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Advance Med Surg Exam 1 Test Note *MUST KNOW*
CKD
For CKD Pt, Don’t increase protein for body to heal, More teaching question.
Priority question, see Pt with hypotension 1 st before HTN.
With CKD Pt’s, Asterixis (hand flapping) is a early sign before
encephalopathy.
For CKD pt’s obtain protein from MEAT and Eggs, limit daily to 1-3 g/day
Important teaching to check wt daily, ‘’same everything’’
Hemodialysis
Pt is expected to have…..more efficient clearance of waste, NOT MORE
ENGERY.
Use Subclavian Route till fistula is mature.
During hemodialysis pt is on heparin, must have Protamine sulfate- Antidote
Acute Pancreatitis
Pain is described as a ‘’BORING” feeling, place Pt in fetal position, and NPO.
Review Table 54.3 pg. 1184 potential complication of Acute Pancreatitis:
septic shock from pancreatic infection, hemorrhage, acute kidney failure,
paralytic ileus, hypovolemic shock, pleural effusion, a RDS, atelectasis,
pneumonia, multi organ system failure, DIC, type 2 DM
Review Box on pg 1185: Causes of Serum Laboratory Abnormalities in Acute
Pancreatitis: Increased Amylase, Elevated lipase, Elevated trypsin, Elevated
Elastase, Elevated glucose, Decreased calcium and mag, Elevated bilirubin,
elevated ALT/AST, and C-reactive protein
Guarding and Ridge ABD/see 1st, esp. when they were not having pain and
now is.
Chronic Pancreatitis
PERT (pancreatic enzyme replacement therapy, take with meals, glass of
H2O, don’t chew, don’t mix with protein, take after antiacids, H2 blockers,
wipe mouth, do not crush.
Needs 4,000-6,000 cal/day, increased calories, small bland fx meals.
Pg. 1162 QSEN box best practice for Pt safety and quality care. Pre/post
Paracentesis intervention
o Explain the procedure and answer patients’ questions.
o obtained vital signs, including wt before the procedure.
o ask the patient to void before the procedure to prevent injury to the
bladder.
o position the patient in bed with head of bed elevated.
o monitor vital signs per protocol.
o measure the drainage and record accurately.
Downloaded by Travis Scott ()
Advance Med Surg Exam 1 Test Note *MUST KNOW*
CKD
For CKD Pt, Don’t increase protein for body to heal, More teaching question.
Priority question, see Pt with hypotension 1 st before HTN.
With CKD Pt’s, Asterixis (hand flapping) is a early sign before
encephalopathy.
For CKD pt’s obtain protein from MEAT and Eggs, limit daily to 1-3 g/day
Important teaching to check wt daily, ‘’same everything’’
Hemodialysis
Pt is expected to have…..more efficient clearance of waste, NOT MORE
ENGERY.
Use Subclavian Route till fistula is mature.
During hemodialysis pt is on heparin, must have Protamine sulfate- Antidote
Acute Pancreatitis
Pain is described as a ‘’BORING” feeling, place Pt in fetal position, and NPO.
Review Table 54.3 pg. 1184 potential complication of Acute Pancreatitis:
septic shock from pancreatic infection, hemorrhage, acute kidney failure,
paralytic ileus, hypovolemic shock, pleural effusion, a RDS, atelectasis,
pneumonia, multi organ system failure, DIC, type 2 DM
Review Box on pg 1185: Causes of Serum Laboratory Abnormalities in Acute
Pancreatitis: Increased Amylase, Elevated lipase, Elevated trypsin, Elevated
Elastase, Elevated glucose, Decreased calcium and mag, Elevated bilirubin,
elevated ALT/AST, and C-reactive protein
Guarding and Ridge ABD/see 1st, esp. when they were not having pain and
now is.
Chronic Pancreatitis
PERT (pancreatic enzyme replacement therapy, take with meals, glass of
H2O, don’t chew, don’t mix with protein, take after antiacids, H2 blockers,
wipe mouth, do not crush.
Needs 4,000-6,000 cal/day, increased calories, small bland fx meals.
Pg. 1162 QSEN box best practice for Pt safety and quality care. Pre/post
Paracentesis intervention
o Explain the procedure and answer patients’ questions.
o obtained vital signs, including wt before the procedure.
o ask the patient to void before the procedure to prevent injury to the
bladder.
o position the patient in bed with head of bed elevated.
o monitor vital signs per protocol.
o measure the drainage and record accurately.
Downloaded by Travis Scott ()
