EXAM 1: NSG4100 / NSG 4100 (LATEST
UPDATES STUDY BUNDLE PACKAGE WITH SOLUTIONS)
NURSING PRACTICE - ADULT HEALTH III | QUESTIONS
& ANSWERS | GRADE A | 100% CORRECT - GALEN
Signs and Symptoms of Uremia .....ANSWER.....Fatigue, SOB,
unexplained weight loss, N/V, muscle cramps. change in mental
status, metallic taste in mouth, pruritus.
Pathophysiology of End Stage Renal Disease (ESRD)
.....ANSWER.....Renal function declines and end products of
protein metabolism accumulate in the blood. Uremia develops
and adversely affects every system in the body. Usually
associated with a low GFR. The more waste products in the
system the more severe the symptoms.
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Uremic Pericarditis .....ANSWER.....Inflammation and irritation of
the visceral and parietal layers of the pericardium by metabolic
toxins that accumulate due to renal failure.
Uremic Treatment .....ANSWER.....Diuretics and Hemodialysis and
if the patient is already on hemodialysis we need to intensify it.
Clinical manifestations of fluid overload in ESRD
.....ANSWER.....Pericarditis, pericardial effusions/tamponade,
pulmonary infiltrates, JVD, edema, HF, hypertension,
hyperkalemia, metabolic acidosis
BUN normal range .....ANSWER.....10-20
Creatinine normal range .....ANSWER.....0.5-1.2
Sodium normal range .....ANSWER.....135-145
Potassium Normal range .....ANSWER.....3.5-5
Magnesium normal range .....ANSWER.....1.5-2.5 (high in ESRD
pt)
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Normal urine output range .....ANSWER.....30mL/hr
Dietary restrictions for patients with ESRD .....ANSWER.....Low
protein, low potassium, no potatoes or oranges or citrus fruits, no
salt substitute, fluid restrictions
How much protein is allowed in a patient with ESRD?
.....ANSWER.....1.2-1.5 mg/kg/day
What medications are used to treat ESRD?
.....ANSWER.....Calcium acetate/carbonate, Phosphate-binding
agents (Phoslo, Renagel), Erythropoeitin, Antihypertensive and
cardiac medication, Ionotropes, Anticonvulsants
What are important topics for patient education in ESRD?
.....ANSWER.....Dietary education, S/S of hyperkalemia (muscle
cramps, urine abnormalities, respiratory distress, decrease
cardiac contractility, EGK changes, decrease reflexes, tingling in
hands and feet, paralysis), worsening S/S of kidney disease
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(anemia, difficulty breathing, nocturia, swelling and puffiness of
feet and ankles, high BP, changes in mental status, poor digestion
Possible complications after Hemodialysis
.....ANSWER.....Bleeding, Infection, and Hypotension
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