Urine Trouble
What would we expect with BUN and creatinine during AKI?
Double Jeopardy
What is the normal for both of these labs
What is they would both be elevated.
creatinine 0.8-1.2
BUN 8-22
This lab is used to help stage Chronic Kidney Disease and decide need for Dialysis.
What is GFR? (Glomerular Filtration Rate)
Normal 125
Stage 1: >90
Stage 2: 60-89
Stage 3: 30-59
Stage 4: 15-29
Stage 5: <15
Occurs within 24-48 hours of a traumatic head injury and peaks within 3 days.
Double Jeopardy:
Name a treatment for this.
What is cerebral edema?
Double jeopardy:
Elevate head of bed (20–30°)
Maintain oxygenation and blood pressure
Temperature control
controlled hyperventillation- lowers CO2 causes vasoconstriction-decrease edema
Ventriculostomy, shunt, decompressed craniotomy,tumor/lesion removal
Medications to treat hyperkalemia.
Regular insulin IV + Dextrose (D50)( severe)
Insulin drives potassium into cells; glucose prevents hypoglycemia
Loop diuretics, Sodium bicarbonate ( if
acidosis), albuterol
Kayexalate-
Kayexalate is a cation-exchange resin.
In the intestines, it exchanges sodium ions for potassium ions.
Potassium binds to the resin and is then excreted in the stool.
This gradually lowers serum potassium levels.
The primary purpose of a triage area in mass casualties is to ____.
What is sort patients and allocate resources efficiently?
This is the most common type of intrarenal AKI.
Double jeopardy:
What are the 2 main causes of this AKI.
What is ATN?
Double Jeopardy:
What is Ischemia and Nephrotoxins.
Finding this in the urine can be a sign of infection, trauma, obstruction, or cancer
What are RBCs or blood?
A potentially life-threatening condition that occurs in individuals with spinal cord injuries above the T6 level, characterized by an exaggerated autonomic response to stimuli. It is a massive sympathetic nervous system discharge triggered by afferent stimuli originating below the level of the spinal cord injury.
What is Autonomic Dysreflexia?
Common triggers
Bladder issues (most common, ~85% of cases): blocked catheter, distended bladder, UTI
Bowel issues: constipation, fecal impaction, enemas
Skin issues: pressure sores, ingrown toenails, tight clothing, cuts
Medication used to treat Anthrax.
What are antibiotics? (ciprofloxacin or doxycycline as first-line agents) and antitoxins (such as obiltoxaximab [Anthim] or anthrax immune globulin [Anthrasil].
What type of trauma is most prevalent with MVA's, falls, or contact sports?
What is Blunt Trauma.?
Indications for dialysis?
What is AEIOU?
Acidosis, electrolyte imbalance, ingestion, overload (volume), uremia
First diagnostic study to confirm a head injury?
What is a Cat scan?
Common sign for a basilar skull fracture.
What is racoon eyes?
What is Battle sign. Battle's sign, also known as mastoid ecchymosis, is a late indication of fracture of middle cranial fossa of the skull, appearing as bruising over one or both of the mastoid processes at least one day after the injury.
What is the medication treatment for anaphylaxis?
What is Epinephrine (Adrenaline) IM injection. Drug of choice and must be given immediately.
Adjunct Medications (AFTER Epinephrine)
Antihistamines (diphenhydramine, cetirizine, ranitidine)
Help relieve hives and itching, but do not reverse airway obstruction or shock.
Corticosteroids (methylprednisolone, prednisone)
Reduce risk of biphasic (delayed) reactions.
Beta-agonists (albuterol nebulizer)
Used if bronchospasm (wheezing) persists after epinephrine.
IV fluid used in the first 24 hours following a burn injury.
Double Jeopardy: What is the initial burn care method called?
What is Lactated Ringers (LR)?
What is Concensus? care with burns refers to standardized, evidence-based guidelines for managing burn patients, focusing on early airway protection, fluid resuscitation, wound care, infection control, pain management, and referral to specialized burn centers.
Signs and symptoms for this inflammatory disease include:
hematuria, proteinuria, electrolyte imbalances, renal insufficiency, edema, hypertension, and thrombotic events.
What is Glomerulonephritis.
Acute Poststreptococcal Glomerulonephritis is associated with Group A strep. Seeking treatment and completing antibiotic therapy is crucial to prevent kidney damage.
What labs are drawn during a trauma?
CBC (Complete Blood Count) → Hemoglobin/hematocrit for blood loss, WBC for infection/inflammation, platelets for clotting.
Basic Metabolic Panel (BMP) → Electrolytes, renal function, glucose.
Coagulation studies (PT/INR, aPTT) → Assess clotting ability, especially if patient is on anticoagulants.
Type & crossmatch
ABG + lactate
Bed mobility, transfers, feeding, grooming, bowel, bladder that are dependent are expected outcomes for what spinal cord level range.
What is C1-C4?
Medication used to alkalinize the urine
Sodium bicarbonate used in the treatment of renal calculi formed from uric acid.
1. Corrects metabolic acidosis.
2. Buffers blood PH. Neutralizes excess acid in the blood
3. Dialysis fluid component. maintains the acid-base balance during dialysis sessions
4. Has the potential to slow the progression of kidney disease. Some studies suggest that correcting metabolic acidosis with oral sodium bicarbonate may help slow the decline of kidney function in certain stages of CKD.
During a mass casualty, which injury receives care first?
a. Abdominal evisceration
b. Open fracture of the left forearm
c. Sprained ankle
d. Sucking chest wound
What is D.
Contact the provider if bleeding from the insertion site lasts longer than 30 minutes following treatment, for no thrill/bruit, or findings of infection.
What is Client education for Hemodialysis?
What labs are elevated in renal disease?
What are:
Potassium
BUN
Creatinine
Sodium
Phosphate
These are two of the five possible primary mechanisms of SCI.
What is Hyperflexion, Hyperextension, axial loading, rotation, and penetration injuries?
What medications are used to lower cerebral edema?
Mannitol IV → draws fluid out of brain tissue into circulation.
Hypertonic saline → alternative osmotic agent, especially in hypotensive patients Sedatives & seizure prophylaxis → reduce metabolic demand and prevent secondary injury.
Corticosteroids controversial Sometime use for tumor causing
An airplane crash results in mass casualties. The nurse is directing personnel to tag all victims. Which information should be placed on the tag? Select all that apply.
1. Triage priority
2. Identifting information when possible (name,age,address,)
3. Medication and treatment administered.
4.Presence of jewelry.
5. Next of kin.
Double jeopardy:
What is the tag system rating?
What is 1,2,3
Double jeopardy:
Yellow Tag: Major injury that requires prompt treatment within 2 hours. Serious injuries but not immediately life-threatening.