Care Ii Test 1

Front 1

What is the most common type of dehydration?

Back 1

Isotonic dehydration

Front 2

What are three causes of isotonic dehydration?

Back 2

1. Hemorrhage
2. Excessive GI losses
3. Capillary leak syndrome (sometimes caused by IL-II)

Front 3

Hypertonic dehydration is commonly seen in what kinds of patients?

Back 3

Elderly patients; increase in solute (excess) with limited ability to increase oral intake.

Front 4

True/False. A nurse can order an I&O.

Back 4

TRUE. A nurse can put a patient on I&O.

Front 5

How do you measure ice chips in terms of I&O?

Back 5

Half their volume (Ex: If 300 mL of ice chips, 150 mL is documented).

Front 6

A prolonged PR interval and prominent U-wave is consistent with what condition?

Back 6

Hypokalemia

Front 7

A peaked T wave is consistent with what condition?

Back 7

Hyperkalemia

Front 8

Lead poisoning can possibly result in what condition?

Back 8

Hypophosphatemia

Front 9

What is the antidote to magnesium?

Back 9

Calcium gluconate

Front 10

What IV solution should you avoid with head trauma patients?

Back 10

D5 (Dextrose 5%)

Front 11

Under what conditions should you not use lactated ringers solution?

Back 11

Liver dz, renal failure

Front 12

Osmoreceptors are located where in the brain?

Back 12

Hypothalamus

Front 13

What disease is characteristic of too little ADH?

Back 13

Diabetes insipidus

Front 14

This component of the RAAS stimulates thirst.

Back 14

Angiotensin II

Front 15

This is the most common type of dehydration.

Back 15

Isotonic (hypovolemic)

Front 16

Psychogenic polydipsia could possibly contribute to what kind of dehydration?

Back 16

Hypotonic dehydration

Front 17

Lethargy and somnolence are associated with what kind of dehydration?

Back 17

Hypotonic

Front 18

Isotonic dehydration is characterized as < ___ ml 24-hr urine output.

Back 18

500 mL

Front 19

John, 32, comes into the ER complaining of headache, nausea, and vomiting. A comprehensive metabolic panel is taken, and his serum sodium is shown to be 158. What is the proper course of action?

A) Infuse slowly with D5W, pending physician's orders.

B) Encourage patient to drink fluids, obtain orders for lactated ringer's.

C) Start D5/LR Na 0.9% pending physician orders.

Back 19

A) True. D5W is a hypotonic solution and can be used to treat hypertonic state.

B) While this may treat some of the symptoms of hypernatremia, it is not the most correct answer.

C) This is a hypertonic solution, and will only further dehydrate the cells.

Front 20

True/False. A nurse can put a patient on I&O without doctor's orders.

Back 20

True

Front 21

Range of sodium levels?

Back 21

135-145 mEq/L

Front 22

ADH is released from what gland?

Back 22

Pituitary

Front 23

Which part of the brain stimulates thirst?

Back 23

Hypothalamus

Front 24

Cushing's syndrome is associated with (hypo/hyper)natremia.

Back 24

Hypernatremia

Front 25

S3 gallop, JVD, HTN are associated with what electrolyte disturbance?

Back 25

Hypernatremia

Front 26

Chloride levels?

Back 26

98-107

Front 27

Deficit of bicarbonate tends to accompany what electrolyte imbalance?

Back 27

Hyperchloremia

Front 28

Potassium range?

Back 28

3.5-5

Front 29

A prominent U wave is associated with what electrolyte imbalance?

Back 29

Hypokalemia

Front 30

You can infuse no more than ___ to ___ mEq per hour of potassium.

Back 30

10-15

Front 31

Spastic colon and abdominal cramps are associated with what electrolyte imbalance?

Back 31

Hyperkalemia

Front 32

Widened QRS and/or peaked T wave is associated with what electrolyte imbalance?

Back 32

Hyperkalemia

Front 33

Calcium range?

Back 33

8.6-10.2
(Ionized 4.5-5.5)

Front 34

Magnesium goes hand-in-hand with what other electrolyte?

Back 34

Calcium

Front 35

Having your thyroid removed can lead to what electrolyte imbalance?

Back 35

Hypocalcemia

Front 36

Cvostek's/Trousseau's sign is associated with what electrolyte imbalance?

Back 36

Hypocalcemia

Front 37

Shortened QT interval, widened T wave is associated with what electrolyte imbalance?

Back 37

Hypercalcemia

Front 38

If the albumin level is low, you need to correct for which electrolyte?

Back 38

Calcium

Front 39

Increase calcium by ___ mg/dL for every 1 g/dL of albumin below normal.

