Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NURS 4390 Adult Health Theory > Week Seven Modules > Flashcards

Week Seven Modules Flashcards

1
Q

the anterior pituitary hormone produces which hormones?

the posterior pituitary hormone produces what hormone?

A

adreno-corticoid hormone (ACTH) and thyroid stimulating hormone (TSH)

vasopressin/ anti-diuretic hormone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is the job of both the pituitary and adrenal glands?

A

secrete hormones for cellular regulation of the entire body as well as fluid and electrolyte balance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is the main function of the anterior pituitary?

what is the main function of the posterior pituitary?

A

regulates growth, metabolism, and sexual development

secretes vasopressin which helps to maintain fluid and electrolyte imbalance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is the main function of the adrenal gland hormones?

A

provide life sustaining assistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

issues with the anterior pituitary can cause what kinds of diseases?

if the patient is experiencing cushing’s disease this means there is _____ levels of cortisol

if the patient is experiencing addison’s disease this means there is ____ levels of cortisol

A

addison’s disease and cushing’s disease

high

low

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is the etiology of cushing’s disease?

cushing’s disease means that there is anterior pituitary _____

how are adenomas classified?

A

most common cause is a pituitary adenoma (tumor)

hyperfunction

classified by the hormone that is secreted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are some common s/s we’d expect to see with cushing’s disease?

A

elevated plasma cortisol levels, weight gain, truncal obesity, “moon face”, and loss of bone density

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are some nursing interventions for cushing’s disease?

A

first, you’ll want to do an assessment of the complicating conditions such as CV, DM, and infections

monitor VS, daily weight, and glucose

emotional support –> due to appearance changes such as truncal obesity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

when it comes to providing emotional support for your patient, you’ll want to remember

patients may feel ____ or _____

remain _____ to the patient’s condition

offer _____ and unconditional acceptance

A

unattractive; unwanted

sensitive

respect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are some expected diagnostic tests for a patient who has been diagnosed with cushing’s disease?

A

chem 7 (especially Na+, K+, and glucose); 24 urine tests, serum cortisol level, and dexamethasone suppression test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are the normal ranges for serum cortisol?

what are the normal ranges for the dexamethasone suppression test?

A

at 8 am: normal ranges are from 5 - 23 mcg/dL

at 4pm: normal ranges are from 3 - 13 mcg/dL

low dose: >50%
high dose: same as above

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

how can we surgically manage cushing’s disease due to anterior pituitary hyperfunction?

before any of these surgical procedures occur what might the patient’s pre-op teaching consist of?

A

hypophysectomy; trasnphenoidal approach or transnasal approach; if tumor cannot be reached, then craniotomy

teach the patient about mustache dressing (dri pad placed under the nose), do not cough, brush teeth (oral rinse is okay), bend over, or blow your nose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what does post-op care look like for a patient who has cushing’s disease?

A

assess VS, assess congestion and mental status, assess the OR site and observe for drainage, teach drug plan, and teach the patient to report any s/s of hyperpituitarism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

addison’s disease = _______

what is the etiology of addison’s disease?

A

adrenocortical insufficiency

all 3 classes of adrenal corticosteriods are reduced and these patients also have low cortisol levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

addison’s disease may cause things like _____ or lack of pituitary ACTH _____

up to 80% of addison’s disease cases are due to an _______ response

A

ACTH deficiency; secretion

autoimmune

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is the function of ACTH?

what are some functions of androgens?

A

regulate the levels of cortisol which is released by the adrenal glands

in women, androgen plays a key role in the hormonal cascade that starts puberty;

regulates the function of bone, liver, kidneys, and muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

name some functions of cortisol

A

controls blood sugar levels, regulates metabolism, reduces inflammation, assists with memory, and has a controlling effect on the salt/water balance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what are some signs and symptoms of addison’s disease?

A

has a slow onset, symptoms are not evident until 90% of the adrenal cortex is destroyed, anorexia, nausea, progressive weakness, bronze colored skin, and salt craving

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are some nursing interventions for addison’s disease?

