adult health final

automated peritoneal dialysis

(APD) dialysis machine that controls the fill, dwell, and drain phases, and cycles four to eight exchanges per night with 1 to 2 hours per exchange. OVERNIGHT

peritoneal dialysis removes:

protein from the blood, excess fluid, waste, and electrolytes

A nurse is providing instructions about bowel cleansing with polyethylene glycol-electrolyte solution (PEG) for a client who is going to have a colonoscopy. Which of the following information should the nurse include?

"Abdominal bloating might occur." While PEG is well-tolerated, adverse effects include nausea, bloating, and abdominal

A nurse is caring for a client following the surgical placement of a colostomy. Which of the following statements indicates the client understands the dietary teaching?

"Eating yogurt can help decrease the amount of gas that I have." The client who has a colostomy can include yogurt into his diet to help reduce odors and intestinal gas.

The nurse is providing discharge teaching for a patient newly diagnosed with type 2 diabetes mellitus who has been prescribed metformin. Which patient statement indicates the need for further teaching?

"I need to watch constantly for signs of low blood sugar"

A nurse is providing teaching to a client who takes opioid pain medication and has a new prescriptions for docusate sodium. Which of the following statements by the client indicates an understanding of the teaching?

"It may take up to 3 days for the medication to work." --need to take drink 8 ounces of water decussate sodium --Docusate sodium = stool softener

A nurse is teaching a client who has pre-dialysis end stage kidney disease about diet. Which of the following instructions should the nurse include?

"Reduce intake of foods high in potassium." The client should reduce foods high in potassium because potassium clearance is impaired inthe client who has end-stage kidney disease.

A nurse is teaching a client who has a new diagnosis of Type 1 diabetes mellitus about self-administration of insulin. Which of the following instructions should the nurse include?

"Store the current bottle of insulin at room temperature."

A nurse is caring for a client who has nausea and a prescription for metoclopramide intermittent IV bolus every 4 hr as needed. The client asks the nurse how metoclopramide will relieve her nausea. Which of the following explanations should the nurse provide?

"The medication relieves nausea by promoting gastric emptying."

The nurse is preparing to insert a nasogastric (NG) tube into a 68-year-old female patient who is nauseated and vomiting. She has an abdominal mass and suspected small intestinal obstruction. The patient asks the nurse why this procedure is necessary. What response by the nurse is most appropriate?

"The tube will help to drain the stomach contents and prevent further vomiting."

A nurse is caring for a client who reports recurrent flank pain, nausea, and vomiting for 24 hr. Which of the following actions is the nurse's priority?

Administer pain medication.

when teaching the patting with diabetes about insulin administration, the nurse should include which instructions for the patient?

--Consistently use the same size of insulin syringe to avoid dosing errors

The patient with CKD asks why she is receiving nifedipine (Procardia) and furosemide (Lasix). The nurse understand that these drugs are being used to treat the patient's.

--hypertension

A patient is admitted into the ER with acute abdominal pain. Number the nursing action in the best order of implementation priority

1 - measurement of vitals 2- physical assessment of the abdomen for distention, bowel sounds, and pigmentation changes 3 - assessment of onset, location, intensity duration, and frequency and character of the pain 4 - anticipate orders for diagnostic studies on manifestations 5 - administer prescribed analgesics

During routine health screening, a patient is found t have fasting plasma gluocse (FGB) of 132mg/dL. At the follow-up visit, a diagnosis of diabetes would be made based on which laboratory results?

1. A1C of 7.5% 2. FPG > 127

Peritoneal dialysis: glucose concentrations

1.5%, 2.5%, 4.25% higher tonicity will pull off more fluid

what is the elected range for A1C?

4-6%

ileostomy post operative changes in output

500-1000 ml/day paste like

ileostomy normal postoperative output

>1,000 mL/day starting 2-3days post op Can be bile-colored or liquid

Which patient should the nurse plan to teach how to prevent or delay the development of diabetes?

A 34 y/old woman who's parents both have type 2 diabetes

A patient with type 1 diabetes uses 20 U of Novolin 70/30 (NPH/regular) in the morning and at 6:00pm. When teaching the patient about this regimen, what should the nurse emphasize?

A set meal plan with a bedtime snack is necessary to prevent hypoglycemia --need to provide food at peak time --bedtime --> intermediate insulin

A nurse is assessing a client who is taking chlorothiazide sodium. The nurse recognizes which of the following as a manifestation of hypokalemia?

A. Shallow respirations A client's shallow respirations are a sign of weakness in the accessory muscles of breathing, due to hypokalemia.

The patient is receiving the following medications. Which one is prescribed to relieve symptoms rather than treat a disease?

Antidiarrheal agents

Lispro insulin (Humalog) with NPH (Humulin H) insulin is ordered for a patient with newly diagnosed type 1 diabetes. The nurse knows that hone the lsspro insulin is used, when should it be administered?

At mealtime or w/n 15 mins of meals --lispro = rapid acting

what drug is contraindicated for patients with active hepatic disease?

Atorvastatin is contraindicated for a client who has active hepatic disease, but it does notinteract with contrast material.

A nurse is teaching a client's partner about how to obtain a blood pressure reading. Which of the following actions by the partner indicates a need for further instruction?

B. Places the client's arm above the level of the client's heart The partner should place the client's arm at heart level to ensure accurate blood pressure readings.

A nurse is reviewing the BUN and creatinine levels of an older adult client who has chronic kidney disease. The nurse should expect which of the following findings?

BUN 45 mg/dL and creatinine 8 mg/dL

Which class of oral glucose-lowering agents is most commonly used for people with type 2 diabetes because it reduces hepatic glucose production and enhances tissue uptake of glucose?

Biguanide -- Metformin --decrease BG in liver --increase insulin sensitivity @ tissue level - improve glucose transport to cells

A nurse is preparing a client for a kidney biopsy. Which of the following client conditions should the nurse identify as a contraindication for this diagnostic test?

Bleeding tendencies

A nurse is caring for a client who has ulcerative colitis and is teaching the client about the common link with Crohn's disease. Which of the following information should the nurse include?

Both are inflammatory The nurse should inform the client that both disease processes are an inflammatory process of the gastrointestinal tract

A nurse is teaching a client who has angina pectoris about starting therapy with SL nitroglycerin tablets. The nurse should include which of the following instructions regarding how to take the medication

C. "Take one tablet at the first indication of chest pain."

A nurse is reviewing blood pressure classifications with a group of nurses at an in-service meeting. Which of the following should the nurse include as a risk factor for the development of hypertension?

C. Obstructive sleep apnea (OSA) OSA is a condition in which the client's airway becomes blocked by the relaxation of the tongue and muscles of the oropharynx, effectively obstructing the airway. The obstructed airway results in surges in the both the systolic and diastolic pressure during sleep and, in some clients, through the waking hours even when breathing is normal.

