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NUR 336 Exam 4 Questions With Complete Solutions
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NUR 336 Exam 4 Questions With Complete Solutions
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NUR 336 Exam 4 Questions With Complete SolutionsAcute Kidney Injury: definition, cause, labs, Tx Correct
Answers - definition: decreased GFR occurring over hours to
days resulting in inability to clear blood of urea and regulate the
fluid and electrolytes balance
- cause: poor kidney perfusion, ischemia, toxicity, nephropathy,
sepsis
- labs: elevated BUN, elevated creatinine, elevated K+, low
Na+, metabolic acidosis, anemia, proteinuria, hematuria, may
have abnormal ECG due to electrolyte imbalances
- Tx: dialysis to remove fluid if FVO is present, isotonic IV
hydration, PRBC transfusion
Acute Postinfectious Glomerulonephritis: definition, s/s, Tx,
eval of Tx Correct Answers - definition: inflammation of
glomeruli in response to preceding illness (often strep URI or
skin infection)
- s/s: hematuria (dark tea colored urine), proteinuria, oliguria,
HTN, peripheral and/or pulmonary edema, anorexia, arthralgia,
abdominal pain, malaise
- Tx: diuretics, antibiotics, i/o, daily weights, monitor creatinine,
kayexalate for high K+, antihypertensives, could require dialysis
if kidney function is decreased significantly
- evaluation: i/o will show fluid balance, daily weight will go
down to baseline, urinary output will go back to normal (1
ml/kg/hr for older kids), creatinine will return to expected range
Appendicitis: definition, s/s, complication, priority interventions
Correct Answers - definition: inflammation of the appendix
,- s/s: pain in periumbilical area that migrates towards RLQ
(McBurney's sign), low grade fever, n/v, guarding, laying with
knees bent, obturator sign (pain w/ internal rotation of flexed
thigh), iliopsoas sign (pain on extension of right hip), merkels
sign (kid jumps and lands on heel causing RLQ pain)
- complication: perforation/rupture indicated pain suddenly
resolving
- priority interventions: NPO, IV hydration, prep for surgery
with antibiotics and pain meds
ASD: definition, diagnosis, assessment findings, nursing
interventions? Correct Answers - definition: hole in septum
between the atria which would normally close within 4-8 weeks
of fetal development stays open which allows more blood to
flow from the right atrium into the left atrium, increasing
pulmonary blood flow
- Diagnosed via Echocardiogram which shows enlarged right
side of heart
- Assessment findings: heart murmur, atrial dysrhythmias,
increased incidence of emboli, SOB, easily fatigued, poor
feeding/growth, enlarged right sided heart chambers
- interventions: small and frequent feedings while monitoring
tolerance, watch for s/s of CHF, prep pt and fam for surgical
closure via cardiac catheterization, monitor for grunting,
retractions, nasal flaring, and increased WOB, if giving digoxin
hold if HR is below 90 and watch potassium levels
Biliary atresia: definition, s/s, Tx Correct Answers - definition:
congenital absence/closure of major bile duct which results in
cirrhosis
, - s/s: significant jaundice at 2 weeks, dark urine, light colored
stools, enlarged liver
- Tx: Kasai procedure to make new bile duct, IV fluids, low fat
high protein, fat soluble vitamin supplementation, liver
transplant if Kasai procedure fails
Celiac disease: definition, s/s, Dx, priority interventions Correct
Answers - definition: hereditary immune disease where body
mounts an immune attack on small intestine microvilli when
wheat gluten is ingested causing poor nutrient absorption
- s/s: bloating, v/d, weight loss, gas, foul smelling stool, delayed
growth/development, rash, iron deficiency anemia, B12
deficiency, osteoporosis due to inadequate calcium absorption
- Dx: endoscopy w/ biopsy, CBC, immune function blood test to
look for high IgA which indicates inflammation
- interventions: gluten free diet, consult dietician for resources
for family, educate family to follow up regularly with a
gastroenterologist
Chronic kidney disease: stages, s/s, labs, Tx Correct Answers -
stages: 1= GFR>90%; 2= GFR 60-89%; 3= GFR 40-59%; 4=
GFR 15-29%; 5/end= GFR <15%
- s/s: HTN, poor growth, abd pain, arthralgias, fatigue, anemia,
electrolyte abnormalities, muscle cramps, bone pain, seizures,
nausea/vomiting, pruritus, dyspnea
- labs: high BUN, high creatinine, high K+, low Na+, metabolic
acidosis, anemia, proteinuria, hematuria, possible dysrhythmias
- Tx: dialysis, i/o + daily weights, watch for seizures, correct
electrolytes; kidney transplant list for end stage
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