Nantroup Exam 3

3 Types of Acute Renal Failure

-Prerenal: decreased blood volume -Renal: direct result to kidney(nephrotoxic drugs, transfusions reactions, trauma, glomerulephrtits, severe muscle excretion, polycystic kidney disease -Postrenal:obstruction, BPH, renal calculi

Fluorouracil (Adrucil)

-antimetabolite -topical medication -used to tx precancerous lesions on the skin -used to tx actinic/solar keratosis, basal carcinoma

Treatment of Acute Renal Failure

-monitor fluid and electrolyte balance -monitor alteration in PAWP(8-12) -assess for hypervolemia(RESTRICT FLUIDS) -promote nutrition (RESTRICT PROTEIN AND POTASSIUM, HIGH CARBS) -prevent impaired mobility -prevent fever/infection -pt should be on cardiac monitor

Acromegaly

-occurs with excess growth hormone. -marked by coarsening a facial features and soft tissue swelling of the hands and feet. -A glucose tolerance test in combination with a GH measurement is the most reliable method of confirming acromegaly

5 most common cancer metastasis sites

#1 LIVER!! -lymph nodes -lung -bone -brain

Prior to hemodialysis

-determine current meds -assess AV fistula for bruit -obtain clients weight -assess electrolytes and BP

Acute/Urgent Dialysis is indicated when:

-increased K -increased acidosis -fluid overload -impending edema -to remove toxins (overdose) -hyperkalemia -hypercalcemia -hypertension

Corticosteroids

-prolonged use can cause osteoporosis, cataracts, HTN, diabetes -should be withdrawn from med slowly to minimize reaction to loss of steroids -adrenal glands are suppressed -causes increased BS

The patient admitted with hypothyroid crisis (myxedema coma) would most likely have which of the following electrolyte abnormalities? 1. Hyponatremia 2. Hypernatremia 3. Hyperglycemia 4. Hypocalcemia

1. Hyponatremia Rationale: Patients with myxedema coma suffer from hyponatremia. This usually is a result of inappropriate secretion of antidiuretic hormone (ADH). Also, the myxedematous state results from the interstitial accumulation of a mucopolysaccharide substance that attracts water and produces water retention. Therefore, the hyponatremia is caused by dilution. Hypoglycemia is also seen in myxedema coma, owing to the hypometabolic state

i. A client with acute renal failure develops hyperkalemia. What drug should the nurse prepare to administer? 1. Kayexalate 2. Furosemide 3. Dopamine 4. Mannitol

1. Kayexalate Rationale: Kayexelate is a cation exchange resin that exchanges sodium for potassium. This drug can be given orally or as a retention enema.

After cancer chemotherapy, a client experiences nausea and vomiting. The nurse should assign highest priority to which intervention? 1. Withholding fluids for the first 4 to 6 hours after chemotherapy administration 2. Serving small portions of bland food 3. Administering metoclopramide and dexamethasone as ordered 4. Encouraging rhythmic breathing exercises

3. Administering metoclopramide and dexamethasone as ordered

A client is admitted for treatment of the syndrome of inappropriate antidiuretic hormone (SIADH). Which nursing intervention is appropriate? 1. Infusing I.V. fluids rapidly as ordered 2. Encouraging increased oral intake 3. Restricting fluids 4. Administering glucose-containing I.V. fluids as ordered

3. Restricting fluids Rationale: To reduce water retention in a client with the SIADH, the nurse should restrict fluids.

positive Chvostek's sign

A decrease in ionized calcium causes an increase in neuromuscular excitability. Tapping over a branch of the facial nerve and observing for twitching of the upper lip on the ipsilateral (same) side as stimulation

Antineoplastic antibiotic

A type of anticancer drug that blocks cell growth by interfering with DNA, the genetic material in cells. -Examples of these are Doxorubicin, Mitoxantron, and Bleooxane

After hip replacement surgery, patient legs should be

ABDUCTED with toes pointing upward

a. A patient tells the nurse that he read that asbestos is a carcinogen and asks whether that means it causes cancer. Which of the following explains what a carcinogen is? i. Any agent or condition that can promote the proliferation of altered, mutated cells ii. Any chemical, physical, or genetic agent that can irreversibly alter cellular DNA, causing abnormal cells to be produced iii. Any agent or condition that causes chronic irritation and stimulation of tissue, resulting in uncontrolled overgrowth of tissue iv. A specific, known chemical or physical agent that can start uncontrolled cellular proliferation by fracturing cellular DNA

Any chemical, physical, or genetic agent that can irreversibly alter cellular DNA, causing abnormal cells to be produced Rationale: Any chemical, physical or genetic agent that can irreversibly alter cellular DNA, causing abnormal cells to be produced.