A patient returns to the surgical unit with a nasogastric tube to low interment suction, Iv fluids, and a Jackson-Pratt drain at the surgical site following an exploratory laparotomy and a repair of a bowel perforation. Four hours after admission, the patient experiences nausea and vomiting. What is the priority during intervention for the patient?

Check the characteristics of gastric drainage and the patency of the NG tube

A patient has a PRN order for loperamide. For which condition should the nurse administer this medication?

Chronic diarrhea associated with inflammatory bowel disease --Loperamide is an antidiarrheal agent. It is used to manage acute and chronic diarrhea in conditions such as inflammatory bowel disease. --Loperamide can also be used to reduce the volume of drainage from an ileostomy.

Insulin decrease or increases blood glucose levels?

DECREASES

Type 1 associated with ______

DKA

In replying to a patients about the seriousness of her chronic kidney disease (CKD), the nurse knows that stage of CKD is based on what

Glomerular filtration rate (GFR)

A nurse is admitting a client who was prescribed antibiotic therapy and now has a Clostridium difficile infection. Which of the following actions should the nurse take

Disinfect equipment in the client's room daily

a nurse is teaching a middle-age client about hypertension. Which of the following information should the nurse include in the teaching?

Diuretics are the first type of medication to control hypertension decreasing blood volume and lowering BP

A nurse is planning care for a client who has diverticulitis. Which of the following menu selections should the nurse include in the plan?

Grilled chicken breast with white rice Both of these items are low in fiber which is advised during the inflammation of diverticulitis. In the presence of diverticulosis, a high-fiber diet is indicated

In addition to promoting the transport of glucose from the blood into the cell, what does insulin do?

Increases amnio acid transport into cell and protein synthesis --insulin = growth, repair, and storage

two hormones that are imbalanced in diabetes

Insulin and Glucagon

A nurse is teaching a client who has a new prescription for regular insulin and NPH insulin. Which of the following instructions should the nurse include in the teaching?

Keep the open vial at room temperature.

The nurse would question the use of which cathartic agent in a patient with renal insufficiency?

Magnesium hydroxide (Milk of Magnesia) Milk of Magnesia may cause hypermagnesemia in patients with renal insufficiency. The nurse should question this order with the health care provider. Bisacodyl, lubiprostone, and cascara sagrada are safe to use in patients with renal insufficiency as long as the patient is not currently dehydrated.

in the caring for the patient with AKI, of what should the nurse be aware?

Managing fluid balances in the patient with AKI is taking accurate daily weights

A nurse is collecting a medication history from a client who is scheduled to have a cardiac catheterization. Which of the following medications taken by the client interacts with contrast material and places the client at risk for acute kidney injury?

Metformin

a client is teaching a client who has a new prescription for hydrochlororthiazide for management of hypertension. Which of the followup instruction should the nurse include?

Monitor for leg cramps --hypokalemia --fatigue, tacycardia, leg cramps, and muscle weakness

Basal-bolus regimen

Most closely mimics endogenous insulin production Rapid- or short-acting (bolus) insulin before meals Intermediate- or long-acting (basal) background insulin once or twice a day

A nurse is providing teaching to a client with a colostomy about appropriate food choices. Which of the following foods should the nurse include in the teaching

Pasta Pasta may thicken stool and is an appropriate food choice for a client with a colostomy.

what is glycosated hemoglobin (HbA1c)?

Percentage of your hemoglobin is coated with sugar

A nurse is reviewing the laboratory data of a client following a hemodialysis treatment. The nurse should expect to find a decrease in which of the following laboratory values?

Potassium

A patient with AKI has serum potassium level of 6.7 and the following results: pH 7.28, PaCO2 30mmHg, PaO2 86 mmHg, HCO3 18. The nurse recognizes that treatment of the acid-base problem with sodium bicarbonate would cause a decrease in which value?

Potassium levels *potassium moves out of the cell

A nurse is reviewing the medication list for a client who has a new diagnosis of type 2 diabetes mellitus. The nurse should recognize which of the following medications can cause glucose intolerance?

Prednisone Corticosteroids such as prednisone can cause glucose intolerance and hyperglycemia. Theclient might require increased dosage of a hypoglycemic medication.

A nurse is providing dietary teaching to a client who has chronic kidney disease (CKD).The nurse should instruct the client to limit which of the following nutrients? (Select all that apply.)

Protein Phosphorous Sodium

dietary fiber supplements or bulk forming laxatives (treatment for impaction)

Psyllium polycarbophil methylcelulose

Meglitinides

Repaglinide Nateglinide Action: increase insulin production, administered for post-meal hyperglycemia NI: -take w/ first bite

A nurse is caring for a client who is being admitted for an acute exacerbation of ulcerative colitis. Which of the following actions should the nurse take first?

Review the client's electrolyte values. The greatest risk to this client is injury from impaired function of cardiac or respiratory muscles; therefore, the first action the nurse should take is to review the client's electrolyte values. The client might have low sodium, potassium, and chloride from frequent diarrhea.

A nurse is assessing a client who has peritonitis. Which of the following findings should the nurse expect?

Rigid abdomen A rigid, boardlike abdomen is a manifestation of peritonitis

A nurse is caring for a client who needs a stool specimen collected. Which of the following actions should the nurse take when obtaining the specimen?

Send specimen container immediately to the lab

In a patient with AKI, which laboratory urinalysis result indicates tubular damage?

Specific gravity fixed at 1.010 --A urine specific gravity that is consistently 1.010 and urine osmolality of about 300 mOsm/kg is the same specific gravity and osmololity as plasma. This indicates that tubules are damaged and unable to concentrate urine. --Hematuria is more common with post renal damage. --Tubular damage is associated with a high sodium concentration (greater than 40 mEq/L).

A nurse is preparing a teaching plan for a client who has chronic constipation secondary to irregular bowel habits. Which of the following should the nurse plan to include in the teaching?

The client should follow a high-fiber diet to establish bowel regularity. The client who has chronic constipation should consume a diet with high-fiber food sources, including bran and complex carbohydrates.

A nurse is caring for a client who has chronic renal disease and is receiving therapy with epoetin alfa. Which of the following laboratory results should the nurse review for an indication of a therapeutic effect of the medication?

The hematocrit (Hct)

while carrying for a patient in the oliguric phase of AKI, the nurse monitors the patients for associated collaborative problems. When should they notify the HCP?

The patient experiences increasing muscle weakness and abdominal cramping *nueromuscular impairment

The patient with CKD is brought to the ED with Kussumal respiration's. What does the nurse know about CKD that could cause the patient's Kussmaul reparations.

They are caused by reparatory compensation for metabolic acidosis

A nurse is creating a plan of care to maintain the skin integrity of a client who experiences frequent diarrhea due to ulcerative colitis. Which of the following interventions should the nurse include in the plan?