A

life long hormone therapy (glucocorticoids & mineralcorticoids); monitor the patient while correcting fluid and electrolyte imbalances; take VS and blood sugar; and guard the patient against infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

another nursing intervention we want to be agile about is making sure we obtain _____ and monitor _____

A

daily weights; intake/output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what does the patient teaching plan look like for an individual who has been diagnosed with addison’s disease?

A

educate the patient about the need for lifelong replacement therapy, lifelong medical supervision, prevention of infection, prevent falls, and wear a medication alert ID bracelet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

another important teaching tip we might want to mention to a patient with addison’s disease would be what?

A

always carry an emergency medical kit that contains 100 mg IM (intramuscular) hydrocortisone, syringes, and instructions for use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what are some abnormal lab findings we would expect to see in a patient with addison’s disease?

A

hyperkalemia, hypochloremia, hyponatremia, hypoglycemia, and anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is an ACTH stimulation test?

A

a test where base line cortisol and ACTH levels are drawn, patient is given an IV injection of synthetic ACTH, and then cortisol and ACTH levels are rechecked

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

with an ACTH stimulation test, the normal expected response would cause a ___ in cortisol levels

however, people with addison’s disease will have ____ to ___ increase in their cortisol levels

A

rise

little; no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what are some of the main functions of the thyroid?

A

thyroid stimulating hormone stimulates the thyroid gland to produce T4 and T3

the thyroid takes iodine found in many foods and converts it into T4 and T3

these hormones help regulate the body’s metabolic rate, heart function, digestive function, and mood maintenance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what are two examples of thyroid disorders?

A

goiter and hyperthyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what is goiter?

what can cause goiter?

A

goiter is an enlargement of the thyroid gland with/without s/s of thyroid dysfunction

increased levels of TSH can stimulate thyroid enlargement and cause goiter formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

thyroid hormone levels should be monitored in patients who take what medications?

A

lithium, phenytoin, and rifampin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

if the individual has ____ iodine levels then they are also at risk for developing goiter

low iodine can cause goiter because iodine is a necessary component in the synthesis of ______

low iodine levels tend to be a problem for people living in _______

A

low

thyroid hormones

developing countries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what causes hyperthyroidism?

what is the etiology behind hyperthyroidism?

what does the diagnosis for hyperthyroidism look like?

A

excessive secretion of T3 and T4

most common etiology is Grave’s disease (50 - 60% of cases), autoimmune disorders, and autoantibodies that work against the thyroid

high levels of T3 and T4 with low levels of TSH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

what is the next most common cause of hyperthyroidism?

A

subacute thyroiditis which usually occurs following episodes of extreme stress or infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what are risk factors for grave’s disease?

does grave’s disease have a familial component?

A

being between the ages of 40 - 60 years old; women often are diagnosed more than men

yes, about 15% of patients have a relative with grave’s disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

what are s/s of grave’s disease/hyperthyroidism?

A

all metabolic activities are accelerated; energy expenditure increases with a rise in heat production; effects of hyperthyroidism can be seen in all body systems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

patients with grave’s disease will also have _____ sensitivity to the SNS neurotransmitters which puts them at risk for things like ____ or ____

another symptom to be on the lookout for is ___ which is what?

A

enhanced; a-fib; heart failure

exopthalmos which is a wide-eyed stare that is often present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

what are some signs and symptoms of grave’s disease that we can observe?

A

anxiety, tremor, tachycardia, weight loss, and decreased fertility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

what are some treatment options for graves’ disease?

A

ablation of the hyperactive thyroid gland, medications like methimazole, PTU, and radioactive iodine; or surgery where the gland itself is removed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

after a patient goes under ablation therapy, the thyroid gland is rendered as “____”, and replacement thyroid hormone (___) is needed for life

A

inactive; levothyroxine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

what are some medication interventions for graves’ disease?

