No Sugarcoating It
These three “polys” are classic symptoms of diabetes.
What are polyuria, polydipsia, and polyphagia?
Rationale: These symptoms result from hyperglycemia causing osmotic diuresis and increased hunger/thirst.
This condition causes excessive dilute urine and extreme thirst.
What is diabetes insipidus?
Rationale: DI results from lack of ADH or kidney response, leading to large volumes of dilute urine.
These drugs are given to prevent transplant rejection.
What are immunosuppressants?
Rationale: They suppress immune response but increase infection risk.
Foods rich in this nutrient should be reduced in a client with pre-dialysis ESRD.
What is potassium?
Rationale: Once the client begins dialysis, potassium can be removed by the process of diffusion during dialysis, but prior to dialysis initiation, the client should reduce foods high in potassium because potassium clearance is impaired in the client who has pre-dialysis end-stage kidney disease.
Both of these disorders are considered inflammatory bowel diseases.
What is Crohn's and ulcerative colitis?
Rationale: Both Crohn's and ulcerative colitis involve inflammation of the colon.
This life-threatening condition is characterized by ketones and metabolic acidosis.
What is diabetic ketoacidosis (DKA)?
Rationale: DKA occurs due to insulin deficiency causing fat breakdown and ketone production.
This condition leads to fluid overload and dilutional hyponatremia.
What is SIADH?
Rationale: Excess ADH causes water retention, diluting sodium levels.
This condition is an autoimmune disorder causing ascending paralysis.
What is Guillain-Barré syndrome?
Rationale: GBS attacks peripheral nerves causing progressive weakness.
Invasive procedures are avoided for 4 to 6 hr following dialysis because of this.
What is increased bleeding?
Rationale: There is an increased risk of bleeding related to anticoagulant use during dialysis.
With long-standing ulcerative colitis, this complication occurs due to chronic blood loss in small amounts over time.
What is anemia?
Rationale: Clients with ulcerative colitis often report bloody stools and are therefore at increased risk for developing anemia.
This must be corrected before insulin is started in DKA.
What is potassium level?
Rationale: Insulin shifts potassium into cells, risking severe hypokalemia if not corrected first.
This diagnostic test differentiates neurogenic from nephrogenic DI.
What is the vasopressin (ADH) test?
Rationale: Response to ADH determines whether the issue is pituitary (neurogenic) or renal (nephrogenic).
This is the top priority in nursing care for GBS.
What is respiratory support?
Rationale: Paralysis can affect respiratory muscles, leading to failure.
This powerful antibiotic is contraindicated in patients with chronic kidney disease due to it's potential nephrotoxic adverse effects.
What is Vancomycin?
Rationale: Vancomycin is known to be associated with nephrotoxicity.
Higher than normal fluid intake is encouraged in clients with this condition to maintain hydration.
What is inflammatory bowle disease; ulcerative colitis.
Rational: Clients with inflammatory bowel disease such as ulcerative colitis are at risk for fluid volume deficit due to frequent episodes of diarrhea.
This is the hallmark clinical manifestation of HHS.
What is significant dehydration and serum glucose levels greater than 600 mg/dL, without ketone production.
Rationale: Profound hyperglycemia (usually >600 mg/dL), severe dehydration, and little to no ketones because enough insulin is present to prevent lipolysis and ketogenesis.
In this condition, as water is lost, the blood becomes more concentrated, resulting in increased serum osmolality and hypernatremia.
What is Diabetes Insipidus?
Rationale: In diabetes insipidus, the kidneys cannot reabsorb water, leading to large amounts of dilute urine. As water is lost, the blood becomes more concentrated, resulting in increased serum osmolality and hypernatremia.
In a patient who recently received a kidney transplant, these findings—oliguria, swelling, pain at the transplant site, and blood or protein in the urine—indicate this serious complication.
What is acute transplant rejection?
Rationale: Acute rejection typically occurs within 1 week to 3 months post-transplant and results from the recipient’s immune system attacking the new organ. This leads to inflammation and impaired kidney function, which presents as oliguria, graft tenderness, edema, and abnormal urine findings (hematuria/proteinuria).
This syndrome is caused by the rapid decrease in fluid volume and BUN levels during dialysis. Manifestations include headache, nausea, vomiting, restlessness, seizures, and coma.
What is dialysis disequilibrium?
Rationale: Dialysis disequilibrium syndrome can develop during or after hemodialysis. The change in urea levels can cause cerebral edema and increased intracranial pressure, resulting in HA, N/V, restlessness, seizures, and coma.
This medication can be given to reduce inflammation, but it must be taken with food to avoid GI distress.
What is Prednisone?
Rationale: Prednisone must be taken with food to prevent ulcerations and other GI discomfort.
A plasma osmolarity of greater than 320 mOsm/L and rising glucose level is an indicator of this condition.
What is HHS?
Rationale: A plasma osmolarity of greater than 320 mOsm/L with elevated glucose is an indicator of HHS.
This nursing intervention is key in management of SIADH to prevent dilutional hyponatremia.
What is fluid restriction?
Rationale: Nursing actions focus on managing the severe hyponatremia associated with SIADH by restricting fluid intake to prevent dilutional hyponatremia.
This type of transplant is human to human donation.
What is an allograft?
Rationale: Allografts are human to human donations.
This stage of CKD involves a severely decreased GFR as well as hypertension, anemia, malnutrition, altered bone metabolism, edema, metabolic acidosis, hypercalcemia, possible uremia, and azotemia.
What is stgae 4 CKD?
Rationale: Stage 4 CKD involves a severely decreased GFR as well as hypertension, anemia, malnutrition, altered bone metabolism, edema, metabolic acidosis, hypercalcemia, possible uremia, and azotemia.
This complication of inflammatory bowel disease can lead to life threatening cardiac issues.
Rationale: Fluid and electrolyte imbalances can lead to dysrhythmias.