Wipe perianal area with warm water and apply a barrier cream The nurse should instruct the client to wipe the perianal area and apply a barrier cream to decrease skin breakdown when in contact with fecal material.

The nurse is teaching a patient how to mix regular insulin and NPH insulin in the same syringe. Which action, if performed by the nurse, indicates the need for further teaching?

Withdraw NPH first --clear (regular) to cloudy (NPH)

Which complication of chronic kidney disease is treated with erythropoietin (EPO)? a. Anemia b. Hypertension c. Hyperkalemia d. Mineral and bone disorder

a. Anemia

a nurse is caring for a client who has hypertension and asks the nurse about prescription for propranolol. The nurse should inform the client that the medication is contraindicated in clients who have a history of which of the fowling conditions?

asthma beta-blocker -- bronchospasms

what is the primary way that a nurse will evaluate the potency of a AVF?

auscultate for a bruit at site

Metformin

classified as a biguinide and is the most commonly used med for type 2 DM initially. It is also often used a preventative medication for those at high risk for developing DM. When used alone, metformin lowers the blood sugar after meal intake a swell as fasting blood glucose levels. Metformin does not stimulate insulin release and therefore poses little risk for hypogylcemia.

On examining a patient 8 hours after having surgery to create a colostomy, what should the nurse expect to find? a. Hyperactive, high-pitched bowel sounds b. A brick-red, puffy stoma that oozes blood c. A purplish stoma, shiny and moist with mucus d. A small amount of liquid fecal drainage from the stoma

b. A brick-red, puffy stoma that oozes blood

What is the most serious electrolyte disorder associated with kidney disease? a. Hypocalcemia b. Hyperkalemia c. Hyponatremia d. Hypermagnesemia

b. Hyperkalemia

colonoscopy prep drugs

bisacodyl polythylene glycol

ileostomy pattern of output

continuous output

a patient with AKI is a candidate for continuous renal replacement therapy (CRRT). What is the most common indication for use of a CRRT?

fluid overload --> removes solute and fluids in unstable hemodynamic patient

Polydipsia and polyuria related to diabetes mellitus are primarily due to which of the following?

fluid shifts resulting from the osmotic effect of hyperglycemia.

sigmoid colostomy output

formed stool (greater chance of bowel continence through colostomy irrigation)

what is a glucagon?

hormone release by the pancreas.

what should the nurse teach the patient with diverticulitis to do?

maintain a high fiber diet and encourage fluid intake of at least 2L a day

what does A1C evaluate?

test evaluates treatment effectiveness and compliance

a nurse is providing teaching to a client who has hypertension and a new prescription for captopril. Which of the following instructions should the nurse provide?

do not use salt substitutes while taking this medication ACE inhibitor can cause hyperkalemia due to potassium retention by the kidney

Metabolic acidosis occurs in the oliguric phase of AKI as a result of impairment of:

excretion of hydrogen ions

a nurse is providing teaching about the Mediterranean diet to a client newly who has a new diagnosis of hypertension. Which of the following stamens by the client indicates a need for further teaching?

"I will limit my intake of red meat twice a week"

A client who is schedule for a barium swallow asks the nurse why a laxative is necessary following the procedure. Which of the following responses should the nurse make?

"The laxative helps eliminate the barium."

A nurse is providing teaching a client who has Crohn's disease and a new prescription for methotrexate. Which of the following instructions should the nurse include? (Select all that apply.

--Do not drink alcoholic beverages while taking this medication. --Report unexplained bruising to the provider. --Avoid people who have infections. --It may take 3 to 6 weeks to achieve the medication's therapeutic effects --Methotrexate can cause thrombocytopenia. Clients should report bruising or petechiae as they may indicate a low platelet count. --Methotrexate causes bone marrow suppression and increases the risk for infection. --NSAIDs interact with methotrexate and should be avoided. Providers sometimes prescribe folic acid to help minimize the side effects of methotrexate.

A patient with chronic kidney disease is considering whether to use peritoneal dialysis (PD) or hemodialysis (HD). Which of the following statements are correct when comparing PD to HD? Select all that apply.

--PD (Peritoneal dialysis) causes less cardiovascular stress when compared to HD (hemodialysis). --PD requires fewer dietary restrictions than HD.

An 83 year old female patient was found lying on the bathroom floor. She said she fell 2 days ago and has not been able to take her heart medication or eat or drink anything since then. What conditions could be causing prerenal acute kidney injury (AKI) in this patient? Select all that apply.

--hypovolemia --decreased cardiac output -Because the patient has had nothing to eat or drink for 2 days, she is probably dehydrated and hypovolemic. -Decreased cardiac output is most likely because she is older and takes heart medicine, which is probably for heart failure and decreased CO cause prerenal AKI.

risk factors of DM:

-BMI >25 -first degree relative with DM -age 45 or older -report of sedentary lifestyle -Hx of vascular disease, polyccrstic ovary syndrome, gestational DM, giving birth infant to infant >9lbs -BP higher than 140/90 -HDL <35, Triglycerides >250

administration of insulin

-Subcutaneous injection -use same size syringe -regular insulin (given IV) -absorption is fastest through the abdomen, arm, thigh, and butt -ABDOMEN preferred spot -rotate injection sites

Clotting/infection at the site (hemodialysis)

-heparin used in dialysis process to prevent blood clotting and to flush lines after use. Can cause bleeding issues

what are the infrarenal causes of acute kidney injury (AKI)

-nephrotoxic drugs -acute glomerulonephritis -tubular obstruction by myoglobin *direct damage to kidney tissue

call doctor when sick -- guidelines

-presence of moderate to large urine ketones or ketonuria for more than 24 hours -blood glucose >250 that does not resolve with treatment -Fever >101F, no response to acetaminophen, or lasts more than 24 hours -feeling disoriented or confused -experiencing rapid breathing -persistent N/V/D -inability to tolerate liquids -illness that lasts longer than 2 days

A nurse is caring for a client who has end stage renal disease (ESRD). Which of the following are expected findings? Select all that apply.

-slurred speech --bone pain --pruritus --hypertension --tachypnea

what are characteristics of type 2 diabetes?

1. B-cell (beta) exhaustion 2. Insulin resistance 3. genetic predisposition 4. altered production of adipokines 5. inherited defect in insulin receptors 6. Inappropriate glucose production in the liver

how do you mix regular insulin and NPH insulin?

1. air added to NPH vial first 2. air added to regular insulin 3. regular insulin is withdrawn 4. bubbles removed 5. dose of NPH is withdrawn

3 phases of PD:

1. inflow -- fill peritoneum 2. dwell -- solution sitting in peritoneal cavity and equilibration is occurring 3. drain -- solution and waste products being drained, should look clear to very light yellow) after all have been completed -- its called an EXCHANGE

how long is the life of a RBC?

