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57 Cards in this Set

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Glomerulonephritis

1. Inflammation of glomerulus of kidney characterized by: (Select all that apply)
• Proteinuria, Hematuria, Flank Pain, Headache
2. During nursing assessment and history, you would ask:
• Have you had a sore throat in the past 2-3 weeks?
3. Glomerulonephritis, if caught Early:
• 90% of children will recover; 70% of adults will recover
4. Most Acute Glomerulonephritis is caused by:
• Infection (ie: Streptoccocal) or related to other systemic disease (Primary & Secondary)
5. Uremia is indicated by: (Select all that apply)
• Nausea, Vomiting, Anorexia, Lethargy
6. What diagnostic test is the BEST indicator of Kidney Function from urine/blood:
• Creatinine Clearance Test (24 hour to assess GFR)
7. Acute Glomerulonephritis patient urine will have characteristic:
• Color (Redish Brown, “Coke” Colored, Smokey)
8. Acute Glomerulonephritis treatment:
• Bed rest to decrease tissue catabolism breakdown so kidneys don’t work so hard
9. Acute Glomerulonephritis diet teaching:
• ↓ Protein
10. Acute Glomerulonephritis expected finding with bedrest:
• ↑ Urine Output
11. Acute Glomerulonephritis will restrict K+ & Protein to prevent:
• Hyperkalemia & Uremia due to ↑ BUN
12. Glomerulonephritis patient teaching:
• Routine checkups for kidney function MUST continue even when Pt. feeling better
13. Clinical manifestations of Chronic Glomerulonephritis (CGN):
• No symptoms for many years
14. Oliguria leads to:
• ↑ K+ from potassium retention
• Hyperphosphatemia with ↓ Ca+
• Metabolic Acidosis develops with Loss of Bicarbonate
• Respiratory compensation with Kussmaul’s (↑Rate & ↑Depth of Breathing)
15. Signs of Renal Failure:
• HTN, Oliguria, Electrolyte Imbalance, Uremia
Lupus

1. What is the genetic link between Lupus, RA, Psoriatic Arthritis:
• RUNX-1 protein (rheumatoid factor)
2. Only way to Diagnose Systemic Lupus Erythematosus (SLE):
• Complete Medical History
• Physical Exam (Evidence of Multi-System Organ: Skin, Joints, Kidney, Lung, Nervous, etc.)
• Blood Tests (CBC, RUNX-1, Antinuclear Antibody (ANA), Erythrocyte Sedimentation Rate (ESR), Immunoglobulins, Venereal Disease Syphilis (VDRL), etc.)
• There is no single exam to diagnose SLE
• CBC may reveal Pancytopenia=↓ in ALL cells RBC, WBC, etc.
3. Pt.’s should be taught that:
• Stress causes a high-incidence of exacerbations (flare-ups)
4. 1st Sign of Lupus:
• Skin involvement (“Butterfly Rash” – red, dry, scaly skin on Face, Sun-Exposed Upper Body)
• Can also be Lesions (Discoid=Coinlike) & Alopecia
5. Lesions especially evident when client exposed to sunlight & UV light – Pt. Teaching:
• Wear Hat, Clothing, Sun Screen, Avoid prolonged Sun/UV/Fluorescent Exposure
6. There are 11 Signs associated with Lupus:
• Must have at least 4 to be diagnosed
7. Majority of deaths in SLE are caused by:
• Renal (50% will have renal disease)
8. Lupus is treated with:
• High-Doses of Steroids (ie: Prednisone & other Corticosteroids)
9. Other Drugs/Treatments to treat SLE:
• Plaquenil - Hydroxychloroquine (Anti-Malarial helps ↓ Inflammation)
• Imuran – Azathioprine (Immunosuppressant)
• Cytoxan – Cyclophosphamide (Immunosuppressant)
• Cortisone (Topical)
• Plasmapheresis (Plasma Exchange for autoimmune disorders)
10. Discoid Lupus Erythematosus (DLE) is characterized by:
(immediate family member best)
• Affects only small % & Skin (Discoid=individual round “Coinlike” lesions)
• “Scarring” Lesions
11. Systemic Lupus Erythematosus (SLE) is characterized by:
• Chronic, Progressively Worsens (Onset Acute or Insiduous=Steady)
• Inflammatory connective tissue disorder
• Spontaneous remissions and exacerbations (flare-ups)
• Systemic – usually non-scarring
12. SLE “Risk Factors” from the following Medications:
• Hydralazine – Apresoline (HTN Drug)
• INH – Isoniazid (TB Drug)
• Procainamide – Pronestyl (Abnormal Heart Rhythm Drug)
• Chlorpromazine – Thorazine (Anti-Psychotic Drug)
• (Anti-Seizure Meds) Phenytoin/Dilantin, etc.
13. Classic CNS symptoms of Lupus:
• Fever (unknown origin)
• Fatigue
• Weight Loss
• Malaise
14. Cardiovascular symptoms of Lupus:
• Pericarditis, Vasculitis, Raynaud’s
15. Diagnosis of DLE:
• Skin Biopsy (because it’s not systemic)
16. Teach Pt. in Acute Setting:
• Monitor skin changes daily
17. Teach Pt. to monitor which MAJOR SIGN of flare-up with SLE:
• Fever/Body Temp. (can become seriously ill during this time)
Acute Renal Failure (ARF)

