Renal
What is the medical terminology for increased/frequent urination
polyuria
What is the medical term for rapid breathing?
tachypnea
If a patient is experiencing SOB, what is the nurses priority action?
Sit the patient's HOB up
You walk into your patients room and you hear a harsh high pitched sound when your patient tries to breath. You do not even need your stethoscope to hear it. What is this?
Stridor. Medical emergency!
Demonstrate how to apply a nasal cannula onto an adult mannequin.
Demonstrates with adult size tubing, not pediatric. Prongs facing down. Secure tubing around the ears and secure snug under the chin
How many mL/hr is an adult expected to output
30mL/hr
What is orthopnea?
SOB upon lying supine
Because 02 is a medication that requires a prescription, even if my patient urgently needs 02, requires a different 02 delivery device, or needs to increase the amount I need to get a MD order before intervening. True or false?
Your patient is here with pulmonary edema. What lung sound do you anticipate hearing?
Crackles (rales)
Demonstrate how to set up a nebulizer treatment and provide teaching on how to utilize it
Connect the appropriate pieces of the neb set up, pour medication into chamber, secure, connect to O2, set O2 liter. Advise patient to keep mouth sealed around mouthpieces vapor is normal, breath in and out like normal.
What electrolyte imbalance do we worry about the most regarding patients with renal insufficiency
K ( hyperkalemia or hypokalemia)
True or false. Ipratropium bromide/albuterol is the name of the #1 rescue medication used in asthma?
False. This is called a DuoNeb. Albuterol inhaler ALONE is the rescue medication.
The MD is worried about fluid status of a patient. They order daily weights but the patient is bedbound. How do you get an accurate weight? Give some examples (must name at least 2)
same time, same scale/bedscale, same clothing, same linens/pillows/blankets on bed from the first weight, nothing additional on the bed, "zero out" the bed prior to their arrival on the floor.
What are some signs of fluid overload in a patient? (must get at least 3)
Crackles in the lungs, weight gain, edema, increased BP, increased SOB, etc
Your patient is on strict Is +Os. They have a foley in. Demonstrate how you would MOST accurately measure urine from their Foley catheter bag.
Get a urinal, drain the urine into the urinal, and measure. Some of the catheter bags are not exactly accurate. This method ensures a more accurate depiction for a patient on strict Is +Os.
What treatment is performed for ESRD?
hemodialysis
What is the concern with giving COPD patients "to much" O2?
decrease respiratory drive and cause hypoventilation
Your patient remains hypoxic despite intervention. They need a non rebreather. What 02 L do you put it up to for the device to work?
10-15L.
PS, make sure the reservoir bag is also inflated
Your patient gets dialysis and has a fistula in place. What do you need to do to ensure it is working appropriately?
Palpate the fistula and feel a thrill, listen for bruit
A patient comes in with AKI due to hypovolemia. The MD orders isotonic fluid bolus. Pick your fluid and prime your line.
Pick NS or LR. Spikes appropriately and primes controlled
If a renal patient wanted a OTC pain medication which would you give (Ibuprofen or Tylenol) and why?
Tylenol. Because Ibuprofen is nephrotoxic and we want to avoid further damage to the kidney
What are the two main branches/types of COPD
emphysema and bronchitis
What should you check before giving a medication like furosemide? And why?
vital signs (BP) and electrolytes (K). Check to monitor for hypotension and hypokalemia
Your patient walked into the emergency department with a known UTI that keeps getting worse. She says that her back hurts. What + assessment finding would worry you for pyelonephritis?
+CVA tenderness
Your patient just coded. Grab a parter and demonstrate 60 seconds of CPR on an adult mannequin.
Demonstrate 30:2 ratio CPR at appropriate depth and rate. Be careful not to hyper inflate the lungs with BVM. Make sure bed is flat and back board is in place