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function of renal system

1. filter toxins to eliminate through urine 2. regulate BP + pH

Which intervention would the nurse implement for a client with a ureteral calculus? SATA 1. limiting fluid intake at night 2. monitoring intake and output 3. straining the urine at each voiding 4. recording the client's BP 5. administering the prescribed analgesic

2 3 5

AV fistula why do patients have it what to assess for what to avoid

AV fistula - used for dialysis treatments - assessment: listen for bruit, feel for thrill --> these are healthy, normal signs - avoid: blood draw and BP from side of the fistula

Acute Kidney Disease (AKD)

Acute Kidney Disease (AKD): - Reversible - causes: trauma, septic shock, shock, medications

Bariatric procedure types

Bariatric procedure = for patients with elevated BMI surgery types: sleeve, band, reunan-Y

Biggest worry of a kidney stone

Obstruction

Peptic Ulcer - bacteria cause treatment

Peptic Ulcer bacteria caused: h. pylori treatment: 2 antibiotics + PPI

which health problems most likely contributed to the development of a hiatal hernia? SATA aging obesity bronchitis esophagitis binge drinking

aging obesity

which test result would confirm the diagnosis of benign prostatic hyperplasia (BPH)?

biopsy of prostatic tissue

which clinical manifestation would the nurse expect the client to report when experiencing renal calculi? SATA 1. blood in urine 2. irritability and twitching 3. dry, itchy skin and pyuria 4. frequency and urgency of urination 5. pain radiating from the kidney to a shoulder

blood in urine frequency and urgency of urination

the nurse is caring for a client admitted with peritonitis. which finding in the medical record is most likely the cause? gastritis hiatal hernia diverticulosis bowel obstruction

bowel obstruction

the nurse is assessing a client with a diagnosis of hemorrhoids. which factors in the client's history most likely played a role in the development of hemorrhoids? SATA constipation hypertension eating spicy foods bowel incontinence numerous pregnancies

constipation numerous pregnancies

for which clinical indicator would the nurse monitor when caring for a client with cholelithiasis and obstructive jaundice? SATA dark urine yellow skin pain on urination clay-colored stool coffee-ground vomitus

dark urine yellow skin clay-colored stool

which laboratory test change leads the nurse to determine that the lactulose administered to a client with cirrhosis of the liver is effective?

decreased ammonia

which instruction should the nurse include in a teaching plan for a client who has a new colostomy and is learning how to care for the skin around the stoma? a. cut an opening about 1/3 inch larger than the stomal pattern b. avoid the use of soap and other irritating agents c. eat yogurt and drink buttermilk and parsley d. empty the pouch before it is one-third full

empty the pouch before it is one-third full

Which information about benign prostatic hyperplasia (BPH) is important for the nurse to consider when caring for a client with that condition?

it predisposes to hydronephrosis

which nursing assessment would help confirm the diagnosis of intussusception

observing characteristics of stools

Oliguric phase of AKI description s/s

oliguric = little to no urine production due to kidney damage s/s: - increased urine specific gravity - elevated BUN + creatinine - hypertension - fluid volume overload (jugular vein distention, lung crackles, edema) - elevated electrolytes (most worried with K+)

which type of pain would the nurse expect a patient with duodenal ulcer to report? pain that is: a. relieved with eating b. worse with antacids c. relieved with sleep d. worse 1 hour after eating

pain that is relieved with eating

Acute Kidney Damage monitor:

Acute Kidney Damage monitor: daily weights

Bowel Obstruction: causes treatment

Bowel Obstruction causes: stricture, fecal impaction, mass, twisting (volvulus = mechanical twisting) or (intersusation = tunneling of the bowel) treat: NG tube --> decompress and rest bowels

which pain description would the nurse expect a client to report when describing pain associated with a suspected duodenal peptic ulcer? a. an ache radiating to McBurney point b. an intermittent, colicky right-flank pain c. a gnawing sensation in the epigastric area d. a generalized abdominal pain intensified by movement

C

CAUTI what is it

CAUTI = catheter associated UTI nursing actions: - ensure good catheter care - keep bag below patient - monitor tubes for kinks - monitor for abdominal distention **advocate to have catheter removed as soon as able to

Dialysis what is it?