Back 39

0.8

Front 40

Normal albumin levels?

Back 40

4

Front 41

Normal range for phosphorus?

Back 41

2.7-4.5

Front 42

Lead poisoning is associated with what metabolic imbalance?

Back 42

Hypophosphatemia

Front 43

Hypoparathyroidism is associated with what metabolic imbalance?

Back 43

Hyperphosphatemia/hypocalcemia

Front 44

Excess vitamin D is associated with what metabolic imbalance?

Back 44

Hyperphosphatemia

Front 45

Aluminum and calcium-based antacids bind with what?

Back 45

Phosphorus-- can be used to treat hyperphosphatemia.

Front 46

Levels for magnesium?

Back 46

1.5-2.5

Front 47

Magnesium is linked to what other electrolyte?

Back 47

Calcium

Front 48

Depression, psychosis and confusion is associated with what metabolic imbalance?

Back 48

Hypomagnesemia

Front 49

Torsade de pointes is associated with what two metabolic imbalances?

Back 49

Hypokalemia, hypomagnesemia

Front 50

What is the antidote to magnesium overdose?

Back 50

Calcium gluconate

Front 51

What is the most common cause of glomerulonephritis?

Back 51

Immunologic abnormalities

Front 52

What can a buildup of urea in the body eventually cause?

Back 52

Encephalopathy

Front 53

A medical condition characterized by abnormally high levels of nitrogen-containing compounds, such as urea, creatinine, various body waste compounds, and other nitrogen-rich compounds in the blood.

Back 53

Azotemia

Front 54

The site of retention (edema) in nephrotic syndrome is where?

Back 54

The distal nephron tubules and collecting ducts.

Front 55

True/False. If a patient is excessively uremic, the life of red blood cells decrease.

Back 55

True

Front 56

If a patient is excessively uremic, the life of red blood cells decrease.

Back 56

Decreases

Front 57

What is the most common cause of chronic kidney disease and end-stage renal failure?

Back 57

Glomerulonephritis

Front 58

___ is the most accurate measurement of kidney function.

Back 58

Creatinine

Front 59

Normal creatinine level for men. For women.

Back 59

Men: 0.9-1.3
Women: 0.6-1.1

Front 60

Why do you generally collect a creatinine clearance measurement?

Back 60

In the case of administering nephrotoxic drugs.

Front 61

What is the hallmark symptom of nephrotic syndrome?

Back 61

Urinary excretion > 3.5 g protein in 24 hours (proteinuria).

Front 62

If a patient is dehydrated, you will see a(n) (elevated/decreased) BUN.

Back 62

Elevated

Front 63

Pyelonephritis is usually caused by what bacteria?

Back 63

E. coli.

Front 64

What is the most common etiology of pyelonephritis?

Back 64

Obstructed urine flow (cancer, a stone, pregnancy, enlarged prostate, etc...).

Front 65

What is a good assessment test for patients with a possibility of pyelonephritis?

Back 65

CVA tenderness

Front 66

Dilation of renal pelvis and calces.

Back 66

Hydronephrosis

Front 67

True/False. It's OK to clamp off the nephrostomy tube.

Back 67

FALSE. Never, ever clamp off the nephrostomy tube! Urine will stagnate and back up-- will cause kidney pressure and possible pyelonephritis. Also, you NEVER irrigate a nephrostomy tube!

Front 68

True/False. It's OK to irrigate a nephrostomy tube.

Back 68

FALSE!

Front 69

Proteinuria and hematuria are hallmark symptoms of (nephritic/nephrotic) syndrome.

Back 69

Nephritic

Front 70

Hallmark symptom: Proteinuria ALONE.

Back 70

Nephrotic syndrome

Front 71

What bacteria is the cause of glomerulonephritis?

Back 71

Usually type A streptococcal throat infection.

Front 72

How much urine should a person normally produce an hour?

Back 72

30mL

Front 73

Nephrotic syndrome is characterized by (hyper/hypo)tension.

Back 73

Hypotension

Front 74

Possible nursing diagnosis of nephrotic syndrome?

Back 74

Risk for infection

Front 75

This is the site of renin production.

Back 75

Juxtoglomerular apparatus

Front 76

Where is ADH secreted?

Back 76

Posterior pituitary

Front 77

One pound equals approximately ___ mL.

Back 77

500

Front 78

This is a good measurement of glomerular filtration rate.

Back 78

Creatinine clearance

Front 79

___ is the primary cause of chronic kidney disease.

Back 79

Diabetes

Front 80

Glomerulonephritis is also called:

Back 80

Acute nephritic syndrome

Front 81

An abnormal concentration of nitrogenous wastes in the blood.

