NUR 445: Final Exam (STUDY GUIDE)
1. Kidney Transplant: Nursing interventions pre-transplant. (5 points- "Connie loves baking cookies everyday): - Consent
- Labs (ex. BUN, Cr, CBC)
- Baseline vital signs
- Cardiology (ex. EKG)
- Education
2. Kidney Transplant: Nursing interventions post-transplant. (6 points- "Dennis is very sad, Lisa's away"): - Daily weight
- I&O
- Vitals (ex. BP, temp.)
- Signs of pain, infection
- Labs (ex. WBC, Cr, BUN)
- Administer medications (ex. antibiotic, immunosuppressants)
3. Acute Renal Failure: What are the four key assessments findings? ("Chris' a
B.U.M): - Creatinine over 1.3 = bad kidney
- BUN over 20
- Urine output 30 mL/hr less = kidney in distress
- Metabolic acidosis pH below 7.35
4.What is acute kidney injury (AKI)?: A condition characterized by an acute, rapid loss of renal function.
Note: An accumulation of nitrogenous waste products such as urea, nitrogen, and creatinine and progressive increases
in potassium.
5.What are six risk factors for AKI? ("Susan and Eddie often cooks chorizo"): -
Sepsis
- Administration of contrast medication
- Exposure to nephrotoxins
- Older population
- Clients who undergone major surgery
- Clients with acute illness
6. AKI: Causes- Pre-renal: External factors that reduce renal blood flow
,Examples: Obstruction, low blood pressure, and low cardiac output
7. AKI: Causes- Intrarenal: Involve direct damage to the renal system.
Examples: CT contrast, antibiotics (ex. vancomycin, gentamicin), untreated infection, overuse of NSAIDs.
Note: Creatine over 1.3 = bad kidney
8. AKI: Causes- Postrenal: Mechanical obstruction of the lower urinary tract.
Examples: BPH, prostate cancer, calculi, trauma, and tumors.
9. Assessment of an AV fistula: A functional AV fistula or graft has a palpable pulsation, a thrill, and a bruit on
auscultation.
10. What is SIADH?: Syndrome of inappropriate antidiuretic hormone secretion
Important: Too much ADH is released = kidney retain excess water.
11. What are five symptoms of SIADH? ("Silly Sam Hides His Sweaty Socks"): - Stop in urination (Urine output reduced)
- Sticky, thick concentration (High specific gravity >1.030)
- Hypoosmolality and hyponatremia
- High blood pressure
- Swelling (ex. edema)
- Seizures (watch for headache/confusion)
12. What are five nursing interventions for SIADH? ("Reyna Loves Consuming
Some Ice Cream": - Restrict fluids
- Loop diuretics
- Correct sodium deficit (Hypertonic solution, IV 3% saline)
- Seizure preauction
- If able, give (per order) oral sodium tablets
13. Describe Cushing's syndrome.: The adrenal glands do produce too much steroid hormones, specifically cortisol.
Remember, cushion of steroids.
, NUR 445: Final Exam (STUDY GUIDE)
14. What are some interventions for Cushing's syndrome? (7 interventions- "Randy Ask Andy About Monitor Skin
Infections"): - Remove underlying cause (ex. tumor, reduce steroid dosage)
- Administration of medication (ex. Dexamethasone replacement)
- Assessment of fluid loss
- Adrenalectomy
- Infection control
- Skin and wound care
- Monitor electrolytes
15. What is thyroid storm?: A life-threatening condition that occurs with uncontrolled hyperthyroidism.
16. What are some symptoms of thyroid storm? (9 symptoms): - Weight loss
- Exophthalmos (budging eyes)
- Tachycardia
- Fever
- Severe agitation
- Systolic HTN
- Abdominal pain
- Tremors
- Changes of LOC
17. What is DKA?: A deficiency of insulin leading to the use of stored fats for energy.
Note: Associated with type one. Faster onset, easier to treat.
