NR 325 Exam 1 Concept Review
1. How do you mix insulins (Regular & NPH)?
draw up the clear before cloudy, roll NPH, inject air into clear then cloudy
2. What is the duration of Regular Insulin subq, NPH Insulin subq, and Insulin Glargine?
Regular short acting insulin subq – (3-6 hours) given 30-60 minutes before meals, only U-
100 given through the IV. U-500 is NEVER GIVEN IV.
NPH intermediate acting insulin subq – (16-24 hours)
Glargine log acting insulin subq – ( 18-24 hours)
3. Name Causes of Hyperglycemia?
(Hot and dry! Sugar is high), illness/ Steroid medication/ oral antidiabetic medications/
diabetes/ Stress - Flushed dry skin/ stress, lack of insulin/ carb intake/ obesity.
4. Name examples of phases of kidney injury? What would you expect in terms of urine
output?
Onset – begins with the injury. (Ex. Patient has an obstruction from a kidney stone)
Oliguria – right when the kidney is insulted. Decreased or scant urine output 100-400
per 24 hours
Diuresis – kidney starting to recover and make urine.
Recovery – may take up to 12 months for kidney function to fully recover.
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5. What causes Pyelonephritis? Name complications of Pyelonephritis?
upper UTI, caused by E. Coli when left untreated leading Pyelonephritis. Biggest
complication is urosepsis which can result in septic shock and death.
6. What causes Glomerulonephritis? Name a complication of Glomerulonephritis? What
labs would you expect to be off during acute glomerulonephritis? What kind of diet
would this patient need?
Most common cause: recent streptococcal, strep throat.
Complications – can lead to sepsis, end-stage kidney disease
Labs – positive for strep throat culture, BUN and creatinine increase
Diet – low sodium and fluid restriction.
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7. What is the hyperkalemia protocol and how does this effect Renal patients?
Hyperkalemia cocktail – regular short acting insulin IV to shift Ka back into the
cells, sodium bicarb and calcium gluconate to prevent any heart problems, D50
IV (thick sugar) to prevent hypoglycemia
renal patients can’t get rid of the electrolytes. Watch electrolyte shift for renal
patients, high ka levels may require hyperkalemia protocol
Give regular insulin IV D50 (thick sugar) IV Sodium bicarbonate and sometimes
calcium gluconate.
8. What is the indication for the use of CRRT?
Continuous low blood pressure.
9. Name the types of incontinence and what you would expect?
Stress incontinence – loss of urine with physical exertion
Urge incontinence – strong desire to urinate
Overflow incontinence – pressure of urine in an overfull bladder overcomes sphincter control
Reflex incontinence – associated with neurologic dysfunction and occurs when no warning or
stress precedes periodic involuntary urination
10. Name some normal lab values in relation to Kidney. What is too high?
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