Exam 2 papers/diagnostic tests Flashcards by Logan Kaiser

hypoparathyroidism

papers

positive trousseaus

tingling lips

decrease calcium

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hyperparathyroidism

increase calcium

increase risk of kidney stones

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hyperglycemia

DKA

Bg>200

fruity breath

long term complication of paresthesia

polydyspia

polyuria

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hyperthyroidism

intolerance to heat

weight loss

hand tremors

insomnia

exopthalamus

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hypoglycemia

bg >50

slurred speech

decreases Loc

irritable

headaches

shakiness

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hypothyroidism

levothyroxine treatment

preioribtol edema

listlessness

hoarsness

coarse, scaly skin

fatigue

intolerance to cold

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pre op thyroidectomy

place
teach
expect
anser

place pt on antithyroid meds to bring thyroid back to normal baseline and reduce rusk of hemorrhage

teach to support neck after surgery

expect hoarseness and scar

anwer questions

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post op thyroidectomy

resp distress
hemorage
laryngeal
tetany

Resp distress
Asses- RR, rhythm, effort, stridor// use humidified air, assist w cDB & keep suction equipment available at bedside

hemorrage-
assess- hem/edema at incision, dressing to make sure tis not too tight and for drainage//monitor BP and pulse for shock –greatest risk is 12-24 hrs

laryngeal
assist ability to speak, note quality of voice//edema will subside but harness and loss of voice volume

tetany
assess for calcium deficiency-tingling at feet, toes, fingers, twitches, Assess C+T/// monitor serum calcium levels, keep calc gluconate at bedside, thyroid surgery may injure parathyroid gland

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impaired vision changes

thyroidectomy

monitor acuity of vision, photophobia, integrity of lid closure

teach pt to protect eyes using tinted glasses, artificial tears, eye patches, cool compress and to lift straining

elevte HOB and report and visual changes

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nutrition thyroidectomy
limit
outcome
interventions
monitor

limit weight loss

outcome-weight approbate for height and free of NVD and AB pain

interventions-weigh daily
eat high protein, carbs and in small frequent meals

monitor labs data for albumin and lymphocytes

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anxiety/body image

thyroidectomy

encourage pt to verbalize feelings about self

encourage self compassion

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Pain interventions

preop
postop
vision
nutriton
anxiety

thyroidectomy

pre op-use antithyroid meds/ support neck when coughing

post op- narcotics can worsen respiratory distress, resp. 02 for hoarseness, calcium for teeny

vision-monitor for eye pain, exopthalmuas, cover and moisten eyes

nutrition-assess pain, analgesics, inc appetite

anxiety/body image-manage pain can decrease anxiety, establish trusting relationships

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prostatectomy-waht looks like

activity-no/no/excercise
can occur
inc/inc
0
monitor
teach

urinary cath. (maybe drain)

Activity
* No strenuous activity for 6-8 weeKs
* No driving for a weeks
* Leg exercise dt inc risk of blood clots

Bleeding can occur w/ BM, coughing, or inc Exercise

inc fluids at rest until urine is clear

inc fluids, fiber. laxatives at staol softeners as needed to prevent straining

0 sex for 6 weeks

Monitor abilty to urinate, excessive bleeding, Chills, fever, abd pain, swollen or tender serotum

Teach Kegel exercises

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Lithotripsy-pre op

Pre-DP
- assess knowlege and understanding of the procedure providing information as needed (anXiety reduced)

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Lithotripsy-post op

-Monitor for hemorrhage -bloody urine
-monitor for cloudy urine
- monitor for decreased urinary output and flank Pain (Sighs of ObSurtive urine flow)
- Care for indeWelling cattacter
- increase fluid intake
- Monitor for stones
- encourage activity,
- diet low in Purines (goose, Sardines, chicken),
- encourage loW Sodium/ restrieted Protien diet
- reduce risk for UTI’s

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Cystitis–manifestations

dysuria

urgency

noctura

foul/cloudy urine

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Cystitis–manifestations

in elderly
_
thermia
inc
if untreated

fever

w/ hypothermia

inc risk of uti

if untreated can go into kidneys and develop bladder stones

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Cystitis–type of meds and teaching

antibiotics

teaching
inc fluids

take full coarse of antibiotics

report/follow up if symptoms reside

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TURP pre op
aware
signed
fluids?
preop
prep

