Summary NUR 265 Advanced Medical Surgical Nursing Exam #1 Solution Guide_Fall 2023.

NUR 265 Advanced Medical Surgical Nursing Complex Elimination Renal: Acute Kidney Injury- Abrupt loss of kidney function. It can happen in hours to days, Pathophysiology: Fluid and electrolyte imbalances occur. Labs and Diagnostics: GFR decreases. (90-120ml/min) Creatinine increase. (0.5-1.2mg/dl) protein breakdown. BUN increase. (10-20mg/dl) Hemoglobin- 12-18 Hematocrit- 37- 52 3 Types: Pre-Renal Causes: (Hypotension) The issue is before the kidney. (Impaired renal perfusion) Blood or fluid loss, low blood pressure, infection/sepsis, decreased cardiac output, decreased peripheral vascular resistance, vascular obstruction, renal artery stenosis, severe burns, and severe dehydration. Intra- Renal Causes: (Hypertension) Issue inside the kidney. Acute tubular necrosis, damage from nephrotoxins, bleeding in the kidney, thrombi or emboli in the kidney, pyelonephritis, high blood calcium levels, drugs/dyes that damage kidneys (nephrotoxic). Post-Renal Causes: (Hypertension) The issue is after the kidney. Urine outflow obstruction. Pelvic trauma, obstruction, prostate disease, bladder cancer, cervical cancer, kidney stones, neurogenic bladder (bladder not emptying fully) Signs and Symptoms for Identifying Renal Issues: Neuro- GCS – lowest it can be is 3. The highest it can be is 15. Labs Cardio- pulse pressure 40-60. A pulse pressure of less than 39 is bad. A wide pulse pressure indicates possible aortic sclerosis, iron deficiency anemia, or hyperthyroidism. Pulmonary- pulmonary edema- pink frothy sputum, give furosemide. GastrointestinalIntegumentary- Uremic frost- crystals form on the skin. Jaundice and Purities. Hyponatremia: Low sodium- Signs and symptoms: Headache, confusion, seizures, coma, death Fluid Volume Overload: Low Fluid Output- Low Urine Output- Constipation Procrit- Is a medication used to make WBCs (White Blood Cells) Azotemia- retention and buildup of nitrogenous wastes in blood. CON