Exam 1 advanced Medsurge review
Renal questions
• Educational activities for patients with chronic kidney disease,
what are they at risk for, things that can develop CKD.
THE MOST COMMON CAUSES OF CKD ARE DIABETES AND
HYPERTENSION; OTHER RISK FACTORS INCLUDE HYPERLIPIDEMIA,
SMOKING, THE USE OF RECREATIONAL DRUGS, NSAIDS, OBESITY,
GLOMERULONEPHRITIS, OVER THE AGE OF 60, POLYCYSTIC KIDNEY
DISEASE, LUPUS AND ATHEROSCLEROSIS
THEY CAN DEVELOP HYPERKALEMIA, HYPERTENSION, ANEMIA,
DYSLIPIDEMIA, RENAL OSTEODYSTROPHY, HYPERPARATHYROIDSM,
HYPOCALCEMIA
• Patients receiving dialysis, s/s of dizziness or lightheaded, what is
the nursing priority. Something that you can do with that patient does
not need to administer medications.
THESE S/S DUE TO HYPOTENSION; DECREASE THE FLUID RATE
REMOVAL AND REPLACE FLUID IV; CHANGE POSITONS
• What is the first thing you assess on a patient before they have
dialysis?
YOU WILL ASSESS WHAT TYPE OF ACCESS IS NEEDED AND FOR
HOW LONG?
HEMODIALYSIS, CONTINUOUS RENAL REPLACEMENT THERAPY,
PERITONEAL DIALYSIS.
,• Actions that the nurse can delegate for patient with AKI with fluid
volume overload.
MANAGE FLUID BALANCE: RN
ADMINISTER DIURETICS: LPN/RN
ADMINISTER POTASSIUM-LOWERING THERAPY: LPN/RN
POSITIONING, AMBULATION, COUGH AND DEEP BREATHING: AP
WEIGH THE PATIENT DAILY: AP
SKIN CARE: AP
MONITOR AND DOCUMENT FOOD INTAKE: AP
• What type of medications can you administer for a patient with
fluid volume overload? Types of diuretic, for patients with renal disease
LOOP DIURETIC (FUROSEMIDE, BUMETANIDE)
OSMOTIC DIURETIC (MANNITOL)
FLUID OVERLOAD S/S: NECK VEIN DISTENTION, BOUNDING
PULSE, EDEMA, HYPERTENSION, HEART FAILURE, PULMONARY
EDEMA, PERICARDIAL AND PULMONARY EFFUSION
• Patients with hypertension and renal insufficiency, can you
administer hydrochlorothiazide, what are the electrolyte imbalance
risks for the patient and this medication.
HYPOKALEMIA, DEHYDRATION, HYPERCALCEMIA,
HYPOCHLOREMIA, ALKALOSIS, HYPOMAGSEMIA, HYPONATREMIA,
HYPOPHOSPHATEMIA, HYPOVOLEMIA
USE CAUTIOUSLY IN RENAL IMPAIRMENT
• Lab results of an ABG result, what interventions can be done for
the patient, understand what is wrong with and what to do
, HCO3 (BICARBONATE): 22-26 mEq/L
pH: 7.35.7.45
PACO2 (CARBON DIOXIDE): 35-45 mm Hg
METABOLIC ACIDOSIS (DECREASED IN BICARB, DECREASED
PH): ASSESSING ABGS (BICARB, BASE EXCESS, AND SERUM CO2),
OBTAINING V/S (BP, PULSE, CARDIAC RHYTHM), AND CHECKING
LAB RESULTS, ESPECIALLY BLOOD GLUCOSE AND SERUM
ELECTROLYTES, CAUTIOUS ADMINISTRATION OF SODIUM BICARB
MAY BE INDICATED, DIALYSIS MAY BE NEEDED FOR PATIENTS WITH
RENAL FAILURE AND FOR METABOLIC ACIDOSIS CAUSED BY A
TOXIC REACTION TO A MEDICATION
• CKD assessing a patient, what are the physiological changes you
may see.
HYPERTENSION, HEART FAILURE, PULMONARY EDEMA, GI
SYMPTOMS, NEUROLOGICAL SYMPTOMS
• Patient with acute kidney injury, what kind of T wave and what
changes can happen based on the EKG.
PEAKED T-WAVES
• Before you administer calcium, carbonate what labs should you
check before.
CHECK CALCIUM LEVELS (8.2-10.2) & PHOSPHATE LEVELS (2.5-4.5)
• Patient in dialysis and you are reviewing medications, what
medications should you question.
ANTIHYPERTENSIVE MEDICATIONS OR CARDIAC MEDICATION TO
AVOID HYPOTENSIVE EVENTS THAT MAY OCCUR FROM FLUID
SHIFTS IN DIALYSIS; TAKEN AFTER DIALYSIS
Renal questions
• Educational activities for patients with chronic kidney disease,
what are they at risk for, things that can develop CKD.
