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1
Q

Acute HF: Nursing collaborative mgmt

A

Primary goal to improve LV function

  • increase intravascular volume
  • decrease preload
  • decrease afterload
  • improving gas exchange & oxygenation
  • improving cardiac function
  • reducing anxiety
2
Q

Acute HF: collaborative care for decreasing preload

A
  • reduce amount of volume returned to LV
  • diruetics
  • nutritional therapy: decrease Na
  • high fowler’s
3
Q

Acute HF collaborative care: decreasing afterload

A
  • decrease pulmonary congestion (alveolar level)
  • ACE & ARBs: decrease constriction, alter aldosterone (not as effective in AA pop)
  • Nesiritide (Natrecor)- afterload & preload reducer
4
Q

Acute HF collaborative care: gas exchange

A
  • decrease pulmonary congestion
  • IV morphine- acute phase. low dose to vasodilate
  • administer oxygen
  • possible intubation- severe cases
5
Q

Acute HF collaborative care: cardiac function

A
  • Digoxin (watch for toxicity)
  • newer inotropics: PDE III inhibitor: Milrinone (Primacor)
  • B blockers: help reduce SNS response
  • hemodynamic monitoring
6
Q

Chronic HF: Nursing & Collaborative Mgmt

A
  • treat underlying cause
  • maximize (optimize) cardiac output
  • alleviate symptoms
  • rest
  • biventricular pacing
  • oxygenation treatment
  • mechanical hearts
  • heart transplantation
7
Q

Chronic HF drug therapy

A
  • ACE
  • ARBs
  • Inotropic drugs: Digoxin, PDE inhibitor
  • vasodilators
  • beta blockers
  • diuretics
  • anticoagulants (Warfarin)
  • antidysrhythmic drugs
8
Q

HF discharge training

A
MAWDS
M- medications (lasix, ACE, Bbs_
A- activity (coupled w/rest)
W- weight: best indicator of fluid status
D- diet: limit fat, sodium
S- symptoms

follow-up appointment: better outcomes
call HCP if weight changes >2 lbs overnight or >5lbs in one week

9
Q

Heart Failure

A
  • abnormal condition- impaired pumping
  • a syndrome, not a disease
  • associated w/long-standing HTN & CAD
    • results from the heart’s inability to pump amount of oxygenatied blood needed to meet metabolic requirements
10
Q

HF Risk Factors

A
  • CAD & its risk factors
  • Age
  • Hypertension: to compensate for increase bp, heart thickens. over time force of contraction weakens, preventing normal filling
  • increase cholesterol
  • AA descent: higher incidence & mortality
11
Q

Types of HF

A

Left sided:
- most common
- blood backs up thru left atrium and into pulmonary veins
Right sided:
- backflow to right atrium and venous circulation
- results from diseased right ventricle
- COPD complications
- one sided can lead to biventricular failure

12
Q

left sided HF clinical manifestations

A
  • PND
  • increase pulmonary capillary wedge pressure
  • cough
  • crackles
  • wheezes
  • blood tinged sputum
  • restlessness
  • confusion
  • orthopnea
  • tachycardia
  • exertional dyspnea
  • cyanosis
13
Q

right sided HF clinical manifestations

A
  • fatigue
  • increased peripheral venous pressure
  • ascites
  • enlarged liver & spleen
  • JVD
  • anorexia & complaints of GI distress
  • swelling in hands & fingers
  • dependent edema
14
Q

Acute HF general clinical manifestations

A
pulmonary edema
- agitation
- pale or cyanotic
- cold, clammy skin
- severe dyspnea, crackles, cough (hacking, productive, dry), "frothy" secretions
- tachypnea
- tachycardia
s/s decreased CO
- head to toe, abnormal heart sounds (s3 s4)
15
Q

HF: diagnostic studies

A

Primary goal to determine underlying cause

  • history and physical
  • ABGs, serum chemistries
  • chest xray
  • 12 lead ECG
  • hemodynamic assessment/monitoring
  • Echocardiogram (gold standard)- LVEF
  • stress testing
  • nuclear imaging studies
  • cardiac cath (underlying problem)
  • labs
16
Q

UTI

A
  • most common health care acquired infection
  • most common cause of sepsis in hospitalized patients
  • -“urosepsis”
    • most common organisms are from GI tract (E. coli)
  • common source of hospital-acquired UTI (CAUTI)
17
Q