Back 81

Azotemia

Front 82

Primary presenting features of acute glomerular inflammation.

Back 82

Hematuria, edema, azotemia, elevated BUN, proteinuria

Front 83

___ is a type of renal failure characterized by increased glomerular permeability and is manifested by massive proteinuria.

Back 83

Nephrotic syndrome

Front 84

What is the hallmark sign of nephrotic syndrome?

Back 84

Massive proteinuria

Front 85

Major manifestation of nephrotic syndrome?

Back 85

Edema

Front 86

Treatment for iron toxicity?

Back 86

Deferoxamine

Front 87

Treatment for lad toxicity?

Back 87

Dimerkrole with calcium edetate

Front 88

Name me some medications that are potentially nephrotoxic.

Back 88

Antibiotics:
Amphotericin B
Methicillin
Rifampin
Sulfonamides
Tetracycline
Vancomycin
Aminoglycosides

Antineoplastics: Cisplatin, cyclophosphamide, methotrexate

NSAIDs

Acetaminophen
Captopril
Quinine

Front 89

Acute Renal Failure consists of three phases. What are they?

Back 89

The oliguric phase, the diuretic phase, and the recovery phase

Front 90

In the event of an emergency, what can you administer to treat extreme cases of hyperkalemia?

Back 90

Insulin + Dextrose

Front 91

Failure of the kidneys to produce urine.

Back 91

Anuria

Front 92

Production of abnormally small amounts of urine.

Back 92

Oliguria

Front 93

Accumulation of nitrogenous waste products in the blood caused by the kidneys' inability to filter our these waste products.

Back 93

Uremic syndrome

Front 94

Hallmark symptom of uremic syndrome?

Back 94

Oliguria

Front 95

___ AKF occurs outside the kidney, and is caused by intravascular volume depletion, dehydration, decreased cardiac output, decreased peripheral vascular resistance, decreased renovascular blood flow, and infection or obstruction and nephrotoxicity.

Back 95

Prerenal

Front 96

___ AKF occurs within the parenchyma of the kidney; caused by tubular necrosis, prolonged prerenal ischemia, infection or obstruction, and nephrotoxicity.

Back 96

Intrarenal

Front 97

___ AKF occurs between the kidney and urethral meatus, such as bladder neck obstruction, bladder cancer, calculi, and infection.

Back 97

Postrenal

Front 98

A kidney stone can result in ___ AKF.

Back 98

Postrenal

Front 99

Renal cell carcinoma can result in ___ AKF.

Back 99

Intrarenal

Front 100

Urethral stricture can result in ___ AKF.

Back 100

Postrenal

Front 101

Hypertension is an example of ___ AKF. HyPOtension is an example of ___ ARF.

Back 101

Intrarenal; prerenal

Front 102

What kind of diet should ARF patients adhere to?

Back 102

Low protein, high carbohydrate diet with restricted potassium and sodium intake.

Front 103

There are four stages of chronic kidney failure. What are they?

Back 103

Renal impairment
Renal insufficiency
Renal failure
End stage renal disease

Front 104

This stage of chronic kidney failure is associated with 75-85% function loss.

Back 104

Renal insufficiency

Front 105

This stage of chronic kidney failure is associated with >85% function loss.

Back 105

End stage renal disease

Front 106

This stage of chronic kidney failure is associated with 40-75% function loss.

Back 106

Renal impairment

Front 107

This stage of chronic kidney failure is associated with GFR 10-20% normal.

Back 107

Renal failure

Front 108

What medications are important to withhold before a hemodialysis treatment?

Back 108

Antihypertensives, water-soluble vitamins, certain antibiotics, and digoxin.

Front 109

A rapid change in the composition of the extracellular fluid occurs during the hemodialysis, and solutes are removed from the blood faster than from the CSF and brain. Fluid is pulled into the brain, causing cerebral edema.

Back 109

Disequilibrium syndrome

Front 110

Dialysis encephalopathy can occur from...

Back 110

An aluminum toxicity from dialysate water sources containing aluminum

Front 111

What is the difference between the solutions in peritoneal and hemodialysis?

Back 111

In peritoneal dialysis, the dialysate is sterile.

Front 112

Treatment for heparin overdose?

Back 112

PROTAMINE SULFATE!

Front 113

What percent of cardiac output do the kidneys get?

Back 113

25%

Front 114

What is the leading cause of nephrotoxic failure?

Back 114

Antibiotics

Front 115

What's a characteristic symptom of iron toxicity?

Back 115

Myopathy