Chemotherapy Side effects

BONE MARROW SUPPRESSION -N/V -impaired immune response -impaired oral mucous membranes -stomatitis -fatigue

Medications for RA patients

COX 2 (celebrex) DMARDS gold salts antimalaria (hydroxychologine) immunosuppressive agents corticosteroids

a. A client undergoes a biopsy of a suspicious lesion. The biopsy report classifies the lesion according to the TNM staging system as follows: TIS, N0, M0. What does this classification mean? i. Carcinoma in situ, no abnormal regional lymph nodes, and no evidence of distant mestastasis

Carcinoma in situ, no abnormal regional lymph nodes, and no evidence of distant mestastasis

Diabetes Insipidus is tx with

Desmopressin

Juvenile arthritis affects patient height?

FALSE does not affect patient height in adulthood

Meds for osteoporosis

Fosamax Raloixfene (estrogen replacement) Calcitonin

Most common symptom of ARF

HYPERKALEMIA

Possible complication following joint replacement (arthroplasty)

Impingement Syndrome

Trousseau's sign

Inflating a BP cuff on the upper arm or having the patient hyperventilate will both produce carpopedal spasm -Another method for producing this phenomenon is hyperventilation, in which the alkalotic state decreases serum calcium level

Meds for Gout

NSAIDS Colchicine Allopurinol Probenecid STOP ASPIRIN

Regular or crystalline insulin given IV to tx ketoacidosis?

ONLY REGULAR (short acting) can be used IV to treat hyperglycemia

Chvostek's sign

Tap on the facial nerve just below the temple. Positive when nose/eye/lip/facial muscles twitch

Trousseau's sign

Temporarily occlude arterial blood flow (with BP cuff inflated) above the normal systolic pressure. A positive Trousseau's sign occurs when the hand and fingers contract from ischemia

The LPN/LVN performs postoperative care for a client after a Whipple procedure for treatment of pancreatic cancer. The LPN/LVN is MOST concerned if which of the following occurs? i. There is clear, colorless, bile-tinged drainage from the NG tube. ii. The NG tube is connected to intermittent low suction. iii. The client is lying in a semi-Fowler's position iv. The LPN/LVN instills air to open the drainage lumen of the NG tube.

There is clear, colorless, bile-tinged drainage from the NG tube. Rationale: drainage should be serosanguineous; clear, colorless, bile-tinged drainage or frank bleeding may indicate problems with anatomosis sites and you need to contact the MD.

a. Based on the knowledge of the primary cause of ERSD, the nurse knows to assess the most important indicator. What is the indicator? i. pH and HCO3 ii. Blood pressure iii. Serum Glucose iv. Urine Protein

iii. Serum Glucose Rationale: 1. The nurse would evaluate serum & urine levels of glucose because diabetes is the primary cause of renal failure.

Diabetes insipidus casues

increased intracranial pressure and head trauma assess decreased urine specific gravity, increased serum osmolaity , and dehydration

Rheumatoid Arthritis

inflammed, swollen joints positive RF factor >80

Primary Gout

inherited defect of purine metabolism

Secondary Gout

acquired condition following hematopoietic or renal disorders

Chemotherapy Med

alkylating agents anetimetabolites antitumor abx hormonal agents vinca alkaloids

The physician has ordered a thyroid scan to confirm the diagnosis. Before the procedure the nurse should:

assess the client for allergies Rationale: A thyroid scan uses a dye, so the client should be assessed for allergies to iodine.

Erythropoietin

can be given to stimulate the production of red blood cells, a hormonal function that is lost with renal failure

Graves' disease

causes bulging of the eyes, weight-loss, and heat intolerance.

