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NSG123 Exam 3 Review
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What does BUN measure?
Amount of urea nitrogen in the blood
What GFR classifies as Stage 5 Chronic Kidney Disease?
<15
What is a normal GFR?
90-100
What is a normal BUN level?
7-20 (ish)
Hypercalcemia is common in CKD. True or False?
False- hypocalcemia
Medications for erectile dysfunction will not work without _______.
Sexual Stimulation
Renal colic from renal calculi can cause excruciating pain. Pain management is an important nursing intervention for these patients. True or False.
True
What foods should be avoided in patients with a history of oxalate renal stones?
spinach, rhubarb, strawberries, tea, peanuts
What symptoms would we expect a patient to experience with a renal calculi lodged in the bladder?
UTI symptoms, urinary retention if stone blocked bladder neck
What symptoms would we expect a patient to experience with a renal calculi lodged in the ureter?
Acute, excruciating, colicky, wavelike pain that radiates down the thigh to the genitalia, hematuria, desire to void but little/no urine
Phenazopyridine is an antibiotic commonly prescribed for treatment of a UTI. True or False
False, urinary analgesic, OTC
Urinary retention is a common side effect of oxybutynin and does not need to be reported to the provider.
False.
You are caring for a patient with urinary incontinence. What education will you provide about how to manage this diagnosis?
Voiding schedule, Delay void after feeling urge, avoid caffeine/carbonation/alcohol/art. sweeteners; kegels
What is iatrogenic incontinence?
involuntary loss of urine due to extrinsic factors- mainly meds
Describe functional incontinence.
Not a disorder of the urinary tract. Another disorder is the cause: dementia, etc
Describe urge incontinence
involuntary loss of urine soon after the urge to urinate is felt; unable to get to toilet in time
Describe stress incontinence.
Involuntary loss of urine due to sneezing, coughing, changing position(mainly women w/ vaginal deliveries; some men post radical prostatectomy
List 2 organic causes of erectile dysfunction.
Cards disease, endo disease, cirrhosis, CKD, neuro disorders, drug abuse, smoking, alcohol, long term opioid use
List 2 psychogenic causes of erectile dysfunction.
anxiety, fear, depression, pressure to perform sexually, negative body image, absence of desire, privacy
What are the 2 categories of causes of erectile dysfunction?
Psychogenic and Organic
How does finasteride work?
5-alpha-reductase inhibitor; prevent conversion of testosterone to DHT, decreases size of prostate
How does tamsulosin (Flomax) work?
For BPH, Alpha-adrenergic blocker, relaxes smooth muscle of bladder neck and prostate
Alfuzosin (Uroxatral) works by relaxing smooth muscle of the bladder neck and prostate improving urine flow and relieving symptoms of BPH. True or False
True
Post op care for a TURP involves continuous bladder irrigation. The nurse should keep that rate at a steady pace. There is no reason to measure the irrigation amount as it is just used to flush the bladder. True or False.
False. Need to be sure that the patient is not retaining fluid in the bladder or absorbing into the body (fluid volume overload)
Your patient is scheduled for a TURP. What education will you provide regarding a catheter post procedure?
Catheter will be in place (with irrigation), pink urine is likely, catheter in place until urine is fully clear, could go home with catheter, goal: no clots
Your patient came to ER after being unable to void for 8 hours. He has a history of BPH. Are we concerned?
Yes! Prostate could be obstructing the urethra. Need to attempt to cath (coude). If unable, then may need urology consult.
What are risk factors for BPH?
Smoking, heavy alcohol use, diabetes, western/American diet
What are s/s of BPH?
Urine freq, urgency, nocturia, hesitation, decreased stream, incomplete emptying, dribbling, UTIs
Excessive blood transfusions can lead to which type of reaction?
iron overload
What flower is digoxin made from? (just an interesting tidbit of knowledge)
Foxglove (digitalis)
What are signs of digoxin toxicity?
anorexia, nausea, visual disturbances, confusion, bradycardia
How can you verify a patient is suffering from digoxin toxicity?
Lab draw digoxin level
Cilostazol is an antiplatelet and vasdodilating medication that is used for peripheral artery disease. True or False
True
Excessive alcohol use is a risk factor for peripheral arterial disease. True or False
False
Diuretics can improve symptoms with heart failure and also slow disease progression. True or False?
False
What lab can be used to diagnose heart failure?
BNP
Jugular vein distention is a sign of left sided heart failure. True or False
False; Right sided
Diastolic heart failure is caused by a stiff and non-compliant heart muscle. True or False
True
Systolic heart failure occurs due to a weakened heart muscle. True or False?
True
A common side effect of calcium channel blockers is __________.
Constipation
ACE Inhibitors can lead to increased water and sodium excretion. True or False
True
Removing the causative substance will stop Thalassemia symptoms. True or False?
True
This type of anemia is caused when the destruction of red blood cells outpaces the bone marrow's production of them.
Hemolytic
This type of anemia is caused by inadequate numbers of erythrocytes produced by the bone marrow.
Hypoproliferative
What is pernicious anemia?
Vit B12 deficiency due to absence of intrinsic factors. Common in gastric bypass surgery.
What are signs of fluid volume overload?
dyspnea, confusion, increased BP, peripheral edema, JVD
Name 3 symptoms of a blood transfusion reaction?
Back pain, chest pain, hypotension, tachycardia, dyspnea
What symptoms are likely to manifest with a platelet count <20k?
Petechiae (under 5k= spontaneous bleeding)
What is immune thrombocytopenic purpura?
ITP; autoimmune disorder characterized by destruction of normal platelets
What can cause secondary Immune thrombocytopenia purpura?
Autoimmune disease, viral infections, medications
What is the priority for a patient admitted with a platelet defect?
Find the cause (then treat the cause)
What is the hallmark sign of peripheral artery disease?
Intermittent Claudication


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