Galen College of
Nursing NUR 265
Exam 1 Review 2026 |
Advanced Med-Surg
Key Points, Lab Values
& Practice Questions
Galen College of Nursing
Nur265 Advanced Medsurg
Medical Surgical Nursing: Ignatavicius, Workman, Rebar, Heimgarterner 10th edition
Exam 1 (unit 1,ch63, 53, 54, Unit 2/3 31, 32, 33,35 please see page numbers (will be on exam)
Know these Labs
Normal Urine per hr= 30mL/hr
-Creatine 0.6-1.2= Best indicator of kidney function
-BUN- 10-20 (if higher affected by stress, dehydration)
-WBC- 5-10,000
-Hemoglobin- men 14-18; women 12-16
-Albumin-3.5-5.0
-Lipase-0-110
-Potassium- 3.5-5.0...Opposite relationship to NA ...... (K=Assess heart EKG)
-Sodium- 135-145....Opposite relationship to K ............ (Na=Assess LOC Neuro check)
-Calcium- 9-10.5
-Phosphorous- 2-4.5
MAP – 65-100 or more normal (perfusion to vital organs) = 2(Diastolic BP)+ (Systolic BP) /3
GFR- 90 or higher
Remember: Low sodium; high potassium for fluid overload; High sodium; low potassium for
dehydration
AKI= Acute kidney injury- rapid loss of kidney function from renal cell damage build-up of
ammonia
-Onset- abrupt and reversible
-S/S- 1st sign decrease urine output, oliguria less than .5mL/kg/hr , azotemia, w/ progression =
fluid overload signs; Bowels=urinary retention; high Bp, high pulse, bounding;; crackles in
lungs. (xray); infiltration; skin= edema, anascara; confusion, low sp02, increased RR; reduced
perfusion signs= MAP below 65, HR up, thready pulse, respiratory alkalosis PH low SpO2 88%
;SOB, REMEMBER assess for hypotension and tachycardia= SHOCK);
Assess for fluid overload- low o2 stat, edema, BP up, dyspnea, SOB, tachycardia, JVD, crackles,
(Dx Xray: infiltration); hyperventilating, resp alkalosis (Dx ABG)
-Patho- GFR decrease (filtration); can be hours or days = tell HCP if decrease in urine output
,(less than 30ml/hr)
, -Causes- prerenal (prefusion); dehydration, blood loss, cardiac output, heart failure, cardiogenic
shock, infection, obstruction, NG suctioning, sepsis, Vomiting/diarrhea, hypertension
intrarenal (in renal): myoglobinuria, BPH, tubular necrosis, renal ischemia, obstruction,
nephrotoxicity, intrarenal infection; acute Poly nephritis, contrast, mycins antibiotics (peak and
trough), NSAIDs, naproxen, post-renal (after renal) blockage; bladder neck obstruction, bladder
cancer, calculi, post renal infection, tumor
-4 phases=initiation/ onset; oliguric phase, Diuretic phase, recovery phase
1. Onset phase – decrease urine output 1-3 weeks
2. Oliguric phase= 1-3 weeks; less than 400mL/24hrs, High specific gravity; S/S
anorexia, N/V, decreased urine output
3. Diuretic phase- 3-6L per day, low specific gravity; output 1000-2000mL/day (have
foley catheter monitor urine output) replace fluids monitor electrolytes; may need
dialysis; Polyuria can be a sign of recovery
4. recovery phase- 12 months or less
Renin-angiotensin 1 and 2 = retention of sodium and retention of water
Labs- Creatine over 1.3, BUN over 20; urine less than 30mL/hr; metabolic acidosis Ph below
7.35; ABG, high K hyperkalemia; sodium is low; no anemia related to AKI
Nursing interventions= VS; I&O, daily weights (1 lb per day = fluid retention); labs BUN ,
creatine, electrolytes; acidosis (treat w/ sodium bicarb); 2L of fluid per day; avoid/prevent
HYPOtension; Assess for fluid overload- low o2 stat, edema, BP up, dyspnea, SOB,
tachycardia, JVD, crackles, (Dx Xray: Infiltration); hyperventilating, resp alkalosis (Dx ABG)
Meds- diuretics
Diet (mod protein, high carb); restrict potassium & sodium; avoid nephrotoxic meds; if poor
appetite enteral or parenteral nutrition
Prevent- hydration!!!!; Na and K know levels; Avoid indwelling caths if possible; prevent
infection, maintain electrolytes
Teaching- low sodium, low potassium, low phosphorous, high carb diet; only specific moderate
