Renal/Urinary NGN Flashcards
the following flashcards are related to renal and urinary ngn case study that is on evolve
when educating a client with intersittial cystisis, which food would the nurse mention is a bladder irritant? select all that apply. (3)
- milk
- white chocolate
- citurs fruit
- aged cheeses
- cottage cheese
- green, leafy vegetables
- bananas
- melons
- tomatoes
- citrus fruits
- aged cheese
- tomatoes
all three irritate the bladder
Which information would the nurse provide to decrease the incidence of further infections in a 17-year-old female who has experienced multiple non–sexually transmitted genitourinary infections? Select all that apply. One, some, or all responses may be correct. (6)
- Dry off after swimming
- Select cotton underwear
- Ensure douching once weekly
- Wear loose-fitting clothes
- Avoid taking bubble baths
- Refrain from scented toilet tissue
- Drink fluids up to 3 liters a day
- Clean perineum from back to front
- Dry off after swimming
- Select cotton underwear
- Wear loose-fitting clothes
- Avoid taking bubble baths
- Refrain from scented toilet tissue
- Drink fluids up to 3 liters a day
which clinical manifestations would the nurse expect in a pediatric client diagnosed with acute post-streptococcal glomerulonephritis? select all that apply (4)
- hematuria
- proteinuria
- periorbital edema
- decreased specific gravity
- mildly elevated blood pressure
- decreased skin turgor
- bladder distention
- urethra inflammation
why those 4
why not the rest?
- hematuria
- proteinuria
- periorbital edema
- mildly elevated blood pressure
the inflammotory response allows the kidneys for red blood cells to enter the urine
capillary permeability in the kidney allows protein to pass in the urine
glomerular filtration rate is reduced, resulting in sodium retention, making edema evident and the blood pressure to increase from all the fluid
now the no’s
- it would be increased specific gravity due to the retention
- skin turgor will not decrease cause of the fluid retention ; pitting
- bladder distention indicates incomplete emptying, not fluid retention
- not inflammation cause its not STI’s
a client has undergone a genitourinary reconstruction surgery. which assessment finding by the nurse supports suspicion of impending shock? select all that apply (4)
- oliguria
- lethargy
- decreased thrist
- irritability
- increased specific gravity
- distended neck veins
- hypotension
- slurred speech
why those 4
why not the rest
- oliguria
- irritabilty
- increased specific gravity
- hypotension
decreased blood to kidneys causes oliguria, so no pee
irritability is due to the lack of oxygen in brain
decreased urine makes more gravity
hypotension is declining blood volume
in shock its restless not lethargy unless its late stage
decreased circulation of volume makes you thirsty and have notably flat neck veins
slurred speech doesn’t happen here
A client is receiving furosemide to relieve edema. The nurse will monitor the client for which expected response? Select all that apply. One, some, or all responses may be correct. (5)
- Weight loss
- Impaired glucose tolerance
- Narrowed pulse pressure
- Increased urine specific gravity
- Excessive loss of potassium ions
- Pronounced retention of sodium ions
- Puffiness in the feet
- Decreased calcium levels
- Weight loss
- Impaired glucose tolerance
- Narrowed pulse pressure
- Excessive loss of potassium ions
- Decreased calcium levels
those are clinical manifestation you should know ^
hypotension is a complication from receiving hemodialysis ; this can occur when rapid fluid is being taken away from the body
-actions to take would be to
1. infuse 200ml of saline bolus
2. slow hemodialysis treatment
- monitor would be to
fluid status - if they are removing too much
weight - weight can contribute to fluid In the body
select 5 client assessment findings that would require immediate follow-up by the nurse.
