ADHII 1st

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Author:
Anonymous
ID:
64931
Filename:
ADHII 1st
Updated:
2011-02-08 07:17:36
Tags:
Adult Health
Folders:

Description:
renal, reproductive, neuro, ostomy, pain & palliative, veni/IVaccess
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  1. Noncuffed is for ____ term use. How many mos?
    Cuffed is for ____ term use. How many mos?
    • 1. short. < 1mos
    • 2. long. more than 1 mos
  2. True or False

    We should start patient on hemodialysis if pt. has a low GFR
    False. Hemodialysis is based on pt.'s symptoms, not GFR
  3. Why is femoral not a common site for hemodialysis?
    Because of hematoma, mobility restrictions, and infxn
  4. The most common complication of post-dialysis is hypotension. Intervention?
    Hold vasoactive drugs before HD
  5. What are the most common access complications in HD?
    Thrombosis (clotting)- thrombolytic drug, stricture - tx baloon angiolasty
  6. What r the differences between AV fistula & AV graft? (HD)

    What are AV fistula/graft precautions?
    AV fistula is formed by connecting artery to vein. The increased pressure of the arterial blood flow into the vein causes the vessel walls to thicken (increases strength)

    AV graft - synthetic material used to connect artery & vein

    Precautions - assess for access circulation - thrill/bruit & assess distal pulse.
  7. What is the anticoagulation used in Hemodialysis?

    Heparin remains active in the body for 4-6 weeks. What is the pt. at risk for during or immediately after HD?
    Heparin - prevents blood clots from forming within the dialyzer or blood tubing

    Hemorrhage
  8. Peritoneal Dialysis is convenient because it's mobile and you can move a lot more. But what is its disadvantage?

    How much exchanges & how often should you give exchanges to patient?

    Can insulin, abx be placed in diasylate?
    Everytime you connect or disconnect it is an increase chance to peritonitis: cloudy urine, board-like pain, fever, malaise N/V

    Depends on the patient's manifestations & lab data.

    Yes
  9. Who is ideal for peritoneal dialysis?
    If hemodynamically unstable, cannot tolerate anticoagulation, vascular access problems, or PD until AV fistula matures, also older adults
  10. What are the exclusion criteria for renal transplant?

    What test is usually ordered after renal transplant? Why?
    Advanced cardiac dz, cancer in the last 2-5 yrs, all metastatic cancer, chronic infxn, alcohol or other substance abuse

    Renal scan. To assess renal function
  11. When is nephrectomy usually done for?

    What should we do first prior to nephrectomy?
    When pt. has renal cell carcinoma, renal trauma

    Arterial embolization because renal cell tmours are highly vascular
  12. What is the tx for kidney dz d.o that shows signs of htn, edema & fluid overload? (i.e: Glomerulonephritis, PKD)
    diuretic, sodium & water restriction (UOP + 500cc)
  13. What usually precedes in acute GN? What is the recovery rate?

    What are the diagnostic tools for acute GN?
    Infection. Recovery rate is quickly & completely

    • U/A to check proteinuria, hematuria.
    • Diagnosed by renal biopsy
  14. What are the tx for acute GN?
    • Uremia - meds, dialysis, plasmapheresis PRN
    • Fluid overload, HTN, edema - diuretics, Na & water restriction (UOP + 500)
    • Infxn - abx
  15. Tx for overflow incontinence?
    Surgery to remove the obstruction or repair of genital prolapse

    • Intermitten cath
    • Bladder compression
  16. Tx for urge incontinence
    Drug to relax smooth muscle & increase bladder's capacity

    Nutrition - avoid foods that have direct bladdedr stimulating or diuretic effect

    • Behavioral interventions: bladder training (increase interveral by 15-30 min til bladder can tolerate more volume)
    • habit training (for cognitively impaired) - void q2h. Goal is to pee before incontinence occur
  17. What does CKD tx primarily focuses on?
    Control the CAUSES OF CKD

    Adhere to drugs, regular physical activity, water, avoid OTC & NSAIDs
  18. Nursing int/tx for dysmenorrhea
    • Prostaglandin synthetase inhibitors: NSAID
    • Oral contraceptives
    • Low fat & vegetarian diet,
    • Thiamine, Ca, Mg, V1 & fish oil supplements
  19. tx for endometriosis
    • NSAIDs
    • Oral contraceptives
    • Ca & Mg supplements

    Surgical - remove the endometrial implants
  20. Nursing intv for fistula (reproductive system)
    • Assist in perineal hygiene sitz bath
    • Bladder, bowel training
    • Wear disposable undergarment
  21. What is the most common gynecological cancer? (major cause of pelvic pain & infertility)

    What is the assessment finding for this?

    Dx test for this?
    Endometrial cancer

    Postmenopausal bleeding, palpable uterine mass or polyp

    Transvaginal ultra sound & endometrial biopsy. Pap smear
  22. If it's a benign & asymptomatic ovarian cyst, what is the tx

    What is considered large?
    Oral contraceptives to depress ovulation

    Large is 6-8 cm. Evaluate for cancer. CT, MRI, laparoscopy
  23. What are the early predictable metastasis of prostate cancer?

    What is the late metastasis?
    Nearby lymph nodes, bones of sacrum, pelvis, lumbar spine

    Late - lungs, liver, adrenals, & kidneys
  24. What diet risk factors predispose a patient to prostate cancer?
    • Diet high in animal fat
    • Vit D & E deficiency
  25. Tx for prostate cancer
    Prevent by having screening for men >50

    Surgery: Prostate removal

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