proteins,
Nursing NUR 265
Exam 1 Review 2026 |
Advanced Med-Surg
Key Points, Lab Values
& Practice Questions
Galen College of Nursing
Nur265 Advanced Medsurg
Medical Surgical Nursing: Ignatavicius, Workman, Rebar, Heimgarterner 10th edition
Exam 1 (unit 1,ch63, 53, 54, Unit 2/3 31, 32, 33,35 please see page numbers (will be on exam)
Know these Labs
Normal Urine per hr= 30mL/hr
-Creatine 0.6-1.2= Best indicator of kidney function
-BUN- 10-20 (if higher affected by stress, dehydration)
-WBC- 5-10,000
-Hemoglobin- men 14-18; women 12-16
-Albumin-3.5-5.0
-Lipase-0-110
-Potassium- 3.5-5.0...Opposite relationship to NA ...... (K=Assess heart EKG)
-Sodium- 135-145....Opposite relationship to K ............ (Na=Assess LOC Neuro check)
-Calcium- 9-10.5
-Phosphorous- 2-4.5
MAP – 65-100 or more normal (perfusion to vital organs) = 2(Diastolic BP)+ (Systolic BP) /3
GFR- 90 or higher
Remember: Low sodium; high potassium for fluid overload; High sodium; low potassium for
dehydration
AKI= Acute kidney injury- rapid loss of kidney function from renal cell damage build-up of
ammonia
-Onset- abrupt and reversible
-S/S- 1st sign decrease urine output, oliguria less than .5mL/kg/hr , azotemia, w/ progression =
fluid overload signs; Bowels=urinary retention; high Bp, high pulse, bounding;; crackles in
lungs. (xray); infiltration; skin= edema, anascara; confusion, low sp02, increased RR; reduced
perfusion signs= MAP below 65, HR up, thready pulse, respiratory alkalosis PH low SpO2 88%
;SOB, REMEMBER assess for hypotension and tachycardia= SHOCK);
Assess for fluid overload- low o2 stat, edema, BP up, dyspnea, SOB, tachycardia, JVD, crackles,
(Dx Xray: infiltration); hyperventilating, resp alkalosis (Dx ABG)
-Patho- GFR decrease (filtration); can be hours or days = tell HCP if decrease in urine output
,(less than 30ml/hr)
, -Causes- prerenal (prefusion); dehydration, blood loss, cardiac output, heart failure, cardiogenic
shock, infection, obstruction, NG suctioning, sepsis, Vomiting/diarrhea, hypertension
intrarenal (in renal): myoglobinuria, BPH, tubular necrosis, renal ischemia, obstruction,
nephrotoxicity, intrarenal infection; acute Poly nephritis, contrast, mycins antibiotics (peak and
trough), NSAIDs, naproxen, post-renal (after renal) blockage; bladder neck obstruction, bladder
cancer, calculi, post renal infection, tumor
-4 phases=initiation/ onset; oliguric phase, Diuretic phase, recovery phase
1. Onset phase – decrease urine output 1-3 weeks
2. Oliguric phase= 1-3 weeks; less than 400mL/24hrs, High specific gravity; S/S
anorexia, N/V, decreased urine output
3. Diuretic phase- 3-6L per day, low specific gravity; output 1000-2000mL/day (have
foley catheter monitor urine output) replace fluids monitor electrolytes; may need
dialysis; Polyuria can be a sign of recovery
4. recovery phase- 12 months or less
Renin-angiotensin 1 and 2 = retention of sodium and retention of water
Labs- Creatine over 1.3, BUN over 20; urine less than 30mL/hr; metabolic acidosis Ph below
7.35; ABG, high K hyperkalemia; sodium is low; no anemia related to AKI
Nursing interventions= VS; I&O, daily weights (1 lb per day = fluid retention); labs BUN ,
creatine, electrolytes; acidosis (treat w/ sodium bicarb); 2L of fluid per day; avoid/prevent
HYPOtension; Assess for fluid overload- low o2 stat, edema, BP up, dyspnea, SOB,
tachycardia, JVD, crackles, (Dx Xray: Infiltration); hyperventilating, resp alkalosis (Dx ABG)
Meds- diuretics
Diet (mod protein, high carb); restrict potassium & sodium; avoid nephrotoxic meds; if poor
appetite enteral or parenteral nutrition
Prevent- hydration!!!!; Na and K know levels; Avoid indwelling caths if possible; prevent
infection, maintain electrolytes
Teaching- low sodium, low potassium, low phosphorous, high carb diet; only specific moderate
proteins,
