UPDATED Hondros Nur 212 Exam 2 100% SOLUTION 2023//2024

Normal creatinine levels? - ANSWER Male: 0.6-1.2 Female: 0.5-1.1 Normal GFR? - ANSWER 90-120ml/min At which GFR level does dialysis begin? - ANSWER 15 S/S of acute glomerulonephritis? - ANSWER Headache, increased BP, facial edema, malaise, low grade fever, weight fain, proteinuria, hematuria, and oliguria S/S of chronic glomerulonephritis? - ANSWER Proteinuria and hematuria Lab findings for glomerulonephritis? - ANSWER Increased BUN, CR Decreased albuminin Common se of hemodialysis? - ANSWER Hypotension due to all of the blood and fluids leaving the body Nephrotic syndrome ss - ANSWER SEVERE proteinuria MASSIVE edema Hypertension, foamy urine, anasarca, ascites Why might medication doses be decreased for a patient with kidney issues? - ANSWER Due to medications not being excreted through kidneys Prerenal causes - ANSWER Due to decreased blood flow to kidneys Cardiovascular disorders, hypovolemia, peripheral vasodilation, renal vascular obstructions, severe vasoconstriction Intrarenal causes - ANSWER Due to damage to the gumeruli, interstitial tissue or tubules (parynchymal damage) Acute tubular necrosis, exposure to nephrotoxins, acute GNP, SLE, obstetric complications, and malignant hypertension Post renal causes - ANSWER Obstruction to the urine collecting system BPH Phases of AKI - ANSWER Oliguric Diuretic Recovery (if not then CKD may develop) Oliguric Phase - ANSWER Urinary changes (output less than 400ml/day) Lasts 10-14 days Neck veins distended, bounding pulse, edema, hypertension Increased potassium (causing heart issues!) Diuretic Phase - ANSWER Daily urine output 1-3 liters may reach 5L or more Monitor for hyponatremia, hypokalemia, and dehydration as well as hypotension This phase may last 1-3 weeks Why would calcium gluconate be given to a patient with AKI? - ANSWER Due to hyperkalemia, calcium gluconate raises the threshold at which dysrhythmias occur therefor protecting the heart Nursing interventions for almost all kidney patients - ANSWER Fluid restriction Daily weights If there is abdominal pain during hemodialysis what should the nurse do? - ANSWER Decrease the flow rate What is given to excrete potassium? - ANSWER Kayexelate What is an important thing to remember for the process of peritoneal dialysis? - ANSWER It must be completely STERILE What is a major complication from peritoneal dialysis? - ANSWER Peritonitis If patient begins to have pain or cramping during peritoneal dialysis what should the nurse do? - ANSWER Slow down the infusion rate At what temperature is peritoneal dialysis given? - ANSWER Must be warmed to body temperature What medication can cause an IBS flare up? - ANSWER Sulfasalazine (anti- inflammatory medication) Treatment goals for CKD? - ANSWER Treat hyperkalemia, HTN, and mineral/bone disease Potassium enriched foods? - ANSWER Bananas, tomatoes Why would a patient with CKD have pruritus? - ANSWER Due to uremic frost (urea crystallizes on skin) cure for ulcerative colitis - ANSWER illiostomy, removal of colon, J-pouch issues for Crohns can happen from where? - ANSWER From mouth to anus Common signs/symptoms of Crohn's disease and ulcerative Colitis - ANSWER diarrhea, weight loss abdominal pain, fever and fatigue drug classes used to treat IBD - ANSWER corticosteroids - decreases inflammation immunosuppressants - suppresses immune response antimicrobials - prevent or treat secondary infection aminosalicylates - decreases inflammation indications a illeostomy or other surgical therapy may be needed are - ANSWER - fistulas - intestinal obstruction - inability to decrease corticosteroids what may increase your risk for an exacerbation with IBD's? - ANSWER -stress -illness - infection Fluid/ electrolyte complications with IBD? - ANSWER -hypokalemia -hypovalemia In the oliguric phase when may the onset be delayed for as long as a week? - ANSWER when nephrotoxic drugs are involved recovery phase - ANSWER GFR increases; BUN/CR plateau and decrease; major improvements in 1-2 weeks, impaired function for 12 months, if no recovery=CKD What blood gas issue are you at risk for with CKD? - ANSWER Metabolic acidosis - patient may develop kussmaul respiration's patient with AKI, what are some post-renal causes? - ANSWER renal calculi