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NSG 4100 Exam 1 Latest Update
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NSG 4100 Exam 1 Latest UpdateSigns and Symptoms of Uremia - ANSWER Fatigue, SOB, unexplained weight
loss, N/V, muscle cramps. change in mental status, metallic taste in mouth,
pruritus.
Pathophysiology of End Stage Renal Disease (ESRD) - ANSWER Renal function
declines and end products of protein metabolism accumulate in the blood. Uremia
develops and adversely affects every system in the body. Usually associated with a
low GFR. The more waste products in the system the more severe the symptoms.
Uremic Pericarditis - ANSWER Inflammation and irritation of the visceral and
parietal layers of the pericardium by metabolic toxins that accumulate due to
renal failure.
Uremic Treatment - ANSWER Diuretics and Hemodialysis and if the patient is
already on hemodialysis we need to intensify it.
Clinical manifestations of fluid overload in ESRD - ANSWER Pericarditis,
pericardial effusions/tamponade, pulmonary infiltrates, JVD, edema, HF,
hypertension, hyperkalemia, metabolic acidosis
BUN normal range - ANSWER 10-20
Creatinine normal range - ANSWER 0.5-1.2
Sodium normal range - ANSWER 135-145
Potassium Normal range - ANSWER 3.5-5
Magnesium normal range - ANSWER 1.5-2.5 (high in ESRD pt)
Normal urine output range - ANSWER 30mL/hr
Dietary restrictions for patients with ESRD - ANSWER Low protein, low
potassium, no potatoes or oranges or citrus fruits, no salt substitute, fluid
restrictions
How much protein is allowed in a patient with ESRD? - ANSWER 1.2-1.5
mg/kg/day
What medications are used to treat ESRD? - ANSWER Calcium acetate/carbonate,
Phosphate-binding agents (Phoslo, Renagel), Erythropoeitin, Antihypertensive
, and cardiac medication, Ionotropes, Anticonvulsants
What are important topics for patient education in ESRD? - ANSWER Dietary
education, S/S of hyperkalemia (muscle cramps, urine abnormalities, respiratory
distress, decrease cardiac contractility, EGK changes, decrease reflexes, tingling in
hands and feet, paralysis), worsening S/S of kidney disease (anemia, difficulty
breathing, nocturia, swelling and puffiness of feet and ankles, high BP, changes in
mental status, poor digestion
Possible complications after Hemodialysis - ANSWER Bleeding, Infection, and
Hypotension
What type of medication should be held before dialysis? - ANSWER
Antihypertensive and antiarrhythmic medications
What metabolic imbalance is common with ESRD? - ANSWER Metabolic Acidosis
(pH lower than 7.35, HCO3 lower than 22, CO2 normal 35-45)
What type of patient is a candidate for CRRT? - ANSWER Clinically unstable
patient who are hypotensive, patient with fluid overload secondary to oliguric
kidney disease, patient who kidneys cannot handle their acutely high metabolic or
nutritional needs.
Nursing interventions/Care of a post nephrectomy patient. - ANSWER Assess
Respiratory status, loot at drainage tubes and incision sites frequently to watch for
blood loss and infection, DVT, pain, urinary drainage look at color and amount,
circulation, auscultate heart and lungs every shift, DW
What education should a patient receive if they are being discharged home with an
indwelling catheter? - ANSWER Need to learn the adequacy of urine output, need
to use asepsis technique while cleaning and never irrigate regularly, only change
when there is leakage, blockage or encrustation, clean with soap and water, the
tube needs to be anchor to minimize manipulation, wash the perineal area twice a
day
Explain the surgical procedure of a kidney transplant. - ANSWER For the
individual receiving the kidney the old ones are not removed. The new kidney is
placed on patient iliac fossa anterior to the iliac crest because it allows easier
blood flow. The renal artery of the donated kidney is sutured to the iliac artery and
the renal vein to the iliac vein. The ureter of the donated kidney is sutured to the
bladder and once the blood supply as been established in the OR urine should
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