Tutoring for Exam 3 Flashcards
What is the dietary management of pancreatitis? - What patient teaching would you give someone?
- Low fat diet (avoid high-fat diet)
- Avoid alcohol
- Consume only lean meats
Dietary management for a pt with cholecystitis or cholelithiasis:
- Eat lean meats
- High-fiber {grains/ vegetables/ fruits}
- Low-fat
Hepatic encephalopathy findings:
Increased ammonia levels NH3 levels
{Accumulation of ammonia in the system effects the pts brain. The pt might have Asterixis and hyper reflexive, so when you check their reflexes, they will be over exaggerated}
Life threating complications of Asities?
- Respiratory failure
[ Asities - collection of fluid within the abdominal cavity, the pt has a very round belly – skinny with big round belly ]
Pre-cancerous changes associated with GERD?
Barrett’s Esophagus
{A precursor for developing esophageal cancer. Recommended that pt with this go in and get checked every 6 months}
Pathophysiology of Acute Kidney Injury: Post-renal
Kidney stones {and blood clots, BPH, urethral edema}
Pathophysiology of Acute Kidney Injury: Intra-renal
Lack of filtration of the the kidneys causing damage to the nephro-tubules epithelial cells
{Nephrotoxic agents, infections, ischemia and blockages such as renal calculi, polycystic kidney disease}
Pathophysiology of Acute Kidney Injury: Pre-renal
Hypovolemia (and shock, blood loss, embolism, pooling of fluid due to ascites or burns, cardiovascular disorders, sepsis)
What are the nursing actions for a pt with hyperkalemia?
Monitor the heart (especially when electrolytes are abnormal)
What are the initial manifestations in Acute Kidney Injury, what is seen first?
Decreased urine output (Polyuria)
Urine characteristics in nephrotic syndrome, what are you going to find in the pts urine?
Proteinuria’s (high levels of protein)
Pathophysiology of Multiple Sclerosis:
You will see demyelination of the neurosensors (nerve fibers of the brain and spinal cord)
{Motor neuron issues within the brain stem because there is an autoimmune reaction happening}
Pathophysiology of Parkinson’s Disease:
Tremors due to DECREASED dopamine levels
What is the primary nursing dx with someone who has ALS?
Due to progressive muscle loss, we are concerned with breathing (aspiration)
What is the nursing priority assessment for a pt with Myasthenia Gravis?
- Airway
- Breathing
- Swallowing
Pathophysiology of Gillian Barre Syndrome:
Generates antibodies that cross-react
{Destruction of myelin sheath covering peripheral nerves as result of immunologic response}
What happens in a swallow evaluation / swallow screen: What is the criteria for a FAILED swallow screen/ swallow eval?
- When they are not coughing
- They have to drink for a certain period of time
- Horse voice quality
- Wet burping quality {fluids are not passing properly}
[Dysphagia- difficulty swallowing]
Renal Calculi / Nephrolithiasis priorities of care of a pt with a kidney stone:
Pain control Pain is the first in assessment Take care of the pain first.
[Encourage the pt to take more fluids/ monitor output INO]
Nursing care for a pt with a kidney stone:
Straining the urine. We want to make sure the stones are passing.
Prevention of Renal Calculi:
Hydration (drinking plenty of fluids)
What is the most common type of kidney stone composted of?
Calcium oxalate
Characteristics of struvite kidney stones:
Most common in women
Struvite v.s. Calcium oxalate kidney stone: Which one is most closely associated with UTI?
Struvite
Pathophysiology of Celiac Disease {Attacks the intestines}
Intolerance to gluten An antibody response that the body produces in response to gluten
Colon causes a hypertonicity of the bowl and causes it to act like a laxative
What happens as a result of this autoimmune response (Celiac Disease). What happens to the intestines?
Damages the intestinal villi {damage to the mucosa layer of the small intestines occurs following ingestion of a substance called gluten}
Pathophysiology of Ulcerative Colitis:
**Inflammation and hemorrhaging in the mucosal layer of the colon which causes abscesses which then causes necrosis and ulcer formation because of the necrosis and the necrotic cells beginning to slump off ***
Non-specific inflammatory condition of the colon
*With the inflammation and hemorrhaging in the lining of the colon [the mucosal layer] eventually there will be abscesses that will slump off over time. As they slump off the bowl will develop necrosis and that is what causes the ulcer formation. The blood in the colon causes a condition called pertinacity of the bowl; this causes this situation to act like a laxative with ulcerative colitis. They will have a lot of diarrhea. Causes a hypertonic state.
They will also have weight loss because they are not absorbing nutrients properly.
Pathophysiology of Graves-Disease:
Hyperthyroidism = over stimulation of the thyroid hormones (immunoglobulins)
What is causing the over simulation of thyroid hormones in Graves-Disease?