Cushing syndrome

causes thin extremities, truncal obesity and a "moon face

SIADH is tx with

declomycin

Diet for Gout

decrease purines aka no red meats, organ meats, wine, beer cheese increase fluid intake

Tx of Osteoporosis

diet high in Ca and Vit d safety precautions to prevent bone fractures

Aspirin should be taken with

food, milk or large glass of water to reduce G.I. upset

Bicarbonate

given to pt with HIGH potassium levels (3.5-5 normal) -increases pH and pushes K back into the cells

Whipple Procedure Post Op Complications

hemorrhaging hypovolemic shock bile leak hepatorenal failure rapid deterioation of the kidney

The LPN/LVN instructs a client in the outpatient clinic about probenecid (Benemid). It is MOST important for the LPN/LVN to make which of the following statements? i. "Drink at least 6 to 8 glasses of water each day." ii. "Take the medication on an empty stomach." iii. "You may take aspirin for minor pain." iv. "You are permitted to drink wine with dinner."

i. "Drink at least 6 to 8 glasses of water each day." Rationale: Benemid is an anti-gout medication that increases the excretion of uric acid, increased fluids will increase excretion of uric acid side effects include nausea rash and constipation.

a. Trousseau's sign can be elicited in the hypocalcemic patient by: i. Applying a BP cuff to upper arm, inflating it, and observing for carpopedal spasm. ii. Tapping a finger on the supramandibular portion of the parotid cland and observing for twitching of the upper lip on the side opposite to the stimulation. iii. Tapping a finger on the supramandibular portion of the parotid gland and observing for twitching of the upper lip on the same side as stimulation. iv. Having the patient hyperventilate (more than 30 breaths/minute) to produce carpopedal spasm resulting from respiratory acidosis.

i. Applying a BP cuff to upper arm, inflating it, and observing for carpopedal spasm.

A client has been receiving chemotherapy. Upon assessing the client during morning rounds, the nurse notes the client is now bleeding from intravenous and venipuncture sites. Stool is positive for occult blood. The client is requesting to sit in a chair for a meal. The nurse implements the following interventions: (Select all that apply.) i. Assess level of consciousness ii. Apply pressure to the bleeding sites iii. Check intake and output records

i. Assess level of consciousness ii. Apply pressure to the bleeding sites iii. Check intake and output records Rationale: The client may experience disseminated intravascular coagulation (DIC) following cancer experience and chemotherapy treatment. If the nurse notes the client is experiencing unexpected and abnormal bleeding, the nurse will assess level of consciousness (the client can be bleeding in the brain) and intake and output records (the client may experience decreased urinary output as a result of poor renal perfusion). The nurse applies pressure to venipuncture sites to decrease bleeding. The nurse will assess vital signs more frequently than once a shift. The nurse minimizes client activities to decrease risk for injury.

a. In the client experiencing acute renal failure the nurse should evaluate which laboratory diagnostic tests to assess renal function? (Mark all that apply) i. Blood urea nitrogen ii. Creatinine iii. Electrolytes iv. Complete Blood Count

i. Blood urea nitrogen ii. Creatinine Rationale: Blood urea nitrogen and creatinine evaluate renal function electrolytes will provide information on hyponatremia and hyperkalemia and complete blood count will indicate the degree of anemia in a renal client

A client with head trauma develops a urine output of 300 ml/hr, dry skin, and dry mucous membranes. Which of the following nursing interventions is the most appropriate to perform initially? i. Evaluate urine specific gravity ii. Anticipate treatment for renal failure iii. Provide emollients to the skin to prevent breakdown iv. Slow down the IV fluids and notify the physician

i. Evaluate urine specific gravity

A client with diabetes insipidus is extremely dehydrated and is unable to take oral fluids. Fluid therapy is prescribed. Which intervention would be most important for the client? i. Measuring the urine output every 30 minutes ii. Monitoring the rate of IV infusions iii. Measuring the fluid intake iv. Weighing the client daily

i. Measuring the urine output every 30 minutes Rationale: The nurse must measure the urine output every 30 minutes when administering prescribed fluid and drug therapy when the client is acutely ill or extremely dehydrated, fails to take oral fluids, or is beginning to receive medical treatment. Doing so ensures adequate kidney function. Although monitoring the rate of IV infusions, measuring fluid intake, and weighing the client daily are important, measuring the urine output every 30 minutes is the priority

a. According to the tumor-node-metastasis (TNM) classification system, T0 means there is i. No evidence of primary tumor

i. No evidence of primary tumor Rationale: T0 means that there is no evidence of primary tumor. N0 means that there is no regional lymph node metastasis. M0 means that there is no distant metastasis. M1 means that there is distant metastasis.

Which intervention is the highest priority for a client with Addisonian crisis? i. Preventing irreversible shock ii. Preventing infection iii. Relieving anxiety iv. Lowering blood pressure

i. Preventing irreversible shock Rationale: In Addisonian crisis there's an uncontrolled loss of sodium in the urine and impaired mineral corticoid function resulting in loss of extracellular fluid and low blood volume and possible irreversible shock.

