Exam 1: NUR2502/ NUR 2502 (New 2023/ 2024 Update) Multidimensional Care III/ MDC 3 Exam| Complete Guide with Questions and Verified Answers| 100% Correct – Rasmussen
Exam 1: NUR2502/ NUR 2502 (New 2023/
2024 Update) Multidimensional Care III/
MDC 3 Exam| Complete Guide with
Questions and Verified Answers| 100%
Correct – Rasmussen
QUESTION
Endometrial Cancer
Answer:
-Most common gynecologic malignancy
-usually slow growing
-if diagnosed early 95% survival rate
QUESTION
S/S of endometrial (uterine) cancer
Answer:
-abnormal uterine bleeding, especially in post menopausal women
-pain during urination
-pain during intercourse
QUESTION
Endometrial cancer diagnostic
Answer:
-endometrial biopsy: gold standard
QUESTION
Treatment for endometrial (uterine) cancer
Answer:
-Total hysterectomy
-radiation
-chemotherapy
-hormonal therapy
QUESTION
Cervical Cancer is known as
Answer:
“silent killer” generally asymptomatic in early stages
QUESTION
How to detect cervical cancer early?
Answer:
pap smear
QUESTION
Late stage symptoms of cervical cancer
Answer:
vaginal discharge that becomes dark and foul smelling, vaginal bleeding becomes heavier, pain,
weight loss, anemia, cachexia: wasting syndrome (weight and muscle loss)
QUESTION
Cervical Cancer diagnosis
Answer:
-pap smear
-colonoscopy
-biopsy
QUESTION
Treatment for cervical cancer
Answer:
-prevention (HPV vaccine)
-Surgery
-Chemotherapy
-Hormone therapy
-Radiation
QUESTION
Surgeries for Cervical Cancer
Answer:
-hysterectomy: removal of uterus and cervix
-Vulvectomy: remove part or all of the vulva
-Myomectomy: removal of fibroids from the uterus
-Vaginectomy: removal of vagina
QUESTION
Cervical Cancer is usually seen in _ and endometrial cancer is usually seen in
Answer:
women in reproductive years
Girls & young women
QUESTION
Ovarian Cancer
Answer:
leading cause of death for reproductive cancers
-epithelial tumors grow on the surface of the ovaries
QUESTION
Risk factors for ovarian cancer
Answer:
-over 40
-personal or family history of ovarian or breast cancer
-diabetes
–Nulliparity (or first child after 30)
-Infertility
-Early menarche/ late menopause
-Endometriosis
-Obesity or high fat diet
QUESTION
Ovarian Cancer signs/ symptoms
Answer:
-mild or vague symptoms: nausea, indigestion, gas
-abdominal pain/ swelling
-Late stage:
ascites, pleural effusions, lymphedema, intestinal obstruction, malnutrition
QUESTION
Diagnosis of Ovarian cancer:
Answer:
-dependent on yearly pelvic examinations
-Can use screening tumor marker CA-125 but it is non specific so it could be an indicator or
endometriosis, fibroid, or other benign conditions.
QUESTION
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What is the 2nd most common malignancy in women and 2nd leading cause of death in women?
Breast cancer
How does breast cancer start?
From the epithelial lining of the ducts or the epithelium of the lobules
99% of breast cancers occur in what gender?
women
breast cancer is slightly more common in what race of women?
white
breast cancer in men is similar across?
all ethnic groups
Risk factors for breast cancer?
-post menopause (increasing in age after 60)
-Estrogen (HRT: hormone replacement therapy) (post menopause therapy) can be with progesterone or alone.
- History or genetics (history of breast, colon, endometrial, &ovarian cancer, or family history of breast cancer) (*Gene BRCA1 or BRCA2 hold a 5-10% genetic risk)
-Alcohol
-Childbirth after age 30
-Obesity
-Smoking
-Breast cellular changes: hyperplasia, atypical appearance (increased risk)
Breast cancer signs and symptoms
-lump in breast
-swelling
-skin irritation
-dimpling
-breast pain
-nipple pain
-nipple turning inward
-redness
-scaliness
-thickening of the nipple
-unusual discharge
-lump in the armpit
(more rare but can present itself as an orange peel)
Where is the most common location of breast cancer?
upper outer quadrant is the most glandular tissue, as a result it is the most common location of a cancer
Breast cancer screening & diagnostics
-history
-physical assessment and examination
-mammogram (less effective in younger women due to denser breast tissue)
-ultrasound
-MRI (gives more details than a mammogram or ultrasound)
-Biopsy
-Labs
-Pathology
Breast health large breast challenges
-Impaired comfort
-Back pain
-diffculty finding clothing that fits
-expensive bras
-fungal infections under breasts
-redness, chaffing or rash, under breasts.