THE MOST COMMON CAUSES OF CKD ARE DIABETES AND
HYPERTENSION; OTHER RISK FACTORS INCLUDE HYPERLIPIDEMIA,
SMOKING, THE USE OF RECREATIONAL DRUGS, NSAIDS, OBESITY,
GLOMERULONEPHRITIS, OVER THE AGE OF 60, POLYCYSTIC KIDNEY
DISEASE, LUPUS AND ATHEROSCLEROSIS
THEY CAN DEVELOP HYPERKALEMIA, HYPERTENSION, ANEMIA,
DYSLIPIDEMIA, RENAL OSTEODYSTROPHY, HYPERPARATHYROIDSM,
HYPOCALCEMIA
• Patients receiving dialysis, s/s of dizziness or lightheaded, what is
the nursing priority. Something that you can do with that patient does
not need to administer medications.
THESE S/S DUE TO HYPOTENSION; DECREASE THE FLUID RATE
REMOVAL AND REPLACE FLUID IV; CHANGE POSITONS
• What is the first thing you assess on a patient before they have
dialysis?
YOU WILL ASSESS WHAT TYPE OF ACCESS IS NEEDED AND FOR
HOW LONG?
HEMODIALYSIS, CONTINUOUS RENAL REPLACEMENT THERAPY,
PERITONEAL DIALYSIS.
,• Actions that the nurse can delegate for patient with AKI with fluid
volume overload.
MANAGE FLUID BALANCE: RN
ADMINISTER DIURETICS: LPN/RN
ADMINISTER POTASSIUM-LOWERING THERAPY: LPN/RN
POSITIONING, AMBULATION, COUGH AND DEEP BREATHING: AP
WEIGH THE PATIENT DAILY: AP
SKIN CARE: AP
MONITOR AND DOCUMENT FOOD INTAKE: AP
• What type of medications can you administer for a patient with
fluid volume overload? Types of diuretic, for patients with renal disease
LOOP DIURETIC (FUROSEMIDE, BUMETANIDE)
OSMOTIC DIURETIC (MANNITOL)
FLUID OVERLOAD S/S: NECK VEIN DISTENTION, BOUNDING
PULSE, EDEMA, HYPERTENSION, HEART FAILURE, PULMONARY
EDEMA, PERICARDIAL AND PULMONARY EFFUSION
• Patients with hypertension and renal insufficiency, can you
administer hydrochlorothiazide, what are the electrolyte imbalance
risks for the patient and this medication.
HYPOKALEMIA, DEHYDRATION, HYPERCALCEMIA,
HYPOCHLOREMIA, ALKALOSIS, HYPOMAGSEMIA, HYPONATREMIA,
HYPOPHOSPHATEMIA, HYPOVOLEMIA
USE CAUTIOUSLY IN RENAL IMPAIRMENT
• Lab results of an ABG result, what interventions can be done for
the patient, understand what is wrong with and what to do
, HCO3 (BICARBONATE): 22-26 mEq/L
pH: 7.35.7.45
PACO2 (CARBON DIOXIDE): 35-45 mm Hg
METABOLIC ACIDOSIS (DECREASED IN BICARB, DECREASED
PH): ASSESSING ABGS (BICARB, BASE EXCESS, AND SERUM CO2),
OBTAINING V/S (BP, PULSE, CARDIAC RHYTHM), AND CHECKING
LAB RESULTS, ESPECIALLY BLOOD GLUCOSE AND SERUM
ELECTROLYTES, CAUTIOUS ADMINISTRATION OF SODIUM BICARB
MAY BE INDICATED, DIALYSIS MAY BE NEEDED FOR PATIENTS WITH
RENAL FAILURE AND FOR METABOLIC ACIDOSIS CAUSED BY A
TOXIC REACTION TO A MEDICATION
• CKD assessing a patient, what are the physiological changes you
may see.
HYPERTENSION, HEART FAILURE, PULMONARY EDEMA, GI
SYMPTOMS, NEUROLOGICAL SYMPTOMS
• Patient with acute kidney injury, what kind of T wave and what
changes can happen based on the EKG.
PEAKED T-WAVES
• Before you administer calcium, carbonate what labs should you
check before.
CHECK CALCIUM LEVELS (8.2-10.2) & PHOSPHATE LEVELS (2.5-4.5)
• Patient in dialysis and you are reviewing medications, what
medications should you question.
ANTIHYPERTENSIVE MEDICATIONS OR CARDIAC MEDICATION TO
AVOID HYPOTENSIVE EVENTS THAT MAY OCCUR FROM FLUID
SHIFTS IN DIALYSIS; TAKEN AFTER DIALYSIS