UTI classification

A
  • upper tract: renal parenchyma, pelvis, ureters: s/s fever, chills, flank pain
  • lower tract: lower urinary tract: no usual systemic manifestations (localized symptoms)
  • sites of infection: pylonephritis, cystitis
    ascending tract can move quickly to systemic
18
Q

predisposing factors to UTI

A
  • factors increasing urinary stasis: intrinsic obstruction, extrinsic obstruction, urinary retention (tumor, stones)
  • foreign bodies: urinary calculi, urologic instrumentation (CAUTI)
  • anatomical factors: congenitial defects leading to obstruction or urinary stasis, fistula exposing urinary stream to skin, vagina, or fecal stream, shorter urethra
  • sexual intercourse
  • immunosuppression
  • functional disorders (constipation, voiding dysfunction, fecal compaction)
19
Q

UTI clinical manifestations

A

symptoms:
- dysuria, frequent urination (>q2h), urgency, suprapublic discomfort or pressure
- hematuria, or sediment, cloudy uring
- flank pain, chills, fever indicate pyelonephritis
- bacteriruia may have no symptoms or nonspecific symptoms like fatigue or anorexia

20
Q

UTI clinical manifestations in older adults

A
  • could be asymptomatic
  • non-localized abdominal discomfort rather than dysuria
  • may have cognitive impairment
  • less likely to have fever
  • frequently we see falls from the cognitive impairment
21
Q

UTI diagnostic studies

A
  • urinalysis: clean catch is preferred, or cath or suprapubic needle aspiration
  • urine culture and sensitivity
  • imaging studies in some cases: IVP or abdominal CT when obstruction suspected.
22
Q

Collaborative Care: Some UTI drug therapy

A
  • Trimthoprim-sulfamethoxaole or nitrofurantoin: used to treat uncomplicated
  • Pyridium: OTC, provides soothing effect on ut mucosa. stains urine reddish orange, anesthetic, doesn’t treat the infection
  • Prophylactic or suppressive antibiotics: pts w/repeated UTIs, prevent recurrence or a single dose prior to events likely to cause UTI
23
Q

UTI Nursing Management: Health Promotion

A
  • avoid unnecessary catheterization & early removal of indwelling catheters
  • aseptic technique must be followed during instrumentation procedures
  • handwashing
  • wear gloves for care of urinary systems
  • routine & thorough perineal care for all hospitalized patients
  • avoid incontinent episodes by answering call light & offering bedpan at frequent intervals
24
Q

UTI Nursing Management: Acute Care Intervention

A
  • instruct patient about drug therapy & side effects
  • emphasize taking full course despite disappearance of symptoms
  • second or reduced drug may be ordered after initial course in susceptible patients
  • instruct patient to watch urine for changes in color & consistency and decrease or cessation of symptoms
  • counsel on persistence of lower tract symptoms beyond treatment or onset of flank pain or fever should be reported immediately
25
Q

UTI Nursing Management: Ambulatory and Home Care

A
  • emphasize compliance with drug regimen
  • maintain adequate fluid intake
  • regular voiding
  • void after intercourse
  • temporary discontinue use of diaphragm
  • instruct on follow-up care with urine culture
  • recurrent symptoms typically occur 1-2 weeks after therapy
26
Q

UTI Nursing Management: Evaluation

A
  • use of nonanalgesic relief measures
  • appropriate use of analgesics
  • pass urine without urgency
  • urine free of blood
  • adequate intake of fluids
27
Q

Glomerulonephritis

A
  • immunologic processes involving the urinary tract predominantly affect the renal glomerulus
  • inflammation of the renal glomeruli (functional unit of the kidney)
  • Accumulation of antigen, antibody and complement in the glomeruli, results to tissue injury (type III hypersensitivity)
28
Q

Acute glomerulonephritis

A
  • patient assessment: connection with sore throat? (strep infection), proteinuria
  • physical assessment
  • clinical manifestations: hallmark facial swelling, frothy urine
  • laboratory assessment: protein or hematuria
  • other diagnostic tests: electrolyte imbalance
  • may develop an acute kidney injury
  • tx: find underlying cause and treat. some resolves on its own.
29
Q

Glomerulonephritis collaborative care

A
  • management of infection
  • prevention of complications
  • dialysis
  • plasmapheresis (like dialysis. filters foreign bodies off plasma)
  • patient education
30
Q

chronic glomerulonephritis

A
  • develops over period of 20-30 years or longer (progressive. had an acute version and was in remission)
31
Q

