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Med Surg III Nrsg 116 > Renal and GI > Flashcards

Renal and GI Flashcards

1
Q

What are some associated symptoms of ascites?

A

Portal hypertension increases capillary pressure/obstructs blood flow, vasodilation to splanchnic ciruculation (abdominal organs), hormones increase fluid retention, albumin decreases which decreases osmotic pressure, albumin moves into abdominal cavity

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2
Q

What are the best ways to manage diverticular disease at home?

A

2L fluids/day, cooked veggies, fruit, exercise, bulk laxitives (psyllium fiber/stool softeners)

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3
Q

What is the GFR for stage 1 CKD?

A

> 90

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4
Q

What is the GFR for stage 2 CKD?

A

60-89

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5
Q

What is the GFR for stage 3 CKD?

A

30-59

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6
Q

What is the GFR for stage 4 CKD?

A

15-29

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7
Q

What is the GFR for stage 5 CKD?

A

<15

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8
Q

With peritoneal dialysis, how is dialysate moved into and out of the abdominal cavity?

A

By raising and lowering the bag of dialysate

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9
Q

What is “felt and heard” in a fistula?

A

A “thrill” is felt and a “bruits” is heard. A result would be “positive thrill and bruits”

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10
Q

How often do you change an ostomy appliance?

A

Every 3-7 days

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11
Q

When replacing an ileostomy appliance, how big do you cut the hole?

A

1/8 inch bigger than the stoma

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12
Q

What dietary restrictions are usually required for dialysis patients?

A

Fluids restricted to 500-600 mL more than output, sodium 2 g or less, reduce protein and potassium

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13
Q

How often is dialysis done, and how does it affect drug level?

A

3-4X/week is usually necessary. Water soluble drugs are readily filtered by dialysate, but fat soluble are not

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14
Q

What serious complications are monitored for in cirrhosis?

A

Jaundice, portal hypertension (which causes ascites and varices), hepatic encephalopathy/coma

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15
Q

What is it important to monitor for with Crohn’s?

A

Electrolytes, dysrhythmias, GI bleed, perforation of bowel

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16
Q

What are some important nursing actions for ulcerative colitis?

A

High protein/low residue diet, I&O, daily weight, symptoms of dehydration, oral fluids, address diarrhea.

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17
Q

What are the symptoms of portal hypertension?

A

Ascites (straie, distended veins, umbilical hernia), varices (hematemesis, melana, deterioration, shock)

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18
Q

What is the etiology and prevention of chronic gastritis?

A

Etiology = ulcers, H. Pylori, autoimmune, diet, meds, alcohol, smoking, reflux) Prevention = Diet, rest, reduce stress, avoid alcohol/NSAIDs

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19
Q

What are the risk factors for CKD?

A

DM, HTN, chronic glomerulonephritis, pyelonephritis/infections, tract obstruction, hereditary lesions, vascular disorders, meds/toxins

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20
Q

What is defined as “progressive irreversible loss of renal function”?

A

Chronic kidney disease?

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21
Q

Acute kidney disease is _____.

A

Reversible (usually)

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22
Q

What is the normal rate for GFR?

A

125 mL/hr

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23
Q

At what stage of CKD would a patient probably have some dialysis? Full dialysis? Transplant list?

A

Some = stage 3. Full = stage 4. Transplant = stage 5

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24
Q

Name the 8 causes of CKD listed.

A

DM, HTN, obstruction of tract, hereditary lesions, vascular disorders, meds/toxins, chronic glomerulonephritis, pyelonephritis/other infections

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25
Q

What med is particularly hard on the kidneys and what med is given to aid the kidneys in its removal?

A

Radioactive dye from the cath lab. Mucomyst.

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26
Q

What are some s/s of CKD?

A

Decreased urine output, weight gain, joint pain, elevated BP, rapid/irregular heartbeat, dry/fragile skin, itching, uremic frost, RBC low and imbalance of electrolytes

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27
Q

What lab results indicate CKD?

A

Hypocalcemia, hyperkalemia, hyperphosphatemia, decreased RBCs/urine protein/urine creatinine, metabolic acidosis, elevated BUN/serum creatinine

28
Q

What are some complications of CKD?

A

Uremia (nitrogenous wastes in blood), HF, anemia, HTN, electrolyte imbalances, pathologic fractures, mental changes, seizures

29
Q

What kind of dietary changes are made for CKD?

A

Low protein/potassium, fluids 500-600 mL more than previous days output

30
Q

What is given to increase RBC production?

A

Erythropoietin

31
Q

What other meds will increase RBC production besides erythropoietin?

A

Calcium and phosphorous binders, anti-hypertensives, anti-seizure meds

32
Q

What is a common way to access vein/artery for dialysis?