A

with methimazole, we want to remind women to report pregnancy b/c the drug can cause birth defects and should not be used while the woman is pregnant

with PTU, we need to teach the patients to report darkening of the urine or yellowing of the skin/eye whites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

another patient teaching tip we might offer to a graves’ disease patient would be …..

A

teach patients to avoid crowds and people who are ill because the drugs they are prescribed reduce the immune response, which increases the risk for infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

what are some nursing interventions for graves’ disease?

A

monitor patient for complications (check VS every 4 hours and look out for increase in temp and BP b/c this could be a sign of “thyroid storm”)

reduce stimulation - encourage the patient to rest in a quiet environment

promote comfort - lower room temperature, suggest a cool shower

teach the patient and family about therapeutic drugs and procedures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

if the patient has graves’ disease, the serum T3 levels will be ____, the serum T4 will be _____, and the TSH levels will be ____

A

increased; increased; low

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

what are the normal ranges for serum T3?

what are the normal ranges for serum T4?

what are the normal levels for TSH?

A

70 - 205 ng/dL

4 - 12 mcg/dL

2 - 10 micro/mL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

hypothyroidism is the same as _______

A

hashimoto’s thyroiditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

what causes hypothyroidism to occur?

A

occurs when T3 and T4 levels are low and the TSH remains high

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

what is primary hypothyroidism?

what can cause primary hypothyroidism?

what is secondary hypothyroidism?

A

happens when the thyroid itself does not secrete t3 and t4 - about 90% of patients

autoimmune thyroid destruction, endemic iodine deficiency, cancer, and drugs

the pituitary is not secreting enough TSH, so there are low levels of T3 and T4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

thyroid disease is much more common in ____ than ____

it has been found that _____ have a higher incidence than African Americans or Asian Americans

A

women; men

caucasians

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

hashimoto’s thyroiditis is an _____

hashimoto’s thyroiditis is the most _____ of hypothyroidism

what are some risk factors for hashimoto’s thyroiditis?

A

autoimmune disease

common cause

greater than 50 years old; pregnancy; radiation to the neck; female; family history

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

taking medications like ______, _____, _____, and lithium can increase your risk of hashimoto’s thyroiditis

A

radioactive iodine; amiodarone; interleukin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

what are some s/s of hypothyroidism?

A

hyper carotenemia (causing yellow/orange tint to the skin); puffy face; hoarse voice; brittle nails; high cholesterol and high triglycerides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

what is the treatment program for hypothyroidism?

A

replacement hormone therapy

patient will be prescribed levothyroxine that needs to be taken on an empty stomach 30 min to 1 hour before breakfast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

what are some nursing interventions for hypothyroidism?

A

monitor VS, improve ventilation and oxygenation, prevent hypotension, and observe and chart the presence of lethargy, drowsiness, and poor attention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

syndrome of inappropriate antidiuretic hormone occurs when there is _____ ADH

A

too much

54
Q

with SIADH, water is _____ causing a dilutional effect on Na+ leading to _______

SIADH occurs when there is a problem in which ______ is secreted, even when plasma osmolarity is ___

A

retained; dilutional hyponatremia

vasopressin; low; normal

55
Q

what some other causes of SIADH?

A

recent head trauma, cerebrovascular disease, tuberculosis/pulmonary disease, cancer, and medications

56
Q

what are some s/s of SIADH?

A

hyponatremia, hypothermia, loss of appetite, bounding pulse, lethargy and headaches

57
Q

what are some nursing interventions for SIADH?

A

restrict fluid intake (500 - 1000 ml in 24 hours)

promote excretion of water

monitor responses to therapy by doing things like taking daily weight

prevent complications

teach and educate the patient about fluid restrictions

58
Q

remember:

with SIADH, weight gain of ____ or more per day is cause for concern

1 kg = ____ of fluid

A

1kg

1 L

59
Q

what are some other nursing interventions to keep in mind when providing care for a patient diagnosed with SIADH?