120 days

why do you need insulin?

to push the glucose into the cell for energy use and store extra glucose in the liver in form of glycogen

A nurse is monitoring a client who has acute kidney injury. Which of the following laboratory findings should the nurse expect?

Elevated BUN

A nurse is developing a teaching plan for a client who has an ileostomy and will require stoma care. Which of the following information should the nurse include?

Empty the pouch when it is 1/2 full. The nurse should instruct the client to empty the pouch when it is 1/3 to 1/2 full.

A nurse is caring for a client who has end-stage kidney disease (ESKD) and reports having shortness of breath and swelling in his lower extremities. Upon assessment, the nurse notes the client has crackles in his lungs and an elevated blood pressure. The nurse should suspect which of the following based on the client's manifestations?

Hypervolemia

a nurse is providing teaching about a heart healthy diet to a group with hypertension. Which of the following statements by one of the clients indicates a need for further teaching?

I may eat 10 ounces of lean protein each day limit to 5-6 oz per day

A dehydrated patient is in the Injury stage of the RIFLE staging of AKI. What would the nurse antidote first in the treatment of the patient?

IV admin of fluid and furosemide (Lasix) *Serum creatine x2 *GFR decreased by 50% *0.5ml/kg/hr

A nurse is teaching a client who has chronic kidney disease and a new prescription for epoetin alfa. The nurse should instruct the client to increase dietary intake of which of the following substances?

Iron --Epoetin alfa is a synthetic form of erythropoietin, a substance produced by the kidneys thatstimulates the bone marrow to produce red blood cells. Increased iron is needed for theproduction of hemoglobin and red blood cells by the bone marrow.

After teaching a group of students about laxatives, the instructor determines that the teaching has been successful when the students identify which agent as an example of a bulk forming laxative?

Psyllium

.A nurse in a PACU is assessing a client who has a newly created colostomy. Which of the following findings should the nurse report to the provider?

Purplish-colored stoma A stoma that is purplish in color indicates ischemia. The nurse should notify the provider

Mealtime insulin (bolus)

Rapid-acting (bolus) Lispro, aspart, glulisine Onset of action 15 minutes Injected within 15 minutes of mealtime Short-acting (bolus) Regular with onset of action 30 to 60 minutes Injected 30 to 45 minutes before meal Onset of action 30 to 60 minutes

A nurse is caring for an adolescent client who has a long history of diabetes mellitus and is being admitted to the emergency department confused, flushed, and with an acetone odor on the breath. Diabetic ketoacidosis is suspected. The nurse should anticipate using which of the following types of insulin to treat this client?

Regular insulin

A nurse is reviewing the medication list for a client who has a new diagnosis of a small bowel obstruction. The nurse should withhold which of the following medications?

Senna

A nurse is reviewing laboratory findings for four clients. Which of the following clients has manifestations of acute kidney injury?

Serum creatinine 6 mg/dL

A nurse is caring for a client with chronic kidney disease (CKD) and states she has heartburn. The provider prescribes aluminum hydroxide. The client asks, "Why can't I just take the antacid magaldrate my husband has at home?" The nurse explains to the client that aluminum hydroxide is the preferred antacid because it lowers which of the following?

Serum phosphorus levels --Aluminum-based formulas are also a phosphate binder, helping to lower serum phosphoruslevels in clients who have CKD.

A patient with diabetes is learning to mix regular insulin and NPH insulin in the same syringe. The nurse determines that additional teaching is needed when the patient does what?

Withdraws the NPH does into the spring first

The patient with chronic kidney disease is considering whether to use peritoneal dialysis (PD) or hemodialysis (HD). What are advantages of PD when compared to HD (select all that apply)? a. Less protein loss b. Rapid fluid removal c. Less cardiovascular stress d. Decreased hyperlipidemia e. Requires fewer dietary restrictions

c. Less cardiovascular stress e. Requires fewer dietary restrictions

a nurse is providing teaching to a client who has hypertension and a new prescription for verapamil. Which of the following beverages should the nurse tell the client to avoid while taking this medication?

grapefruit juice

what is the most appropriate snack for the nurse to offer a patient with stage 4 CKD

hard candy --raisins (pottasium) --ice cream (protein) --dill pickles (sodium)

what is insulin?

hormone produced by the beta cells of the pancreas.

When administering insulin, the nurse must keep in mind that which is the most immediate and serious adverse effect of insulin?

hypoglycemia

The patient with a new ileostomy needs discharge teaching. What should the nurse include in this teaching?

if leakage occurs, promptly remove the pouch, clean the skin, and apply new pouch

Number the following in the order of the phases of exchange in PD. Begin with 1 and end with 3. a. Drain b. Dwell c. Inflow

inflow dwell drain

ketosis for DM

ketosis -- Type 1 -- common ketosis -- Type 2 -- rare

A patient on HD develops. thrombus of a subcutaneous arteriovenous graft (AVG), requiring its removal. While waiting for a replacement graft or fistula, the patient is most likely to have what done for treatment?

long-term cuffed catheter tunneled subcutanoulsy to the jugular vein

a patient with ulcerative colitis has a total proctocolectomy with formation of a terminal ileum stoma. What.is the most important NI of the patient, what should the nurse expect to find?

measure the ileostomy output and determine the status of the patient's fluid balance

continuous ambulatory peritoneal dialysis (CAPD)

method of peritoneal dialysis whereby a patient manually performs exchanges or cycles throughout the day 3-4times/day

vascular access sites for Hemodialysis:

most difficult --Types-- -arteriovenous fistulas and grafts (fell the thrill, hear the bruit, distal pulses circulation, no B/P, injections, IVs, no tight clothing)

#1 cause of type 2 diabetes

obesity

how does glucagon work?

opposite of insulin by increasing our blood sugar when low levels occur. The release of glucagon will cause the liver to release the stored glycogen so you can get glucose in your body.

A nurse is reviewing the arterial blood gas values of a client who has chronic kidney disease. Which of the following sets of values should the nurse expect?

pH 7.25, HCO3- 19 mEq/L, PaCO2 30 mm Hg The nurse should expect a client who has renal failure to have metabolic acidosis, which is characterized by a low HCO3-, a low pH, and a low or normal PaCO2. Expected reference ranges for these laboratory values are as follows: pH 7.35 to 7.45, HCO3- 21 to 28 mEq/L, and PaCO2 35 to 45 mm Hg.

a patient with inflammatory bowel disease has a nursing diagnosis of imbalanced nutrition: less than body requirements related to decreased nutritional intake and decreased intestinal absorption. Which assessment data surrpour of this diagnosis?

pallor and hair loss

A nurse is caring for a client who is postoperative following abdominal surgery. Which of the following findings should indicate to the nurse that client's peristalsis is returning?

passage of flatus

acute tubular necrosis (ATN) is the most common cause of internal AKI. which patient is most likely to develop ATN?