18. What are the seven S/S of DKA?: - Polyuria
- Polydipsia
- Polyphagia
- Kussmaul respirations (rapid, deep respirations)
- Fruity, acetone smell to the breath
- Nausea and vomiting
1. Kidney Transplant: Nursing interventions pre-transplant. (5 points- "Connie loves baking cookies everyday): - Consent
- Labs (ex. BUN, Cr, CBC)
- Baseline vital signs
- Cardiology (ex. EKG)
- Education
2. Kidney Transplant: Nursing interventions post-transplant. (6 points- "Dennis is very sad, Lisa's away"): - Daily weight
- I&O
- Vitals (ex. BP, temp.)
- Signs of pain, infection
- Labs (ex. WBC, Cr, BUN)
- Administer medications (ex. antibiotic, immunosuppressants)
3. Acute Renal Failure: What are the four key assessments findings? ("Chris' a
B.U.M): - Creatinine over 1.3 = bad kidney
- BUN over 20
- Urine output 30 mL/hr less = kidney in distress
- Metabolic acidosis pH below 7.35
4.What is acute kidney injury (AKI)?: A condition characterized by an acute, rapid loss of renal function.
Note: An accumulation of nitrogenous waste products such as urea, nitrogen, and creatinine and progressive increases
in potassium.
5.What are six risk factors for AKI? ("Susan and Eddie often cooks chorizo"): -
Sepsis
- Administration of contrast medication
- Exposure to nephrotoxins
- Older population
- Clients who undergone major surgery
- Clients with acute illness
6. AKI: Causes- Pre-renal: External factors that reduce renal blood flow
,Examples: Obstruction, low blood pressure, and low cardiac output
7. AKI: Causes- Intrarenal: Involve direct damage to the renal system.
Examples: CT contrast, antibiotics (ex. vancomycin, gentamicin), untreated infection, overuse of NSAIDs.
Note: Creatine over 1.3 = bad kidney
8. AKI: Causes- Postrenal: Mechanical obstruction of the lower urinary tract.
Examples: BPH, prostate cancer, calculi, trauma, and tumors.
9. Assessment of an AV fistula: A functional AV fistula or graft has a palpable pulsation, a thrill, and a bruit on
auscultation.
10. What is SIADH?: Syndrome of inappropriate antidiuretic hormone secretion
Important: Too much ADH is released = kidney retain excess water.
11. What are five symptoms of SIADH? ("Silly Sam Hides His Sweaty Socks"): - Stop in urination (Urine output reduced)
- Sticky, thick concentration (High specific gravity >1.030)
- Hypoosmolality and hyponatremia
- High blood pressure
- Swelling (ex. edema)
- Seizures (watch for headache/confusion)
12. What are five nursing interventions for SIADH? ("Reyna Loves Consuming
Some Ice Cream": - Restrict fluids
- Loop diuretics
- Correct sodium deficit (Hypertonic solution, IV 3% saline)
- Seizure preauction
- If able, give (per order) oral sodium tablets
13. Describe Cushing's syndrome.: The adrenal glands do produce too much steroid hormones, specifically cortisol.
Remember, cushion of steroids.
, NUR 445: Final Exam (STUDY GUIDE)
14. What are some interventions for Cushing's syndrome? (7 interventions- "Randy Ask Andy About Monitor Skin
Infections"): - Remove underlying cause (ex. tumor, reduce steroid dosage)
- Administration of medication (ex. Dexamethasone replacement)
- Assessment of fluid loss
- Adrenalectomy
- Infection control
- Skin and wound care
- Monitor electrolytes
15. What is thyroid storm?: A life-threatening condition that occurs with uncontrolled hyperthyroidism.
16. What are some symptoms of thyroid storm? (9 symptoms): - Weight loss
- Exophthalmos (budging eyes)
- Tachycardia
- Fever
- Severe agitation
- Systolic HTN
- Abdominal pain
- Tremors
- Changes of LOC
17. What is DKA?: A deficiency of insulin leading to the use of stored fats for energy.
Note: Associated with type one. Faster onset, easier to treat.
18. What are the seven S/S of DKA?: - Polyuria
- Polydipsia
- Polyphagia
- Kussmaul respirations (rapid, deep respirations)
- Fruity, acetone smell to the breath
- Nausea and vomiting