A

An AV fistula

33
Q

Which type of gastritis leads to ulcers?

A

Chronic

34
Q

What are the s/s of Acute Gastritis?

A

Abdominal discomfort, HA, N/V, lassitude, hiccuping

35
Q

What are the s/s of chronic gastritis?

A

Epigastric discomfort, anorexia, heartburn after eating, belching, sour taste, N/V, food intolerance

36
Q

What are the treatments for gastritis?

A

Acute = Avoid alcohol and NSAIDs, if due to acid/alkali avoid emetics/lavage. Chronic = Avoid alcohol/NSAIDs, diet, rest, reduce stress

37
Q

How do you assess for gastritis?

A

History, presenting s/s, abdomen, 72 hr diary

38
Q

What are the nursing interventions for gastritis?

A

Acute = nothing oral. Both = avoid alcohol, caffeine, smoking

39
Q

Where is diverticular disease most common?

A

Sigmoid colon. LLQ

40
Q

What’s the difference between diverticulosis and diverticulitis?

A

Diverticulosis = pouching. Diverticulitis = inflammation/infection

41
Q

What test is done to verify diverticular disease?

A

Colonoscopy

42
Q

What type of diet causes diverticular disease?

A

Low fiber

43
Q

What are the s/s of diverticular disease?

A

Diverticulosis = LLQ pain, chronic constipation precedes it, nausea, anorexia, bloating. Diverticulitis = Severe LLQ pain, N/V, fever, chills, leukocytosis

44
Q

What are the complications of diverticular disease?

A

Perforation, peritonitis, abscess, bleeding, sepsis

45
Q

What are the 2 types of IBD?

A

Crohn’s disease and ulcerative colitis

46
Q

What are some potential complications of IBD?

A

Electrolyte imbalance, cardiac dysrhythmias, GI bleed/fluid loss, perforation

47
Q

What kind of diet will these patients be on?

A

High protein/low ash or TPN

48
Q

How is fluid and nutrient absorption affected with a diversion?

A

Decreased

49
Q

What’s the most common cause of cirrhosis? Other causes?

A

Malnutrition due to alcoholism. Ifection, anorexia, metabolic disorders, nutritional deficiencies, hypersensitivity

50
Q

What are the s/s of cirrhosis?

A

Jaundice, portal hypertension, hepatic encephalopathy/coma, nutritional deficiencies

51
Q

What causes portal hypertension?

A

Restricted blood flow through the liver

52
Q

What does portal hypertension lead to?

A

Ascites and varices

53
Q

What else can cause ascites?

A

Vasodilation of splanchnic circulation, aldosterone changes, decreased synthesis of albumin, movement of albumin into the peritoneal cavity

54
Q

What type of scale is best when weighing patients with ascites?

A

Stand-up scale

55
Q

What is assessed for patients with ascites?

A

Weight/girth, straie, distended veins, umbilical hernia, fluids in abdominal cavity (dullness/fluid wave), fluid/electrolyte imbalances

56
Q

What is the treatment for ascites?

A

Low sodium, diuretics, bed rest, paracentesis, salt-poor albumin

57
Q

What does salt-poor albumin do?

A

Shifts sodium back into the vascular system where it can be excreted

58
Q

How often is endoscopy done for patients with cirrhosis?

A

q2yrs

59
Q

What are the s/s of varices?

A

Hematemesis, melana, general deterioration, shock

60
Q

What is the treatment for bleeding varices?

A

Treat shock, O2, IV electrolytes and volume expanders, blood and blood products, nitro/vasopressin, propranolol and nadolol to reduce portal hypertension. Balloon tamponade.

61
Q

What is acute pancreatitis and what usually causes it?

A

Blockage of bile duct, usually by a gall stone, backs up pancreatic enzymes and autodigestion and inflammation of the pancreas occur.

62
Q

What usually causes chronic pancreatitis?

A

Alcoholism

63
Q

What are the s/s of acute pancreatitis?

A

Abdominal guarding, N/V, fever, jaundice, confusion, agitation, flank/umbilical bruising, respiratory distress, hypoxia, renal failure, hypovolemia, shock

64
Q

What are the s/s of chronic pancreatitis?

A

Severe upper abdominal/back pain, weight loss, steatorrhea, comes and goes

65
Q

What are the acute assessments for pancreatitis?

A

Focus on pain/discomfort, fluid/electrolytes, alcohol use, GI, respiratory, anxiety/coping

66
Q

What are the potential complications with pancreatitis?

A

Electrolyte imbalances, pancreatic necrosis, shock, MODS, DIC

67
Q

What are the treatments for pancreatitis?

A

Analgesics, low intermittent suction, frequent oral care, bed rest, promote comfort/relieve anxiety

Med Surg III Nrsg 116 (3 decks)

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