Renal
Urine output in oliguric vs. non-oliguric phase vs. diuretic phases
<400ml/day vs. 1-2L/day day vs. 4-5L/day
A patient had a colonoscopy that showed a cobble-stone appearance of the GI lining. This is found in...
Crohn's Disease
Steps in treating DKA
1) FLUIDS
2) BG control (insulin at 0.1unit/kg/hr)
3) correct acidosis with bicarb
Diet related to fiber with diverticulosis vs. diverticulitis
diverticulosis=high fiber (whole grains, wheat, cereals)
diverticulitis=NO fiber
Which of the following insulins has no peak but a duration of 24 hours?
A. NPH
B. Novolog
C. Lantus
D. Humulin N
C. Lantus
A 36 year old male patient is diagnosed with acute kidney injury. The patient is voiding 4 L/day of urine. What complication can arise based on the stage of AKI this patient is in? Select all that apply:
A. Water intoxication
B. Hypotension
C. Low urine specific gravity
D. Hypokalemia
E. Normal GFR
B, C, D
Used to promote bowel rest for patients with UC or Crohn's. Hung for 24 hours then changed out. What do you do if the replacement is not there when you need to change it.
Give Dextrose10 and run at the same rate the TPN was being given
4. A patient has a blood glucose of 45 and is sweating, cold, and clammy. The patient is conscious. What is your next nursing intervention?
A. Recheck the blood glucose in 5 minutes.
B. Give the patient 15 grams of a complex carbohydrate.
C. No intervention is needed because this is a normal blood glucose.
D. Give the patient 15 grams of a simple carbohydrate.
D- give 15g of a simple carb (glucose)
(glucagon is used when patient is unconscious)
Hand flap that occurs due to the buildup of toxins in Cirrhosis
Asterixis
Signs of Hypoparathyroidism
Chvostek (facial twitch) and Trousseau's sign (twitch of hard with BP cuff inflated)
Select all the patients below that are at risk for acute intra-renal injury:
A. A 45 year old male with a renal calculus.
B. A 65 year old male with benign prostatic hyperplasia.
C. A 25 year old female receiving chemotherapy.
D. A 36 year old female with renal artery stenosis.
E. A 6 year old male with acute glomerulonephritis.
F. An 87 year old male who is taking an aminoglycoside medication for an infection.
C, E, F
-all have risk for damage to nephrons of kidney
(A and B=postrenal risk; D= prerenal risk)
Affects the inner layer of the intestinal lining
Ulcerative Colitis
Which of the following is NOT a S/S of hypoparathyroidism:
A. Tingling of lips
B. Low serum Calcium levels
C. Low phosphorus
D. Muscle twitching
C. - they will actually have high phosphorus
Treating HTN, ascites (complications due to liver failure)
Give albumin THEN furosemide
A patient arrives to the ER and is unable to give you a health history due to altered mental status. The family reports the patient has gained over 10 lbs in 1 week and says it is mainly “water” weight. In addition, they report the patient hasn’t been able to urinate or eat within the past week as well and was recently diagnosed with small cell lung cancer. On assessment, you note the patient’s HR is 115 and BP 180/92. Patient sodium level is 90. Which of the following conditions do you suspect the patient is most likely presenting with?
A. Addison's Disease
B. SIADH
C. DI
D. Fluid Volume Deficient
B.
Treatment of one of the big complications of AKI
complication=hyperkalemia
treatment=D5 + insulin
D5 to prevent hypoglycemia and insulin helps put K+ back into the cell
A patient reports frequent heartburn twice a week for the past 4 months. What other symptoms reported by the patient may indicate the patient has GERD? SELECT-ALL-THAT-APPLY:
A. Bitter taste in mouth
B. Dry cough
C. Melena
D. Difficulty swallowing
E. Smooth, red tongue
F. Murphy’s Sign
A, B, D
True or False: The Somogyi effect causes the patient to experience an increase in the BG during the hours of 2-3am
False- Somogyi effect is HYPOglycemia around 2-3am and then rebound hyperglycemia when waking up
Dawn phenomenon= morning hyperglycemia without nightime hypoglycemia
1.5-3 hours after meals
Pain relieved with food b/c bicarb released
Melena
A patient has an extremely high T3 and T4 level. Which of the following signs and symptoms DO NOT present with this condition?
A. Weight loss
B. Intolerance to heat
C. Smooth skin
D. Hair loss
D. hair loss
Treatment of a complication of renal lithiasis
complication= hydronephrosis
treatment=nephrostomy tubes
complication=obstruction due to scarring
S/S=early satiety, epigastric fullness, gastric reflux, abdominal pain, vomiting of undigested foods
You are performing discharge teaching with a patient who is going home on Synthroid. Which statement by the patient causes you to re-educate the patient about this medication?
A. “I will take this medication at bedtime with a snack.”
B. “I will never stop taking the medication abruptly.”
C. “If I have palpitations, chest pain, intolerance to heat, or feel restless, I will notify the doctor.”
D. “I will not take this medication at the same time I take my Carafate.”
A. Synthroid should be taken in the morning 30-60 minutes before breakfast
Risk for infection and risk of hyperglycemia
Which of the following is not a typical sign and symptom of Cushing’s Syndrome?
A. Hyperpigmentation of the skin
B. Hirsutism
C. Purplish striae
D. Moon Face
A.