Tissue Integrity
What might be abnormal with application of silver sulfadiazine (Silvadene).
Rash, blueish-green or gray skin discoloration, leukopenia, interstitial nephritis.
What is a main concern of peritoneal dialysis and how to do you prevent it?
Peritonitis and aseptic (sterile) technique.
A & B (D is only developed after developing Hep B, so the Hep B protects against Hep D also)
What is cullen's sign?
Blue discoloration (ecchymosis) around the umbilicus
Who must be notified if someone is diagnosed with Hepatitis?
Health department if they are a food worker
Singed facial hair, black sputum
What are the most important important labs for renal function?
BUN, Creatinine, Na+, K. Creatinine is one of the most reliable labs for kidney disease.
What is the purpose of lactulose and who typically receives it?
Describe dumping syndrome.
rapid gastric emptying, common after partial gastrectomy
12 months by dermatologist, at least, and self-checks monthly
If a patient has an electrical burn, what should you be prepared to perform and be concerned with?
ECG, electrical activity of the heart
What medications should be avoided in the geriatric population with renal impairment?
NSAID, toxic antibiotics, Demerol (Meperidine)*specific to geriatric, caution with Digoxin, ACE, ARBS, Iv contrast
What is fector hepaticus? What is asterixis?
(sweet, fruity, fecal breath odor). Report asterixis (flapping hands)
What is a primary risk factor of renal and bladder cancer?
Smoking
What are the most common injuries in adults and younger children?
Moist heat injuries
What are the key differences between:
1st Degree Burn (Superficial)
2nd Degree Burn (Partial Thickness)
3rd Degree Burn (Full Thickness)
1st-Painful, blanch, no blisters
2nd-Blister, can still blanch, weep. Can be superficial or deep partial thickness
3rd- Pale, dry, leathery, painless
What are the symptoms of disequilibrium syndrome and how do you prevent it?
-Headache, decreased LOC, muscle twitching, seizures
-Slow rate of dialysis
What are some symptoms of ulcerative colitis?
-Frequent, watery stools,
-Stools with mucus
-Nutritional deficiencies
-Bloody stool
What is the most common cause of chronic pancreatitis?
Alcoholism
What is the difference between peritoneal and hemodialysis?
Peritoneal-Catheter in the abdomen, typically overnight, indwell fluid and then drain
Hemodialysis-Through fistula, requires anticoagulation, shorter duration
Both have similar effects due to increased time with peritoneal dialysis
What places the elderly at an increased risk for burns?
-Mobility
-Decreased reaction time to danger
-Decreased senses
-Thinner skin
-More comorbidities for complications
Give a cause for each area of potential kidney injury:
Prerenal
Intrarenal
Postrenal
Pre-Sepsis, shock, Hypovolemia
Intra-Trauma, Hypoxic injury, contrast dye, alcohol
Post-Stone, tumor, Spinal cord disease
State the transmission route for hepatitis:
Hep A
Hep B
Hep C
Hep A-fecal-oral
Hep B- Blood
Hep C-Blood
Teaching for a patient to prevent skin cancer?
Limit sun exposure (Do you know times to avoid?)
Sunscreen (Do you know minimum spf?)
Self-skin exams
Avoid tanning beds
Proper protective clothing
-Air embolism
-Administer O2 (per facility order), contact primary care provider, rapid response team, stop dialysis, turn patient on side, head lower than feet