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NUR 3180: STUDY GUIDE FOR FINAL EXAM- FALL 2023
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NUR 3180: STUDY GUIDE FOR FINAL EXAM- FALL 2023
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NUR 3180: STUDY GUIDE FOR FINAL EXAM- FALL 2023The examination will contain 100 multiple questions. Time allotted for this exam will be 2 1/2
hours.
The following study guide is intended to assist you in preparing for the examination and
may not contain all information included on the exam.
The template is as follows: 2 questions related to chronic disorders; 9 questions related to
hematological disorders; 9 questions related to Oncological disorders; 9 questions related to
immunological; 9 questions on Upper IG disorders; 8 questions related to Lower GI
disorders; 8 questions related to Biliary/Pancreas; 9 questions related to Hepatic disorders;
8 questions related to Endocrine disorders; 9 questions related to endocrine-Diabetes
disorders; 8 questions relate to urinary disorders (infectious, obstructive..); 12 questions
related to renal disorders (glomerulonephritis, RF, Cancer..)
Please review the following concepts:
• Chronic disorders:
o Activity and tolerance, levels of activity, outcomes when planning activities/
plan of care chronic conditions.
• Hematological disorders:
o Blood transfusion nursing interventions, rate of first 5-minute infusion.
Electrolytes for patients with polycythemia Vera, Neutropenia, Risk factors of
anemia, B12 deficiency and nurse assessment, iron deficiency anemia, blood
transfusion and reactions
ful
• Oncological disorders:
o Revise Leukemias, lymphoma, myeloma with ss., nursing management,
treatment, radiation and effective nursing interventions, chemotherapy induced
anemia (nursing diagnosis). Revise bone marrow transplant, ATP.
• Immunological disorders:
o Hypersensitivities be able to differentiate them, AIDS and signs and symptoms,
labs, education, RA ss, preoperative and medication assessment by the nurse, SA
labs
• Upper GI disorders
o GERD and patient education, EGD: be able to explain and care after test. Hiatal
hernia, GI bleeding sings, H. Pylori, gastroenteritis and fluid replacement, PUD,
purpose of NGT, duodenal ulcer,
• Lower GI
o Crohns disease, ulcerative colitis, and signs of complication, appendicitis
assessment, diverticulitis, diverticulosis including diagnostic tests, peritonitis,
gastric surgery and diet- education, small and large bowel obstructions including
complications Who may receive TPN?
• Biliary/ Pancreatic/ hepatic
, o Cholecystitis, cholelithiasis signs and symptoms, importance of ambulation after
surgery, pancreatitis, liver cirrhosis including end-stage, general lab results,
jaundice, Whipple procedure, cancer, liver transplant, hepatitis- types education,
ascites, TIPS, complications. Fetor hepaticus.
• Hepatic disorders
o See above, include diet. Blumberg’s sign. Acute and chronic conditions.
o Hepatitis types, ss. education
• Endocrine disorders
o Pituitary hyper-hypo, SIADH nursing interventions, Addison’s disease and
compliance, hyper, hypothyroidism, parathyroid, thyrotoxicosis, surgeries E.g.
Adrenalectomy, thyroidectomy - complications, lab results, pheochromocytoma,
IVF replacement …
• Endocrine- Diabetes
o Diabetes type one, ss, causes, assessment findings by the nurse, priorities,
teaching to diabetic patients both types, incorrect blood glucose? What to do,
DKA, insulins IV, SQ, 50% glucose
• Renal disorders/urinary disorders
o Chronic Kidney Disease
▪ CKD is an umbrella term that describes kidney damage or a decrease in
the glomerular filtration rate (GFR) lasting for 3 or more months.
Untreated CKD can lead to end-stage kidney disease (ESKD).
▪ Risk factors include cardiovascular disease, diabetes, hypertension, and
obesity, with diabetes being the main cause of CKD- anything that
messes with blood flow to kidneys
▪ Main one is diabetes because the kidneys are working harder because of
the high sugar levels
▪ Stages in CKD include (normal GFR is 125 ml/min/1.73):
• Stage 1 GFR>90 mL/min/1.73
• Stage 2 GFR 60-89 mL/min/1.73
• Stage 3 GFR 30-59 mL/min/1.73
• Stage 4 GFR 15-29 mL/min/1.73
• Stage 5 GFR <15 mL/min/1.73**
o In Stage 5, the patient is diagnosed with end-stage
kidney disease and the patient will need renal
replacement therapies, dialysis, or kidney transplantation
• Clinical manifestations include elevated serum creatinine (0.6-1
is normal), anemia due to decreased erythropoietin production,
metabolic acidosis, edema, and as it progresses abnormalities in
electrolytes, heart failure worsens because you’re not excreting
fluids, and hypertension becomes more difficulty to control.
,o Acute Nephritic Syndrome
▪ Acute nephritic syndrome is a type of renal failure with glomerular
inflammation. Glomerulonephritis is an inflammation of the glomerular
capillaries that can occur in acute and chronic forms- will have problems
with filtering and you’ll go into kidney injury.
▪ Relation with respiratory infections and the cause
• Following some infections (streptococcal infection of the throat,
impetigo, upper respiratory tract infections, mumps, varicella
zoster virus, Epstein-Barr virus, hepatitis B, and HIV), the
antigens outside of the body initiate an antigen-antibody
production that is deposited in the glomerulus of the kidneys
leading to glomerulonephritis and a decreased GFR
• Know it’s upper respiratory
▪ Clinical Manifestations
• Hematuria (RBC casts indicate glomerular injury)
• Edema and some degree of hypertension
• Azotemia (abnormal concentration of nitrogenous wastes in the
blood)
• Proteinuria
• High concentration of Na in urine. 20 is normal in urine.
• Hypoalbuminemia because kidneys aren’t getting the protein
• Hyperlipidemia
• Oliguria
• Decreased GFR
• High creatinine normal 0.6-1.2
• High BUN. Normal 7-18
, ▪ Medical Management includes supportive care and dietary modifications
(low protein bc its tough on the kidneys), and antibiotics (primarily
penicillin for strep infection), corticosteroids to decrease inflammation of
the glomerulus, and immunosuppressant’s. Eat high value protein like
eggs and meat.
o Polycystic Kidney Disease PKD is a genetic disorder characterized by the
growth of numerous cysts in the kidneys. When these cysts are formed, they are
filled with fluid, destroying the nephrons. This leads to reduced kidney function
that leads to kidney failure. Not curable.
▪ Autosomal dominant symptoms appear later in life while autosomal
recessive happens earlier in life
▪ Clinical Manifestations
• Signs and symptoms results from kidney function loss and the
increased size of the kidneys
• Hematuria, polyuria, hypertension, renal calculi and associated
UTIs, and proteinuria
• The growing cysts are noted with reports of abdominal fullness
and flank pain
• Leads to kidney failure and you eventually need a transplant or
dialysis
o Renal Failure Renal failure results when the kidneys cannot remove the body’s
metabolic wastes or perform their regulatory function
▪ Acute Kidney Injury
• Rapid loss of renal function due to damage to the kidneys. AKI
can lead to metabolic acidosis and fluid and electrolyte
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