MDC3 Nursing Concept Guide_ Key Topics for Final Exam Preparation

MDC3 Exam 1 - concept guide

Modules 1-3
There are a TON of topics covered in these modules / chapters. To help you focus a little, here
are some of the possible topics for your upcoming exam.
You are responsible for reading the chapters assigned for this module.
For all concepts, please review: Management of Care, Safety and Infection Control, Health
Promotion and Maintenance, Psychosocial Integrity, Basic Care and Comfort, Pharmacological
and Parenteral Therapies, Reduction of Risk Potential, Physiological Adaptation, ADPIE - The
Nursing Process, Priority, Complications, Patient and Family Education and Self-Management,
Delegation, Cultural/Spiritual Considerations. Nutrition.
Consider what nursing diagnoses may be present in the conditions covered, what interventions
relate to those diagnoses.
You will have select all that apply questions – make sure you review best practices for answering
these questions!
Pay special attention to the following concepts:
Major Concept Subsections
AKI- Acute renal Categories / causes
failure Sudden injury to the kidney from a variety of causes.
•HUGE range of conditions – from mild functional loss to severe
impairment
•Rapid loss (a few hours to a few days)
•Potentially reversible if identified and treated rapidly
•However, does have a HIGH morbidity and mortality
associated with it
PRERENAL – Perfusion related!
•Injury to the kidney caused by interruption / disruption of flow
TO the kidney
•This is reversible
•Hypovolemia
•Blood or fluid loss (trauma, sepsis, surgery)
•Hypotension
•MI
•Dehydration
•Renal artery stenosis
•Bleeding or clotÝng in renal blood vessels
POSTRENAL – Outflow related
•Injury to the kidney caused by interruption / disruption of flow
OUT of the kidney
•Inability of the kidney to drain, increases hydrostatic pressure
in the kidney damaging the renal pelvis initially and progresses
to renal tubules
•Can be reversed
•Obstruction
•BPH or prostate cancer
•Trauma

, MDC3 Exam 1 - concept guide


Major Concept Subsections
•Renal calculi
•UTI
INTRARENAL – injury to the kidney
•Damage to the internal structures of the kidney (either directly
or as a result of pre or post renal issues)
•Sepsis
•Nephrotoxic drugs
•Glomerulonephritis
•Acute tubular necrosis (Most common cause of intrarenal
disease)
•Prolonged prerenal ischemia
•Bleeding in the kidney
•PKD, pyelonephritis
•Thrombus
•Cancers
•Toxin

Lab abnormalities
Increase of creatinine >0.3 mg/dL within 48 hrs
Increase in creatinine >1.5 x baseline
Urine output less than 0.5 ml/kg/hr >6 hrs

BPH- benign Signs and symptoms
prostatic DifÏculty starting urine stream
hyperplasia Decreased velocity of urine stream
Intermittent voiding
Dribbling at the end
Incomplete bladder emptying / retention
Increased risk / recurrence of infection
Urinary frequency / urgency / dysuria
Nocturia / incontinence
Bladder or urethra pain
Hematuria – commonly associated with infection
Nursing care / education
Can take up to 2 months for bladder function to return
to normal
STAY HYDRATED!
Medications – all three types
Alpha blockers – relax the smooth muscles of the
prostate and bladder neck to improve urine flow
(improve urethral diameter)
Terazosin
Doxazosin

, MDC3 Exam 1 - concept guide


Major Concept Subsections
Tamsulosin
Alfuzosin
Silodosin
Phosphodiasterase-5 inhibitors – primary use is ED –
relax lower urinary tract smooth muscles
Tadalfil (Cialis)
Sildenafil
5-alpha reductase inhibitors – block the production of
DHT (dihydroxytestosterone)
Finasteride
dutasteride
Post-operative care
Monitor for bleeding
CBI if ordered
Monitor UOP carefully – volume and quality
Keep catheter and care for it appropriately until
removed by urologist
Monitor for signs of infection
Mobilize
Pain control

Breast Cancer Screening
Yearly 40-54, every 2 years for > 55
Risk factors
Alcohol – 2 or more alcoholic drinks daily increases by
1.5x
Childbirth – giving birth AFTER age 30 or never having
children increases the risk of breast cancer
Obesity – a definitive risk factor – on the flip side,
exercising daily decreased the risk
Smoking – a definitive risk factor
Breast cellular changes – hyperplasia, atypical
appearance – increased risk
Breast density (not breast size)
High socioeconomic status
Education / prevention
Self-breast examination
Diagnostics / testing
Mammogram
Ultrasound
MRI
Biopsy
Labs