Exam (elaborations)
Nurs 2400 GI_GU
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- TAMU Business 101 Semester Final Exam
Exam of 15 pages for the course TAMU Business 101 Semester Final Exam at TAMU Business 101 Semester Final Exam (Nurs 2400 GI_GU)
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Nurs 2400 GI/GU- ANS-
Acute renal injury (failure):
Pre-renal causes - ANS-1. volume depletion Ex: (GI loss through nasogastric suction,
vomiting or diarrhea, ), hemorrhage, renal loss (diuretic agents, osmotic diuresis)
2. Impaired cardiac efficiency ex: Cardiogenic shock, dysrhythmias, HF, MI
3. Vasodilation ex: anaphylaxis, antihypertensive medications or other meds that cause
vasodilation, spesis
Acute renal injury (failure): Intra-renal causes - ANS-1. prolonged renal ischemia
2. nephrotoxic agents
3. Infectious processes
Acute renal injury (failure): Labs and normal ranges - ANS-BUN <20 measures product
of protein metabolism; Serum Creatinine < 1.35 mg/dL; Both BUN and Creatinine have
to be elevated to Dx kidney damage. Creatinine clearance or GFR 85-135 mL/min;
Acute renal injury (failure): Post renal Causes - ANS-urinary tract obstruction ex: BPH,
blood clots, calculi, strictures, Tumors
Acute Tubular Necrosis (ATN): Acetylsysteine (Acetadote): Classification -
ANS-Antidote for Acetaminophen toxicity; mucolytic
Acute Tubular Necrosis (ATN): Causes - ANS-Long term hypotension r/t shock, sepsis,
dehydration, radiology contrast dye; gentamycin; NSAID - ibuprofen. Long term cardiac
disease, trauma.
Acute Tubular Necrosis (ATN): Continuous renal replacement therapies (CRRTs) -
ANS-Most common. Methods used to replace normal kidney function by circulating the
patient's blood through a hemofilter. For patients who are hemodynamically UNSTABLE
and who have overdosed on something; Pulling too much fluid off patient can cause
them to go into heart arrest. Done only inpatient. 24-48 hours; SCUF, CVVH, CVVHD-->
difference is RATE of dialysis.
Acute Tubular Necrosis (ATN): Diuresis phase 3/4 - ANS-period marked by a gradual
increase in urine output, which signals that glomerular filtration has started to recover.
, Labs stabilize and eventually decrease. Continue to observe patient because kidney
function has not reach normal capacity. WATCH FOR SYMPTOMS OF DEHYDRATION
Acute Tubular Necrosis (ATN): Hemodialysis - ANS-R/t a really high electrolyte level. A
procedure that circulates the patient's blood through an artificial kidney to remove waste
products and excess fluid. Outpatient-fistula (stethoscope to hear fistula brui) ;
Temporary catheter placed;
Acute Tubular Necrosis (ATN): Initiation phase 1/4 - ANS-Begins with the initial insult
and ends when oliguria develops.
Acute Tubular Necrosis (ATN): Medical management - ANS-General: eliminating
underlying cause; maintain fluid balance (Daily weights, fluid losses, BP, urine
concentrations), avoiding fluid excesses (findings include dyspnea, tachycardia, JVD);
providing renal replacement therapy.
Pre-renal: optimizing renal perfusion
Intrarenal: Tx with supportive therapy, with removal of causative agents.
Post renal: relieving obstruction
Acute Tubular Necrosis (ATN): Nutrition - ANS-implement K+, phospate, and Mg+
restrictions. Restrict fluid intake if prescribed
Acute Tubular Necrosis (ATN): Nutritional supplements - ANS-Phosphorus binders
Acute Tubular Necrosis (ATN): Oliguria or anuric phase 2/4 - ANS-Accompanied by an
increase in the serum concentration of substances usually excreted by the kidneys such
as urea, creatinine, uric acid, organic acids, and the intracellular cations K+, Mg+.
Anuric.
Acute Tubular Necrosis (ATN): Pharmacologic Management- Diuretics -
ANS-Furosemide, Thiazide, potassium sparing Manitol
Acute Tubular Necrosis (ATN): Recovery phase 4/4 - ANS-Signals the improvement of
renal function and may take 3-12 months! Lab values return to the normal levels
Acute Tubular Necrosis (ATN): Ultrafiltration/aquaphoresis - ANS-Used with patients
that have MRSA. Doesn't work as quickly or as effectively. Power PICC used. Slower,
can clot off. Something the patient can go home with. Water based pressure to increase
oncotic pressure to pull the fluid out.
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