Cellular Regulation
Lab finding for Disseminated Intravascular Coagulation(DIC)
Decreased Platelets
Increased PT/aPTT
Decreased Fibrinogen
Increased D-dimer
S & S of Disseminated, Intravascular Coagulation (DIC) How to confirm suspensions
Draw labs-platelet count, PT/aPTT, fibrinogen, D-dimer
bleeding form IV site, mucosal bleeding, hypotension, and new confusion
What is the normal urine output for a patient?
30ml/hr
What lab finding will you see with Acute Pancreatitis
Elevated amylase & Elevated lipase
What Labs are important before Chemotherapy and why
Complete Blood Count (CBC)
it assess bone marrow, function, specifically neutrophil and platelet levels. This helps adjust the treatments to ensure patient safety
S & S of Immune Thrombocytopenic Purpura (ITP0
Low platelet count,
normal hemoglobin, WBC Pt/aPTT,
No Hemolysis
bruising, petechiae, nosebleeds
Hemophilia A patient with joint swelling from hitting his knee what intervention should the nurse do
Administer prescribed factor VIII replacement
to help with deficiency in clotting fator VIII this stops the bleed and prevent long term joint damage
Pre-renal acute kidney injury presents with dehydration & hypotension what intervention are important
Administer IV isotonic fluids as prescribed which addresses the dehydration and restores BP and kidney perfusion. This is life saving and critical
How to prevent infection risks during Chemo
Avoiding raw fruits & Vegetables
Avoiding sick people
Maintaining personal hygiene & frequent handwashing
Adhere strictly to instruction from healthcare team including diet and medications
Diabetes Insipidus Treatment & Nursing Management
Desmopressin (DDAVP)-synthetic form of antidiuretic hormone (ADH)
Daily WT-common sign of fluid imbalance
Thiazide diuretics- reduce urine output
Low urine specific gravity-Inability of kidneys to concentrate urine
Hypotonic IV fluids- correct dehydration avoiding hypernatremia
What is Tumor lysis syndrome and when is it likely to occur
It is a potentially life-threatening metabolic complication that occurs after cytotoxic cancer therapy.
it rapidly breakdown tumor cells and releases large amount of intracellular components (potassium, phosphate, & nucleic acids) into bloodstream overwhelms body homeostatic mechanisms and lead to hyperkalemia, hyperphosphatemia, hyperuricemias, acute kidney injury
SAIDH interventions and lab values
urine specific gravity increased
serum sodium decreased
Limit fluids, give diuretic, bet flat or slightly elevated, neuro checks, seizure precautions, daily WT, strict I/O
Waht are the causes of
Pre-renal
Intra renal
Post renal
Pre renal- caused by reduced blood flow to kidneys such as dehydration or low blood pressure
Intra renal caused by direct damage to kidney tissue itself such as kidney infection or damage from medicine
Post renal caused by obstruction of urine flow from kidneys such as blocked urine flow from a kidney stone
What do you monitor for with a patient who crashed his motorcycle and has left flank pain and gross hematuria
Vital signs and report hypotension- potential trauma to kidney or abdominal organs can lead to blood loss so monitor for signs of shock like hypotension, increased HR, decreased urine output
A priority sign of Acute post strep glomerulonephritis (APSGN
High BP-APSGN caused fluid & sodium retention leading to hypertension and can result in hypertension encephalopathy or cardiac complication
SIADH vs Diabetes Insipidus
SIADH-Increased ADH leading to water retention & low sodium-fluid retention & hyponatremia. Treatment is fluid restriction-fluid rete
Diabetes Insipidus-Decreased ADH leading to excessive urination (polydipsia) extreme thirst (polydipsia) hydration & hypernatremia. Treatment maintaining adequate fluid intake administering prescribed meds
What are findings of renal trauma?
Hematuria, Flank pain, Low BP, Ecchymosis over flank or abdomen
Elevated serum creatinine, low hematocrit. abnormal findings on CT
monitor for hypovolemic shock
What is the relationship to glomerulonephritis of
Cause
Common symptom
Urine appearance
Nursing intervention
Cause- Follows recent Strep throat infection
Common symptom- Swelling in face, hanks or feet
Urine appearance- Tea colored or cola colored urine
Nursing intervention-Monitor BP & restrict sodium
Hydro nephrosis is swelling of a kidney due to buildup of urine caused by a blockage
what intervention does the nurse do
Monitor I/O-assess kidney function and urine drainage
Pain medication-this is very painful
Urinary catheterization or sent placement to relieve obstruction
assessing flank pain and tenderness which is a primary symptom of hydro nephrosis & kidney stones
S & S of hydronephrosis & cause
Obstruction of urine flow leading to dilation of the renal pelvis and calyces
flank pain, abdominal mass, nausea, vomiting & urinary tract infection symptoms
A Hypothyroidism Patient stopped her levothyroxine and is lethargic and confused and now minimally responsive (Myxedema Coma) what intervention should the nurse do? Symptoms of hypothermia, bradycardia, hypotension, Altered mental status
Thyroid hormone replacement IV levothyroxine
Warming blankets to address hypothermia
What Assessment will the nurse find in acute pyelonephritis
Aching flank pain-hallmark symptom of kidney tissue being inflamed and swollen,
fever & chills-common systemic responses to infection.
symptoms of frequent painful urination (Dysuria) & cloudy or bloody urine
Interventions of Acute pyelonephritis
Administer prescribed IV antibiotics-Treats infection & prevents complications
Increase fluid intake-hydration flushes bacteria from urinary tract & prevent dehydration especially with fever
Monitor I/O assesses renal function ,hydration status effectiveness of fluid therapy
priority intervention for bowel obstruction
insert NG tube- to decompress the bowel by removing gas and fluid from the stomach & intestines
Appropriate nursing for enteral tube feeding
Flush the tube after checking residual volumes- to maintain patency & accurate measurement of next residual volume
keep the feeding solution at room temperature-Cold causes gastric cramping
replace open system formula bag and tubing every-prevent bacterial contamination & infection 25 hrs
elevate the HOB 30-45" during feeding-prevent aspiration