- Incidents of confusion
- S3 heart sound
- Body mass index: 31.9 kg/m2
- Lung fields: Bilateral crackles
- Smokes 1 pack of cigarettes/day
- Unstable gait
- Considering early retirement
- Blood pressure 168/102 mm Hg
- Adult children live out-of-town
- Glycosylated hemoglobin 9.2
- Incidents of confusion
- S3 heart sound
- Lung fields: Bilateral crackles
- Unstable gait
- Blood pressure 168/102 mm Hg
confusion is considered a sign of electrolyte imbalance
s3 heart sound - heart failure or fluid overload
crackles - fluid in the lungs
unstable gait - electrolyte imbalance or muscle weakness
blood pressure - increased circulating volume
uncontrolled hyperntesion can cause kidney issues
- body mass isn’t big so its fine
- smoking isn’t good but not the reason why he isn’t peeing right now
- early retriemtn doesn’t matter
- kids don’t matter
- a1c is measuring last 3 months, and not the current blood sugar rn
what are labs that are done for patients with chronic kidney disease? (4)
what are things we see in urine (2)?
creatinine
potassium
red blood cells
glomerurlar filtration rate
protein
albumin/creatinine
what is indicated or contraindicated and why for a patient with high risk of cardiac dysrhtymias secondary to the critical potassium level of 7 and fluid overload?
Insert an indwelling urinary catheter
Apply cardiac monitor
Bleeding times: international normalized ratio (INR), prothrombin time (PT), and partial thromboplastin (PTT) STAT
Feel for a thrill or auscultate a bruit on the arteriovenous (AV) access
Prepare for dietary consult
Monitor neurological status
Intravenous fluids of 0.9% normal saline at 150 mL/hr
contraindicated ( not recommended for kidney failure )
indicated ( dysthryamias )
indicaited ( dialsysis reason )
contraindicated ( has a central line not av )
indicaited ( diertary issue with diabetes & fluids )
indicated ( confusion is the first sign of neuro issues )
contraindicated ( why add more fluid if its overloaded )
after the client recevied hemodialysis for the first time at the bedside, which actions would the critical acre nurse take? select all that apply. (6)
- monitor for cues related to disequilibrium syndrome
- report hand numbness, pain, reduced blood flow related to steal syndrome
- weight client
- administer all previously help antihypertensive medications upon completion of dialysis
- consult registered dietitian about protein intake related to dialysis
- assess for indication of orthostatic hypotension
- maintain cardiac monitor for potential cardiac events
- follow oral fluid restrictions per shift
- teach client to recognize indications of peritonitis
- monitor for cues related to disequilibrium syndrome
- weigh client
- consult registered dietitian about protein intake related to dialysis
- assess for indication of orthostatic hypotension
- maintain cardiac monitor for potential cardiac events
- follow oral fluid restrictions per shift
disequilibrium syndrome is
- headache, nausea, vmoititng, change of LOC
you’d hope the dialysis helped lose weight for the client
make sure to talk about protein since dialsysi removes it from the body and we need protein to heal up and be good
hypotension is a complication of hemodialysis
cardiac monitors can be from fluid overload so they should have it, since even with dialysis we are pulling a lot of fluid away, we still want to make sure they are good in case if it pulls too much
fluid should be restricted if we are going to be doing dialaysisi
the no’s
- steal syndrome occurs with an AV access, patient doesn’t have that
- don’t administer anti-hyperntesionve, it makes them even more hypotenseive
- peritonititsi is a long term complication from long term use of dialysis, the patient was just using it for an acute situation
which is effective behavior teaching by the nurse to patient and explain why for each of them
fluids (1)
- occasionally uses 1/2 cup ice chips to quench thirst
- takes orange juice when hypoglycemic
- keeps water at bedside for medications
nutrition (2)
- selects apple to snack
- consumes bananas daily
- does not salt food
medications (2)
- takes prescribed calcium carbonate with meals
- identifies water-soluble medications
- takes prescribed oral iron supplements with meals
fluids (1)
- occasionally uses 1/2 cup ice chips to quench thirst
remember patient is fluid overload, don’t wanna give them too much water, so instead use ice chips for easy relief
( orange juice would make them more overload & high potassium )
( having water there is tempting to drink )
nutrition (2)
- selects apple to snack
- does not salt food
apples are low potassium and super good for renal client
salt cause fluid rention so good they don’t use it
( banana is high potassium, very bad )
medications (2)
- takes prescribed calcium carbonate with meals
- identifies water-soluble medications
( iron isn’t need cause he isn’t anemic or have low iron )