patient with major surgery who required a blood transfusion *tubular necrosis = ischemia, nephrotoxins, sepsis

need sterile technique for:

peritoneal dialysis

what indicates the nurse that a patient with oliguria has pre-renal oliguria

urine testing reveals a low specific gravity

Background Insulin (Basal)

used to control glucose IN BETWEEN MEALS and OVERNIGHT INTERMEDIATE - ACTING -NPH -Can mix with short and rapid acting insulins -Cloudy, must agitate mix LONG - ACTING -Glargine -Detemir -Released steadily and continuously with NO peak action -do not mix with other insulin

a nurse is caring for a client who has a new diagnosis of essential hypertension. The nurse should monitor the client for which of the following findings that is consistent with this diagnosis?

vertigo (key word essential hypertension)

a patient on a medical unit has a potassium level of 6.8. what is the priority action that the nurse should take?

place the patient on a cardiac monitor

A nurse is assessing a client who reports frequent vomiting and diarrhea for the past 3 days. Which of the following findings should the nurse expect? (Select all that apply.

poor skin turgor hypotension flat neck veins

a nurse is revving the serum laborite finding for a client who has hypertension and is prescribed hydrocholorthiazide. which of the following should the nurse report?

potassium @ 2.3 mEq/L monitor client for dysrhythmias

what happens to pancreas when we have low blood sugar?

releases glucagon

what happens to the pancreas when we have high blood sugar?

releases insulin

a 68 year/old man with the history oh heart failure from hypertension has AKI as a result of the effects of nephrotoxic diuretics. Currently his serum potassium 6.2 with cardiac changes, his BUN is 108, his serum creatinine is 4.1, his serum HCO3 is 14. He is somnolent and disoriented. Which treatment should the nurse expect to be used for him?

renal replacement therapy

sigmoid colostomy postoperative changes output

semi-formed stools

In report, the nurse learns that the patient has a transverse colostomy. What should the nurse expect when providing care for the patient?

semiformal stools in a pouch with the need to monitor fluid balance

hemodialysis (out of body)

shunts blood from the body through a dialyzer and back into circulation --3 times/week for 4 hours

transverse colostomy normal postoperative output

small semi-liquid with some mucous 2-3 after surgery, blood can be present in the first few days post op

sigmoid colostomy normal postoperative output

small to moderate amount of mucus with semi-formed stool 4-5 days post op

A nurse is discussing good food choices with a client who is recovering from an exacerbation of inflammatory bowel disease and is to start a low-lactose diet. Which of the following foods is the best choice for the client?

soy milk

Why are the hormones cortisol, glucagon, epinephrine, and goth hormone reffed to as a counter regulatory hormone?

stimulate glucose output by the liver *opposite effects of insulin

transverse colostomy post operative changes in output

stool-like, semi-formed, or formed

A nurse is caring for an older adult client who reports taking bisacodyl tablets daily. Which of the following responses should the nurse make?

"Excessive laxative use may cause an electrolyte imbalance. Bisacodyl is a stimulant laxative that acts by stimulating intestinal motility and increasing the amount of water and electrolytes within the intestines; therefore, chronic use of laxatives can lead to fluid and electrolyte imbalance.

A nurse is caring for a client who reports taking Bisacodyl to promote a daily bowel movement. Which of the following assessment questions should be the nurse's priority?

"How long have you been taking the bisacodyl?"

The nurse identifies a need for additional teaching when a patient with acute infectious diarrhea makes which statement?

"I may use OTC loperamide (Imodium) or paregoric when I need to control the diarrhea" Anti-peristaltic agents can cause prolong expires of infectious diarrhea

The nurse is discharging a client from the hospital who has a new prescription for furosemide. Which of the following client statements indicates an understanding of the teaching?

"I need to limit my sun exposure and wear sunscreen while on this medication."

A nurse is teaching a client who has diabetes about which dietary source should provide the greatest percentage of calories. Which of the following statements indicates the client understands the teaching?

"I should eat more calories from complex carbohydrates than anything else."

A nurse at a provider's office is instructing a client who is scheduled for an outpatient barium swallow. Which of the following statements by the client indicates an understanding of the teaching

"I should expect light-colored stools after the procedure.

A nurse is providing teaching about ileostomy care to a client. Which of the following statements by the client indicates a need for further teaching?

"I will be certain to take enteric-coated medications." This is not an appropriate statement and indicates a need for additional teaching. Enteric-coated medications should be avoided to reduce the risk of blockage caused by the coating.

A nurse is teaching a client how to do fecal occult blood testing. Which of the following statements by the client indicates a need for further teaching?

"I will continue taking my Coumadin as prescribed. The client should discontinue anticoagulants for one week prior to this testing. This statement requires clarification.

A nurse is teaching a client how to do fecal occult blood testing. Which of the following statements by the client indicates a need for further teaching?

"I will continue taking my Warfarin as prescribed." The client should discontinue anticoagulants for one week prior to this testing. ---This statement requires clarification.

A nurse is teaching a patient who has type 1 diabetes mellitus and his parents about illness management. Which of the following instructions should the nurse include?

"Test the urine for ketones." --Ketonuria can indicate that the child does not have enough glucose for energy and isbreaking down fats to provide glucose to cells. Ketones lead to DKA!

. A nurse is providing teaching to a client who has a new colostomy. Which of the following information should the nurse include in the teaching?

"You may experience a small amount of bleeding around the stoma."

Drugs for IBD (diarrhea) and remission of IBD

-Antimicrobials (ciprofloxacin) -- C.Diff -Corticosteriods (prednisone) -- decrease inflammation and rapidly suppress immune system during execerbations --Immunosuppressants (methotrexate): suppress the immune response to maintain remission --Immunomodulators (infliximab) -- suppress the immune response by inhibit cyctrkine tumor necrosis factor to maintain remission --5-aminosalicylates (sulfasalazine) -- decrease GI inflammation to maintain remission --Hematinics and vitamins -- correct iron deficiency anemia and promote healing (all times)

Diagnosing DM: 2 separate findings on 2 separate days or 1 finding

-Glycosylated Hgb (A1C) greater than 6.5% -fasting glucose greater than 126ml/mL(no caloric intake 8 hrs before) -2-hr glucose greater than 200mg/mL with oral glucose tolerance test (patient drinks 75 grams of glucose and test blood glucose 2 hrs later) -Manifestations of diabetes plus blood glucose greater than 200mg/mL

clinical manifestations of DM

-Polyuria (excess urine production from osmotic diuresis) -Polydipsia (excessive thirst due to dehydration) -Weakness and fatigue -Rapid weak pulse and hypotension -Dry mucous membranes, skin warm, dry, loss of skin turgor -Polyphagia (excessive hunger and eating from inability of cells to receive glucose (b/c of lack of insulin or cellular resistance to available insulin) and the body's use of protein and fat of energy. Type 1: weight loss Recurrent infections, especially yeast (yeast grows in sugar) Slow healing wounds (high sugars affect nerves and vascular blood flow leading to poor circulation) Blurry vision (high sugars cause lens to swell) . Type I: DKA symptoms of fruity breath, N/V, abdominal pain

A nurse is reinforcing teaching with a client regarding reduction of risk factors for coronary artery disease. Which of the following statements by the client indicates an understanding of the teaching? (Select all that apply.)