A

monitor the patient for increased fluid overload, provider a safe environment (in case of neuro changes/seizures), assess for muscle twitching, place seizure pads on bed, assess neuro status frequently (once every 24 hours)

60
Q

what does drug therapy look like for diseases like SIADH?

A

vasopressin receptor antagonists like “vaptans” are given to the patient

these are used to treat SIADH when hyponatremia is present in hospitalized patients

promote water excretion without causing Na+ loss

61
Q

what are some other medications that might be prescribed to patients with SIADH?

A

diuretics - to be used on a limited basic when Na+ levels are near normal but heart failure is present

hypertonic saline (3%) - which is used for treating SIADH patients with low sodium levels

62
Q

diabetes insipidus occurs when there is _____ ADH in the posterior pituitary

A

too little

63
Q

what is the etiology of diabetes insipidus?

with diabetes insipidus, water is ____, due to ADH ___, or the inability of the ____ to ____ to ADH

A

it is a disorder of the posterior pituitary

lost; deficiency; kidneys; respond

64
Q

what happens as a result of diabetes insipidus?

diabetes insipidus can lead to things like ____, ____ and disturbed ______

A

excretion of large volumes of dilute urine

polyuria, dehydration, fluid & electrolyte imbalance

65
Q

with diabetes insipidus, dehydration ____ serum sodium levels and plasma osmolarity which leads to feelings of ____

thirst aids in maintaining ______

A

increases; thirst

hydration

66
Q

what causes PRIMARY diabetes insipidus?

what causes SECONDARY diabetes insipidus?

what causes DRUG RELATED diabetes insipidus?

A

caused by a defect in the hypothalamus or pituitary

caused by tumors, head trauma, and infections

caused by demeclocycline or lithium which are known to interfere with kidneys response to ADH

67
Q

what are some s/s of diabetes insipidus?

A

most symptoms are related to dehydration

key symptoms are increase in urination and excessive thirst

individuals who have had a recent surgery, head trauma, or lithium use are also at risk for developing DI

68
Q

what are some CARDIOVASCULAR s/s of diabetes insipidus that we might see in a patient?

A

hypotension, tachycardia, and weak peripheral pulses

69
Q

what are some KIDNEY/URINARY s/s of diabetes insipidus that we might see in a patient?

A

increased urine output, dilute urine with low specific gravity (less than 1.005)

70
Q

what are some treatment options for diabetes insipidus?

if the patient has been prescribed DDVAP as a nasal spray what education should they receive?

A

drug therapy such as desmopressin acetate (DDAVP) either given sublingually or as a nasal spray

teach the patient that each metered dose delivers 10 mcg and they may only need one or two doses in 24 hours

71
Q

what are some nursing interventions for diabetes insipidus?

A

strict i&os; measure specific gravity; measure patient’s daily weight; encourage the patient to drink fluids; teach the patient that polyuria and polydipsia are signals that the body needs another dose of DDVAP

72
Q

with diabetes insipidus patients, we must teach them the importance of ______ daily adn to identify any signs of weight gain

A

weighing themselves daily

73
Q

if there is a weight gain of more than _____, along with persistent ____ or _____, we must instruct the patient to go to the ___ or call 911 immediately

A

1kg; nausea/vomiting; confusion; ER

74
Q

what is acute kidney injury?

A

injury to the kidney that can range from slight deterioration in kidney function to severe impairment

75
Q

what are some characteristics of acute kidney injury?

A

rapid loss in kidney function; a rise in serum creatinine; or reduction in urine output

76
Q

ACUTE KIDNEY INJURY

  • potentially ______
  • affects patients with other conditions like ____, ____, and _____
  • AKI often follows severe, prolonged _____, and _____
A

reversible

HF, MI, and infections

hypotension; hypovolemia

77
Q

what is the etiology of (PRE-RENAL) acute kidney injury (AKI)?