Immunoglobulins
Pathophysiology of Hashimoto’s Disease (Addison’s Disease):
Your immunity attacks your thyroid and destroys the tissue
-This is the most common thyroid disease and most common cause of hyperthyroidism
For a pt with Chron’s Disease: What is the Dx test that they can run to confirm it?
Colonoscopy
Pathophysiology of Pheochromocytoma:
Adrenal tumors
What occurs in the presence of adrenal tumors on the kidneys?
The hormone is secreted > how we we will see it manifested first in the pts physical:
- *
1. sweating
2. hypertension
3. tachycardia
4. potential for dysrhythmias
S/S of Addison’s Disease:
- Hyperpigmented skin (tanned skin)
- Weight loss
- Hypotension
- Hyperkalemia
- weakness
Clinical manifestations of adrenal crisis:
- Hypoglycemia
- Hyperkalemia
- Hypernatremia
- Hypotension
- Shock
- Changes in LOC
- Fever
- Convulsions
- Fainting
- Fever
- Syncope
S/S Cushing’s Syndrome:
- Moon face
- Buffalo hump
- Obesity (truncal)
- Purple striae
- Thinning limbs
What are the nursing actions for a pt with hyperparathyroidism:
EKG Monitoring (due to hypercalcemia)
Pathophysiology for BPH:
Formation of lesions in the prostate or swelling in the tissues of the prostate
If you have swelling in the tissues around the urethra, what will you see as a result:
Obstructed urination, they will have a difficult time urinating
For your pt who had a trans-ureteral-resection of the prostate (TURP), what would you expect their urine to look like?
Hematuria (Red)
- Really dark/ burgundy
- Make sure the rate is just right for continued irrigation of the bladder clearing out the blood so is does not clot and clearing out clots that may be there
S/S of BPH:
- Polyuria (Frequent urination)
- Weak stream / stream that stops and starts / difficulty starting urination
- Inability to empty the bladder
- Nocturia
- Dribbling at the end of urination
Risk factors for prostate cancer:
- Age
- Genetics
- Race (African-Americans/ Hispanic)
- Diet (obesity)
- Sedentary lifestyle
- Diabetes
For early detection of prostate cancer, what are the test that Dr.s will do?
- PSA (Prostate Specific Antigen): Blood draw
2. Rectal Exam to palpate the prostate
Causes of Chronic Kidney Disease:
- Type 1 or 2 diabetes
- Hypertension
- Prolonged obstruction (Benign Prostatic Hypertrophy [BPH])
- Interstitial nephritis
- Untreated Acute kidney injury
- Polycystic Kidney Disease
Pathology of Chronic Kidney Disease
Gradual progressive loss of renal function over time
What happens as a result of Chronic Kidney Disease? If the kidneys are not functioning properly what is concerning that we will see as a result of that?
- *Decreased GFR (Glomerular Filtration Rate)
If the GFR is decreased; you will see because of the kidney failure all of the toxins are not being filtered out properly - Hyperkalemia
- Anemia decreased production of erythropoietin
- Low levels of vitamin D
- Hyperphosphatimia
Preventative measures that a pt can take to avoid osteoporosis?
- Adequate intake of calcium and vitamin D
- Exercise
- Avoid corticosteroids
What is the normal process for women as the age?
Menopause
Decrease in estrogen
They are at risk for osteoporosis because of their calcium levels getting low
What do we want to promote as women go through menopause to prevent osteoporosis?
- Hormone therapy with estrogen
2. Intake of vitamin D
Pathophysiology of Juvenile Idiopathic Arthritis?
Root cause: Autoimmune disease
For a pt with osteoarthritis what are you going to tell them do do for self-management?
- Rest (especially if the pt is having a really hard day, you don’t want to further stress the joints)
- Weight reduction
- NSAIDs (only take when having moderate/ mild pain)
Risk factors for osteoporosis?
- Age
- Postmenopause
- Obesity
- Smoking
- Family history
- Low-calcium in take
- Female
- Race
- Low body weight
In caring for a pt with heart failure or pulmonary edema - what is going to be a the main priority for interventions for this pt.:
Airway / breathing
Administration of O2 and use of diuretics
S/S of right sided heart failure:
- Jugular Vein Distension (JVD)
- Peripheral Edema
- Asities (Issues with liver function)
- Fluid build up around the abdominal cavity and liver
- Enlarged spleen and liver
- Fatigue and activity intolerance
- Bilateral lower extremity edema
S/S of LEFT sided heart failure:
- Orthopnea {if the pt lays down they will be short of breath// pts will have to be elevated}
-
Increased pulmonary pressure
* Pulmonary edema that produces blood tinged sputum* - Fatigue
- Restlessness and confusion
- Cough
- Cyanosis
- Decreased cardiac output
Nurse management of heart failure:
- *Take frequent breaks to avoid over exertion**
- Reduce cardiac workload, we want to promote rest
- Fluid restriction
What is blood in the colon causes a condition called____________
Hypertonicity