A. "I must stop smoking." D. "I need to monitor my weight." E. "I am limiting my intake of fast foods."

16. A nurse is teaching a client who has hypertension and a new prescription for atenolol. Which of the following findings should the nurse include as adverse effects of this medication?

A. Bradycardia Atenolol is a beta-blocker, which slows the heart rate. The nurse should instruct the client to monitor his pulse rate and report bradycardia.

A nurse is caring for a client who has congestive heart failure and is taking digoxin daily. The client refused breakfast and is complaining of nausea and weakness. Which of the following actions should the nurse take first?

A. Check the client's vital signs. It is possible that the client's nausea is secondary to digoxin toxicity. By obtaining vital signs, the nurse can assess for bradycardia, which is a symptom of digoxin toxicity. The nurse should withhold the medication and call the provider if the client's heart rate is less than 60 bpm.

A nurse is caring for a client who just had a cardiac catheterization. Which of the following nursing interventions should the nurse include in the client's plan of care? (Select all that apply.)

A. Check peripheral pulses in the affected extremity. D. Keep the client's hip and leg extended. E. Have the client remain in bed up to 6 hr.

A nurse is caring for a client who is taking lisinopril. Which of the following outcomes indicates a therapeutic effect of the medication?

A. Decreased blood pressure Lisinopril, an ACE inhibitor, may be used alone or in combination with other antihypertensives in the management of hypertension and congestive heart failure. A therapeutic effect of the medication is a decrease in blood pressure.

A nurse is caring for an older adult client who has had surgery for an intestinal obstruction and has an NG tube to wall suction. Which of the following interventions should the nurse include in the client's postoperative plan of care? (Select all that apply.)

A. Discontinue suction when assessing for peristalsis B. Irrigate the NG tube with 0.9% sodium chloride irrigation solution. C. Place sequential compression devices on the bilateral lower extremities D. Reposition the client from side to side every 2 hr

A nurse is teaching a client who has constipation. Which of the following should the nurse discuss as causes of constipation? (Select all that apply.)

A. Excessive laxative use B. Ignoring the urge to defecate C. Inadequate fluid intake

A nurse is assessing a client prior to administering atenolol. Which of the following findings should prompt the nurse to withhold the medication?

A. Heart rate 46/min The nurse should check the client's heart rate prior to administering a beta-blocker. If the client's heart rate is less than 50/min, the nurse should hold the medication and contact the provider. Atenolol is a beta-blocker and is used in the treatment of hypertension and angina, and following a myocardial infarction. This medication works by slowing the heart rate, decreasing the speed of electrical impulses through the atrioventricular node, and decreasing the force of contraction.

A nurse is teaching a client who has a new prescription for captopril. Which of the following instructions should the nurse include in the teaching?

A. Monitor for a cough. Captopril is an ACE inhibitor used to treat hypertension. The client should monitor and report a cough and dyspnea

A nurse is caring for a client 4 hr postoperative following a kidney biopsy. Which of the following interventions should the nurse take? (Select all that apply).

A. Monitor for hematuria. B. Check for flank pain.

A nurse is caring for a client who has impaired renal function. For which of the following findings should the nurse notify the provider?

A. Urine output of175 mL in the past 8 hr Rationale: The nurse should notify the provider if the client's urinary output is less than 30 mL/hr. This finding indicates a fluid imbalance, decreased circulating fluid volume, and possibly inadequate renal perfusion

A nurse is providing teaching for a client who has hypertension and a prescription change from metoprolol to metoprolol/hydrochlorothiazide. Which of the following statements by the client indicates an understanding of the teaching?

B. "With the new medication, I should experience fewer side effects." When used in combination with thiazide diuretics, a lower dose of the beta-blocker can be used. The benefit is there are fewer side effects when beta-blockers (and other antihypertensives) are used in lower dosages.

A nurse is teaching a client who has a new prescription for transdermal nitroglycerin to treat angina pectoris. Which of the following instructions should the nurse include in the teaching?

B. Apply the transdermal patch in the morning. The client should apply the patch every morning and leave it in place for a 12 to 14 hr, then remove it in the evening.

19. A nurse is caring for a client who is receiving peritoneal dialysis. The nurse should monitor the client for which of the following manifestations of peritonitis?

B. Nausea

A nurse is planning care for a client following a cardiac catheterization accessed through his femoral artery. Which of the following actions should the nurse plan to take?

B. Perform neurovascular checks with vital signs. The nurse should assess color, temperature, and pulse in the affected extremity and monitor the client for neurovascular changes that can indicate a stroke, such as slurred speech and visual disturbances.

A nurse is providing teaching to a client who has a family history of hypertension. The nurse should inform the client that his blood pressure of 124/84 mm Hg places him in which of the following categories?

B. Prehypertension A blood pressure of 124/84 mm Hg places this client in the prehypertension category. Prehypertension is indicated by a systolic pressure between 120 and 130 mm Hg and a diastolic pressure between 80 and 89 mm Hg.

In a patient with AKI, which laboratory urinalysis result indicates tubular damage? a. Hematuria b. Specific gravity fixed at 1.010 c. Urine sodium of 12 mEq/L (12 mmol/L) d. Osmolality of 1000 mOsm/kg (1000 mmol/kg)

B. Specific gravity fixed at 1.010 *can't concentrate urine

A nurse is reviewing the health history for a client who has angina pectoris and a prescription for propranolol hydrochloride PO 40 mg twice daily. Which of the following findings in the history should the nurse report to the provider?

B. The client has a history of bronchial asthma. Beta-adrenergic blockers can cause bronchospasm in clients who have bronchial asthma; therefore, this is a contraindication to its use and should be reported to the provider.

A nurse is caring for a client who has a prescription for a stool test for guaiac. The nurse understands the purpose of the test is to check the stool for which of the following substances?

Blood A guaiac test detects the presence of occult or hidden blood in the stool. The guaiac test is an extremely useful diagnostic screening test for the presence of colon cancer and gastrointestinal ulcers.

A nurse is providing discharge teaching to a client who has a new prescription for verapamil for angina. Which of the following instructions should the nurse include?

C. "Increase your daily intake of dietary fiber." The nurse should instruct the client to increase his daily intake of dietary fiber to reduce the risk of constipation associated with verapamil.

A nurse in a provider's clinic is assessing a client who takes sublingual nitroglycerin for stable angina. The client reports getting a headache each time he takes the medication. Which of the following statements should the nurse make?

