A patient is diagnosed with acute Hep C. What action by nurse is most appropriate?
-Get the viral load and genotype
A nurse administers interferon to a patient with chronic Hep C, what to monitor?
-leukopenia: people who take this med become anemic
What is the main difference in contracting Hep C and Hep B?
- IV drug use (Hep C) Hx, shared needle w/someone (even if drug use from a logn time ago, very pertinent from hx)
- B: sexual contact
Which goal has a high priority in the plan of care for homeless pt admitted w/ viral hep w/severe anorexia and fatigue
-anorexia= nutrition, then fluid
Unimmunized, exposed to Hep B through needle stick, what actions to do right away?
-give immunization Hep B, test for antibodies and give HB immunoglobin
Pt admit w/abrupt onset jaundice, nausea, abnormal liver fxn test, neg for viral cause of hep. Which question by nurse most appropriate?
-do you take any OTC medication?
Pt. w/4+pittind edema w/cirrohisis, wha tlevel to see in chart? (what lab test AST, ALT, Protein)
-Albumin
Pt w. Cirrhosis K 3.2 schedule dose aldacton (potassium sparing) and lasix (potassium wasting), what should nurse do K w/3.2
-don’t give lasix
Pt w/severe cirrhosis, bleeding esophageal varices, important lab?
-ammonia
Pt cirrhosis, 4+ edema feet, legs, what mattress use?
-pressure mattress
Pt needs paracentesis, what to do before procedure?
-empty bladder
Kayexalate order pt hyperkalemia, before giving, what to do?
-listen to bowel sounds (make sure not blocked)
Pt w testicular cancer admit after 1 chemo tx, in reviewing tx plan, you know he is receiving ____ what is appropriate nursing dx for him?
-potential alteration in sexuality
Most important nurse to communicatio to CP about pt w/liver transplant 1 week ago?
-Temp 100.8
Which assessment finding indicate pt experience adverse effects of corticosteroid prescribed after kidney transplantation?
after kidney transplantation?
-knee or hip joint paint
Nurse assessing pt 4 hours after kidney transplant, which info most important to communicate to health care provider?
-Central line pressure increased
@ which point in time do you discuss sexuality w/patient diagnosed with cancer?
-@ diagnosis, treatment, recover, every visit
Hypocalcemia: what happens when low?
Muscle twitch and tense up, notifiy someone righ taway along with finger numb
Med to give for hypocalcemia
calcium glucanae
Which action nurse in ER take first for new pt vomit blood?
-take vital signs
Any pt w/pancreatis?
Must ask if they drink alcohol?
2 types of dyalis: peritoneal and hemodialyss wha tis difference?
One on abd leave fluid; hemo through a vein (insert fistula)
After insertion atriovenious graft r forearm pt complain cold right fingers. Is it importatnt or normal?
-always important, notify PCP
Which menu choice by pt reciveing hemo indicate nurse teach successful?
-poached eggs, whole weat toes, and apple juice (high protein)
Pt need vascular access for hemodialysis, which statement describes advantage of fistula over graft?
-fistula less likely to clot
Peritoneal dialsysi, pt take shower or bath?
Shower
When doing hx for pt for kidney transplant, what is not appropriate candidate fo rkidney transplant?
-cancer any form metastatic
If pt has AKI, and temporary vascular accesss in L femoral vein, what one thing you don’t want pt to do?
-restrict activity
What drugs are nephrotoxic?
-adenomyosis
Nurse will monitor adverse effects by:
-creatinine
Pt w/end stage kidney disease, getting dose procrit, what to report to provider?
-high hemoglobin levels (associated w/higher rate of thrombolytic events from serious cardiovascular events. If HGB above 12)
Dehydrated, anemia, hyperkalemia
put pt on EKG
Which info included when nurse teach self management to pt recieveing peritoneal dialysis?
-eat low potassium, high protein, white salt, take phosphate binders with each meal
3 phases of PD
inflow (fill), dwell (equilibration), drain
inflow phase
amt of solution infused through catheter over 10 min, after infused, inflow clamp close to prevent air from entering tube
dwell
diffusion and osmossis occur between pt’s blood and peritoneal cavity, duration time varies depending on method
drain
15-30 min may facilitate by gently massaging abd or changing position