very sharp that is more intense after a meal high in fat/ETOH consumption
-N/V, cullens/grey turners sign= retroperitoneal bleeding
- fever, tachycardia, hypotension

82
Q

What lab changes are we going to see with acute pancreatitis?

A

-amylase, lipase elevated
-increase ast/alt
-elevated glucose, urinary amylase, stool fat content
-DECREASED CALCIUM

83
Q

A pt with acute pancreatitis should be __________.

A

TOTAL NPO!!!!

84
Q

What medication are people going to be on that have chronic pancreatitis and what do we educate them about it?

A

Creon- take with every meal!

85
Q

What risk factors are associated with pancreatatic cancer?

A

-smoking
-diet high in fat/red meats
- chronic pancreatitis

86
Q

What is the most common cause of barium studies?

A

constipation = encourage fluids, laxatives, and/or enemas.

87
Q

What does small bowel follow through show??

A

small bowel obstructions = chron’s

88
Q

What do we never do if we suspect a perforated colon?

A

-barium enema

89
Q

Nursing considerations for barium enemas?

A

-NPO for 8 hours prior
-encourage fluids after & consider taking a laxative
-expect chalky stool for 24-72 hours posy exam
- pt may be on clear liquids the day before the test and have bowel prep ordered

90
Q

What are some nursing considerations for endoscopy?

A

-NPO 8-10 hours
-NPO until gag reflex has recovered!
-may need to hold ASA and anticoagulation.

91
Q

A person just had an ERCP and is vomiting severe abdominal pain and a fever what do we suspect?

A

-pancreatitis

92
Q

A person just had an ERCP and is vomiting severe abdominal pain and a fever what do we suspect?

A

-pancreatitis

93
Q

Which diagnostic test must pt be cooperative and assist with multiple position changes?

94
Q

Colonoscopy nursing considerations…

A
  • NPO 6-8 hours prior to study - BOWEL PREP
  • HOLD ASA / anticoagulation
  • instruct pt to expect fullness, cramping/farting for several hours after procedure
95
Q

1 cause of stomatitis is what?

96
Q

What is important to educate your pt on when they are using viscous lidocaine for stomatitis?

A
  • aspiration if swallowed!!!
97
Q

What should you NEVER do with neck dissection?

A

-NO ORAL TEMP

98
Q

What is the gold standard surgery for hiatal hernia?

A
  • nissen fundoplication

Adult Health 2 (5 decks)

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