Sickle Cell and renal Calculi
What is your nursing priority when handling a patient with sickle cell crisis with 02 stats of 94%, pain level of 10 out of 10 and poor skin turgor?
A.Pain management
B. Cold therapy
C. Oxygen therapy
D. Hydration with IVF
What is A?
Why A? Pain in sickle cell crisis results from tissue injury caused by poor perfusion and tissue gas exchange from RBC clumping that obstructs blood flow. The pain signals active vascular occlusion and ischemia happening throughout the body.
What is the priority nursing intervention for a patient with HHS is?
What is IVF?
What is the biggest risk factor for a patient with a TPN?
What is infection, hyperglycemic and rebound hypoglycemic?
Infection happens due to non-strict aseptic techniques.
Hyperglycemic happens due to the infusion
Hypoglycemic happens when TPN stops abruptly
What are the most common causes of peptic ulcer disease?
What is H.pylori infection and NSAID?
A patient's arterial blood gas results show: pH 7.48, PaCO₂ 42 mm Hg, HCO₃⁻ 30 mEq/L. Which acid-base imbalance does the nurse identify?
A) Respiratory alkalosis
B) Metabolic acidosis
C) Metabolic alkalosis
D) Respiratory acidosis
What is C?
Why C is correct: The hallmark of a base excess alkalosis is an ABG result with an elevated pH (7.48 > 7.45) and an elevated bicarbonate level (30 > 26 mEq/L), along with normal oxygen and carbon dioxide levels.
What is a indication that a patient has renal calculi?
What is flank pain radiating to the groin?
What insulin is IV infusion?
What is regular insulin?
What is an emergency crisis for a patient with untreated hypothyroidism?
What is Myxedema coma?
The nurse is reviewing medications with a patient who has GERD. Which medication should be discussed with the primary health care provider as potentially worsening reflux?
A) Acetaminophen
B) Calcium channel blocker
C) Antibiotic
D) Anticoagulant
What is B?
Why B is correct: Calcium channel blockers lower LES pressure and cause reflux. Elimination of drugs causing reflux should be explored with the provider.
A nurse is collecting data from a patient at risk for metabolic acidosis. Which patient condition places them at highest risk?
A) Hyperventilation from anxiety
B) Prolonged diarrhea for 3 days
C) Frequent antacid use
D) Shallow breathing from pain
What is B?
Why B is correct: Prolonged diarrhea causes loss of bicarbonate from the GI tract, leading to metabolic acidosis. Rehydration and antidiarrheal drugs are given if acidosis results from prolonged diarrhea.
What does Hydroxyurea do for patients with sickle cell?
What is increase fetal Hgb and decrease sickle cell crisis?
What are the 3 P's symptoms for a patient with diabetes?
What is polyuria, polydipsia and polyphagia?
What are the signs for hypothyroidism?
What is cold intolerance, weight gain, fatigue, constipation, Bradycardia, dry skin and low T3/T4 levels?
Think low, slow and cold
What should you avoid in Peptic ulcer disease?
What is NSAIDS, smoking, alcohol and spicy foods?
Question 6: Compensatory Mechanisms
A patient with chronic COPD has ABG results: pH 7.35, PaCO₂ 55 mm Hg, HCO₃⁻ 30 mEq/L. How should the nurse interpret these findings?
A) Uncompensated respiratory acidosis
B) Compensated respiratory acidosis
C) Uncompensated metabolic alkalosis
D) Combined respiratory and metabolic acidosis
What is B?
Why B is correct: The pH is within normal range (7.35-7.45), indicating compensation. Elevated PaCO₂ indicates respiratory acidosis, while elevated HCO₃⁻ shows metabolic alkalosis occurring as compensation through kidney retention of bicarbonate. This is seen on ABGs as an elevation of HCO₃⁻, although pH remains lower than normal (near 7.35).
What electrolyte do you want to restrict for a patient that has renal calculi?
A. Potassium
B. Sodium
C. Magnesium
D. Calcium
What is D?
Why D? Calcium is the most common cause of renal calculi?
What medication would you give a patient with diabetes type 2 but not a patient with diabetes type 1?
What is hypoglycemic(metformin)?
What is the difference between malnutrition and malabsorption?
What is malnutrition is not enough intake and malabsorption is body can't absorb what is eating?
A patient with peptic ulcer disease asks about dietary recommendations. Which response by the nurse is most appropriate?
A) "You must eat six small meals daily to promote healing."
B) "Avoid any foods that cause you discomfort."
C) "Bedtime snacks will help neutralize stomach acid overnight."
D) "A strict bland diet is required for ulcer healing."
What is B?
Why B is correct: Patients should exclude any foods that cause discomfort. Individual tolerance varies.
What is the a cause metabolic alkalosis?
What is vomiting and NG tube suctioning?
What education teaching would you give for a patient with sickle cell? (Name 4)
What is 3-4L of fluids a day, deep breathing exercises, warm gear on cold days, no alcohol, no smoking, avoid extreme excises, avoid hot and cold temps, avoid airplanes, avoid high altitudes, attend regular primary check ups, vaccines and report illness and infection?
What are signs and symptoms of a patient who has DKA?
What is Kussmaul respiration, fruity breath, hyperglycemia, ketones and dehydration?
What is celiac disease?
What is an autoimmune reaction to gluten?
pt should avoid bread, pasta, malt and beer
What are teaching/lifestyle modifications you want to tell a patient with GERD?
What is avoid caffeine, chocolate, peppermint, fried(fatty) foods, alcohol and tomatoes, eat small meals, no eating 2-3 hours before bed, elevate head of bed and avoid triggers?
What is the common cause for respiratory acidosis?
What is respiratory depression, opioid use, sedatives and COPD?