HURST CORRECT EXAMS QUESTIONS AND
ANSWERS SET A+
✔✔can all clients tolerate hemodialysis ? - ✔✔- no
✔✔unstable ________________________ cant tolerate hemodiaylsis -
✔✔cardiovascular system
✔✔what medications should you hold for a client going to dialysis? select all that apply
1. lisinopril ( cause our BP to drop )
2. nitroglycerin
3. water soluble vitamin
4. ampicilln
5. famiotdine - ✔✔- 1. lisinopril
- 2. nitroglycerin
- 3. water soluble vitamin
- 4. amplicillin
✔✔dialysis lowers what? - ✔✔- BP
✔✔for dialysis one must have what? - ✔✔- vascular access
✔✔with hemodialysis, blood is being removed, cleanses, and then returned at a rate of
_________ to _________ mL/min - ✔✔300-800
✔✔what is a vascular access? - ✔✔A site where they have access to a large blood
vessel because very rapid blood flow is essential for hemodialysis
✔✔AVF ( arteriovenous fistula) goes where? - ✔✔- in forearm with an anastomosis
between an artery and a vein
✔✔AVG (arteriovenous graft) - ✔✔synthetic graft to join the vessels
,✔✔During dialysis two needles are going to be inserted into the vascular access what
do these two needles do? - ✔✔- one needle will allow blood to be pulled from the
circulation and sent to the hemodialysis machine
- for temporary access, the internal juglar or femoral vein is often used for catheter
placement. surgery is not required for temp. placement
✔✔what tips can you give for care of access on a dialysis pt? - ✔✔- DO NOT USE ANY
IV ACCESS ( DRAWING BLOOD, ADMINSTERING MEDS, ETC)
✔✔when a client has an alternate vascular access, what is the associated nursing care
for that extremity? - ✔✔- NO BLOOD PRESSURES
- NO NEEDLE STICKS
- NO CONSTRICTION ON THAT ARM
✔✔why does on assess access of dialysis? - ✔✔- ensure patency
✔✔how does on check access for dialysis ? - ✔✔- palpate for a thrill
✔✔thrill for dialysis is like what? - ✔✔- cat purring sensation ( palpate)
✔✔bruit for dialysis is like what? - ✔✔turbulent blood flow ( ausculate)
✔✔feel the ____________ hear the _________________ - ✔✔thrill, bruit
✔✔for peritoneal dialysis use peritoneal membrane as a what? - ✔✔- filter
✔✔dialysate is infused into the peritoneal cavity by what? - ✔✔- gravity via tenckhoff
catheter
✔✔how much fluid fills the peritoneal cavity? - ✔✔- 2000-2500 mL
✔✔how long does peritoneal dialysis take? - ✔✔- 10 min and remain in the peritoneal
cavity for a prescribed amt of time. this is called dwell time
✔✔the entire process during peritoneal dialysis is called what? - ✔✔- exchange
✔✔why do we warm the dialysis peritoneal diaysis ? - ✔✔- cold promotes
vasoconstriction ---> limits blood flow
- we want it warm; this promotes vasodilation and more blood flow
✔✔what does drainage look like during peritoneal dialysis ? - ✔✔- clear, straw colored
- cloudy = infection
- should be able to read a newspaper through the drainage/effluent
,✔✔what if all the fluid doesnt come out during peritoneal diaylsis ? - ✔✔- turn the client
side to side
✔✔what type of client gets peritoneal dialysis ? - ✔✔- someone who cant tolerate
HEMODIALYSIS or someone who chooses peritoneal
✔✔what kind of complications can someone encounter when dealing with peritoneal
dialysis ? - ✔✔- exit site infection
- major complication is PERITONITIS
✔✔what are some S/S of complications of peritoneal dialysis ? - ✔✔- abdominal pain
- cloudy effluent
✔✔what kind of dietary needs should one follow when dealing with peritoneal dialysis ?
- ✔✔- fiber ( have decreases peristalsis due to abdomial fluid)
- protein ( big holes in peritoneum and lose protein with each exchange
✔✔nephrolithiasis is another word for what? - ✔✔- kidney stone disease
✔✔urolithiasis is another word for what? - ✔✔- stone in ureter
✔✔what are some S/S of kidney stones? - ✔✔- sharp pain and nausea/vomiting
- WBCs INCREASED
- HEMATURIA!!!!!!!!!!!!!!!!!!