UT Caliculi

A

Nephrolithiasis- kidney stone disease

  • majority of cases caused by calcium stones (oxalate, phosphate)
  • caucasian, 20-55 year old men
32
Q

UT Caliculi risk factors

A
  • metabolic: increase Ca, uric acid. hyperparathyroidism, bone disease
  • climate: higher temperatures
  • urinary stasis
  • urinary retention: anticholinergics
  • immobilization
  • dehydration
  • genetic
  • lifestyle
33
Q

UT Caliculi: Clinical Manifestations

A

Manifestations result from obstruction of urinary flow
- ureterovesical junction (UVJ) common site of complete obstruction (haven’t passed urine in a while- medical emergency)
Symptoms:
- abdominal or flank pain (usually severe), hematuria, renal colic
- n/v
- pain may be absent if stone unobstructing: pain is where stone is struggling to pass. generally start in kidney. usually asymptomatic until it begins to mobilize
- stone near UVJ: lateral flank, labia, or groin
- UTI s/s, fever, vomiting, nausea and chills

34
Q

UT Caliculi: collaborative care. diagnostic tests, hx & physical

A

Diagnostic studies

  • urinalysis, urine culture, IVP, retrograde pyelogram, ultrasound, cytoscopy, CT scan
  • serum BUN, creatinine (will be elevated)
  • hx & physical: use of OTC medications and dietary supplements, previous history, family history
35
Q

Indications for endourologic, lithothripsy or open surgical stone removal

A
  • stones are too large for spontaneous passage
  • stones associated with bacteriuria or symptomatic infection
  • stones causing impaired renal function
  • stones causing persistent pain, nausea, or ileus (bowel blockage)
  • inability of patient to be treated medically
  • patient with one kidney
36
Q

UT caliculi nursing management: implementation

A
  • fluid intake should be advised according to persons’s activity, underlying illness, etc
  • normal Ca diet, low animal protein, salt or both
  • pain mgmt & comfort measures
  • teach pt to report spontaneous passage of stone (give a straining device)
  • encourage mobility
  • safety measures, for patients experiencing acute colic, particularly if using opioid analgesics
  • ice packs for bruising with lithotripsy
37
Q

Bladder cancer

A
  • most frequent malignant tumor: transitional cell carcinoma

- most common in men 60-70

38
Q

bladder cancer risk factors

A
  • cigarette smoking
  • exposure to dyes used in rubber and cable industries
  • chronic abuse of certain analgesics (phenacetin)
  • women treated with radiation for cervical cancer
  • cylophosphamide (cytoxan): unknown mechanism
  • chronic recurrent bladder stones and chronic lower UTIs
  • chronic indwelling catheters (long periods)
39
Q

bladder cancer clinical manifestations

A
  • gross painless hematuria (common finding)

- bladder irritability with dysuria, frequency, urgency

40
Q

bladder cancer diagnostic studies

A
  • urine for cytology: detects exfoliated cells from the bladder
  • IVP, ultrasound, CT or MRI
  • cystoscopy- biopsy confirms diagnosis
  • TNM staging (tumor, node, metastases)
  • low stage, low grade bladder cancers are most responsive to treatments and more easily cured
41
Q

surgical therapy: bladder cancer

A
  • transurethral resection
  • laser photocoagulation
  • open loop resection
  • cystectomy: segmental, partial, radical
42
Q

indications for urinary diversion

A
  • cancer of the bladder
  • neurogenic bladder
  • congenital anomalies
  • strictures
  • trauma to the bladder
  • chronic infections with deterioration of renal function
43
Q

bladder cancer postop management

A
  • meticulous skin care around stoma: keep urine acidic to prevent alkaline encrustations, stoma is expected to shrink within first few weeks
  • change appliance as needed
  • psychosocial support: altered body image
  • discharge planning/teaching: proper fitting of appliance, information where to purchase supplies, emergency telephone numbers, location of ostomy clubs, follow-up visits. measures to prevent complications and renal function deterioration.
44
Q

types of AKI

A
  • prerenal: shock, decreased volume, dehydration
  • intrarenal: polycystic, nephritis, dugs (NSAIDS, antibiotics)
  • Postrenal: stones, BPH
45
Q

benign breast disorders

A
  • fibroadenoma
  • solid, slowly enlarging, benign mass; round, firm, easily moveable, nontender, and clearly delineated from surrounding tissue
  • usually located in upper outer quadrant of breast
46
Q

