MIDTERMS: QUIZ 2 RESPONSES TO ALTERED ELIMINATION

Question 1

Inquire about other family members with

Answer 1

renal and/or urinary tract malformations.

Question 2

Ask about family history of kidney disease
with onset in

Answer 2

third to fifth decade

Question 3

Identify family history of male

Answer 3

infertility and
cystic fibrosis

Question 4

Be alert for family members with history of
early-onset renal

Answer 4

(Wilms’ tumor) or other
cancers.

Question 5

is a “snapshot” assessment of
patient urine at one point in time
➢ The urinalysis is a valuable
screening tool for urinary tract
infections, kidney diseases, and
other conditions.

Answer 5

Urinalysis

Question 6

This is to know how much urine the
body is producing in a day or how
much of a particular substance is
eliminated in a day

Answer 6

24-urine collection

Question 7

INSTRUCTIONS FOR COLLECTION OF A 24-HOUR URINE
TEST FORM

Answer 7

This is the end of the collection. Record the
end time on the container label as “Date and Time
Completed.”

Question 8

This non-invasive diagnostic exam uses
sound waves to create images of the
kidney(s)

can assess the
size, location and shape of the kidneys,
ureters and bladder.

Answer 8

Renal ultrasound

Question 9

Renal ultrasound
Preparations

Answer 9

Drink a minimum of 24 ounces of clear
fluid at least one hour before the appointment. Do not
empty the bladder prior to the procedure.
❖ No Fasting or sedation

Question 10

refers to a series of X-rays taken of the
kidneys, their collecting or drainage system
(the ureters), and the bladder.
➢ is commonly done to identify diseases of the
urinary tract, such as kidney stones, tumors,
or infection.

Answer 10

Serum studies intravenous pyelography

Question 11

Serum studies intravenous pyelography

Prep

Answer 11

❖ Inform your physician if there are any allergies,
especially to iodinated contrast materials.
❖ Those with diabetes who are taking metformin
(Glucophage) will have to discontinue this medication
prior to and for 2 days after the IVP

Question 12

NURSING DIAGNOSES

Answer 12

★ Fluid volume excess related to decreased glomerular
filtration rate and sodium retention
★ Risk for infection related to alterations in the immune
system and host defenses

Question 13

is the syndrome in which glomerular filtration
declines abruptly from hours to days and is
usually reversible.

Answer 13

Acute Renal Failure

Question 14

Acute Renal Failure
The main causes are:

Answer 14

➢ Not enough blood flow to the kidneys
➢ Direct damage to the kidneys
➢ Urine backed up in the kidneys

Question 15

is a condition involving a decrease in the
kidneys’ ability to filter waste and fluid from
the blood.
➢ It is chronic, meaning that the condition
develops over a long period of time and is
not reversible.

Answer 15

Chronic Renal failure

Question 16

Chronic Renal failure
Those things can happen when:

Answer 16

● Diabetes (types 1 and 2)
● High blood pressure
● Immune system diseases (lupus nephritis)
● Drugs and toxins

Question 17

➢ also referred to as fluid replacement
➢ this fluids are administered to improve
cardiac and tissue oxygenation, which in part
depends on flow

Answer 17

Fluid resuscitation

Question 18

Two classes of Intravenous solutions:

Crystalloids
Colloids

Answer 18

• which are solutions of electrolytes in water
  that cross freely from the vascular space into
  the interstitium
• are the most commonly administered
  intravenous fluid.

Question 19

Crystalloids examples

Answer 19

EX: PNSS, PLR

Question 20

Colloids EXAMPLE

Answer 20

EX: human plasma (albumin) and
semisynthetic colloids (starches,
gelatins, and dextrans).

Question 21

the inside lining of patient own belly acts as
a natural filter. Wastes are taken out by
means of a cleansing fluid called

Answer 21

dialysate,

Question 22

the inside lining of patient own belly acts as
a natural filter. Wastes are taken out by
means of a cleansing fluid called dialysate,
which is washed in and out of patient belly in
cycles.
➢ This process usually is done three, four or
five times in a 24-hour period while patient
are awake during normal activities. Ea

Answer 22

Peritoneal dialysis

Question 23

This process usually is done in? what hours

Peritoneal dialysis

Answer 23

three, four or
five times in a 24-hour period

Question 24

Two kinds of peritoneal dialysis:

Answer 24

Continuous Ambulatory Peritoneal Dialysis
(CAPD)

Automated Peritoneal Dialysis (APD)

Question 25

➢is “continuous,” machine-free and done
while patient go about their normal activities
such as work or school.
➢ This is done by hooking up a plastic bag of
cleansing fluid to the tube in their belly.

