ATI medications Flashcards

Question

A nurse is reviewing a client’s laboratory findings for urinalysis. The findings indicate the urine is positive for leukoesterase and nitrites. Which of the following is an appropriate nursing action? A. Repeat the test early the next morning. B. Start a 24-hr urine collection for creatinine clearance. C. Obtain a clean-catch urine specimen for culture and sensitivity. D. Insert a urinary catheter to collect a urine specimen.

Answer 1

C. Obtain a clean-catch urine specimen for culture and sensitivity. Obtaining a clean-catch urine specimen for culture and sensitivity is an appropriate nursing action because this determines the antibiotic that will be most effective for treatment of the urinary tract infection.

Answer 2

C. Monitor for orthostatic hypotension. The appropriate action by the nurse is to monitor for orthostatic hypotension because the antihypertensive effect of captopril results in a change in blood flow to the kidneys when an initial dose is administered.

Answer 3

Rids the body of excess fluid and electrolytes Achieves acid-base balance Eliminates waste products Restores internal homeostasis by osmosis, diffusion, and ultrafiltration

Answer 4

Avoid taking blood pressure, administering injections, performing venipunctures or inserting IV lines on an arm with an access site. Elevate the extremity following surgical development of AV fistula to reduce swelling.

Answer 5

Dialysis circuit clotting, air bubbles in blood tubing, temperature of the dialysate (37.8° C [100° F]), regulation of the ultrafiltration. Hypotension, cramping, vomiting, bleeding at the access site, contamination of equipment.

Answer 6

caused by too rapid a decrease of BUN and circulating fluid volume. It may result in cerebral edema and increased intracranial pressure

Answer 7

nausea, vomiting, change in level of consciousness, seizures, and agitation.

Answer 8

treatment of choice for older adult pt unable to tolerate anticoagulation pt with vascular access difficulty pt has chronic infections or are unstable

Answer 9

``` fever purulent drainage redness, swelling bloody, cloudy, frothy dialysate drainage at access site ```

Answer 10

respiratory distress abd pain insufficient outflow discolored outflow

Answer 11

Hemodialysis returns a balance to serum electrolytes. Hemodialysis returns a balance to serum electrolytes by removing excess sodium, potassium, fluids, and waste products; and restores acid-base balance.

Answer 12

Reviewing the client’s current medication history will determine what medications to hold until after dialysis. Assessing the client’s AV fistula for a bruit determines the patency of the fistula for dialysis. Obtaining the client’s weight before dialysis is needed to compare with the client’s weight after dialysis. Checking the client’s serum electrolytes determines the need for dialysis.

Answer 13

The nurse should check the BUN and serum creatinine to determine the presence and degree of uremia or waste products that remain following dialysis. Medications that can be partially dialysed during the treatment should be withheld. After the treatment, the nurse should administer the medications. A client who is post-dialysis is at risk for hypovolemia due to a rapid decease in fluid volume. The nurse should assess the access site for bleeding because heparin is administered during the procedure to prevent clotting of blood with the dialyzing surfaces.

Answer 14

The nurse should assess the client’s level of consciousness. A change in urea levels can cause increased intracranial pressure, and subsequently, the client’s level of consciousness is decreased.

Answer 15

The nurse should monitor serum glucose levels because the dialysate solution contains glucose. The nurse should monitor for cloudy dialysate return, which indicates an infection. Clear, light yellow solution is expected during the outflow process. The nurse should assess for shortness of breath, which may indicate the client’s inability to tolerate a large volume of dialysate. The nurse should check the access site dressing for wetness and determine whether the tubing is kinked, pulled, clamped, or twisted, which can increase the risk for exit site infections.

Answer 16

Anorexia, fatigue, numbness and tingling of extremities, shortness of breath, dry itchy skin, metallic taste in the mouth, muscle cramping

Answer 17

``` Decreased attention span seizures, tremor, heart failure, edema of hands and feet, dyspnea, distended jugular veins, anemia, vomiting, pulmonary edema, hypertension, cardiac dysrhythmias, pallor, dry itchy skin, bruising, halitosis, and diminished or dark‑colored urine ```

Answer 18

Low fat to decrease cholesterol, high fiber to avoid constipation, increased protein to promote healing, rebuild and maintain muscle mass. Normal intake of potassium, calcium, and phosphorus. Restrict sodium intake to prevent fluid retention and hypertension especially when taking prednisone. Avoid concentrated sugars or carbohydrates to control glycemic factors when on prednisone. Magnesium supplements because cyclosporine (Neoral) can reduce magnesium levels. Avoid grapefruit when taking cyclosporine, which causes increased cyclosporine blood levels.

Answer 19

Findings – fever, hypertension, pain at the transplant site within 48 hours after surgery Treatment – immediate removal of the donor kidney.

Answer 20

An antibody mediated response causing vasculitis in the donor kidney, and cellular destruction starts with inflammation that causes lysis of the donor kidney

Answer 21

occurs 1 week to 2 years after surgery Findings – Oliguria, anuria, low-grade fever, hypertension, tenderness over the transplanted kidney, lethargy, azotemia, and fluid retention. Treatment – Involves increased doses of immunosuppressive medications

ATI medications Flashcards

(45 cards)