Assess Knowledge of surgery,

make aware of catheter + possible drains,

consent signed

, NPO,

prè op Vitals,

I-O bowel prep

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TURP Post op

monitor
assess
applye
inv
reduce
make

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monitor I and O//vitals

assess pain/hematuria

apply teds/sODs,

Inc fluids,

reduce strain

make aware of possible bladder spasms

, Asses for TuRP-sundrome,

Lispro (Humalog)
O
P
D

when eat

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Rapid acting

O-15 mins
P-1-1.5 hrs
D-3-4 hrs

Need to start eating 15 mins after

Regular insulin
O
P
D

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short acting
O-30-60 mins
P-2-3 hrs
D-4-6 hrs

NPH insulin
O
P
D

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O2 hrs
P6-8 hrs
D-12-16 hrs

Glargine
O
P
D

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O-1 hrs
P-3-4 hrs
D-10-24 hrs

what insulins can mix/cant mix

CAN-NPH and regular CANT-glargine

what happens to insulin if you exercise

required insulin should go down depends on wt loss, cals loss, and blood glucose

what happens if pt is on sick day

take bs every4 hrs glucose will rise even with no food still take insulin ketones in urine encourage fluids s/s hyper/o glycemic

where is insulin admisterd

SUBQ fatty tissues-abdomen, arms, thighs

how is insulin stored

room temperature , no sun for 30 days

how is insulin given in body

90 degree angle 45 if skinny

BUN-diagnostic test used when normal value when can they be elevated

used to determine renal function and elimination of nitrogenous waste. Urea rises in AKI and CKD. Normal Value: 5-25mg/dl- sometimes can be elevated dt dehyfration-encourage fluid

Urine Culture-diagnostic test why conducted normal values how do

Conducted to identify causative organism of UTI. Normal <10,000 organisms/ml, values >100,000 organisms/ml indicate UTI -urin in steril cup, start voiding,then stop, then fill cup-preferef in morning-constituted

Creatinine-diagnostic test why used normal value when different

Used to evaluate kidney function, this is a by product of the breakdown of muscle & excreted by kidneys. Normal Value: 0.5-1.5 mg /dl-if patenti is in fluid volum overload then level may be lower thn actual

creatinine clearance--diagnostic tests why used keep where

Blood sample and 24-hour urine test used to evaluate GFR & renal function – keep container on ice or refigerated

CT of Kidneys -diagnostic tests allows what what helps visuale assesss what

Allows evaluation of kidney size, tumors, obstructions etc. oral or IV contrast dye used to help visualize – assess allergies to iodion,shellfish or seafood, increase fkuids/know cretninrn and BUN before giving dye

Diagnostic Tests of Renal System Cystoscopy what does done under assess

Direct visualization of bladder wall and urethra. Can obtain tissue bx, stents can be placed, removal of calculi, assess for obstruction- can be done under generl or local anethsia – need to assess for hemorage, bladder perferaiton ,urinary reteion, any gross hermertraria

Intravenous Pyelogram-diangostic test what does diagnoses can be performed asses

Radiologic exam used to visualize the entire urinary tract to diagnosis kidney disorders, stones, tumors, cysts. Can be performed alone or in conjunction with cystoscopy – assess allergies prior to admintration of dye

Renal Biopsy -diagnostic tests used for performed have patient

Used to determine the cause of renal disease, to rule out cancer, check for metastasis. Performed via excision or needle bx. – have patient npo if gen anethia, wathc for external bleeding

Post Void Residual -diagnostic tests measures normal

measures amount of urine left in the bladder after voiding. Normal value <50ml –use bladder scan and report any above 100

Urinalysis-diagnostic tests used for when to get

Examines the constituents of urine, to establish baseline, provide data for diagnosis, or monitor treatment results. – early moring speicim, clean cut specimen, not if pt is menstrating

Hyperglycemia Diabetes and complications

polys DKA, HHS, vasculares, delayed wound healing

hypoglycemia Diabetes and complications

somogoyami=hypo at nighy and rebound hyper in morning cool clammy,pale sweating shakiness nausea, hypotension

DKA Diabetes and complications

fruity breath BS > 250 ketones in urine treated w/ insulin electrolyte imbalance/ dehydration looking at glucose every hour

Macrovasular Diabetes and complications

Pulmonary vascular disease hypertension Coronary artery disease stroke

Microvascualr Diabetes and complications

capillary leak, microthromobossos decreased transport of oxygen leading to tissu e perufsion

Infection Diabetes and complications

delayed healing inadequate bowel emptying-leads to uti sensory defect

foot complications and wind healing Diabetes and complications

nephorpathy, and infection most common ia crack, dry skin tissue perfusion and oxygnetion may not be aware of problems amputation w/ loose glycemic control

HHS Diabetes and complications

elevated BG Decreased LOC medical emergency-high mortality rate osmotic diueresis leading to kidney injury severre dehydration

CBi

frequent checks. assess urine in tubing, admisnter normal saline,

Exam 2 papers/diagnostic tests Flashcards

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