The patient admitted with hypothyroid crisis (myxedema coma) would most likely have which of the following acid-base imbalances? i. Respiratory acidosis ii. Respiratory alkalosis without compensation iii. Metabolic alkalosis iv. Respiratory alkalosis with compensation

i. Respiratory acidosis Rationale: Respiratory acidosis and CO2 narcosis are a result of lowered thyroxine (T4) and Tri-iodothyronine (T3) levels. These hormones increase metabolic functions, such as respiration. Thus, a decrease in T3 and T4 levels depresses respiratory function, thereby causing hypoventilation. In addition, metabolic acidosis may develop as hypoxia increases serum lactate levels.

1. Potentially life-threatening hypercalcemia can occur in cancers with destruction of bone a. For a patient with osteogenic sarcoma, which laboratory value causes you the most concern? i. Sodium level of 135 mEq/L ii. Calcium level of 13 mg/dL iii. Potassium level of 4.9 mEq/L iv. Hematocrit of 40%

ii. Calcium level of 13 mg/dL

The client with a history of diabetes insipidus is admitted with polyuria, polydipsia, and mental confusion. The priority intervention for the client is: i. Measure the urinary output ii. Check the vital signs iii. Encourage increased fluid intake iv. Weigh the client

ii. Check the vital signs Rationale: The large amount of fluid loss can cause fluid and electrolyte imbalance that should be corrected. The loss of electrolytes would be reflected in the vital signs.

When assessing a client with pheochromocytoma, a tumor of the adrenal medulla that secretes excessive catecholamine, the nurse is most likely to detect: i. Blood pressure of 130/70 mm Hg. ii. Blood glucose level of 130 mg/dl. iii. Bradycardia. iv. A blood pressure of 176/88 mm Hg.

iv. A blood pressure of 176/88 mm Hg. Rationale: Pheochromocytoma, a tumor of the adrenal medulla that secretes excessive catecholamine, causes hypertension, tachycardia, hyperglycemia, hypermetabolism, and weight loss. It isn't associated with the other options.

A client visits the physician's office complaining of agitation, restlessness, and weight loss. The physical examination reveals exophthalmos, a classic sign of Graves' disease. Based on history and physical findings, the nurse suspects hyperthyroidism. Exophthalmos is characterized by: i. Dry, waxy swelling and abnormal mucin deposits in the skin. ii. Protruding eyes and a fixed stare. iii. A wide, staggering gait. iv. More than 10 beats/minute difference between the apical and radial pulse rates.

ii. Protruding eyes and a fixed stare. Rationale: Exophthalmos (protrusion of eyeballs) often occurs with hyperthyroidism. The client with hyperthyroidism will often exhibit tachycardia, increased appetite, and weight loss

Which statement about fluid replacement is accurate for a client with hyperosmolar hyperglycemic nonketotic syndrome? i. The client is fluid overloaded and needs I.V. fluid slowly to prevent circulatory overload and collapse. ii. The client is severely dehydrated and needs 2 to 3 L of I.V. fluid rapidly. iii. The client is in need of a dextrose solution containing normal saline solution for gradual rehydration. iv. The client is severely dehydrated and needs 10 L of I.V. fluid over the first 24 hours.

ii. The client is severely dehydrated and needs 2 to 3 L of I.V. fluid rapidly. Rationale: Regardless of the client's medical history, rapid fluid resuscitation is critical for maintaining cardiovascular integrity. Profound intravascular depletion requires aggressive fluid replacement. A typical fluid resuscitation protocol is 6 L of fluid over the first 12 hours, with more fluid to follow over the next 24 hours. Various fluids can be used, depending on the degree of hypovolemia. Commonly ordered fluids include dextran (in cases of hypovolemic shock), isotonic normal saline solution and, when the client is stabilized, hypotonic half-normal saline solution.

