Diabetes
TRUE or FALSE. Adults >50 y/o are at greater risk for developing T1DM.
FALSE.
The patient with newly dx'd T2DM asks about drinking etoh. How should the RN counsel the patient?
The patient should avoid alcohol because of the risk of hypoglycemia!
(however, if they are too drink etoh, drink it with the meal or shortly after the meal, test blood sugar frequently, adjust nighttime insulin dose, eat CHOs before bedtime to prevent hypoglycemia)
AGN happens most commonly after what occurrence? What are the 2 hallmark s/s?
Post-infection (usually strep!). Proteinuria, hematuria
What is the difference in s/s between pyelonephritis and simple UTI/cystitis?
pyelo has systemic s/s like fever, chills, malais, N/V, flank/lower back pain AKA CVA tenderness b/c this infection is in now in the kidney!
TRUE or FALSE. Hispanic, African Americans, Native American, Asian American, and Pacific Islanders are at higher risk of developing T2DM.
TRUE
TRUE or FALSE. Acute illness and recovery from surgery can cause hyperglycemia, which can mean higher doses of insulin and/or short-term sliding scale insulin for T2DMs.
TRUE
Why is the RN concerned with severe, unrelenting headache in someone with PCKD?
the cysts are pressing on the kidney, releasing renin which increases aldosterone release and therefore Na, H20. This can lead to an increase in BP which can cause berry aneurysms to burst in the brain and cause a hemorrhagic CVA
What are the LUTS associated with BPH?
straining, grunting, inability to fully void, urgency, breaks in the stream, dribbling, nocturia
Hold the order and call the PCP for clarification. NPH can only be mixed with regular insulin or rapid acting insulins like aspart, lispro, or glulisine.
IM glucagon
Which two BP medications that may be used in PCKD or nephrosclerosis can cause hyperkalemia?
TRUE or FALSE. FVO can cause the formation of kidney stones.
FALSE
The RN gave the patient insulin lispro mixed with NPH at 0800 before breakfast. When should the RN check the patient for s/s of hypoglycemia?
During the peak of the NPH (4-12 hours after 0800).
How does the RN counsel the patient for maintaining BG during exercise?
Check BGs more frequently, especially if insulin was taken before exercise or if exercise was not planned. Be sure to have a CHO snack handy and to check BG if s/s of hypoglycemia happens. Insulin doses may need to be adjusted post-exercise because of the hypoglycemic effect of exercise.
PCKD and nephrosclerosis
Describe catheter care for someone going home with a new catheter.
Wash daily with soap & water, avoid vigorous exercise & contact sports, do not soak in tubs or go into hot tubs or pools with the catheter in place, increasing fluids & fiber is crucial for maintaining urine output and preventing constipation
What is the difference between the dawn and somogyi phenomenon?
The dawn does NOT have a hypoglycemic event between 0200-0400 while the somogyi DOES have a hypoglycemic event in the morning hours.
How should the patient treat their hypoglycemia at home?
fruit juice, hard candies, regular soda, honey, maple syrup, graham crackers, PO glucose tabs, etc.
A patient post-TURP for BPH has CBI running. What warning s/s is the RN monitoring for frequently?
Sudden cessation in output flow, change in output color to bright red or burgundy, s/s of TURP syndrome (bradycardia, confusion, SOB, headache, HTN)
What lifestyle modifications should the RN teach the patient with urge incontinence about?
Avoid bladder irritants, limit fluids after dinner, pelvic muscle strengthening exercises will help with the pelvic floor and incontinence, & maintain a normal fluid intake daily in order to maintain renal health