exam 3

Question 1

what GFR is character of stage 5 ESKD?

Answer 1

GFR < 15 mL/min

Question 2

what action should be taken for management of stage 1 CKD?

Answer 2

• reduce exposure to nephrotoxins
• manage HTN, DM, anatomic/urinary tract abnormalities

Question 3

How much does serum creatinine have to increase within 48 hrs to be considered AKI?

Answer 3

≥ 0.3 mg/dL

Question 4

how much does serum creatinine have to increase within 7 days to be considered AKI?

Answer 4

≥ 1.5 X baseline

Question 5

how much does UOP have to decrease to be considered AKI?

Answer 5

<0.5mL/kg/h

Question 6

what are 7 causes of AKI?

Answer 6

• sepsis
• circulatory shock
• cardiac surgery (CBP)
• nephrotoxic drugs
• radiocontrast agents
• CKD
• DM

Question 7

what causes prerenal aki?

Answer 7

drop in blood pressure (shock)

Question 8

what causes intrarenal aki?

Answer 8

direct damage to the kidneys by inflammation, toxins, drugs, infection or reduced blood supply

Question 9

what causes postrenal aki?

Answer 9

sudden obstruction of urine flow (BPH, stones, tumor, etc.)

Question 10

what treatment is necessary for stage 5 CKD?

Answer 10

RRT or transplant

Question 11

what is the leading cause of death for patients with CKD?

Answer 11

arrhythmia/cardiac arrest

Question 12

what is DDS?

Answer 12

symptoms related to rapid shift in fluid/electrolytes following HD

Question 13

what meds may be used to prevent kidney transplant rejection?

Answer 13

• prograf (tacrolimus)
• cellcept (mycophenolate)
• prednisolone

Question 14

what is the most common type of MS?
how does it present?

Answer 14

relapsing-remitting type

characterized by remissions and exacerbations, where they return to baseline

Question 15

what is expected for CSF in MS?

Answer 15

increased myelin proteins and WBCs

Question 16

how many areas must plaques be seen on an MRI for confirmation of MS diagnosis?

Answer 16

• presence of plaques in at least 2 areas

Question 17

what are expected findings of neurogenic shock?

Answer 17

hypotension and bradycardia

Question 18

what is the goal MAP for neurogenic shock?

Answer 18

MAP 80-90

Question 19

what meds may be used to treat hypotension in a pt w/neurogenic shock?

Answer 19

• dopamine
• norepi
• dobutamine
• epi
• phenylephrine

Question 20

what may be used in the tx of bradycardia w/neurogenic shock?

Answer 20

atropine or pacemaker

Question 21

what does sciatic nerve pain feel like?

Answer 21

burning/stabbing down leg or foot

Question 22

how may cervical back pain present?

Answer 22

• burning, stabbing pain down arm
• pain in neck , back or shoulders
• headache

Question 23

what order should be implemented first for a patient with acute cholecystitis?

Answer 23

NPO status

Question 24

what education should be provided to prevent cholecystitis?

Answer 24

• increase dietary fiber
• lose weight
• increase physical activity
• limit fatty foods

Question 25

what is the order of care for cholecystitis?

Answer 25

1. NPO 2. place IV 3. pain med (morphine IV) 4. abd ultrasound

Question 26

what finding should a pt report to the provider following a cholecystectomy that may indicate complication?

Answer 26

yellowing of skin/eyes

Question 27

what is a major risk for pancreatitis?

Answer 27

alcohol consumption

Question 28

if a patient complains of pain in the R shoulder following a cholecystectomy, what intervention should the nurse implement?

Answer 28

encourage them to ambulate and change positions

Question 29

what dietary education is necessary for a pt with hx of cholelithiasis?

Answer 29

low fat and high fiber

Question 30

what lifestyle modification should be made to prevent pancreatitis?

Answer 30

- avoid binge drinking and limit alcohol consumption

Question 31

what action should the nurse take if a pt w/pancreatic cancer has jaundice, dark urine and unintentional weight loss?

Answer 31

notify the provider and request liver function tests

Question 32

what type of food should be avoided to prevent flare-ups of chronic pancreatitis?

Answer 32

fatty meals

Question 33

what should be included in the care plan of a client with acute pancreatitis?

Answer 33

- morphine - IV fluids - glucose monitoring - NPO

Question 34

what should be administered for a client experiencing hyperglycemia as a result of acute pancreatitis?

Answer 34

insulin, duh

Question 35

what report by the patient would indicate successful outcomes of non-pharm tx for acute back pain?

Answer 35

- sleeps through night without pain - pt independently uses proper body mechanics - increase ROM - increased mobility

Question 36

what med is priority for a pt w/MS who is having acute exacerbation w/motor weakness and visual changes?

Answer 36

IV methylprednisolone for inflammation

Question 37

why should a pt w/MS avoid hot showers?

Answer 37

causes fatigue

Question 38

what type of activities may be beneficial for a pt w/MS?

Answer 38

- stretching and aerobic exercises to maintain mobility - stress reduction techniques to prevent flares

Question 39

what should a pt w/MS do during the day to conserve energy?

Answer 39

rest

Question 40

what is the benefit of interferon-beta for MS?

Answer 40

fewer relapses

Question 41

if a pt w/ a T5 injury experiences a sudden headache, what action should the nurse take first?

Answer 41

palpate bladder for distension

Question 42

what should improve as a result of sodium bicarb administration for a pt w/AKI?

Answer 42

serum pH

Question 43

what are some side effects possibly experienced during dialysis?

Answer 43

low bp and cramping

Question 44

why is it important that dialysis is initiated for a client who has high potassium levels?

Answer 44

prevent dysrhythmias

Question 45

if a pt experiences headache, nausea, confusion and twitching during hemodialysis, what should the nurse do?

Answer 45

slow/stop the dialysis tx and notify the provider

Question 46

what places the client at risk for DDS with HD?

Answer 46

- rapid initiation of HD after a long period of time without it - chronic renal failure with significant renal decline - high serum urea levels prior to HD

Question 47

what level is elevated specifically in association with pancreatic cancer?

Answer 47

CEA (carcinoembryonic antigen)

Question 48

what may be necessary for nutritional replacement for chronic pancreatitis?

Answer 48

TPN

Question 49

what are the 2 high risk groups for pancreatic cancer?

Answer 49

smokers and 60yr+

Question 50

what are other risk factors for pancreatic cancer?

Answer 50

- DM - chronic pancreatitis - cirrhosis - high red meat intake - long-term exposure to gasoline or pesticides - obesity - male - family hx - gene mutation

Question 51

what are the s/s of pancreatic cancer?

Answer 51

- glucose intolerance - splenomegaly - GI bleed - severe ascites - leg/calf pain - severe weakness/fatigue - LUQ mass

Question 52

what are the care interventions for post lap chole?

Answer 52

- IVFs - elevated HOB - antiemetics - opioids - rest 24 hrs

Question 53

how should fatty foods be introduced after lap chole?

Answer 53

one at a time

Question 54

what lab would be elevated in a patient taking ziconotide that would indicate muscle injury?

Answer 54

creatinine kinase

Question 55

what are 3 interventions for neurogenic shock?

Answer 55

- fluid resuscitation (MAP 80-90) - admin vasopressors - atropine or pacemaker (bradycardia)

Question 56

what is spinal shock?

Answer 56

temporary complete loss of sensation following a spinal injury