Nurs 3210: Exam 1
When does discharge planning start? - ANS-Admission
Who is involved with discharge planning? - ANS-Patient, family, nurse, case manager,
physician, PT/OT
What is the goal of discharge planning? - ANS-Educate, keep patient out of hospital
What do you assess in regards to discharge? - ANS-Stability, ability to understand
instructions, equipment needed at home, transport
What factors affect the discharge plan? - ANS-Dx, patient, environment
Who is responsible for patient and family education? - ANS-Nurse
What is the purpose of patient education? - ANS-informed decisions, medical regimen
adherence, cost
True or False: Health education is an independent function of nursing and is a primary
nursing responsibility - ANS-True
What factors impact patient education? - ANS-Demographic, support system, medical
dx, timing of education, environment
Nursing process of teaching plan: Assess - ANS-Readiness for learning, disabilities,
cultural assessment
Nursing process of teaching plan: Planning - ANS-Priorities, goals, strategies
What is the best strategy for patient learning? - ANS-Having the patient say what they
are doing while performing a task
Nursing process of teaching plan: Implementation - ANS-Nurse implements when
patient is ready to learn
Make sure patient verbalizes understanding and modify if necessary
,Nursing process of teaching plan: Evaluation - ANS-Don't assume that teaching was
always successful, evaluate goals/outcomes (modify if not met)
A nurse identifies that a patient is unable to identify the correct number of oral
medication to take each morning. Which step of the nursing process does this problem
involve? - ANS-Assessment
Acute Kidney Injury - ANS-Pre-renal
Intra-renal
Post-renal
Pre-renal assessment - ANS-Fluid volume deficit, decreased CO, hypotension,
decreased CVP
Increased: Specific gravity, BUN, creatinine, K+
Decreased: UO
Low urinary Na+
Urinary sediment normal
Intra-renal assessment - ANS-Fluid volume excess, oliguria/anuria
Increased: BUN, creatinine, CPK, K+, urine osmolarity
Decreased: H&H, UO, specific gravity
High urinary Na+
Post-renal assessment - ANS-Signs of obstruction (prostate/stones)
Decreased: UO (sometimes none)
BUN/creatinine= normal (elevated in later stages)
AKI stages - ANS-Oliguric/anuric phase
Diuretic phase
Recovery phase
Oliguric/Anuric phase - ANS-24H to 1 week
Urine output less than 400 mL/24H
Duration: 1 day to 8 weeks (usually 8-15 days)
Major problem: hyperkalemia, build up of waste products
, Diuretic phase - ANS-2-6 weeks after oliguric stage
BUN/creatinine improve, but renal function is impaired
Increase in UO (up to 10L/day)
Major problem: dehydration (FVD), hypo Na+/K+
Recovery phase - ANS-Begins when lab values stabilize
Renal function has improved
Ends when patient can return to normal activity
Can take up to 1 year
AKI treatment: Pre-renal azotemia - ANS-Optimize renal perfusion
fluid bolus, lasix, fluid volume expanders (lactated ringers/albumin--pulls fluid from
tissues), dopamine (renal dilation)
AKI treatment: Intra-renal - ANS-Supportive therapy
IV fluids, stop damaging medications
AKI treatment: Post-renal azotemia - ANS-Alleviate the obstruction
remove obstruction, flomax, break stones
AKI treatment: Oliguric phase - ANS-Fluid restriction
Hyperkalemia
Dialysis
Nutrition
Nursing Care
How do you treat hyperkalemia that results from the oliguric phase? - ANS-Regular IV
insulin (puts K+ back into the cells)
Kayexalate
Dialysis
K+ restricted diet
When do you use dialysis to treat the oliguric phase? - ANS-FVE, hyperkalemia,
metabolic acidosis, increased BUN, mental status changes, cardiac toxicity
When does discharge planning start? - ANS-Admission
Who is involved with discharge planning? - ANS-Patient, family, nurse, case manager,
physician, PT/OT
What is the goal of discharge planning? - ANS-Educate, keep patient out of hospital
What do you assess in regards to discharge? - ANS-Stability, ability to understand
instructions, equipment needed at home, transport
What factors affect the discharge plan? - ANS-Dx, patient, environment
Who is responsible for patient and family education? - ANS-Nurse
What is the purpose of patient education? - ANS-informed decisions, medical regimen
adherence, cost
True or False: Health education is an independent function of nursing and is a primary
nursing responsibility - ANS-True
What factors impact patient education? - ANS-Demographic, support system, medical
dx, timing of education, environment
Nursing process of teaching plan: Assess - ANS-Readiness for learning, disabilities,
cultural assessment
Nursing process of teaching plan: Planning - ANS-Priorities, goals, strategies
What is the best strategy for patient learning? - ANS-Having the patient say what they
are doing while performing a task
Nursing process of teaching plan: Implementation - ANS-Nurse implements when
patient is ready to learn
Make sure patient verbalizes understanding and modify if necessary
,Nursing process of teaching plan: Evaluation - ANS-Don't assume that teaching was
always successful, evaluate goals/outcomes (modify if not met)
A nurse identifies that a patient is unable to identify the correct number of oral
medication to take each morning. Which step of the nursing process does this problem
involve? - ANS-Assessment
Acute Kidney Injury - ANS-Pre-renal
Intra-renal
Post-renal
Pre-renal assessment - ANS-Fluid volume deficit, decreased CO, hypotension,
decreased CVP
Increased: Specific gravity, BUN, creatinine, K+
Decreased: UO
Low urinary Na+
Urinary sediment normal
Intra-renal assessment - ANS-Fluid volume excess, oliguria/anuria
Increased: BUN, creatinine, CPK, K+, urine osmolarity
Decreased: H&H, UO, specific gravity
High urinary Na+
Post-renal assessment - ANS-Signs of obstruction (prostate/stones)
Decreased: UO (sometimes none)
BUN/creatinine= normal (elevated in later stages)
AKI stages - ANS-Oliguric/anuric phase
Diuretic phase
Recovery phase
Oliguric/Anuric phase - ANS-24H to 1 week
Urine output less than 400 mL/24H
Duration: 1 day to 8 weeks (usually 8-15 days)
Major problem: hyperkalemia, build up of waste products
, Diuretic phase - ANS-2-6 weeks after oliguric stage
BUN/creatinine improve, but renal function is impaired
Increase in UO (up to 10L/day)
Major problem: dehydration (FVD), hypo Na+/K+
Recovery phase - ANS-Begins when lab values stabilize
Renal function has improved
Ends when patient can return to normal activity
Can take up to 1 year
AKI treatment: Pre-renal azotemia - ANS-Optimize renal perfusion
fluid bolus, lasix, fluid volume expanders (lactated ringers/albumin--pulls fluid from
tissues), dopamine (renal dilation)
AKI treatment: Intra-renal - ANS-Supportive therapy
IV fluids, stop damaging medications
AKI treatment: Post-renal azotemia - ANS-Alleviate the obstruction
remove obstruction, flomax, break stones
AKI treatment: Oliguric phase - ANS-Fluid restriction
Hyperkalemia
Dialysis
Nutrition
Nursing Care
How do you treat hyperkalemia that results from the oliguric phase? - ANS-Regular IV
insulin (puts K+ back into the cells)
Kayexalate
Dialysis
K+ restricted diet
When do you use dialysis to treat the oliguric phase? - ANS-FVE, hyperkalemia,
metabolic acidosis, increased BUN, mental status changes, cardiac toxicity