Dialysis: kidneys are being filtered from the outside

Diuretic phase of AKI description s/s recovery period

Diuretic = too much urine output s/s: - decreased BP - decreased electrolytes - fluid volume deficit - decreased BUN + creatinine recover = up to 1 year !!!!

Diverticulitis description treatment concern

Diverticulitis = diverticulum is inflamed treat: NPO (rest the GI system), then eventually they will be put on clear fluid diet if no change --> surgery concern: perforation of bowel

position for colonoscopy

Left side lying

a client with a diagnosis of incarcerated hernia asks the nurse for an explanation of the condition. which description should the nurse give?

a piece of the intestine has become stuck in a hole in the abdominal wall

which finding in older adult client is associated with a UTI? SATA dysuria urgency confusion incontinence slight rise in temperature

confusion incontinence slight rise in temperature

diverticula discription

diverticula = outpouching of the muscle wall usually asymptomatic

the nurse is caring for a client with a history of alcoholism and cirrhosis who is hospitalized with severe dyspnea as a result of ascites. an increase in which process most likely caused the ascites?

pressure in the portal vein

which description of pain would the nurse expect a client with a ureteral calculus to report?

spasmodic and radiating from the side to the suprapubic area

Benign Enlargement of Prostate (BEP) - what is it - risk factors - treatments

Benign Enlargement of the Prostate (BEP) Presses on the urethra causing: - no urine output --> at risk for hydronephrosis, distended bladder, and UTIs treatments: - medication - surgery: TURP (trans-urethral-retroperitoneal-procedure) this strips down the muscle to make it thinner so urine can pass through

a client is admitted via the ER with tentative diagnosis of diverticulitis. the nurse anticipates that which test will be prescribed? CT scan gastroscopy colonoscopy barium enema

CT scan

Chronic Kidney Disease (CKD)

Chronic kidney disease (CKD) - NOT reversible - asymptomatic in the beginning - Early Stages = management of hypertension by taking diuretics - End stages = dialysis

Cirrhosis description causes s/s diagnosis

Cirrhosis = liver disease caused by fibrotic, scarred liver --> liver no longer functions well causes: medication, alcohol, hepatitis s/s: portal hypertension (ascites, fluid volume overload, esophageal varices) diagnosis: - compensated cirrhosis = OK liver function lab values - uncompensated cirrhosis = BAD liver function lab vales Lab values = ALT / AST

GERD causes concerns treatments

GERD causes: weak esophageal sphincter, obesity, smoking, acid production, pregnancy, medications (NSAIDs) concerns: esophageal erosion, ulcers treatment: medications

GI bleed types:

GI Bleeds: 1. melena = upper GI bleed --> dark blood stool 2. hematochezia = lower GI bleed --> bright red stool

Biggest concern of peptic ulcers, hiatal hernias, and GERD

Perforation = biggest concern look for: coffee ground emesis *** when patient is on NG tube for suctioning --> monitor for electrolyte imbalance !!!

elevated albumin will cause

confusion --> give Enulose !!!

which clinical manifestation would the nurse associate with benign prostatic hyperplasia? a. perineal edema b. urethral discharge c. flank pain radiating to the groin d. distention of the lower abdomen

distention of the lower abdomen

Diverticulosis vs Diverticulitis diet

diverticulOSIS = HIGH fiber diet diverticulITIS = LOW fiber diet

what is a rolling distal hernia

when the stomach goes back and forth above the diaphragm

which recommendations would the nurse give to the client to limit symptoms of GERD? SATA 1. avoid heavy lifting 2. lie down after eating 3. avoid drinking alcohol 4. eat small, frequent meals 5. increase fluid intake with meals 6. wear an abdominal binder or girdle

