Adult Health I- Test 4

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1

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 _________________.

Pancreatitis

2

The most common causes for _____________ in the US are alcoholic liver disease and hepatitis C.

Cirrhosis

3

A nurse identifies an elevated ____________ level as the usual indication for hepatic encephalopathy.

Ammonia

4

Laennec's cirrhosis is caused by _______________.

Alcohol abuse

5

Patients with cirrhosis are susceptible to _____________ because they are lacking in factors II, VII, IX, and X.

Bleeding

6

Massive ascites may cause renal vasoconstriction, triggering the _________________ system resulting in sodium and water retention.

Renin-angiotensin

7

A patient with cirrhosis will be instructed to limit their ________ intake to 1-2g per day, and take vitamin B1 and folate supplements.

Sodium

8

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?

Paracentesis

9

Lactulose will help a patient with cirrhosis remove excess ammonia through their __________.

Stool

10

_________________ 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)

11
  • 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
  • Firefighters
  • Police officers

People at risk for hepatitis B infection

12

Patients with hepatitis should eat small frequent meal with high-__________, moderate-fat, and moderate-protein.

Carbohydrate

13

Laminvudine (Epivir-HBV), entecavir (Baraclude), telbivudine (Tyzeka), and pegylated interferon alpha-2b (Peg-intron_ are all antiviral drugs given to patients with ______________.

Hepatitis B

14
  • Positive Kehr's sign
  • Guarding of the abdomen
  • Abdominal distension
  • Mental state change
  • Hypotension
  • Tachycardia and tachypnea
  • Pallor, diaphoresis, cool clammy skin

Signs of liver trauma

15

______________ is a tumor marker for cancers of the liver.

Alpha-fetoprotein

16

Clinical manifestations of liver ________________ may include tachycardia, fever, right upper quadrant or flank pain, decreased bile pigment and volume, and increasing jaundice.

Rejection

17
  • 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

18

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?

Pruritis

19

_____________ is usually the go-to analgesic for treatment of acute biliary pain.

Meperidine (Demerol)

20

A nurse caring for a patient with a T-tube after cholecystectomy should avoid raising the drainage system above the level of the ____________.

Gallbladder

21

Patients with ______________ often have a gray-blue discoloration of the abfomen and periumbilical area.

Pancreatitis

22

Typically a patient is diagnosed with acute pancreatitis after presenting with severe abdominal pain in the mid-epigastric area of the ______________.

Left upper quadrant

23

Helping a patient obtain a ____________ position decreases the abdominal pain of pancreatitis.

Side-lying knee-tuck

24

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.

Frequent

25

The position of choice for a patient undergoing a Whipple procedure is ______________.

Semi-Fowler's

26
  • Color
  • Odor
  • Turbidity
  • 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

27

Vasopressin is also known as ______________.

ADH (antidiuretic hormone)

28
  • Seafood
  • Eggs
  • Milk
  • Chocolate

Allergies for IVP

29

Impairment in the thirst mechanism associated with aging makes an older adult patient more vulnerable to ____________.

Hypovalemia

30

Normal GFR averages __________.

125 mL/min

31

A nurse may interpret findings in a patient of anorexia, nausea, vomiting, muscle cramping, and pruritis as signs of ___________.

Uremia

32

A patient with dehydration would show lab values of the BUN _________ faster than the creatinine level.

Rising

33

____________ is the best indicator of kidney function.

Serum creatinine

34

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?

Glucophage (Metformin)

35

A patient undergoing a Captopril renal scan should be monitored for _______________.

Orthostatic hypotension

36

A patient prescribed Pyridium should be notified that ___________ urine is a known side effect.

Orange

37

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.

Kidney

38

A nurse should monitor for ___________ in a patient that has undergone a kidney biopsy.

Hemorrhage

39

Patients who have central nervous system lesions from stroke, multiple sclerosis, or parasacral spinal cord lesions may have _____________ incontinence.

Detrusor hyperreflexia

40

A patient reporting the loss of small amounts of urine during coughing, sneezing, jogging, or lifting is describing urinary __________ incontinence.

Stress

41
  • 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

42

Thiazides or loop diuretics are the best medications for preventing ___________ urinary stones.

Calcium

43

__________ is the best medication for preventing uric acid stones.

Allopurinol

44

Potassium citrate is the best medication for preventing __________ stones.

Cystine

45
  • Spinach
  • Black tea
  • Rhubarb
  • Dairy
  • Organ meats
  • Whole grains
  • Poultry
  • Fish
  • Gravies
  • Red wine
  • Sardines

Foods to avoid in prevention of urinary calculi

46
  • Chemicals used in hair dressings, rubber, paint, electric cables, and textiles
  • Tobacco
  • Schistosoma heamatobium (parasite)
  • Cyclophosphmide (Cytoxan)

Causes of bladder cancer

47

___________ asymmetry is a clinical manifestation in a patient with an obstruction in the urinary system associated specifically with hydronephrosis.

Flank

48
  • Obstruction with reflex
  • Structural deformaties
  • Neurogenic impairment of voiding

Manifestations associated with chronic pyelonephritis

49

Acute systemic lupus erythematosus and diabetic nephropathy are are systemic conditions that may indicated in the cause of acute ________________.

Glomerulonephritis

50

A nurse assessing a patient with possible acute glomerulonephritis would inspect the hands, face, and eyelids for signs of ____________.

Edema

51

Radionuclide scintillation is used to help identify ___________ formation that is common in acute pyelonephritis.

Abscess

52

A patient diagnosed with acute pyelonephritis should be notified complete the full regimen of ______________, such as Bactrim, Cipro, Macrodantin, or Macrobid.

Antibiotics

53

A patient with chronic glomerulonephritis reports irritability, forgetfulness, and trouble concentrating. A nurse will expect to see an increase in __________ on the lab report.

BUN

54

A nurse caring for a patient with acute glomerulonephritis would expect to see ________________ colored urine.

Smokey/cola

55
  • Heart failure
  • Shock
  • Sepsis

Common causes of prerenal failure

56
  • Vasculitis
  • Renal artery stenosis
  • Exposure to nephrotoxins

Common causes of intrarenal failure

57
  • Urethral cancer
  • Kidney stones
  • Atony of bladder
  • Obstruction

Common causes of postrenal failure

58

Aminoglycosides and NSAIDS are ______________ medications.

Nephrotoxic

59
  • 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

60
  • Urine output 100-400 mL/day
  • Does not respond to fluid challenge or diuretics
  • Lasts 1-3 weeks

Oliguric phase of kidney failure

61
  • Sudden onset within 2-6 weeks after oliguric phase
  • Kidneys start to recover
  • Lasts 2-6 weeks

Nonoliguric phase of kidney failure

62

A nurse must assess urine output of a every hour for the first ______ hours post kidney transplant.

48

63

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.

Rejection