✔✔anytime you suspect a kidney stone, get a ________ specimen ASAP and have it
checked for ____________ - ✔✔urine
RBCs
✔✔if a kidney stone is present, the client will get what immediately? - ✔✔- pain
medication
✔✔what is the treatment for kidney stones? - ✔✔- ondansetron ( zofran)
- increase fluids
✔✔a nurse is assessing a client diagnosed with kidney stones who just returned from
extracoprporeal shock wave therapy ( lithotripsy).
the client is supine in bed with an indwelling catheter in place. which finding would be
the best indicator that the treatment has been effective?
1. total absence of pain
2. the indwelling catheter is draining freely
3. rebound tenderness is absent during abdominal assessment
, 4. sand-like sediment has settled in the bottom of the indwelling cathether bag - ✔✔- 4.
sand-like sediment has settled in the bottom of the indwelling catheter bag
✔✔a nurse is working in the ED and is assigned to care for the client in examination
rooms 1,2 and 3. the nurse recieves the following report from the off going nurses.
which client would go see first?
1. the client in room 1 is an elderly person who has fallen and is currently in CT to rule
out a subdural hematoma
2. client in room 2 is diagnosed with kidney stones, positive for hematuria and has 8/10
pain
3. the client in room 3 has a blood pressure of 90/40 - ✔✔- 3. the client in room 3 has a
blood pressure of 90/40
✔✔pancreatitis - ✔✔auto-digestion of the pancreas
✔✔the pancreas has two seperate functions what are they? - ✔✔- endocrine- insuling
- exocrine- digested enzymes
✔✔there are two types of pancreatitis what are they and what are the causes? - ✔✔-
acute and chronic
- cause #1- gallbladder disease
- cause #2 - alcohol
✔✔what are some S/S of pancreatitis ? - ✔✔- pain increases with eating
- ascites
- abdominal mass
- cullens sign
✔✔cullens sign - ✔✔bruising in the skin around the umbilicus
✔✔what does the diagnosis of pancreatitis show? - ✔✔- serum lipase and amylase go
up
- WBCs increase
- blood sugar increase
- PT, aPTT increase
✔✔what is the treatment for pancreatitis ? - ✔✔- GOAL: CONTROL PAIN
- decrease gastric secretions ( NPO, NGt suction , bed rest) want stomach to be empty
- pain meds ( fentanyl patches ( duragesic)
- anticholinergics, why? dry up secreations
✔✔what are some examples of anticholinergics? - ✔✔- benztropine ( cogentin)
- diphenoxylate/atropine ( Lonox)
ANSWERS SET A+
✔✔can all clients tolerate hemodialysis ? - ✔✔- no
✔✔unstable ________________________ cant tolerate hemodiaylsis -
✔✔cardiovascular system
✔✔what medications should you hold for a client going to dialysis? select all that apply
1. lisinopril ( cause our BP to drop )
2. nitroglycerin
3. water soluble vitamin
4. ampicilln
5. famiotdine - ✔✔- 1. lisinopril
- 2. nitroglycerin
- 3. water soluble vitamin
- 4. amplicillin
✔✔dialysis lowers what? - ✔✔- BP
✔✔for dialysis one must have what? - ✔✔- vascular access
✔✔with hemodialysis, blood is being removed, cleanses, and then returned at a rate of
_________ to _________ mL/min - ✔✔300-800
✔✔what is a vascular access? - ✔✔A site where they have access to a large blood
vessel because very rapid blood flow is essential for hemodialysis
✔✔AVF ( arteriovenous fistula) goes where? - ✔✔- in forearm with an anastomosis
between an artery and a vein
✔✔AVG (arteriovenous graft) - ✔✔synthetic graft to join the vessels
,✔✔During dialysis two needles are going to be inserted into the vascular access what
do these two needles do? - ✔✔- one needle will allow blood to be pulled from the
circulation and sent to the hemodialysis machine
- for temporary access, the internal juglar or femoral vein is often used for catheter
placement. surgery is not required for temp. placement
✔✔what tips can you give for care of access on a dialysis pt? - ✔✔- DO NOT USE ANY
IV ACCESS ( DRAWING BLOOD, ADMINSTERING MEDS, ETC)
✔✔when a client has an alternate vascular access, what is the associated nursing care
for that extremity? - ✔✔- NO BLOOD PRESSURES
- NO NEEDLE STICKS
- NO CONSTRICTION ON THAT ARM
✔✔why does on assess access of dialysis? - ✔✔- ensure patency
✔✔how does on check access for dialysis ? - ✔✔- palpate for a thrill
✔✔thrill for dialysis is like what? - ✔✔- cat purring sensation ( palpate)