1. avoid heavy lifting 3. avoid drinking alcohol 4. eat small, frequent meals

the nurse is taking care of a client with cirrhosis of the liver. which clinical manifestations would the nurse assess in the client? SATA ascites hunger pruritus jaundice headache

ascites pruritus jaundice

Gallbladder

cholecystitis = gallbladder infection cholelithiasis = gallstones function of gallbladder = bile surgery = cholecystectomy --> post-op: steatorrhea (fatty stool), dumping syndrome

for which clinical indicator associated with a complication of portal hypertension would the nurse assess in the client? a. liver abscess b. intestinal obstruction c. perforation of the duodenum d. hemorrhage from esophageal varices

hemorrhage from esophageal varices

which factor may contribute to a client developing urinary calculi? a. increased fluid intake b. urine specific gravity of 1.017 c. jogging 3 miles a day d. history of hyperparathyroidism

history of hyperparathyroidism

ostomies : ileostomy stool colostomy stool concern

ileostomy = loose stool colostomy = formed stool priority nursing concern: fluid and electrolyte balance when to change: 1/3 full

which instruction would the nurse use when preparing a client who successfully passed his or her renal calculus for discharge home? "continue to strain all urine" "increase fluid intake" "limit dietary potassium" "maintain bed rest for 24hrs"

increase fluid intake

which is the priority intervention for a dependent client with peptic ulcer disease (PUD) who is vomiting bright red blood? a. apply oxygen b. place the client in a side-lying position c. prepare to administer packed RBCs d. assess the client's pulse and BP

place the client in a side-lying position

which clinical manifestation is an early indicator of intestinal strangulation from bilateral inguinal hernias? increased flatus projectile vomitting sharp abdominal pain decreased bowel sounds

sharp abdominal pain = early indicator persistent vomiting = indicator decreased bowel sounds = late indicator

Types of Dialysis

1. peritoneal = can be done at home but big risk for infection 2. hemodialysis = tube goes in and out of body, AV fistula (takes 3 months to mature), will need central line if not matured

after assessing a client with 25 yr history of excessive alcohol use which finding would the nurse consider consistent with the clients history? elevated temperature signs of liver infection low blood ammonia level small liver with rough surface

small liver with rough surface

the nurse is obtaining a health history from a client with a diagnosis of peptic ulcer disease. the nurse identifies a possible contributory risk factor when the client makes which statement? "my blood type is A positibe" "I smoke one pack of cigarettes a day" "I have been overweight most of my life" "my BP has been high lately"

I smoke one pack of cigarettes a day

Kidney stones: Nursing priority Biggest Concern Treatment options

Kidney Stones: - Nursing priority = treat pain first - hydronephrosis = obstruction caused by stone --> causes fluid backup and kidney damage - treatment: lithotripsy (stone blaster), medication, increase fluids

Partial vs Complete Bowel Obstruction

Partial Obstruction = can poop, have bowel sounds Complete Obstruction = no poop, no bowel sounds BELOW site of obstruction but there will be high pitched sounds (burgyburgy) about the site of obstruction

Post-Op Bariatric Surgery priority monitor nursing action education

Post-Op Bariatric Surgery priority: airway, vital signs monitor: skin breakdown nursing action: ambulate patient to prevent DVT / pneumonia education: small volume liquid diet only

a client with cholecystitis is placed on a low-fat, high protein diet. which nutrient would the nurse teach the client to include in this diet? skim milk boiled beef poached eggs steamed broccoli

skim milk NOT boiled beef or poached eggs (still have fat) NOT broccoli (gassy)

Hiatal Hernia what is it diagnosis concern treatment

Hiatal Hernia = stomach goes above the diaphragm diagnosis: endoscopy concern: strangulation, necrosis of that area of the stomach treat: - surgery - lifestyle modifications: loose fitting clothing, head elevated while sleeping, nutrition/diet, do not eat before bed

Post-Op TURP surgery care

Post-Surgery for TURP: - 3 way catheter is used to irrigate - make sure to deduct irrigation mL from total urine output !!!! - clots are normal 24-48 hours post op beyond this look for signs of hemorrhage - irrigate clots out of the catheter Education: - good catheter care, monitor for s/s of infection, TURP syndrome (support due to decreased sexual function for year post op)