C. "Try taking a mild analgesic to relieve the headache."

nurse is providing discharge instructions to a client following a cardiac catheterization. Which of the following information should the nurse include?

C. "You will notice a small hematoma at the incision site."

The medication prescribed for the patient with IBD include cobalamin and iron injections. What is the rationale for using these drugs?

Correct malnutrition

A nurse is teaching a client who has chronic kidney disease about the process of continuous ambulatory peritoneal dialysis (CAPD). Which of the following information should the nurse include in the teaching

C. CAPD requires the client to follow fewer dietary and fluid restrictions than hemodialysis requires.

. A nurse is teaching a client who takes aspirin daily for coronary artery disease about herbal supplements. The nurse should instruct the client that which of the following herbal supplements may interact adversely with aspirin?

C. Feverfew The nurse should instruct the client to avoid taking feverfew with aspirin because it suppresses platelet aggregation and places the client at risk for bleeding when taken with aspirin.

A nurse is caring for a client who has a new prescription for propranolol. The nurse should monitor the client for which of the following adverse reactions to this medication?

C. Postural hypotension

Which drugs will be used to treat the patient with chronic kidney disease for mineral and bone disorder? Select all that apply.

Cinacalcet (sensipar), Sevelamer (renagel), Calcium acetate (phoslo) --Cinacalcet, a calimimetic agent to control secondary hyperparathyroidism; --Sevelamer, a non calcium phosphate binder; --calcium acetate, a calcium based phosphate binder are used to treat mineral and bone disorder in CKD.

A nurse is providing discharge teaching to a client who has a new arteriovenous fistula in the right forearm. Which of the following manifestations should the nurse include in the teaching as a possible indication of venous insufficiency

Cold and numb numbness distal to the fistula site Pallor and numbness distal to the fistula site are possible indicators of venous insufficiency and should be immediately reported to the provider

A nurse is providing teaching to a client who has renal failure and an elevated phosphorous level. The provider instructed the client to take aluminum hydroxide 300 mg PO three times daily. For which of the following adverse effects should the nurse inform the client

Constipation Constipation is a common side effect of aluminum-based antacids. The nurse should instruct the client to increase fiber intake and that stool softeners or laxatives may be needed.

A nurse is discussing laboratory values associated with the renal system with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the values?

Creatinine levels are increased in clients who have acute kidney injury

The nurse is planning care for a patient with Crohn's disease. What is the major difference between ulcerative colitis and Crohn's disease?

Crohn's disease often recurs after surgery, whereas ulcerative colitis is curable with a colectomy.

A nurse is teaching a client who has diabetes mellitus and receives 25 units of NPH insulin every morning if her blood glucose level is above 200 mg/dL. Which of the following information should the nurse include?

Expect the NPH to peak in 6-14 hours.

A nurse is caring for a client who reports having chronic constipation. Which of the following herbal supplements should the nurse recommend?

Flaxseed high-fiber

A nurse is caring for a client who has diabetes and plans to administer his regular insulin subcutaneously before he eats breakfast at 0800. After checking the client's morning glucose level, which of the following actions should the nurse take?

Give the medicine at 0730

Suldonylureas

Glipizide, Glyburide, Gimiperide action: increase insulin production by the pancreas NI: avoid alcohol administer 30 mins to meal

Type 2 associated with ______

HHS

A patient with chronic kidney disease is receiving epoetin alfa. Which laboratory result would indicate a therapeutic effect of the medication?

Hct 33% Therapeutic effect is seen when the hematocrit reaches between 30% and 33%

a man with end stage renal disease (ESRD) is scheduled for HD following a healing of AVF). What should the nurse explain to him that will occur during dialysis?

He will be able to visit, read, sleep, and recline in chair while watching TV

A nurse is caring for a client immediately following a hemodialysis treatment. For which of the following manifestations will the nurse administer a PRN dose of phenytoin?

Headache, restlessness Headache and restlessness are manifestations of disequilibrium syndrome, which occurs during or after hemodialysis due to the rapid shift of fluids, pH, and osmolarity between fluid and blood that occurs.. This condition can cause cerebral edema leading to seizures and coma, and a PRN dose of the anticonvulsant phenytoin should be administered.

A nurse is assessing a client in the oliguric phase of acute kidney injury. Which of the following findings should the nurse expect?

Hyperkalemia

A nurse is reviewing the laboratory test results from a client who has prerenal acute kidney injury (AKI). Which of the following electrolyte imbalances should the nurse expect

Hyperkalemia

Biguinides

Metformin (glucophage); lowers serum glucose levels by inhibiting hepatic glucose production and increasing sensitivity of peripheral tissue to insulin; adverse reactions: abdominal discomfort and diarrhea; many drug-drug interactions, extended release tablets should be taking with evening meal; use cautiously with preexisting renal or liver disease or HF; wait 48 hours to restart dosage after diagnostic studies requiring IV iodine contrast media

Which statement would be correct for a patient with type 2 diabetes who was admitted to the hospital with pneumonia?

The patient may have sufficient endogenous insulin to prevent ketosis but is at risk for hyperosmolar hyperglycemic syndrome (HHS)

A nurse is assessing a client who has a colostomy. Which of the following findings should the nurse report to the provider?

The stoma is pale in color. The stoma should be pinkish to cherry red in color, which indicates an adequate blood supply. If the stoma becomes pale, bluish, or dark, the nurse should report this finding to the provider immediately.

A nurse is caring for a client who has Crohn's disease. Which of the following food choices would follow the recommended diet for clients who have Crohn's disease?

Toast with jelly Toast with jelly is an appropriate food choice by the client. It does not contain large amounts of lactose, fat, or fibe

A nurse is teaching a client who has acute kidney injury about the oliguric phase. Which of the following information should the nurse include in the teaching?

Urine output is less than 400 mL per 24 hr.

A nurse is reviewing the medication record for a client who has chronic kidney disease. Which of the following medications should the nurse identify as having the potential to cause nephrotoxicity?

Vancomycin

A patient has a new prescription for metoclopramide. On review of the chart, the nurse identifies that this medication can be safely administered with which condition?

Vomiting following chemotherapy Metoclopramide is a GI stimulant and antiemetic. Because it is a GI stimulant, it is contraindicated with gastrointestinal obstruction, hemorrhage, or perforation. It is used in the treatment of vomiting after surgery, chemotherapy, or radiation.

A nurse is assessing a client who has hypokalemia as a result of nausea, vomiting, and diarrhea. Which of the following findings should the nurse expect?

Weak, irregular pulse Common manifestations of potassium depletion include a weak and irregular pulse, muscle weakness, fatigue, and ventricular dysrhythmias.

what is the most important thing the nurse should do when caring for a patient who has contracted C diff?

