PNR 206 (MEDSURG 2) Exam 4 DUE 17TH JUN 2024/2025

PNR 206 (MEDSURG 2) Exam 4 DUE 17TH JUN 2024/2025 Urinary obstruction in older males - CORRECT ANSWER-In men, the prostate gland hypertrophies with age and can cause varying degrees of obstruction to the normal flow of urine Kidney function - CORRECT ANSWER-20% of the blood flowing through the glomerulus is filtered at any one time The kidneys regulate BP The kidneys increase RBC production Glomerular filtration rate (GFR) - CORRECT ANSWER-Is the amount of blood filtered by the glomeruli in a given time (average GFR is about 125 mL/min) Age related changes of renal system - CORRECT ANSWER-Kidney function begins to degrade after age 45 years and renal blood flow and GFR gradually decrease with each decade Secretion of renin, aldosterone and vitamin D activation are decreased Residual urine and urine incontinence Nocturia Nephrotoxic medications - CORRECT ANSWER-Aminoglycosides (gentamicin, streptomycin) Sulfonamides (trimethoprim-sulfamethoxazole) Antifungals (amphotericin B) Antitubercular (rifampin) Cephalosporins Tetracyclines Misc. (vancomycin, polymyxin B) Ace inhibitors Antineoplastic (cisplastin, methotrexate) Immunosuppressants (cyclosporine) NSAIDs Renal biopsy-pt teaching - CORRECT ANSWER-Collect 24 hr urine specimen prior to procedure. To diagnosis the cause of kidney disease, to cancer, or to evaluate kidney transplant rejection, bladder dysfunction. Postop care must lie on back 6-24 hours Urge incontinence - CORRECT ANSWER-the involuntary loss of urine when there is a strong urge to urinate Stress incontinence - CORRECT ANSWER-Sneezing Laughing Coughing Aerobic exercise Mixed incontinence - CORRECT ANSWER-A combo of different types, such as stress and urge incontinence Overflow incontinence - CORRECT ANSWER-When bladder is too full. Occurs when their is poor contractility of the detrusor muscle or obstruction of the urethra as in prostate hypertrophy in male or genital prolapse in the female Functional incontinence - CORRECT ANSWER-Cognitive inability to recognize the urge to urinate or a self care deficit. Inability to reach bathroom because of restraints , side rails, or out of reach walker Neurologic incontinence - CORRECT ANSWER-Caused by disorders of the neurologic system (multiple sclerosis or spinal cord injury) Bethanechol (Urecholine) - CORRECT ANSWER-Bladder stimulant. Monitor for orthostatic hypotension and bradycardia Immediately report severe dizziness or difficulty breathing Rise slowly from lying to standing position Labs to monitor when patient is on Bactrim - CORRECT ANSWER-CBCHemoglobin hematocrit WBCs BUN Acute glomerulonephritis - CORRECT ANSWER-Most commonly occurs 2-3 weeks after a group A beta-hemolytic streptococcal infection such as "strep throat" or impetigo Acute glomerulonephritis symptoms - CORRECT ANSWER-Fever Chills Flank pain Widespread edema Puffiness around the eyes Visual disturbances Marked hypertension Acute glomerulonephritis diagnosis - CORRECT ANSWER-Urine may be smoky, will contain red blood cells, and protein and will have an increased specific gravity nephrotic syndrome - CORRECT ANSWER-Severe edema, facial edema, especially periorbital edema (may be present in the morning), lower extremity edema is more evident at end of the day hypoalbuminemia Visceral pain - CORRECT ANSWER-Organs and the linings of the body cavities Visceral pain treatment - CORRECT ANSWER-NSAIDs Opioids (interrupts transmission phase) nonpharmacological Transduction - CORRECT ANSWER-Begins when tissue damage causes the release of substances that stimulate the nociceptors and initiate the sensation of pain Transmission - CORRECT ANSWER-involved movement of the pain sensation to the spinal cord Perception - CORRECT ANSWER-Occurs when impulses reach the brain and the pain is recognized modulation - CORRECT ANSWER-occurs when neurons in the brain send signals back down the spinal cord by release of neurotransmitters Neuropathic pain medication - CORRECT ANSWER-NSAIDs Tricyclic antidepressants anticonvulsants corticosteroids Referred pain - CORRECT ANSWER-Pain felt in a part of the body that is different from where the pain originates Phantom pain - CORRECT ANSWER-Occurs where no actual tissue is involved but real pain exists Symptoms of near drowning - CORRECT ANSWER-Pulmonary edema Cardiac irregularities Hypothermic Susceptible to bacterial or fungal pneumonia First degree frost bite (Superficial) - CORRECT ANSWER-reddened skin sweling waxy appearance hard white plaques sensory deficit