NSG 4100 Exam 1 Test Questions And Answers |Well Elaborated|

NSG 4100 Exam 1 Test Questions And Answers |Well Elaborated| What type of medication should be held before dialysis? - ANSWER Antihypertensive and antiarrhythmic medications What metabolic imbalance is common with ESRD? - ANSWER -Metabolic Acidosis (pH lower than 7.35, HCO3 lower than 22, CO2 normal 35-45) What type of patient is a candidate for CRRT? - ANSWER -Clinically unstable patient who are hypotensive, patient with fluid overload secondary to oliguric kidney disease, patient who kidneys cannot handle their acutely high metabolic or nutritional needs. Nursing interventions/Care of a post nephrectomy patient. - ANSWER -Assess Respiratory status, loot at drainage tubes and incision sites frequently to watch for blood loss and infection, DVT, pain, urinary drainage look at color and amount, circulation, auscultate heart and lungs every shift, DW What education should a patient receive if they are being discharged home with an indwelling catheter? - ANSWER -Need to learn the adequacy of urine output, need to use asepsis technique while cleaning and never irrigate regularly, only change when there is leakage, blockage or encrustation, clean with soap and water, the tube needs to be anchor to minimize manipulation, wash the perineal area twice a day Explain the surgical procedure of a kidney transplant. - ANSWER -For the individual receiving the kidney the old ones are not removed. The new kidney is placed on patient iliac fossa anterior to the iliac crest because it allows easier blood flow. The renal artery of the donated kidney is sutured to the iliac artery and the renal vein to the iliac vein. The ureter of the donated kidney is sutured to the bladder and once the blood supply as been established in the OR urine should flow showing a success. What should the nursing assessment focus on post-kidney transplants? - ANSWER -Rejection-oliguria (production of small amount o urine), edema, fever, increase BP, weight gain. Infection-fever, high HR, high WBC What topics should be included in post-op kidney transplant teaching? - ANSWER -Rejection S/S, Infection S/S, and being medication compliance (needing to be on Immunosupressants for the rest of their life). What is the focus of care for a brain-dead patient that is an organ donor? - ANSWER -To maintain good perfusion (good BP means good perfusion), decrease risk for infection, and maintaining hemodynamic stability. Risk factors for bladder cancer - ANSWER -Smoking occupational exposure (especially to rubber), genetic mutations Risk factors for renal cancer - ANSWER -Smoking, occupational exposure especially asbestos What are the dietary recommendations for bariatric surgery patient? - ANSWER Small frequent meals, need to eat slowly and chew thoroughly, do not drink with meals, walk at least 30 minutes a day, take dietary supplements, only drink low calorie drinks What is dumping syndrome? - ANSWER -Rapid transit of food bolus from stomach to small intestine. What are signs and symptoms of dumping syndrome after bariatric surgery? - ANSWER -Elevated heart rate, dizziness, sweating, N/V, bloating, abdominal pain, diarrhea Risk factors for oral and esophageal cancer - ANSWER -Smoking, excessive alcohol, previous head and neck cancer, HPV infections Risk factors for gastric cancer - ANSWER -Eating a diet with salty and smoked foods, chronic gastritis, smoking, obesity, ulcers, H. pylori infection What kind of diet do oral/esophageal/gastric cancers patient need? - ANSWER Mechanical soft diet along with small sips of water, no spicy or greasy foods Signs and symptoms/complications of fluid overload in Liver Disease. - ANSWER -Ascites, crackles, esop varies(bleeding in the esoph due to back up), portal hypertension, hypertension Education for patients on preventing colon cancer. - ANSWER -Screening starting at the age of 50 unless the patient has a family history or is at high risk, watch for bright red blood in stool Risk factors for colon cancer - ANSWER -Smoking, UC/Crohn's African American Sign/Symptoms of colon cancer - ANSWER -Change in bowel habits and blood in the stool Signs/Symptoms of pancreatitis - ANSWER -Abdominal pain, tenderness, back pain, pain after meals, pain after alcohol ingestion Nursing Intervention/treatments for pancreatitis. - ANSWER -Patient will be NPO and have an NG TUBE, we will need to treat the pain and give the patient H2 reduce stomach acid (cimetidine)/PPI- reduces the amount of stomach acid made by glands in the lining (Nexium-esomeprazole) Dietary recommendations for pancreatitis - ANSWER -Avoid high fat foods, small meals, avoid alcohol, measure abdominal girth Risk factors for pancreatic cancer - ANSWER -Older males, obesity, alcohol, smoking, diabetes, environmental exposure