Wear gloves and wash hands with soap and water

a nurse is reviewing the medical record of a client who has hypertension and new prescription for metoprolol. which of the following findings should the nurse investigate further?

a history of L side heart failure look for shortness of breath and weight gain indicating fluid retention

A patient with ulcerative colonist undergoes the first phase of total proctocolectomy with ideal pouch and anal anastomosis. On initial postoperative assessment of the patient, what should the nurse expect to find?

a loop ileostomy with aplastic rod and hold it in place

Prevention of AKI is important because of the high mortality rate. Which patients are at increased risk for AKI (select all that apply)? a. An 86-year-old woman scheduled for a cardiac catheterization b. A 48-year-old man with multiple injuries from a motor vehicle accident c. A 32-year-old woman following a C-section delivery for abruptio placentae d. A 64-year-old woman with chronic heart failure admitted with bloody stools e. A 58-year-old man with prostate cancer undergoing preoperative workup for prostatectomy

a. An 86-year-old woman scheduled for a cardiac catheterization b. A 48-year-old man with multiple injuries from a motor vehicle accident c. A 32-year-old woman following a C-section delivery for abruptio placentae d. A 64-year-old woman with chronic heart failure admitted with bloody stools e. A 58-year-old man with prostate cancer undergoing preoperative workup for prostatectomy

Which drugs will be used to treat the patient with CKD for mineral and bone disorder (select all that apply)? a. Cinacalcet (Sensipar) b. Sevelamer (Renagel) c. IV glucose and insulin d. Calcium acetate (PhosLo) e. IV 10% calcium gluconate

a. Cinacalcet (Sensipar) --> calciummonimc agent (2nd hyperparathyroidism) d. Calcium acetate (PhosLo) --> calcium phosphate binder b. Sevelamer (Renagel) --> non-calcium phosphate binder

A nurse is preparing a teaching session about reducing the risk of complications of diabetes mellitus. Which of the following information should the nurse plan to include in the teaching? (select all that apply)

a. Increase physical activity and daily exercise. c. Reduce cholesterol and saturated fat intake. d. Maintain optimal blood pressure to prevent kidney damage. e. Enroll in a smoking cessation program.

For the patient hospitalized with inflammatory bowel disease (IBD), which treatments would be used to rest the bowel (select all that apply)? a. NPO b. IV fluids c. Bed rest d. Sedatives e. Nasogastric suction f. Parenteral nutrition

a. NPO b. IV fluids e. Nasogastric suction f. Parenteral nutrition

The nurse is caring for a patient with newly diagnosed type 1 diabetes mellitus. What information is essential to include in patient teaching before discharge from the hospital? Select all that apply

a. Use of a portable glucose monitor. c. Hypogylcemia prevention, symptoms, and treatment. d. Insulin administration.

A 20 year old patient with a history of Crohn's disease comes to the clinic with persistent diarrhea. What are common characteristics of Crohn's disease (select all that apply)

a. weight loss c. abodminla pain e. has a segmented distribution f. involves the entire thickness of the bowel wall

Which are appropriate therapies for patients with diabetes? Select all that apply.

b. Use of statins to treat dyslipidemia. d. Use of ACE inhibitors to treat nephropathy. e. Use of laser photocoagulation to treat retinopathy. In patients with diabetes who have microalbuminuria or macroalbuminuria, angiotensin-converting enzyme (ACE) inhibitors (e.g., lisinopril [Prinivil, Zestril]) or angiotensin II receptor antagonists (ARBs) (e.g., losartan [Cozaar]) should be used. Both classes of drugs are used to treat hypertension and have been found to delay the progression of nephropathy in patients with diabetes. The statin drugs are the most widely used lipid-lowering agents. Laser photocoagulation therapy is indicated to reduce the risk of vision loss in patients with proliferative retinopathy, in those with macular edema, and in some cases of non-proliferative retinopathy

What does the dialysate for PD routinely contain? a. Calcium in a lower concentration than in the blood b. Sodium in a higher concentration than in the blood c. Dextrose in a higher concentration than in the blood d. Electrolytes in an equal concentration to that of the blood

c. Dextrose in a higher concentration than in the blood

During the nursing assessment of the patient with renal insufficiency, the nurse asks the patient specifically about a history of a. angina. b. asthma. c. hypertension. d. rheumatoid arthritis.

c. hypertension.

a nurse in a provers office reviewing the laborite results of a client who take furosemide for hypertension. The nurse notes that the clients potassium level is 3.3. The nurse should monitor the client for which of the following complications?

cardiac dysthrmias low potassium

what is contraindicated for ibuprofen?

clients who have asthma or severe hepatic or renal disease. Itshould be used with caution in clients who have a bleeding disorder.

Which serum laboratory value indicates to the nurse that the patient's CKD is getting worse? a. Decreased BUN b. Decreased sodium c. Decreased creatinine d. Decreased calculated glomerular filtration rate (GFR)

d. Decreased calculated glomerular filtration rate (GFR)

What extraintestinal manifestations are seen in both ulcerative colitis and Crohn's disease? a. Celiac disease and gallstones b. Peptic ulcer disease and uveitis c. Conjunctivitis and colonic dilation d. Erythema nodosum and osteoporosis

d. Erythema nodosum and osteoporosis

what indicates to the nurse that a patient with AKI is in the recovery phase?

deceasing blood urea nitrogen (BUN) and creatinine levels

what laboratory findings are expected in ulcerative colitis as a result of diarrhea and vomiting?

decreased: -Na, K, Mg, Cl, and HCO3

In replying to a patient's questions about the seriousness of her chronic kidney disease, the nurse knows that the stage of CKD is based on what?

glomerular filtration rate (GRF)

A nurse is caring for a client who has acute kidney injury (AKI). Which of the following arterial blood gas values would the nurse expect this client to have?

pH 7.26, HCO3 14, PaCO2 30

a nurse is assessing a client who is taking lisinopril to treat hypertension. which of the following findings is a priority to report?

swelling of the tongue manifestation of angioedema

a nurse is providing teaching to a client who has hypertension and a new prescription for hydroclorothiazide. which of the following instructions should the nurse provide?

take the medication early in the day avoid nocturia

a nurse is establishing heath promotion goals for a female client who smoke cigarettes, has hypertension, and has a BMI of 26. Which of the following goals should the nurse include?

the client will walk for 30 mins 5 days a week

what is type 2 NIDDM

the pancreas makes insulin, but the insulin Ade does not work as it should. --insulin resistance --sugar in blood-insulin is released-cell can't recognize the insulin-glucose builds up in blood stream

what is type 1 IDDM? (Insulin dependent diabetes mellitus)

the pancreas produces little insulin or no insulin at all --sugar in blood-no insulin-cell starving-glucose builds up in bloodstream

which description accurately describes the care of a patient with CKD?

the use of calcium based phosphate binders in the patient with CKD is contraindicated when serum calcium levels increase