fibrocycstic breast changes

A
  • fibrocystic changes of breast (may involve lobules, ducts, stromal tissues)
  • common in premenopausal women between 20-50 years of age
  • possibly caused by imbalance in normal estrogen-to-progesterone ratio
  • rubbery, ill-defined
  • painful/tender (opposite of malignant lumps)
  • increased tenderness & size prior to menstruation
  • symptoms increase in the premenstrual phase
47
Q

filbrocystic breast changes: collaborative care

A
  • diagnostic studies: aspiration or needle biopsy, mammography or ultrasound
  • surgical removal
  • supportive undergarments
  • OTC pain relievers
  • caffeine
  • vitamins
  • low Na diet or diuretics
  • hormones
48
Q

types of breast cancer

A

intra-ductal

non ductal

49
Q

complications of breast cancer

A
  • invasion of lymph channels causing skin edema
  • metastasis to lymph nodes
  • bone, lungs, brain, liver- sites of metastatic disease from breast cancer
  • ulceration of overlying skin
50
Q

clinical manifestations of breast cancer

A
  • single lump, mass, or mammographic abnormality
  • painless, hard, irregular edges= more likely to be cancerous
  • can also be tender, soft, or rounded
  • orange peel appearance
  • swelling of all or part of a breast
  • skin irritation or dimpling
  • breast or nipple pain
  • nipple retraction
  • redness, scaliness, or thickening of nipple or breast skin
  • a discharge other than breast milk, e.g. clear or bloody
51
Q

breast cancer in men

A
  • of all breast cancers, 1% occur in men
  • usually presents as hard, painless, subareolar mass
  • often widely spread disease because it is usually detected at a later stage in women
52
Q

breast cancer collaborative care

A
Diagnostic studies
Surgical Therapy
Radiation therapy
chemotherapy
prophylactic oophorectomy
hormonal therapy
53
Q

axillary lymph node vs. sentinel node dissection

A

exam of nodes more powerful prognostic indicator. increased nodal involvement > 4, increased risk of reoccurrence < risk of lymphedema with SLND

54
Q

Surgical therapy for breast cancer

A

Lumpectomy: if clear margins, no further treatment needed
- conserves the breast, nipple
- removal of tumor with small amts of normal tissue
- radiation post removal
- ALND vs SLND
Modified radical mastectomy
- removal of breast & axillary nodes but conserves the pectoralis muscle

55
Q

radiation therapy: breast cancer

A
  • primary treatment (5-6 weeks)
  • shrink a large tumor size to operable size
  • palliative treatment for pain
  • brachytherapy
56
Q

chemotherapy for b.c.

A

cytotoxic drugs to destroy cancer cells administered pre & post op

  • pre-op (neoadjuvant): shrink tumor, <extensive surgery
  • suppresses tumor growth & prolongs survival
57
Q

diagnostic studies for b.c.

A
  • same as fibrocystic breast changes: aspiration or needle biopsy, mammography or ultrasound
  • ploidy status: tumor differentiation (abnormality), correlates with tumore aggressiveness
  • axillary lymph node vs. sentinel lymph node dissection
  • tumor size: larger the tumor, poorer prognosis
  • stages: TMN classification
58
Q

hormonal therapy: b.c.

A

tamoxifen citrate (Novaldex)- blocks estrogen

  • post menopausal women w/o lymph node involvement, BRCA 2 mutation, or increased risk breast cancer
  • prevention in individuals in high risk category
  • side effects: hot flashes, nausea, vomiting, blood clots, & endometrial cancer
59
Q

breast cancer: post op nursing management

A
  • LOC, v/s
  • bleeding (dsg, drains)
  • infection
  • avoid bp, injections, phlebotomy affected arm
  • ambulation & diet
  • postmastectomy exercises
  • breast reconstruction- dep on patient
  • adjuvant therapy
60
Q

adjuvant therapy

A
  • radiation
  • chemo
  • targeted therapy (e.g. monoclinal antibodies for HER2/neu gene positive cancers)
  • hormonal therapy
  • stem cell transplantation
61
Q

benign prostatic hyperplasia

A
  • glandular units in the prostate that undergo an increase in number of cells, resulting in enlargement or prostate gland.
62
Q

symptoms of BPH

A
  • hyperirritable bladder
  • urgency & frequency
  • hypertrophied bladder wall muscles
  • cellules and diverticula
  • hydroureter
  • hydronephrosis
  • overflow urinary incontinence
63
Q

diagnostic studies for BPH

A
  • digital rectal exam
  • urine analysis & culture
  • serum creatinine and BUN
  • PSA (prostate specific antigen): very controversial
  • urodynamic flow studies
  • cystourethroscopy
64
Q