A

pre-renal factors that reduce systemic circulation causing reduction in renal blood flow

then

the decreased blood flow leads to decreased glomerular perfusion and filtration of kidneys

78
Q

what causes pre-renal oliguria?

with pre-renal etiology factors is there damage to the kidney?

is pre-renal kidney injury reversible?

A

caused by decreased circulating blood volume

no, no damage

reversible with dehydration

79
Q

what is the etiology of (INTRA-RENAL) acute kidney injury (AKI)?

A

caused by direct damage to the kidney tissue resulting in impaired nephron function

80
Q

intra-renal acute kidney injury causes _____ of structures by crystallizing which causes damage to the ____

does intra-renal acute kidney injury affect the kidneys?

A

obstruction; tubules

yes

81
Q

what is the most common cause of intra-renal acute kidney injury?

A

acute tubular necrosis

82
Q

what 3 things cause acute tubular necrosis?

is acute tubular necrosis reversible?

A

due to ischemia, nephrotoxins (90% of the time), or sepsis

yes, it is potentially reversible if the basement membrane has not been destroyed

83
Q

what is ischemia?

what are nephrotoxins?

A

causes disruption in the basement membrane and destruction of the tubular epithelium

causes necrosis of the tubular epithelial cells which can plug the tubules

84
Q

what causes post-renal acute kidney injury?

A

caused by the mechanical obstruction in the outflow of urine

b/c outflow of urine is blocked it can lead to impaired kidney function

85
Q

what are some examples of post-renal acute kidney injuries?

what are some examples of intra-renal acute kidney injuries?

A

benign prostatic hyperplasia, prostate cancer, and kidney stones

prolonged ischemia and nephrotoxins

86
Q

post-renal acute kidney injuries account for less than ___% of acute kidney injury patients

what are the three phases of acute kidney injury?

what can happen if the patient does not recover from AKI?

A

10%

oliguric, diuretic, and recovery

chronic kidney disease may develop

87
Q

the most common initial sign of acute kidney injury is _____

what happens during the oliguric phase?

during the oliguric phase, damaged tubules cannot conserve _____

in the oliguric phase, _____ increases because the kidneys are unable to excrete 80-90% of the body’s potassium

A

oliguria

kidneys cannot excrete acid products so metabolic acidosis occurs

sodium

potassium

88
Q

during the oliguria phase, hyper_____ and hypo____ can occur

during the oliguria phase, the patient will complain of feelings of _____ and ____

A

hyperkalemia; hyponatremia

fatigue and malaise

89
Q

if your patient suffers from high potassium levels what are some things you could do?

A

give kayexalate

hemodialysis

D50 push, followed by 10 units of regular insulin through IV

dietary restrictions - low K+ foods

90
Q

what are some examples of neurologic disorders in the oliguric phase?

A

because nitrogenous waste products are accumulating in the brain issues like fatigue, difficulty concentrating, and seizure can occur

91
Q

what are some hematologic disorders that can occur with the oliguric phase?

what is the most common cause of death in acute kidney injury?

what are some examples of waste products that are produced due to the oliguric phase of acute kidney injury?

A

leukocytosis is often present

infection

the kidneys excrete urea which is the end product of protein metabolism; resulting in high levels of BUN and Creatinine

92
Q

during the oliguric phase of acute kidney injury, it’s important that the patient receives ______

on average, how much fluids will the patient receive per day as part of their fluid replacement treatment?

why is the initial base of 600 mL given?

A

fluid replacement

600 mLs + the amount of the previous day’s urine output

it’s given to replace the insensible fluid loss which consists of things like sweating, respirations,and water in the stool

93
Q

what is the average water loss through diffusion that passes through the skin?

A

approximately 300 mLs + the other 300 mLs that is lost through respirations = which equals 600 mLs

94
Q

when does the diuretic phase of acute kidney injury occur?

during the diuretic phase, you want to monitor the patient for _____ and ______

during the diuretic phase, the kidneys have recovered from their ability to _____ but not to ____ the urine

with the diuretic phase of acute kidney injury we want to monitor ____ levels and ____ levels because of the large losses of fluids/electrolytes

A

when the urine output increases, but the nephrons are not fully functional

hypotension; hypovolemia

excrete waste; concentrate

sodium; potassium

95
Q

what happens during the recovery phase of acute kidney injury?