A client diagnosed with hyperosmolar hyperglycemic nonketotic syndrome (HHNS) is stabilized and prepared for discharge. When preparing the client for discharge and home management, which statement indicates that the client understands his condition and how to control it? i. "I will have to monitor my blood glucose level closely and notify the physician if it's constantly elevated." ii. "If I experience trembling, weakness, and headache, I should drink a glass of soda that contains sugar." iii. "I can avoid getting sick by not becoming dehydrated and by paying attention to my need to urinate, drink, or eat more than usual." iv. "If I begin to feel especially hungry and thirsty, I'll eat a snack high in carbohydrates.

iii. "I can avoid getting sick by not becoming dehydrated and by paying attention to my need to urinate, drink, or eat more than usual." Rationale: The client stating that they will remain hydrated and pay attention to his eating, drinking, and voiding needs indicates understanding of HHNS. Inadequate fluid intake during hyperglycemic episodes commonly leads to HHNS. By recognizing the signs of hyperglycemia (polyuria, polydipsia, and polyphagia) and increasing fluid intake, the client may prevent HHNS. Inadequate fluid intake during hyperglycemic episodes commonly leads to HHNS. By recognizing the signs of hyperglycemia (polyuria, polydipsia, and polyphagia) and increasing fluid intake, the client may prevent HHNS.

A thirty five year old male has been an insulin-dependent diabetic for five years and now is unable to urinate. Which of the following would you most likely suspect? i. Atherosclerosis ii. Diabetic nephropathy iii. Autonomic neuropathy iv. Somatic neuropathy

iii. Autonomic neuropathy

A client in acute renal failure receives an IV infusion of 10 percent dextrose in water with 20 units of regular insulin. The nurse understands that the rationale for this therapy is to i. Correct the hyperglycemia that occurs with acute renal failure. ii. Provide calories to prevent tissue catabolism and azotemia. iii. Facilitate the intracellular movement of potassium iv. Force potassium into the cells to prevent arrhythmias.

iii. Facilitate the intracellular movement of potassium Rationale: Dextrose with insulin helps move potassium into cells and is immediate management therapy for hyperkalemia due to acute renal failure. An exchange resin may also be employed. This type of infusion is often administered before cardiac surgery to stabilize irritable cells and prevent arrhythmias; in this case KCl is also added to the infusion.

a. Nurse April is teaching a client who suspects that she has a lump in her breast. The nurse instructs the client that a diagnosis of breast cancer is confirmed by i. Breast self-examination. ii. Mammography. iii. Fine needle aspiration. iv. Chest X-ray.

iii. Fine needle aspiration. Rationale: 1. Fine needle aspiration and biopsy provide cells for histologic examination to confirm a diagnosis of cancer. A breast self-examination, if done regularly, is the most reliable method for detecting breast lumps early. Mammography is used to detect tumors that are too small to palpate. Chest X-rays can be used to pinpoint rib metastasis.

a. Which laboratory data alteration would the nurse expect to see manifested in a client with renal failure? i. Hypokalemia and metabolic acidosis ii. Hyperkalemia and metabolic alkalosis iii. Hyperphosphatemia and hypocalcemia iv. Hypophosphatemia and hyprcalcemia

iii. Hyperphosphatemia and hypocalcemia

The nurse identifies the treatment of choice for severe ketoacidosis in a conscious person is which? i. Orange juice ii. Candy iii. Insulin iv. Exercise

iii. Insulin Rationale:Insulin therapy is the main therapeutic measure in the treatment of diabetic ketoacidosis; the total amount needed to correct the problem will depend upon the patient's response;

a. A client with a diagnosis of cancer is receiving epoetin alfa (Epogen Procrit) as part of the treatment regimen. The nurse evaluates the effectiveness of this drug by: i. Assessing the client's energy level ii. Monitoring the client's blood pressure iii. Monitoring the hematocrit and hemoglobin levels iv. Assessing the client's level of consciousness

iii. Monitoring the hematocrit and hemoglobin levels Rationale: Epogen does not cure the primary disease condition; however, it helps reduce the anemia that dramatically affects the client's ability to function. The hematocrit and hemoglobin levels will provide reference for evaluating the drug's effectiveness. -Used to tx anemia caused by CKD in patients on dialysis to reduce/avoid the need for RBC transfusions

a. A nurse is reviewing the history of a client who is suspected of having glomerulonephritis. Which of the following would the nurse consider significant: i. Previous episode of acute pyelonephritis ii. History of hyperparathyroidism iii. Recent history of streptococcal infection iv. History of osteoporosis

iii. Recent history of streptococcal infection Rationale: 1. Acute glomerulonephritis is usually caused by Group A beta hemolytic streptococcus.