neurologic manifestations of CKD

A
  • confusion,
  • altered mental status
  • lethargy
  • depression
  • grieving
65
Q

cardiovascular manifestations of CKD

A
  • hypertension
  • heart failure (LV change)
  • dysrhythmias (anemia leading to hypoxic state, electrolyte imbalances)
66
Q

respiratory manifestations of CKD

A
  • acidosis
  • kussmaul respirations (increase rate and depth- compensating for acid state of kidneys)
  • pulmonary edema
67
Q

hematologic manifestations of CKD

A
  • primary is anemia

- alteration in platelets

68
Q

GI manifestations of CKD

A
  • anorexia
  • weight loss
  • n/v
  • uremic levels go through GI, can lead to halitosis
  • diarrhea/constipation
69
Q

skeletal manifestations of CKD

A
  • altered calcium= fractures

- increased parathyroid hormone

70
Q

urinary manifestations of CKD

A
  • oliguric
  • anuric (stasis)
  • increased risk for UTI
71
Q

skin manifestations of CKD

A
  • pruritis/uremic toxin building up.
  • uremic frost- hard crystals on skin
  • greying/dulling of skin
72
Q

general clinical manifestations of HF

A

Fatigue- earliest symptoms, after activities which are not normally tiring r/t decreased CO (chronic hypoxic state)
Dyspnea (PND) or SOB
- caused by alveolar edema
- PND: reabsorption from dependent areas when pt is sleeping. c/o suffocation feelings
Tachycardia
- compensatory mechanism from SNS
Heart murmur: S3, S4 from altered pumping/filling
Heaves/Lifts
- 3rd to 5th ic spaces using ball of hand
Edema/Anasarca
- legs, liver, abdomen
Nocturia r/t recumbent position, increases blood flow
Chest pain r/t decreased coronary perfusion. can be anginal.
weight changes
skin changes: dusky
sleep apnea
behavioral changes

73
Q

HF complications

A
  • pleural effusion: fluid around viscera of lung
  • arrhythmias: PVCs, A fib
  • left ventricular thrombus: stasis
  • hepatomegaly: increased size of liver
  • pulmonary hypertension
74
Q

CHF classification according to functional status

A

I: no symptom limitation with ordinary physical activity
II: ordinary physical activity somewhat limited by dyspnea
III: exercise limited by dyspnea at mild work loads (long distance walking, 2 flights of stairs)
IV: dyspnea at rest of with very little exertion (short distance walking, one flight of stairs)

75
Q

Chronic HF: nursing management planning

A

Overall goals:

  • decrease peripheral edema
  • decrease SOB
  • increase exercise tolerance
  • compliance with medications, diet, clinic appointments
  • no complications
76
Q

Chronic HF: nursing management implementation

A
  • establishment of quality of life goals
  • symptom management
  • conservation of physical/emotional energy
  • support system
77
Q

Chronic HF: nursing management evaluation

A
  • tissue perfusion
  • respiratory status
  • sleep
  • fluid balance
  • activity intolerance
  • anxiety control
  • knowledge: disease process
  • support system
78
Q

ejection fraction values

A

should be between 50-70%

impaired: below 40%

79
Q

classifications of glomerulonephritis

A
  • Extent of damage: diffuse or focal
  • initial cause of disorder: SLE, scleroderma, strep infection
  • extent of changes: minimal or widespread
80
Q

clinical manifestations of acute glomerulonephritis

A
  • facial swelling
  • alteration in urine: rust colored, cloudy, frothy
  • hypertension
  • HF
  • SOB
  • fatigue
  • n/v
81
Q

causes of AKI

A
  • hypovolemic shock

- heart failure: hypoperfused, overloaded

82
Q

prerenal azotemia

A
  • acute AKI

- buildup of nitrogenous waste

83
Q

phases of AKI

A
  • onset: insult occurs. could be from increased amounts of nephrotoxic drugs
  • oliguric: small urine output. increased fluid retention. holding onto sodium.
  • diuretic: aimed at reperfusion
  • recovery
84
Q

terms used with kidney dysfunction

A
  • azotemia: buildup of nitrogenous waste
  • uremia
  • uremic syndrome
85
Q

Stages of CKD

A
  • reduced renal reserve: decrease in GFR. no symptoms unless pt gets an infection, is fluid overloaded, or is pregnant.
  • reduced GFR:
  • ESKD: GFR is less than 15
86
Q