A

the bun/creatinine levels decrease

kidney function may take up to 12 months to stabilize

some patients don’t always recover and progress to end stage renal disease

96
Q

what are some possible nursing interventions for acute kidney injury?

A

daily weights; vitals signs; strict i & o’s; examining the urine (color, clarity, and volume); and checking electrolytes

97
Q

according to the CDC, CHRONIC KIDNEY INJURY is more common in ____ (15%) than ____ (12%)

A

women; men

98
Q

what are some prevention tips for chronic kidney disease?

what are some treatment options for chronic kidney disease?

A

keep blood sugar WDL, keep blood pressure WDL, and having healthy body weight

test patients for creatinine, test patient’s urine for protein

99
Q

what are some risk factors for chronic kidney disease?

A

diabetes and HTN are the major causes of CKD in adults

other risk factors include: heart disease, obesity, and family history

100
Q

what are some other health problems that chronic kidney disease can cause?

A

increases the risk of heart disease and stroke

as the chronic kidney disease worses, there is higher incidence of anemia, low calcium, and high potassium

101
Q

chronic kidney disease is much more ____ than acute kidney injury

prevalence of chronic kidney injury is attributed to ____ rates of ____, ___, and diabetes

since the kidneys are highly adaptive, kidney disease is not detected until there is a considerable amount of _______

A

common

increasing; obesity; HTN

loss of neurons

102
Q

CKD is often _____ about ____% of patients are not aware that they have CKD

A

asymptomatic; 70%

103
Q

if the patient has stage 1 chronic kidney disease, their glomerular filtration rate is either greater than/equal to _____

if the patient has stage 2 chronic kidney disease, their glomerular filtration rate is between ____ and ____

if the patient has stage 3A chronic kidney disease, their glomerular filtration rate is between ___ and ____

A

> =90

60 - 89

45 - 59

104
Q

what is the action plan for stage 1 chronic kidney disease?

what is the action plan for stage 2 chronic kidney disease?

what is the action plan for stage 3a chronic kidney disease?

A

diagnosis and treatment, CVD risk reduction

estimate the progression

evaluate and treat complications

105
Q

what is glomerular filtration rate?

A

how much blood is filtered through the glomeruli each minute

106
Q

what are clinical manifestations of chronic kidney disease?

A

all body systems are affected

s/s are retained urea, creatinine, and hormones

107
Q

_____: a syndrome where the kidney function decreases

A

uremia

108
Q

when does the symptom of uremia tend to occur?

A

when the GFR is less than or equal to 15 mLs/min

109
Q

what are some neuro s/s of chronic kidney disease?

______ should help improve CNS s/s

A

lethargy, decreased concentration, fatigue, and peripheral neuropathy

dialysis

110
Q

what are some neuro/psych s/s of chronic kidney disease?

A

personality and behavioral changes; emotional lability; and depression

111
Q

the most common cause of death in chronic kidney disease is ______

issues like HTN are worsened by the ____ retention

chronic kidney disease patients are susceptible to _____ due to _____

A

cardiovascular disease

sodium

dysrhythmias; hyperkalemia

112
Q

what is a pulmonary s/s of chronic kidney disease?

how does the body compensate for metabolic acidosis?

A

metabolic acidosis

kussmaul breathing which removes CO2 and

113
Q

what are some GI symptoms of chronic kidney disease?

what can chronic kidney disease due to the hematologic system?

A

stomatitis and ulcers; anorexia; weight loss; and malnutrition

can cause anemia, bleeding, and infection

114
Q

why does anemia happen with CKD?

why does bleeding happen with CKD?

why does infection happen in CKD?