✔✔bruit for dialysis is like what? - ✔✔turbulent blood flow ( ausculate)
✔✔feel the ____________ hear the _________________ - ✔✔thrill, bruit
✔✔for peritoneal dialysis use peritoneal membrane as a what? - ✔✔- filter
✔✔dialysate is infused into the peritoneal cavity by what? - ✔✔- gravity via tenckhoff
catheter
✔✔how much fluid fills the peritoneal cavity? - ✔✔- 2000-2500 mL
✔✔how long does peritoneal dialysis take? - ✔✔- 10 min and remain in the peritoneal
cavity for a prescribed amt of time. this is called dwell time
✔✔the entire process during peritoneal dialysis is called what? - ✔✔- exchange
✔✔why do we warm the dialysis peritoneal diaysis ? - ✔✔- cold promotes
vasoconstriction ---> limits blood flow
- we want it warm; this promotes vasodilation and more blood flow
✔✔what does drainage look like during peritoneal dialysis ? - ✔✔- clear, straw colored
- cloudy = infection
- should be able to read a newspaper through the drainage/effluent
,✔✔what if all the fluid doesnt come out during peritoneal diaylsis ? - ✔✔- turn the client
side to side
✔✔what type of client gets peritoneal dialysis ? - ✔✔- someone who cant tolerate
HEMODIALYSIS or someone who chooses peritoneal
✔✔what kind of complications can someone encounter when dealing with peritoneal
dialysis ? - ✔✔- exit site infection
- major complication is PERITONITIS
✔✔what are some S/S of complications of peritoneal dialysis ? - ✔✔- abdominal pain
- cloudy effluent
✔✔what kind of dietary needs should one follow when dealing with peritoneal dialysis ?
- ✔✔- fiber ( have decreases peristalsis due to abdomial fluid)
- protein ( big holes in peritoneum and lose protein with each exchange
✔✔nephrolithiasis is another word for what? - ✔✔- kidney stone disease
✔✔urolithiasis is another word for what? - ✔✔- stone in ureter
✔✔what are some S/S of kidney stones? - ✔✔- sharp pain and nausea/vomiting
- WBCs INCREASED
- HEMATURIA!!!!!!!!!!!!!!!!!!
✔✔anytime you suspect a kidney stone, get a ________ specimen ASAP and have it
checked for ____________ - ✔✔urine
RBCs
✔✔if a kidney stone is present, the client will get what immediately? - ✔✔- pain
medication
✔✔what is the treatment for kidney stones? - ✔✔- ondansetron ( zofran)
- increase fluids
✔✔a nurse is assessing a client diagnosed with kidney stones who just returned from
extracoprporeal shock wave therapy ( lithotripsy).
the client is supine in bed with an indwelling catheter in place. which finding would be
the best indicator that the treatment has been effective?
1. total absence of pain
2. the indwelling catheter is draining freely
3. rebound tenderness is absent during abdominal assessment
, 4. sand-like sediment has settled in the bottom of the indwelling cathether bag - ✔✔- 4.
sand-like sediment has settled in the bottom of the indwelling catheter bag
✔✔a nurse is working in the ED and is assigned to care for the client in examination
rooms 1,2 and 3. the nurse recieves the following report from the off going nurses.
which client would go see first?
1. the client in room 1 is an elderly person who has fallen and is currently in CT to rule
out a subdural hematoma
2. client in room 2 is diagnosed with kidney stones, positive for hematuria and has 8/10
pain
3. the client in room 3 has a blood pressure of 90/40 - ✔✔- 3. the client in room 3 has a
blood pressure of 90/40
✔✔pancreatitis - ✔✔auto-digestion of the pancreas
✔✔the pancreas has two seperate functions what are they? - ✔✔- endocrine- insuling
- exocrine- digested enzymes
✔✔there are two types of pancreatitis what are they and what are the causes? - ✔✔-
acute and chronic
- cause #1- gallbladder disease
- cause #2 - alcohol
✔✔what are some S/S of pancreatitis ? - ✔✔- pain increases with eating
- ascites
- abdominal mass
- cullens sign
✔✔cullens sign - ✔✔bruising in the skin around the umbilicus
✔✔what does the diagnosis of pancreatitis show? - ✔✔- serum lipase and amylase go
up
- WBCs increase
- blood sugar increase
- PT, aPTT increase
✔✔what is the treatment for pancreatitis ? - ✔✔- GOAL: CONTROL PAIN
- decrease gastric secretions ( NPO, NGt suction , bed rest) want stomach to be empty
- pain meds ( fentanyl patches ( duragesic)
- anticholinergics, why? dry up secreations
✔✔what are some examples of anticholinergics? - ✔✔- benztropine ( cogentin)
- diphenoxylate/atropine ( Lonox)