1. 3 Main Causes/Complications leading to acute renal failure:
• Complications of poorly controlled Diabetes (1st most common)
• Complications of uncontrolled HTN (2nd most common)
• Complications of Glomerulonephritis (3rd most common)
2. Kidney’s Function:
• Excretion of Waste, Water, Salt-Balance, Acid-Base Balance, Hormone Secretion
3. When going from Oliguric Phase to Diuretic Phase, a Pt. is:
• Risk for HypOvolemia & Electrolyte Imbalance
4. What food would the nurse say is alright for ARF Pt. to have:
• A Scoop of Ice Cream (High-Calorie)
Chronic Renal Failure (CRF)

1. 2 Signs of “EARLY” CRF:
• Hyposthenuria (loss of urine concentrating ability)
• Polyuria (↑ Urine Output b/c kidneys not reabsorbing water)
2. What disease is the LEADING cause of death in clients with ESRD:
• Cardiac Disease (check for Edema, Assess HR & Rhythm)
3. When fewer than 10%-20% of Nephrons are working: (More than 80-90% Impaired)
• ↓ GFR leads to ESRD
4. You would treat Cardiac Tamponade (Emergency leading to death):
• Requires removal of peridcardial fluid by needle, catheter, or tube into pericardium
5. Don’t Give ? with CRF
Magnesium (Mg)
6. Advantages of giving Epogen (Procrit – Alphapoeitin) for Anemia in CRF:
• ↓ Need for transfusions
• ↑ Well-Being of Pt.
• Pt. tolerates Dialysis better (that’s why given before)
7. The medications to administer for constipation of CRF:
• Metamucil (Psyllium) for constipation (Best Safe Choice)
• Senna, Ducosate/Colace
• DO NOT USE!!! (Mylanta, Maalox, Milk of Magnesia, Aluminum Citrate, Magnesium Citrate)
8. HyperKalemia in CRF causes:
• Paresthesia
• Tall, Peaked T-Waves on ECG (K+ >5.5 mEq/L)
9. Dietary teaching for for CRF:
• Need High-Value Protein (ie: eggs) – need amino acids to repair but restrict to <40 Gm/day
• Restrict K+, Na+, Phosphorous
• Encourage High Complex Carbohydrates & Fat (to prevent catabolism & supply calories)
10. Metabolic Changes for Sodium (Na+) in CRF:
• Early = HypOnatremia
• Late = HypERnatremia
11. Potassium (K+) will become Hyperkalemia:
• When 24 hr. Urine falls below 500 mL
12. Hyperkalemia will cause what signs/symptoms:
• Dysrrythmias
• Muscle Cramps
13. Hyperkalemia will be treated with:
• Kayaxelate
• D5W
• Insulin
Dialysis

1. 3 Criteria for getting Dialysis:
• Fluid Overload NOT RESPONDING to Diuretics
• Uncontrolled Hypertension
• Uremic Manifestations
2. Best Methods for Hemodialysis Vascular Access:
• 1st Choice – Fistula (surgically joining artery to vein & takes 4-6 weeks to heal)
• 2nd Choice – Graft
• Other choices: Subclavian, Internal, Jugular, Femoral (↑ risk for infection)
3. A Nurse would assess for the following with dialysis:
• Weights (dry weight – before & after)
• BP (careful of Orthostatic Hypotension)
• Meds to be withheld
• Assess site (if redness/swelling & suspect infection – send for culture)
• Check for Clots (usually in venous return – determine amount of Heparin to use)
4. Tenckhoff Catheter – Peritoneal Dialysis (PD) – 1 Exchange:
• Infuse Dialysate
• Dwell Time
• Outflow/Drain Time
Renal Transplant

1. Pt. teaching:
• Take Imuran / Azathioprine FOR LIFE (Immunosuppressant/Anti-rejection)
2. Administer what medications for ACUTE inflammation/swelling:
• Prednisone & Solu-Medrol (Methylprednisolone)
3. Rejection of Kidney Transplant:
• Acute Rejection (1-3 weeks post-surgery – RAPID ONSET)
• Chronic Rejection (3 month GRADUAL progression of signs/symptoms)
4. Biggest Barrier to receiving a Transplant:
• Lack of available/viable donors