A

it happens due to decreased production of erythropoietin by the kidneys

due to a defect in platelet function caused by impaired release of platelet factor III

happens b/c the cellular and humoral responses are suppressed

115
Q

what does chronic kidney disease due to the musculoskeletal system?

A

causes mineral and bone disorder due to low vitamin D levels which result in decreased serum calcium levels

when calcium levels are decreased, it stimulates bone demineralization

116
Q

chronic kidney disease patients have ___ levels of calcium and ___ levels of phosporus

A

low; high

117
Q

chronic kidney disease can cause what kinds of s/s to the integumentary system?

when does uremic frost occur?

A

pruritus (itching) and uremic frost which is a rare condition where urea crystallizes on the skin

occurs when the BUN levels are greater than 200

118
Q

when it comes to nutritional therapy for chronic kidney disease what are the 5 treatment goals?

A

maintain optimal nutrition; prevent protein catabolism; minimize uremic toxicity; slow down the progression of renal failure; and position the initiation of dialysis

119
Q

NUTRITIONAL THERAPY FOR CKD:

if the patient is predialysis, you’ll want to avoid feeding the patient ____ protein diets

if the patient is ON dialysis, then the patient should be allowed to have ____ intake of protein

A

high

increased

120
Q

typically, renal patients are placed on the ____ diet

A

DASH

121
Q

NUTRITIONAL THERAPY FOR CKD:

when it comes to sodium restrictions, you’ll want to limit the CKD patient to __ - ___ grams per day

you’ll want to teach the patient to ___ consumption of ____ processed ___, ___, and ____

A

1 - 3 grams;

reduce; canned foods; meats; soups; cottage cheese

122
Q

what are some potassium containing foods we want our CKD patients to avoid?

A

potatoes, bananas, cantaloupe, raisins, broccoli, coffee, and chocolate

123
Q

NUTRITIONAL THERAPY FOR CKD:

when it comes to calcium restrictions, you’ll want to limit the CKD patient to about ___ to ___ grams per day

when it comes to phosphorus restrictions, you’ll want to limit the CKD patient to consume less than ____ mg/day

what are some foods that are high in phosphorus

A

1 - 1.5

10

milk, beer, chocolate, american cheese, dried beans, and bran cereals

124
Q

what are some nursing interventions for chronic kidney disease patients?

A

teach patients about their medications and use “teach back”; monitor urine output & daily weight; assess for s/s of high potassium; monitor BUN/Creatinine levels

125
Q

for end stage renal disease, what is the criteria that needs to be met in order for dialysis to occur?

A

serum creatinine that is 6 mg/dL; general uremic symptoms (n/v, anorexia, itching); pericarditis; mental dysfunction

126
Q

the principles of ____, osmosis, and ____ across a semipermeable membrane are involved in both ____ and ____

A

diffusion; ultrafiltration; hemodialysis; peritoneal dialysis

127
Q

HEMODIALYSIS:

requires access either through a ___ or ___

hemodialysis runs last about __ to ___ hours

it pulls about __ to __ L of fluid from the patient

patients are often very ___ afterwards

what is the purpose of hemodialysis?

what medications are typically held from the patient before a hemodialysis procedure?

A

fistula; mahurkar/hickman

2 - 4

1 - 4

tired

correct fluid and electrolyte imbalances

drugs like antibiotics and HTN medications

128
Q

what are some complications of hemodialysis?

A

infection of the access site; hypotension; cramps; N/V; and blood loss

129
Q

PERITONEAL DIALYSIS:

what are the three individual phases?

these three phases are called an ___

A

inflow (fill) stage; dwell (equilibration) stage; drain stage

exchange

130
Q

what happens in the inflow stage?

how longs does the dwelling stage last?

how long does the drain stage last?

when the draining stage occurs, the dialysate should be ____ b/c cloudy dialysate indicates an ____

A

2L of fluids are infused over 10 minutes

usually between 4-6 hours

15 - 30 minutes

clear; infection

NURS 4390 Adult Health Theory (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions