Adult Health I- Test 4
A nurse caring for a patient with lab results showing elevated lipase, elevated white blood cell count,and an elevated glucose level would suspect they would be suffering from acute _________________.
The most common causes for _____________ in the US are alcoholic liver disease and hepatitis C.
A nurse identifies an elevated ____________ level as the usual indication for hepatic encephalopathy.
Laennec's cirrhosis is caused by _______________.
Patients with cirrhosis are susceptible to _____________ because they are lacking in factors II, VII, IX, and X.
Massive ascites may cause renal vasoconstriction, triggering the _________________ system resulting in sodium and water retention.
A patient with cirrhosis will be instructed to limit their ________ intake to 1-2g per day, and take vitamin B1 and folate supplements.
A nurse will ask a patient to void, place them in a high fowler's position, assess the patient's heart, respiratory, and blood pressure, and weigh them before and after what procedure?
Lactulose will help a patient with cirrhosis remove excess ammonia through their __________.
_________________ is used to treat patients with cirrhosis by destroying the normal flora of the bowel, therefore, diminishing the rate of ammonia production.
Neomycin sulfate (Mycifradin)
- People who have unprotected sex with multiple partners
- Men who have sex with other men
- Drug users who share needles
- People with chronic liver disease
- Police officers
People at risk for hepatitis B infection
Patients with hepatitis should eat small frequent meal with high-__________, moderate-fat, and moderate-protein.
Laminvudine (Epivir-HBV), entecavir (Baraclude), telbivudine (Tyzeka), and pegylated interferon alpha-2b (Peg-intron_ are all antiviral drugs given to patients with ______________.
- Positive Kehr's sign
- Guarding of the abdomen
- Abdominal distension
- Mental state change
- Tachycardia and tachypnea
- Pallor, diaphoresis, cool clammy skin
Signs of liver trauma
______________ is a tumor marker for cancers of the liver.
Clinical manifestations of liver ________________ may include tachycardia, fever, right upper quadrant or flank pain, decreased bile pigment and volume, and increasing jaundice.
- Serum aspartate aminotransferase (AST)
- Serum alanine aminotransferase (ALT)
- Lactate dehydrogenase (LDH)
- Serum total bilirubin
- Urine urobilinogen
- International Normalized Ratio (INR)
Labs to test for hepatic cell destruction
Which sign or symptom does a nurse expect to find when assessing a patient that has been admitted for obstructive jaundice due to the increase of bile salts accumulating in the skin?
_____________ is usually the go-to analgesic for treatment of acute biliary pain.
A nurse caring for a patient with a T-tube after cholecystectomy should avoid raising the drainage system above the level of the ____________.
Patients with ______________ often have a gray-blue discoloration of the abfomen and periumbilical area.
Typically a patient is diagnosed with acute pancreatitis after presenting with severe abdominal pain in the mid-epigastric area of the ______________.
Left upper quadrant
Helping a patient obtain a ____________ position decreases the abdominal pain of pancreatitis.
A patient with acute pancreatitis should be educated to avoid caffeine, alcohol, rich, fatty, spicy foods, and eat small __________ meals of bland, low-fat, high-protein, moderate carbohydrates.
The position of choice for a patient undergoing a Whipple procedure is ______________.
- Specific gravity (1.005-1.030)
- pH (4.6-8)
- Glucose (<2.78)
- Ketones (none)
- Protein (<0.8)
- Bilirubin (urobilinogen [none])
- RBC (0-2)
- WBC (M 0-3, F 0-5)
- Crystals (none)
- Bacteria (<1000)
- Parasites (none)
- Leukoesterase (none)
- Nitrites (none)
Components of routine urinalysis
Vasopressin is also known as ______________.
ADH (antidiuretic hormone)
Allergies for IVP
Impairment in the thirst mechanism associated with aging makes an older adult patient more vulnerable to ____________.
Normal GFR averages __________.
