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Nursing 265 Exam 1 Test Review
1. Complex elimination:
a. Kidney
i. Acute: short term, happens quickly
1. Causes: trauma, hypovolemia, medications (nephrotoxic mycin,
overdose)
2. How you would monitor your patient, expect an elevated
creatinine and bun-your hope is that as you treat them those
levels will come down and they will produce more urine
3. With trauma you will see a period that they are oliguric and then
all of sudden start producing
4. Think about other concerns: fluid volume, and electrolytes
5. Hyperkalemia: cardiac arrythmias- put them on the monitor,
circulation issues
6. Acid base imbalances: kidneys don’t produce bicarb; putting them
in metabolic acidosis
7. Expected vs. complication
a. If they start to say they cant breath and they have crackles
in their lungs and their sats start to drop: complication but
not expected; call the dr.; monitoring for this but it is NOT
EXPECTED
ii. Chronic: acute can become chronic, long term
1. Nursing interventions: low sodium diet, low potassium, moderate
protein(no keto-protein can strain the kidneys), no salt
replacements
2. palpitations, muscle cramps, muscle weakness, monitor potassium
iii. Dialysis: monitor fluids (fluid restriction), daily weights, vitals, hold the
medications (check with PHP), Level of consciousness (if they pull too
much fluid off/too fast you would worry about disequilibrium syndrome-
confused, dizzy, decreased loc)
iv. Considerations with hemodialysis versus peritoneal
1. Graph or fistulas protect the arms (no blood pressures, no lab
draws, no heavy lifting on that arm) assess for thrills or bruit
2. Peritoneal: risk for infection; sterile procedure when accessing
ports; fluid should be warm (not in the microwave), fluid into their
abdomen make sure you know how long the dwell time is, they
empty their bowels (not constipated) which will not let them
absorb like they are supposed to, wear a mask
2. GI
a. Acute pancreatitis:
i. How pancreatitis will review labs: WBC you expect it to go up as a normal
immune response: ast, alt, liver panel, bilirubin levels, amalase and lipase
(digestive enzymes)
b. Chronic pancreatitis:
Downloaded by Travis Scott ()
Nursing 265 Exam 1 Test Review
1. Complex elimination:
a. Kidney
i. Acute: short term, happens quickly
1. Causes: trauma, hypovolemia, medications (nephrotoxic mycin,
overdose)
2. How you would monitor your patient, expect an elevated
creatinine and bun-your hope is that as you treat them those
levels will come down and they will produce more urine
3. With trauma you will see a period that they are oliguric and then
all of sudden start producing
4. Think about other concerns: fluid volume, and electrolytes
5. Hyperkalemia: cardiac arrythmias- put them on the monitor,
circulation issues
6. Acid base imbalances: kidneys don’t produce bicarb; putting them
in metabolic acidosis
7. Expected vs. complication
a. If they start to say they cant breath and they have crackles
in their lungs and their sats start to drop: complication but
not expected; call the dr.; monitoring for this but it is NOT
EXPECTED
ii. Chronic: acute can become chronic, long term
1. Nursing interventions: low sodium diet, low potassium, moderate
protein(no keto-protein can strain the kidneys), no salt
replacements
2. palpitations, muscle cramps, muscle weakness, monitor potassium
iii. Dialysis: monitor fluids (fluid restriction), daily weights, vitals, hold the
medications (check with PHP), Level of consciousness (if they pull too
much fluid off/too fast you would worry about disequilibrium syndrome-
confused, dizzy, decreased loc)
iv. Considerations with hemodialysis versus peritoneal
1. Graph or fistulas protect the arms (no blood pressures, no lab
draws, no heavy lifting on that arm) assess for thrills or bruit
2. Peritoneal: risk for infection; sterile procedure when accessing
ports; fluid should be warm (not in the microwave), fluid into their
abdomen make sure you know how long the dwell time is, they
empty their bowels (not constipated) which will not let them
absorb like they are supposed to, wear a mask
2. GI
a. Acute pancreatitis:
i. How pancreatitis will review labs: WBC you expect it to go up as a normal
immune response: ast, alt, liver panel, bilirubin levels, amalase and lipase
(digestive enzymes)
b. Chronic pancreatitis:
Downloaded by Travis Scott ()
