Renal
What elevated wastes may be seen in an unhealthy kidney?
Urea, creatinine, potassium
What medication may be ordered for a pt with CKD that has high potassium?
Kayexelate, IV glucose and Insulin, Calcium Gluconate
Because it replicates in a backward manner going from RNA to DNA
In RA, vascular granulation tissue grows across the cartilage surface and causes further destruction of the bone known as?
pannus
Diagnostic test that is positive in 97% of pts with SLE.
ANA: Antinuclear antibodies
What does the GFR need to be less than and for how many months w/or w/out kidney damage to be considered renal failure?
less than 60 mL/min for 3 or more months
What medications may be ordered for a diabetic patient and CKD to treat hypertension?
ARBS or ACE Inhibitors because they are considered renal protective.
What are some diagnostic/ screening tests to diagnosis HIV?
HIV antibody, antibody combo immunoassay, Nucleic acid RNA test (NAT)
Clinical manifestations of RA
fatigue, low grade fever, anorexia, weight loss, MORNING STIFFNESS.
What is CREST of scleroderma?
Calcinosis, Raynauds phenomenon, esophageal dysfunction, sclerodactyly, telangiectasias [Localized]
At what stage of kidney disease is there no urine output and regulating BP is difficult?
Stage 5
What medications may be ordered for a CKD patient to treat renal osteodystrophy?
Phosphate binders (PhosLo, Caltrate, Renagel), Vitamin D
What is the frequency of testing (viral load) for HIV pts?
After starting tx?
Then how often?
Q2-4 Weeks after starting, then every 4-8 weeks until undetectable, then Q3-4 Months
What are 2 associated syndromes to RA?
Sjogren (tear ducts) and Felty syndrome (enlarged spleen)
Nursing management in acute care of SLE pts.
monitor weight and I & Os. Neurologic status (visual problems, headaches, seizures, personality changes, memory loss). provide emotional support, explain nature of disease.
Observe for fever, joint inflammation, limitation of motion, location and degree of discomfort, fatigue
Why is there an increased risk of fractures when a patient has chronic kidney disease?
decreased activation of vitamin D, impaired Ca absorption from gut, decreased Ca, increases parathyroid hormone = bone demineralization.
What type of medications should NOT be given to a CKD patient?
Digoxin, metfomin, glyburides, antibiotics such as vanco/gentamycin.
What PrEP medication must test a pt's HBV status prior to prescribing?
Travuda (emtricitabine/ tenofovir alafenamide)
Med for RA that is an immunosuppressive agent and is teratogenic. Must monitor for bone marrow suppression and hepatotoxicity.
methotrexate
List education that must be provided to scleroderma pts.
Wear sunscreen all the time. Continue mobility exercises, alcohol free lotions, smoking cessation
What are the renal and metabolic clinical manifestations of CKD?
Hyperkalemia (fatal dysthymias when at 7), metabolic acidosis, elevated triglycerides, phosphate increase, low calcium, hypermagnesemia, uric acid, mild to moderate hyperglycemia and hyperinsulinemia
What is a HUGE contraindication to administering EPO? (erythropoietin)
Uncontrolled hypertension
What ART medication binds to enzyme reverse transcriptase which prevents viral RNA from converting to the viral DNA?
Non-Nucleoside Reverse Transcriptors (NNRTI)
efavirenz (Sustiva)
What must the pt be tested for prior to starting biologic response modifiers? (etanercept or adalimumab)
[used to treat RA and Scleroderma]
TB test and Chest Xray
What medications are given to SLE, RA, and scleroderma pts to target pain, inflammation, and the immune system?
NSAIDS, NSAIDS and salicylates, Corticosteroids