A nurse may interpret findings in a patient of anorexia, nausea, vomiting, muscle cramping, and pruritis as signs of ___________.
A patient with dehydration would show lab values of the BUN _________ faster than the creatinine level.
____________ is the best indicator of kidney function.
A patient scheduled for an IV urography is asked to hold what medication for at least 48 hours until kidney function has been re-evaluated?
A patient undergoing a Captopril renal scan should be monitored for _______________.
A patient prescribed Pyridium should be notified that ___________ urine is a known side effect.
A nurse should notify the health care provider of hematuria, decreasing urine output, flank pain, and decreasing blood pressure in a patient that has undergone a __________ biopsy.
A nurse should monitor for ___________ in a patient that has undergone a kidney biopsy.
Patients who have central nervous system lesions from stroke, multiple sclerosis, or parasacral spinal cord lesions may have _____________ incontinence.
A patient reporting the loss of small amounts of urine during coughing, sneezing, jogging, or lifting is describing urinary __________ incontinence.
- Finish the entire prescription of ATBs to prevent UTIs
- Balance regular exercise with sleep and rest
- Drink at least 3 L of fluids a day
- Report pain, fever, chills, or difficulty with urination to the health care provider
Self-care measures post lithotripsy
Thiazides or loop diuretics are the best medications for preventing ___________ urinary stones.
__________ is the best medication for preventing uric acid stones.
Potassium citrate is the best medication for preventing __________ stones.
- Black tea
- Organ meats
- Whole grains
- Red wine
Foods to avoid in prevention of urinary calculi
- Chemicals used in hair dressings, rubber, paint, electric cables, and textiles
- Schistosoma heamatobium (parasite)
- Cyclophosphmide (Cytoxan)
Causes of bladder cancer
___________ asymmetry is a clinical manifestation in a patient with an obstruction in the urinary system associated specifically with hydronephrosis.
- Obstruction with reflex
- Structural deformaties
- Neurogenic impairment of voiding
Manifestations associated with chronic pyelonephritis
Acute systemic lupus erythematosus and diabetic nephropathy are are systemic conditions that may indicated in the cause of acute ________________.
A nurse assessing a patient with possible acute glomerulonephritis would inspect the hands, face, and eyelids for signs of ____________.
Radionuclide scintillation is used to help identify ___________ formation that is common in acute pyelonephritis.
A patient diagnosed with acute pyelonephritis should be notified complete the full regimen of ______________, such as Bactrim, Cipro, Macrodantin, or Macrobid.
A patient with chronic glomerulonephritis reports irritability, forgetfulness, and trouble concentrating. A nurse will expect to see an increase in __________ on the lab report.
A nurse caring for a patient with acute glomerulonephritis would expect to see ________________ colored urine.
- Heart failure
Common causes of prerenal failure
- Renal artery stenosis
- Exposure to nephrotoxins
Common causes of intrarenal failure
- Urethral cancer
- Kidney stones
- Atony of bladder
Common causes of postrenal failure
Aminoglycosides and NSAIDS are ______________ medications.
- No BP taken
- No blood draw taken
- Feel for thrill, listen for bruit
- Assess distal pulses
- Elevate affected arm
- Encourage ROM
- Check for bleeding
- Check for infections
- No lifting heavy objects
- No sleeping on affected side
Interventions for AV fistulas
- Urine output 100-400 mL/day
- Does not respond to fluid challenge or diuretics
- Lasts 1-3 weeks
Oliguric phase of kidney failure
- Sudden onset within 2-6 weeks after oliguric phase
- Kidneys start to recover
- Lasts 2-6 weeks
Nonoliguric phase of kidney failure
A nurse must assess urine output of a every hour for the first ______ hours post kidney transplant.
A nurse caring for a patient post kidney transplant knows that a sudden and abrupt decrease in urine is a sign of _____________ and the health care provider should be alerted immediately.