Renal
What can cause Pre-Renal ARF?
Something causes a problem before it reaches the kidneys. Systemic problems like shock, hypotension, MI, HTN, DM.
What drugs should be avoided in renal patients?
Maalox, milk of mag
What is a normal post-void residual?
100 mL
Priority Nursing Intervention for GBS?
Maintain Airway
Monitor respiratory rate, depth, capacity, breath sounds, airway, ABGs
Suction PRN
Trach at bedside
Aspiration precaution diet (thickened fluids, pureed fooods or tube feed as ordered)
What are the risk factors for ADHD?
Genetic factors
Medical issues
Environmental risks
Temperament
Protective factors
What can cause Intra-Renal ARF?
Something in the kidneys themselves is causing a problem – NSAIDs, Vanco, Gentamycin, contrast dyes, glomerulonephritis.
When assessing an AV fistula or graft, what is the nurse looking for?
Bruit and Thrill. Bruit is a turbulent rushing sound that you can hear and a thrill is the feel of that turbulence upon palpation. These findings indicate good blood flow and are what you *should* hear otherwise, the fistula/graft is compromised
Anticipated urinalysis findings with a UTI?
Positive leukocyte esterase.
Positive nitrite.
Presence of WBCs and/or RBCs.
Presence of ≥ 100,000 colonies/mL of bacteria
The client reports having recently had an ear infection and is now experiencing one-sided facial droop, what could the client be experiencing?
Bell's Palsy
What side-effects should the nurse educate the client about for Adderal?
•decreased appetite
•insomnia
Abdominal pain
Emotional lability
Insomnia
Exacerbate motor and vocal tics
Precipitate psychosis
What causes Post-Renal ARF?
Something happening past the kidneys in the lower structures such as kidney stones, bladder tumor.
These lab values are increased in renal failure:
Systemic Fluid Volume
BUN
Creatinine
Magnesium
Potassium
Phosphorus
List the types of stones and what causes them:
Calcium oxalate stone - Avoid oxalate sources like Spinach, black tea, and rhubarb
Calcium phosphate stone - Limit foods high in animal protein to decrease the acidity of urine to prevent calcium precipitation
Struvite stones - Limit high-phosphate foods: Dairy products, red and organ meats, and whole grains
Uric acid stones - Limit intake of purines: Organ meats, poultry, fish, red wines, and sardines.
Cystine stones -Limit animal protein intake
Nursing intervention r/t Bell's Palsy?
Protect the eye of the affected side from corneal abrasions, encourage use of an eyepatch and artificially tears.
Small frequent meals eat on unaffected side.
Encourage ventilating feelings about self-image.
How does impulsivity cause impairments to different aspects of the client's life?
Home environment - is destructive
School - disrupts class
Social - isn't invited to other children's social events
Self - in trouble often
What nursing interventions would you anticipate for a client in renal failure?
Monitoring F&E balance
Reduced metabolic rate
Promote pulmonary function
Prevent infection
Provide skin care
Provide psychosocial support
How many liters of dialysate is infused during peritoneal dialysis - over how long?
1-2 liters over 10 to 20 minutes
The client is concerned that the medication they're taking for their UTI makes their urine red-orange, what would the nurse tell the client about this medication?
That red-orange urine is a normal side effect of Phenazopyridine (Pyridium).
Which facial nerve is involved in Tic Doloureux (Trigeminal Neuralgia).
5th Cranial Nerve
Co-morbid symptoms that can accompany ADHD?
Oppositional Behavior Disorder
Depression
Anxiety
PTSD
Child neglect and abuse
Learning disorder
Conduct disorder
Bipolar disorder
Substance use/abuse
Family systems issues
What diet would you anticipate for a renal patient?
Low sodium, low protein, low potassium, low phosphorus & vitamin supplementation of iron, Vit. D & Calcium
But on HD protein needs increase d/t protein loss during HD.
Peritonitis - maintain sterile technique when hooking client up
Pain – mgmt PRN d/t inflow of dialystate
Blood tinged outflow – normal finding in new client for first 2 weeks but should be clear to yellow tinged thereafter
Poor dialysate flow – reposition the client.
For a client with recurrent UTIs, what antibiotic would the nurse anticipate?
Trimethoprim/sulfamethoxazole (Bactrim) may be used in low doses once daily for UTI prophylaxis.
Nursing interventions for Trigeminal Neuralgia?
avoid trigger factors such as:
too hot or too cold food or fluid
drafts
jarring activity
What drug class is Straterra (atomoxetine) in?
SNRI