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A&P
S&S (1)
S&S (2)
Nursing Care
Kidney
100
What is the difference between an ischemic and hemorrhagic stroke?
Ischemic: sudden loss of blood supply to the brain; disruption of cerebral blood flow due to obstruction of blood vessel. Hemorrhagic: bleeding into brain tissue, ventricles or subarachnoid space
100
A nurse notices her client exhibiting behavioural changes, functional decline, alterations in language ability, and that the client is seemingly unable to identify objects. What might this client be showing signs of?
Alzheimers
100
Painless, blurry vision, reduced contrast sensitivity, sensitivity to glare, reduced visual acuity, cloudiness of lens; describes what condition?
Cataracts
100
Name two important nursing actions for elderly clients living at home who have vision problems:
Make sure medications are clearly marked. Colour co-ordination, bubble packs etc to help decrease chance of med errors for patient. If severe impairment, referral to services that assist with basic care. Provide pamphlets or written material in large text. Verbalize your actions so as not to startle patient.
100
What is a major risk associated with peritoneal dialysis in comparison to hemodialysis? Why?
Infection; peritoneal dialysis is done in the home and not the hospital, therefore there is a greater chance of infection as impeccable sterile technique is crucial
200
Fun fact: the body’s blood volume circles through the kidneys ____ times an hour.
Twelve
200
Edema, jugular vein distention, hepatomegaly and nocturnal diuresis are all symptoms of which type of heart failure?
Right sided heart failure
200
Visual disturbances, dizziness/loss of coordination, trouble speaking/understanding speech, confusion/change in mental status, are all symptoms often associated with what condition?
CVA/ Ischemic stroke/ brain attack
200
What is one of the most important steps to take when your home care client is refusing care?
Find out the root cause of the refusal.
200
End stage renal disease can lead to what commonly found dermatologic manifestation?
itching
300
“Removal of all breast tissue; nipple is left alone; breast reconstruction after can result in distortion and possible numbness of the nipple” What type of mastectomy does this describe?
Subcutaneous
300
Name two manifestations of glaucoma
Loss of vision, haloing around objects, blurred vision, loss of peripheral vision, difficulty focusing, headaches etc
300
Name two post-op wound infection risk factors
age, nutritional status, diabetes, smoking, obesity, remote infections, endogenous mucosal microorganisms, altered immune response, length of preoperative stay, and severity of illness
300
Be sure to ask about clients ______ ______ when you are performing a needs assessment.
support systems
300
“Acute on Chronic” refers to an acute exacerbation of symptoms where the patient eventually returns to their chronic state again. We discussed 5 examples of acute conditions affecting the kidneys. Name 2 of them and explain how they affect the kidneys
Infection - UTI, drugs - diuretics/ACE inhibitors etc, dehydration, urinary tract obstruction or urinary retention - spinal cord compression/renal vein thrombosis/ neurogenic bladder, renal hypoperfusion secondary to dehydration from diarrhea/diuretics/surgery/cardiac failure etc.
400
Protein in the urine can indicate damage to what specific part of the kidney?
Glomeruli
400
Define the following in relation to Alzheimer's; aphasia, apraxia, agnosia, disturbance of executive functioning.
Aphasia; alterations in language ability. Apraxia; impaired ability to execute motor activities despite intact motor functioning. Agnosia; failure to recognize or identify objects despite intact sensory function. Disturbance…; ability to think abstractly, plan, initiate, sequence, monitor and stop complex behaviour
400
What is the difference between conductive hearing loss and sensorineural hearing loss?
Conductive; external ear disorder like impacted/harded cerumen, hardening of tympanic membrane or middle ear disorders. Sensorineural loss involves damage to cochlea or vestibulocholear nerve
400
Name 2 nursing care priorities of a client with Alzheimers.
Assessment of mental status, independence-promoting strategies, strength/mobility enhancement, Incontinence management, sleep management, White noise/music therapy; can decrease verbal agitation, lighting, visual cueing, validation, pet/recreation/art therapies
400
There are 3 categories that can lead to acute renal failure. Name the 3 of them and their meaning.
prerenal - hypoperfusion to kidney intrarenal - damage to kidney postrenal - obstruction to blood flow
500
What is the difference between a simple/total and radical mastectomy?
Simple/total: removal of the entire breast, no axillary lymph node dissection (unless happened to be located within the breast tissue), no muscles are removed from beneath the breast. Radical: removal of the entire breast, levels I, II, and III of the underarm lymph nodes are removed, chest wall muscles under the breast are removed.)
500
Name 2 reasons why anemia can occur in clients with end stage renal disease.
Due to decreased production of erythropoietin production, due to RBCs dying quicker than normal, nutritional deficiencies, bleeding, usually from the GI tract can cause anemia, erythroprotein stimulates bone marrow to produce more RBC. Without erythroprotein (usually made by the kidneys) anemia develops leading to fatigue, angina, and SOB.)
500
Stroke clients should lay on their stomach for 15-30 minutes several times a day for what reasons? Name 2.
Prevent knee and hip flexion, promotes hyperextension of hip joints for normal gait, drains bronchial secretions and prevents contractual deformities
500
What is the main nursing objective of a client with dementia?
Promote the clients remaining functional abilities and behavioural interventions.
500
During End Stage Renal Disease, there can be a systemic effect that causes a decrease in bone density. How does ESRD cause a decrease in bone density?
Decreased serum calcium normally would cause the thyroid to secrete parathormone, but with kidney failure, the kidneys do not recognize this and “shut it off”, causing calcium to leave the bones