Exam 3 Misc

Question 1

What is the most reliable indicator of kidney funciton?

Answer 1

creatinine levels

Question 2

A Patient has a high BUN, what is the next best nursing action?

Answer 2

Check the creatinine. If normal start to explore. Look at H&H. Is there a GI bleed?

Question 3

What diagnostics are bowel preps ordered for?

Answer 3

KUB
IVP
Retro IVP

Question 4

What medications do you want to check before renal biopsy

Answer 4

ASA or warfarin.

Question 5

Three reasons to use Retrograde Pyelogram vs Intravenous Pyelogram

Answer 5

IVP results are not good

Allergic to iodine

Elevated creatinine

Question 6

Renal Biopsy Post Procedure

Answer 6

Apply pressure dressing

Keep on affected side for 30 min - 1hr

Bed rest Q24 hrs

VS Q 5/15 min x 1 hr

No heavy lifting for 1 week

Question 7

UTI: First quick dipstick will be postive for

Answer 7

Nitrites (indicating bacteria)

WBC (Pyuria)

Leukocyte esterase (Pyuria)

Question 8

Urinalysis vs Urine culture

Answer 8

Urinalysis is looking at all the different things

Urine culture is trying to identify the bacteria type

Question 9

4 Reasons a urine culture might be done

Answer 9

1. Complicated or nosocomial UTI
2. Frequent UTI
3. Unresponsive to therapy
4. Questionable diagnosis

Question 10

If a patient has there bladder removed and has significant comorbidities and a shorter life expectancy, what urinary diversions might be expected?

Answer 10

Ileal Conduit

Question 11

AKI phases

Answer 11

Oliguric

Diuretic

Recovery

Question 12

Clinical Manifestations of Oliguria phase of AKI

Answer 12

<400 ml/24 hr

Begins 1 day after hypotensive event and last 1-3 weeks

Question 13

Nephrotoxic Drugs

Answer 13

NSAIDS

Aminoglycosides

Question 14

Potassium Binders

Answer 14

Patiromer (Veltassa)

Sodium zirconium (lokelma)

Sodium polystyrene (Kayexalate)

Question 15

We do not give potassium binder to which type of patients

Answer 15

Patients with a paralytic ileus

Question 16

IV calcium gluconate MOA

Answer 16

Does not lower K. Just raises threshold for excitation

Question 17

Best way to prevent CKD is to control

Answer 17

HTN

DM

Question 18

Nursing Problem CKD: Excess Fluid Volume

Answer 18

Monitor for FVE

Weigh Daily

Fluid restrictions

Question 19

Nursing Problem CKD: Malnourishment

Answer 19

Monitor N/V

Weight trends

Serum protein levels

H&H

Question 20

Nursing Problem CKD: Risk For Injury

Answer 20

Monitor electrolyte levels

Administer prescribed supplements

Question 21

Hemodialysis Complications

Answer 21

Infection

Decreased CO

Cardiac Dysrhythmias

Disequilibrium syndrome

Air embolism

Question 22

Disequilibrium syndrome

Answer 22

Complication of HD. Manifest as disorientation, seizures, HA agitation, N/V

Question 23

Peritoneal Dialysis Complicaitons

Answer 23

Infection

Decreased CO

Fluid overload

Respiratory insufficiency (Pressure)

Abd Pain

Question 24

Advantages and Disadvantages of HD

Answer 24

ADV: Rapid removal of fluid. Can help change electrolyte problems quickly

DISADV:
Vascular access
Heparin
Dietary restriction (less often)
Hypotension

Question 25

Advantages and Disadvantages of PD

Answer 25

ADV: Less complicated and few dietary restrictions. Less CV stress DISADV: PERITONITIS BODY IMAGE ISSUES

Question 26

PD: NSG considerations

Answer 26

Turn side to side to facilitate drainage prn Observe color of dialysate

Question 27

PD: HD considerations

Answer 27

No BP, injections, IV insertions of affected limb

Question 28

AIDS defining cancers

Answer 28

Pneumocysitsi jirovecii Kaposi sarcoma Wasting syndrome Pervasive candidiasis Aids dementia complex

Question 29

Stage 1 of HIV

Answer 29

Early Acute Infection Not detectable No symptoms Infections

Question 30

Seroconversion HIV

Answer 30

Part of stage one Antibodies become detectable and you have the worst flu like symptoms HIGH INFECTIONS Usually around week 3/4

Question 31

Stage 2 HIV

Answer 31

Clinical Latency Virus levels stabilized and body is fighting infection Last 3-12 years without treatment Last decades with treatment Asymptomatic persistent drop in CD4 with increase in virus production

Question 32

Stage 3 HIV

Answer 32

AIDS

Question 33

How often does CD4 and Viral load need to be checked with HIV postive patients

Answer 33

Every 3 - 4 months

Question 34

Factors that affect wound healing: ODD

Answer 34

Skin fragility and loss of turgor Overall wellness Chemo Anti inflammatory Steroids Obesity

Question 35

Diet for wound healing

Answer 35

HIgh protein, carbs, vitamines Moderate fat intake

Question 36

Hydrogel is for _______, __________, ___________, and helps to ….

Answer 36

Infected - deep wounds - necrotic tissue helps promotes autolytic debridement, rehydrate, and fill dead space

Question 37

Complications of wound healing: ODD

Answer 37

Adhesions Contractions Fistulas Excessive granulation tissue Keloid formation

Question 38

What does eGFR take into consideration?

Answer 38

Age Sex Weight Race Bun Creatinine Albumin

Question 39

What is drawn in the middle of 24 hour clearance?

Answer 39

Serum creatinine

Question 40

Urinalysis for a kidney stone is looking at?

Answer 40

Hematuria Crystalluria pH