Answer 25

Continuous Ambulatory Peritoneal Dialysis
(CAPD)

Question 26

The CAPD patients need to do

Answer 26

4 exchanges
per day

Question 27

➢ A machine (cycler) delivers and then drains the
cleansing fluid automatically. The treatment usually is
done at night while patient’s sleep.

Answer 27

Automated Peritoneal Dialysis (APD)

Question 28

Automated Peritoneal Dialysis (APD)
Machine has 3 main function:

Answer 28

➔ Heat PD fluid to body temperature
➔ Controls time of exchange and
amount of fluid used
➔ Monitor treatment safety alarm

Question 29

is a treatment to filter wastes and water from
patient’s blood, as the patient kidneys did
when they were healthy.

Answer 29

Hemodialysis

Question 30

Three types of entrance points are: Hemodialysis

Answer 30

Arteriovenous (AV) fistula
AV Graft
Vascular Acces Catheter

Question 31

this type connects an
artery and a vein. Healing time after surgery: 6-8
weeks to mature.

Answer 31

Arteriovenous (AV) fistula

Question 32

This type is a looped tube. Healing time
after surgery: 2-3 weeks

Answer 32

AV graft

Question 33

this may be inserted into
the large vein in your neck. Healing time after surgery:
Ready for immediate use after placement—not
recommended unless medically necessary

Answer 33

Vascular access catheter

Question 34

To ensure patency, palpate for a thrill or auscultate for a
bruit over the fistula or graft. Notify the HCP if a

Answer 34

a thrill or
bruit is absent

Question 35

➢ is a special type of dialysis that we do for
unstable patients in the ICU whose bodies
cannot tolerate regular dialysis.
➢ is a slower type of dialysis that puts less
stress on the heart.

Answer 35

Continuous Renal Replacement Therapy (CRRT)

Question 36

CRRT is done

Answer 36

e 24 hours a day to slowly and
continuously clean out waste products and
fluid from the patient.

Question 37

It requires special anticoagulation to keep
the dialysis circuit from clotting.

Answer 37

Continuous Renal Replacement Therapy (CRRT)

Question 38

refers to the practice of limiting the intake of
electrolytes.
➢___________ are minerals that carry an
electric charge and are found in your blood,
urine, and sweat.

Answer 38

Electrolytes Restriction

Electrolytes

Question 39

Normal Sodium

Answer 39

135 and 145 milliequivalents per liter
(mEq/L)

Question 40

Normal levels of potassium range from

Answer 40

m 3.5 mmol/L to 5.1
mmol/L in adults

Question 41

Normal adult value for magnesium is

Answer 41

1.5-2.5 mEq/L

Question 42

Total blood calcium

Answer 42

: 8.5 to 10.5 milligrams per deciliter (mg/dL)

Question 43

means that patient can only have a certain
amount of liquid each day.
➢____________ 800-1000 ml/day

Answer 43

Fluid restriction

Question 44

Common medical conditions and associated symptoms
requiring fluid restriction are listed below:

Answer 44

● Heart problems
● Kidney problems
● Endocrine System and Adrenal gland disorders
● Conditions that cause the release of stress hormones
● Treatment with medications called corticosteroids
● Low levels of Sodium in your body (Hyponatremia)

Question 45

They help fuel the brain, kidneys, heart
muscles, and central nervous system

Answer 45

High CHO Diet

Question 46

, also known as starches and sugars.

Answer 46

Carbohydrates

Question 47

r is stored in the liver and muscles as glycogen

Answer 47

Sugar

Question 48

Take sports drinks, gels, or bars, fruit, or hard or
chewy candies during the event at the rate of

Answer 48

of 30 to 60
grams qh or 2h

Question 49

are one type of dietary supplement. They are
sold as tablets, capsules, powders, teas,
extracts, and fresh or dried plants

Answer 49

Halamang Gamot

Question 50

The FDA considers herbal supplements foods, not

Answer 50

drugs

Question 51

CLIENT EDUCATION

Answer 51

Signs & Symptoms of infection
● Fluid intake ( if no restrictions 2-5 L/day )
● Perineal hygiene
● Meds. & side effects on urination, color, and volume

Question 52

REPORTING AND DOCUMENTATION OF CARE

Encourage the patient to drink

Answer 52

2-3L of fluid a day
(Dougherty and Lister, 2015). –if not restricted

Question 53

Ask the patient to observe for any signs of _______ and report these immediately.

Answer 53

voiding
difficulties