A. What is the most common cause of hyperaldosteronism? i. Excessive sodium intake ii. A pituitary adenoma iii. Deficient potassium intake iv. An adrenal adenoma

iv. An adrenal adenoma Rationale: An autonomous aldosterone-producing adenoma is the most common cause of hyperaldosteronism. Hyperplasia is the second most frequent cause. Aldosterone secretion is independent of sodium and potassium intake as well as of pituitary stimulation.

A patient recovering from DKA asks the nurse how acidosis occurs. The best response by the nurse is that i. Insufficient insulin leads to cellular starvation, and as cells rupture they release organic acids into the blood ii. When an insulin deficit causes hyperglycemia, then proteins are deaminated by the liver, causing acidic by-products. iii. Excess glucose in the blood is metabolized by the liver into acetone, which is acidic. iv. An insulin deficit promotes metabolism of fat stores, which produces large amounts of acidic ketones.

iv. An insulin deficit promotes metabolism of fat stores, which produces large amounts of acidic ketones. Rationale:An insulin deficit promotes metabolism of fat stores which produces large amounts of acidic ketones". (acidosis)

A. A female client is receiving methotrexate (Mexate), 12 g/m2 I.V., to treat osteogenic carcinoma. During methotrexate therapy, the nurse expects the client to receive which other drug to protect normal cells? i. Probenecid (Benemid) ii. Cytarabine (ara-C, cytosine arabinoside [Cytosar-U]) iii. Thioguanine (6-thioguanine, 6-TG) iv. Leucovorin (citrovorum factor or folinic acid [Wellcovorin])

iv. Leucovorin (citrovorum factor or folinic acid [Wellcovorin]) Rationale: Probenecid should be avoided in clients receiving methotrexate because it reduces renal elimination of methotrexate, increasing the risk of methotrexate toxicity. -Leucovorin is administered with Methotrexate to protect normal cells, which methotrexate could destroy if given alone.

An elevated blood glucose level in the morning c/b an insufficient amount of insulin. May be caused by: i. The dawn phenomenon ii. The Somogyi effect iii. Insulin warning iv. Morning Hyperglycemia

iv. Morning Hyperglycemia Rationale: The Somogyi effect is nocturnal hypoglycemia followed by rebound hyperglycemia in the morning.

a. The client with chronic renal failure has a potassium of 6.6m. The nurse should anticipate an order for? i. Fureosimide(Lasix) ii. Aluminum hydroxide (Amphojel) iii. Propranolol(Inderal) iv. Sodium Polystyrene Sulfonate (Kayexalate)

iv. Sodium Polystyrene Sulfonate (Kayexalate) Rationale: (Kayexalate) exchanges sodium ions for potassium in the intestines. Lasix remove sodium and excess fluid aluminum hydroxide is used to control hyperphosphatemia it. Inderal may control hypertension

Characteristics of Pagets Diseases

kyphosis and bowing of legs which causes a decrease in patient height #2 most common bone disease after OA

Osteoporosis

low bone mass and deterioation which leads to increased bone fragility

Pagets Disease

metabolic bone disorder

Gout

metabolic bone disorder which causes uric acid accumulation

Chemotherapy Nursing Considerations

monitor bleedings monitor appetite and nutritional status monitor I/Os prophylactic antiemetics small meals prevent infection

Osteoarthritis

most common non-inflammatory joint disease

Management of RA patients

pain control (NSAIDS/Aspirin) alternate rest and activity, position joints properly ice used for inflammation heat (warm showers and hot packs) used to relieve stiffness

Peritoneal Dialysis

procedure that uses the lining of the peritoneal cavity as the semipermeable membrane

Complications of Peritoneal Dialysis

protein loss leakage peritonitis

Gout S/S

redness swelling >7 uric acid

Causes of Osteoporosis

risks (osteopenia) small framed, non obese, white women hypothyroidism causes decreased calcitonin and estrogen high PTH causes calcium to leave the bone

Complications of Radiation

skin reactors fatigue changed sense of smell/taste mucositis, xerstomia hair loss N/V/D loss of appetite

Symptoms of OA

stiffness in hips, knees, vertebrae, and fingers

When theres a DECREASE in kidney filtration..

theres an INCREASE in Phosphate and a DECREASE in Calcium

In Acute Renal Failure

theres an inability to produce erythropoietin also causes Azotemia (high nitrogen levels)

Goal for Peritoneal Dialysis

to remove toxics and metabolic wastes and to reestablish normal fluid and electrolyte balance

Renal arteriography

used for suspected renal artery trauma

Hypothyroidism manifestations

weight gain and poor temp regulation