Cardiac changes in CKD

A
  • HTN
  • hyperlipidemia: later stages
  • HF: early. volume overload.
  • pericarditis: inflammation of outer sac of heart (increase in uremic acid leads to inflam)
87
Q

Priority nursing care: CKD

A
  • dietary restrictions: protein individualized. increase calcium. decrease phosphorus.
  • uremic frost: pruritis. tepid bath. at risk for cellulitis from itching. more end stage.
  • muscle strength, energy: will be low.
  • family members
  • excess fluid volume: renal replacement, diuretics. 500-700mL fluids per day. LOOPS, not K sparing.
  • decreased CO
  • recombinant human erythropoietin: epogen, iron, folic acid
88
Q

vascular access

A
  • AV fistula or graft for long-term permanent access

- hemodialysis catheter, dual or triple lumen, or AV shunt for temp access

89
Q

precautions for vascular access

A

assess for patency. listen for bruits, light palpation for thrills.

  • “save the arm”
  • advise patient against tight fitting clothing
90
Q

complications in vascular access

A
  • thrombosis or stenosis
  • infection
  • aneurysm formation
  • ischemia: bp stopping circulation
  • heart failure: vol overload. not a direct complication.
91
Q

hemodialysis nursing care

A
  • drugs: hold ones that can induce hypotension. antibiotics, antiepileptics, diuretics. customize schedule. insulin is ok
  • postdialysis assessment: hypotension, h/a, n/v, malaise, dizziness, cramps. know baseline. bleeding- esp at site from anticoagulation therapy
92
Q

complications of hemodialysis

A
  • dialysis disequilibrium syndrome
  • infectious disease: if machine not cleaned properly
  • hep b & c
  • HIV
93
Q

complications of peritoneal dialysis

A
  • peritonitis
  • pain
  • exit site/tunnel infections
  • poor dialysate flow: dep on anatomy
  • dialysate leakage
  • other complications: cath infection
94
Q

nursing care for peritoneal dialysis

A
  • before tx: evaluate baseline v/s, weight, labs
  • continually monitor pt for respiratory distress, pain, discomfort
  • monitor prescribed dwell time, initiate outflow
  • observe outflow amount and pattern of fluid
95
Q

complications of kidney transplant

A
  • rejection
  • acute tubular necrosis
  • thrombosis
  • renal artery stenosis
  • other complications
  • immunosuppressive drug therapy
  • psychosocial preparation
96
Q

drug therapy for BPH

A

hormonal manipulation: Proscar. shrink prostate (could take a while).
alpha-adrenergic blockers:
- minipress, Cardura, Hytrin (decrease constriction)
- side effects: orthostatic hypotension, dizziness

97
Q

conservative therapy for BPH

A
  • stents, prostatic balloon

- foley catheters

98
Q

treatment goals for BPH

A
  • restore bladder drainage
  • relieve symptoms
  • treat complications
99
Q

indications for BPH surgery

A
  • decrease in urine flow sufficient to cause discomfort
  • persistent residual in urine
  • acute urinary retention
  • hydronephrosis
100
Q

TURP

A
  • invasive therapy
  • choice for debilitating patient with moderate prostatic enlargement
  • no incision, less likely to cause erectile dysfunction
  • noes not completely remove the prostate tissue
  • bleeding is common
101
Q

preoperative nursing interventions for TURP

A
  • urethral catheter- to restore urinary drainage (Coude or filiform)
  • treat UTI
  • high fluid intake
102
Q

postoperative nursing interventions for TURP

A
  • CBI: use of 3 way foley catheter; removes clots, urinary drainage
  • observe for hemorrhage: 24-36 hours, normal blood clots
  • relieve bladder spasms
  • promote sphincter tone (Kegels)
  • monitor for s/s infection
  • dietary interventions, stool softeners
103
Q

patient teaching: TURP

A
  • catheter care
  • managing incontinence
  • maintain adequate oral intake
  • sexual counseling: erectile dysfunction
104
Q

types of prostatectomy

A
  • suprapubic
  • retropubic
  • perineal
105
Q

biggest complication of prostatectomy procedures

A

bleeding

106
Q

interventions for chronic glomerulonephritis

A
  • slowing progression, preventing complications
  • diet changes: salt, protein, alcohol
  • fluid intake
  • drug therapy: ACE improves blood flow to kidneys. Halts renin, improves vasodilation
  • dialysis, transplantation
  • worried about excessive amounts of electros
  • avoid more inflammation and injury