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NURS 425 FINAL (combo -- exam 2) fully solved & verified for accuracy.
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NURS 425 FINAL (combo -- exam 2) fully solved & verified for accuracy.
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NURS 425 FINAL (combo -- exam 2) fullysolved & verified for accuracy
causes of acute glomerulonephritis - answer d/t GABHS; can occur
d/t strep or skin infection that isn't treated or kid didn't finish abx
course; typically see renal finding 10-21 days post GABHS; recovery
and recurrent is possible; can be acute or chronic
what happens w/ acute glomerulonephritis - answer immune
complexes trapped in glomerular capillary loop causing obstruction,
edema, and vasospasm; antigen-antibody reaction from infectious
agent (strep) and activate WBCs causing inflammation of capillary
wall; cause decrease in GFR r/t removal of waste and excess fluid
SSAs of acute glomerularnephritis - answer COKE/TEA COLOR
URINE EMPHASIS; urinalysis shows proteinuria (foamy urine); pink
colored urine (hematuria); HTN; edema (face, hands, abd, eyes);
fatigue; fever; coke/tea colored urine; HA d/t high BP; increased BP
and RR (dyspnea, crackles)
common age for glomerularnephritis - answer school-agers (6-7
y/o); rare in <2 y/o
risk factors for glomerularnephritis - answer pneumonia; strep;
viral infection; SLE (lupus); HTN; DM; nephrotoxic drugs (NSAIDs,
"MYCIN", tylenol); excessive high intake of protein and sodium
lab results for glomerulonephritis - answer increased BUN and
creatinine; urinalysis (high specific gravity, proteinuria, hematuria,
tea color); BMP shows increased K, Mg and decreased Na; CBC
shows increased WBC; decreased albumin
,SSAs of fluid imbalance complication w/ glomerulonephritis - answer
decreased GFR; dysuria; urine color changes; proteinuria; increased
BP and RR; dyspnea; edema
interventions for fluid imbalance w/ glomerularnephritis - answer
seizure precautions; o2 and position; daily wt; I&O; abd girth; small
frequent meals low in K and Na (avoid watermelon, ham, green veg,
potatoes, bananas); diuretics and anti-HTN meds; RESTRICT FLUIDS
SSAs of nutrition complication w/ glomerulonephritis - answer
decreased hct and hgb; decreased pre/albumin; anorexia
nutrition interventions r/t glomerularnephritis - answer RESTRICT
FLUIDS, K, and NA; tx nausea and pain; skin integrity (d/t edema);
frequent small meals w/ favorite foods; daily wt, I&O
meds for glomerularnephritis - answer furosemide, aldactone (k-
sparing); b-blocker; ACEI; anti-HTN and diuretics
what happens in body w/ nephrotic syndrome - answer alterations
in glomerular membrane to allow protein to pass in urine
(proteinuria) --> decreased protein/albumin in blood --> decrease in
colloidal osmotic pressure in capillaries --> fluid moves to
interstitial space and cavities --> stimulates RAAS, ADH, and
aldosterone to be released
risk factors, cause, common age for nephrotic syndrome - answer
2-7 yo; unknown etiology; can be immune, biochemical, or
congenital (rare and usually end in death); secondary etiology is
glomerular damage r/t other disease
labs/diagnostics and their results for nephrotic syndrome - answer
24 hr urine collection (look at PRO, SG, color of urine) shows PRO in
urine > 3+-4+ (low PRO in blood), SG >1.020, and urine dark and
frothy; hyperalbuminuria (a lot of albumin in urine); hyperlipidemia
,(worry about possible stroke); increased hct and hgb; high Na and
K; increase OR decreased GFR; kidney biopsy only if no response to
meds
dx of nephrotic syndrome - answer kidney biopsy only if no
response to meds
SSAs of nephrotic syndrome - answer PROTEINURIA EMPHASIS;
increased or decreased GFR (different from AGN); decreased UO w/
frothy dark urine; dysuria, hematuria, proteinuria, increased K and
increased Na (different from AGN); increased BP and RR w/ dyspnea
and crackles; edema of eyes, hands, abd (ascites), JVD; lethargy;
seizure precautions; anorexia; activity intolerance
SSAs of fluid imbalance w/ nephrotic syndrom - answer increased
wt, edema, ascites, HTN, anorexia, decreased activity tolerance;
dysuria; frothy and dark urine
interventions for fluid imbalance d/t nephrotic syndrome - answer
meds (steroids, albumin, lasix); rest; I&O; daily wt; evaluation of
labs; watch for infection; educate on avoiding recurrences
SSAs of nutrition problem w/ nephrotic syndrome - answer
abnormal BMP, abnormal Fe (IRON) levels
diet for nephrotic syndrome - answer low-mod protein; no extra
Na; low fat
SSAs of infection r/t shock w/ nephrotic syndrome - answer fever;
increased WBC; increased HR and RR; hypoxia signs; malaise;
increased WOB; late sx are low BP, low UO, poor perfusion, pale and
cool skin, weak pulses
, possible causes of infection r/t shock w/ nephrotic syndrome -
answer pneumonia, peritonitis, cellulitis
interventions for infection r/t shock w/ nephrotic syndrome - answer
blood/urine/wound cultures; IV abx; VS trends; give O2; need higher
level of care; watch for shock complications
meds for nephrotic syndrome - answer furosemide; albumin to
increase plasma volume and decrease edema; steroids (prednisone)
-- if positive response need to taper and if negative response other
immunosuppressant needed; possible chemo
how to know if steroids effective tx for nephrotic syndrome - answer
decreased PRO in urine and gain of PRO and albumin in blood
risk for infection w/ nephrotic syndrome d/t... - answer low PRO in
blood (these pts are immunocompromised)
SSAs of renal disease - answer decreased GFR; dysuria; urine color
changes; proteinuria
interventions for renal disease - answer begin dialysis if needed
(PD 1st, then HD) tx cause of dehydration; assess VS (watch for
increased BP); daily weight; I/Os; neuro (LOC, seizure precautions);
tx electrolyte imbalances; cardiac monitoring; watch for infection
why possible dialysis w/ renal disease? - answer bc uric acid
buildup, K too high, metabolic acidosis
labs for renal failure - answer urinalysis; BMP (focus on k, mg);
ABG (metabolic acidosis): CBC (not producing erythropoietin); drug
test
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