Midterm review

Type of IV fluids for a pt w/ 25% TBSA burns, no prior medical Hx

-The nurse should plan to adm. lactated Ringer's, which is an isotonic solution used to expand vascular volume. -The nurse should plan to adm. dextran 40 in 0.9% Na+Cl-, which is an isotonic colloid solution, to increase the intravascular fluid volume. -Whole blood if the Hct < 20-25% which can result from hemodilution c/b fluid replacement Tx. -contraindications: 0.45NS can cause third-spacing fluid

PSA testing p/t

-dont need to fast -PSA annual testing begins at age 50

A nurse is collecting data from a client who has AKI. According to the RIFLE classification system, which of the following findings should the nurse identify as an indication that the client has ESRD?

A: No urine output w/o renal replacement Tx for more than 3 months. R: In the classification, R is for Risk, I is for Injury, F is for Failure, L is for Loss, and E is for ESRD. According to the RIFLE classification, this is Injury, Failure, and Loss.

A nurse is reinforcing teaching about collecting a 24hr urine for creatinine clearance with a newly licensed nurse. Which of the following instructions should the nurse include?

A: Place signs in the bathroom as a reminder about the test in progress R: The nurse should place signs in the bathroom and alert family members of the test in progress so that everyone saves the specimens appropriately throughout the test. -The nurse should have the client void first thing i the morning, discard the specimen, and collect all subsequent specimens for 24hrs. -The nurse should include the last voided specimen at the end of collection period. -The nurse should instruct the client to avoid engaging in vigorous exercise and ingesting cooked meat, tea, and coffee during the 24hr test period.

A nurse is collecting data from a client who has urolithiasis and reports pain in his thigh. The nurse should identify that this finding indicates the stone is in which of the following structures?

A: Ureter R: When stones are in the ureters, pain radiates to the genitalia and to the thighs -Atones in the bladder produce manifestations of irritation like those os a UTI. They can also cause pain in the vulva and scrotal areas. -The renal pelvis is part of the kidney. Stones in the kidney cause pain in the costovertebral region. -The renal tubules are within the nephron, which is part os the kidney. Stones in the kidney cause flank pain.

A nurse is reinforcing dietary teaching w/ a client who has DM. Which of the following actions should the nurse take first?

Ask the client to identify the types of foods she prefers The nurse should first ask the client about individual food preferences to provide an opportunity for the nurse to include these foods in her diet. Involving the client in the planning will help promote adherence to the dietary plan.

A nurse is caring for a client who is receiving peritoneal dialysis. The nurse notes that the dialysate output is less than the input and that the client's abdomen is distended. Which of the following actions should the nurse take?

Change the client's position -The client is retaining the dialysate solution after the dwell time. The nurse should ensure that the clamp is open and the tubing is not kinked and reposition the client to facilitate the drainage of the solution from the peritoneal cavity.

AKI pt c/o diarrhea, HA, palpitations, and muscle tingling and weakness. Which of the following actions should the nurse take first? A. adm. an analgesic B. check the pt's electrolytes c. measure the pt's wt. d. restrict protein intake

Check the pt's electrolytes The nurse should check the client's most recent K+ values d/t manifestations of hyperkalemia, which can lead to dysrhythmias

A nurse is reinforcing teaching w/ a client who has acute pyelonephritis. Which of the following instructions should the nurse include in the teaching? A. You should avoid taking NSAIDs for pain B. You should maintain complete bed rest until the manifestations decrease C. You should drink 1L of fluid per day D. You should complete entire cycle of ABTx

D. You should complete entire cycle of ABTx The client should complete the full Rx of ABTx to decrease the chance of regrowth of the causative organism. -A client who has acute pyelonephritis can take NSAIDs PRN for pain unless otherwise contraindicated -The client should balance rest and activity and does not require complete bed rest. Ambulation can prevent complications of bed rest such as constipation and urinary stasis -A client who has acute pyelonephritis should drink at least 2L /day unless otherwise contraindicated

findings of kidney transplant rejection

HTN the kidney plays a role in BP regulation. -increased creatinine -increase in sodium -oliguria or anuria

hunger is a manifestation of hypoglycemia or hyperglycemia

Increased hunger is a manifestation of hypoglycemia d/t a cholinergic response from central glucose deprivation

cochlear implant MoA

Transmits impulses directly to auditory nerve endings ind: sensorineural hearing loss

Back pain and flank pain are manifestations of...

UTI. other manifestations include frequency, urgency, and cloudy, foul-smelling urine

Pheochromocytoma lab

catecholamine metabolites Pheochromocytoma is a tumor of the adrenal gland that causes excess release of the catecholamines (epi and norepi) which are hormones that regulate BP and HR

p/t for pt w/ kidney stones Hx

drink 3.8L (4qts) of water daily

Somogyi effect

early-morning hyperglycemia that occurs as a result of nighttime hypoglycemic episodes

A nurse is assisting w/ the preparation of an in-service program about the stages of AKI. Which of the following pieces info should the nurse suggest about prerenal azotemia? a. prerenal azotemia begins prior to the onset of symptoms b. interference w/ renal perfusion causes prerenal azotemia c. prerenal azotemia is irreversible, even in early stages d. infx and tumors cause prerenal azotemia

interference w/ renal perfusion causes prerenal azotemia prerenal azotemia results from interference w/ renal perfusion (e.g. HF or hypovolemic shock)

hypoparathyroidism manifestations

involuntary muscle spasms, muscle twitching and paresthesias

A nurse is caring for a client who has continuous bladder irrigation following TURP. Which of the following actions should the nurse take?

irrigate the indwelling urinary catheter with a syringe as Rx to clear the obstruction and allow urine and irrigating fluid to drain

irritability in a DM I pt is hypoglycemia or hyperglycemia?

irritability is an early manifestation of hypoglycemia for DM I. other early S/Sx are fatigue, HA, difficulty thinking, diaphoresis, and nausea

Addison's diet

low K+ high: Na+, carbs, protein

polyuria is hypoglycemia or hyperglycemia

polyuria is a manifestation of hypoglycemia d/t a deficiency of insulin, which can lead to osmotic diuresis

manifestations of impending airway obstruction

tachycardia, tachypnea, nasal flaring

pyelonephritis p/t prevention for female

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