Breast health small breast challenges
-some choose breast augmentation (important to avoid foods, medications, herbs that increase bleeding before/after surgery)
-Can still perform self examination and have mammograms- but may not be as sensitive
-some evidence of increased risk for non Hodgkins lymphoma Not breast cancer
Breast Cancer Types
-In situ (non-ivasive) breast cancer remains in the mammary
DCIS: ductal carcinoma in situate duct or lobules
-ILC: invasive lobular carcinoma
IDC: invasive ductal carcinoma
Non-invasive or In situ breast cancer is
DCIS: ductal carcinoma is situate
Invasive breast cancer is
ILC or IDC
-the cancer grows into the surrounding tissue and can metastasize
-most likely cause of skin dimpling or peau’d orange
-Aggressive form : itching, rapidly growing lump, breast pain, erythema & edema
Most common invasive cancer
IDC: infiltrating ductal carcinoma
breast cancer treatment
-Surgery: breast conserving & masectomy
-Radiation therapy
-Chemotherapy
-Hormone therapy
breast conserving surgery
removes the entire tumor along with a margin of normal tissue and may include lymph node removal
Masectomy
Total or simple usually involves lymph nodes
Radiation therapy
directed therapy to the site of the cancer (original tumor)
Chemotherapy
(S/E depends on the drugs used, frequency, and dose)
-IV therapy in 2-3 week cycles over 3-6 months
-Regular blood work is needed
Most common chemotherapy drugs 2 or 3 of these drugs mixed usually
-Anthracyclines (doxurubicin & epirubicin)
-Taxanes (paclitazel & docetaxel)
-Cyclophosphadmide
-Carboplatin
Typical side effects of chemotherapy
-hair loss
-nail changes
-mouth sores
-loss of appetite
-N/V
-Diarrhea
-Increase risk of infection
-Easy bruising or bleeding
-Fatigue
-Menstrual changes and infertility
-“Chemo brain”
Lower risk side effects of chemotherapy
-heart damage
-risk of leukemia
-hand foot syndrome (numb, tingling, red, swollen hands & soles)
-Nerve damage
Hormone therapy cancer treatment options
-many block estrogen receptors
-SERM: selective estrogen modulators: tamoxifen, toremifene, fulverstrant.
-AI: artomatase inhibitors: prevent production of estrogen: anastrozole, letrozole, exemestane.
Breast Cancer Prognosis
-tumor size
-nodal involvement
-tumor differentiation
-estrogen & progesterone receptor status
-HER-2 Status: human epidermal growth factor receptor 2
Survival breast cancer rates
-Localized breast cancer: 99%
-Spread to regional lymph nodes: 85%
-Metastic breast cancer: 27%
Benign (non cancer) breast issues:
-Fibroadenoma
-Fibrocystic breast condition
Fibroadenoma
-benign but does hold a slightly increase risk for breast cancer
-tumors are oval, freely mobile, rubbery, and vary in size.
-If cystic: will usually be monitored
-If solid: will usually be removed
Fibrocystic breast condition
-Not a risk factor for breast cancer
-changes to lobules, ducts, & stromal tissues of the rbeast
-Thought to be caused by an imbalance in normal estrogen/ progesterone ratio
-S/E: pain, tenderness, swelling before menstruation.
-Treatment: diuretics to reduce swelling, analgesics for pain, SERM, oral contraceptives
Assessment details
-patient history
-nutrition history
-personal/familyhistory
-co-morbid issues
-history of presenting condition
-physical exam (breast, abdomen, pelvis, genitals)
-psychosocial assessment
-diagnostic (labs usually hormone levels)
Breast cancer nursing interventions
-pain management
-diet support
-comfort
-drug therapy
-support groups
-symptom management
-education
-links to resources
-depression/ anxiety screening
-surgery prep
-post surgery care
-involve client in care planning
-ARM health: functional restoration, precautions, supported with pillow, excercises, PT/OT if appropriate, not dependent for long periods of time, use other arm to carry bags, hygeine habits
Uterine Leiomyoma
-Uterine fibroids
-Benign uterine growth in the myometrium (smooth muscle) classified by locaiton
-Most common benign tumors in women
-3 types: Intramural (in uterine wall), Submucosal(protrudes into the cavity of the uterus can cause bleeding/disrupt pregnancy), Subserosal (protrudes through the other surface, can press against other organs)
Uterine Leiomyoma signs and symptoms
-bleeding, pain, symptoms associated with pelvic pressure
Uterine Leiomyoma Treatment options
-Non-ivasive: monitor, oral contraceptives (most common treatment), magnetic resonance guided focused ultrasound surgery, uterine arter embolization.
-Surgery: laparoscopic myomectomy, hysterectomy
Uterine Prolapse
uterine herniation into the vagina
Uterine prolapse S/S
-feeling pelvic pressure
-dyspareunia (painful intercourse)
-Stress urinary incontinence
-Urinary elimination issues
-Rectocele (hemorrhoids, constipation, fecal impactation)
Uterine Prolapse treatment
-Nothing
-Kegal excercises
-pessary (prosthetic device)
-Surgery: surgical vaginal mesh,
anterior colporrhaphy >posterior colporrhaphy.
anterior colporrhaphy
tightens pelvic muscles for better bladder support, splint abdomen, limit physical activity, weight rest 5lbs, no sex for 6 weeks.
posterior colporrhaphy
reduces rectal bulging, low residue (fiber) diet to decrease bowel movements, avoid straining, sitz baths pain management to aid in fecal elimination.
Endometrial Cancer
-Most common gynecologic malignancy
-usually slow growing
-if diagnosed early 95% survival rate
S/S of endometrial (uterine) cancer
-abnormal uterine bleeding, especially in post menopausal women
-pain during urination
-pain during intercourse
Endometrial cancer diagnostic
-endometrial biopsy: gold standard
Treatment for endometrial (uterine) cancer
-Total hysterectomy
-radiation
-chemotherapy
-hormonal therapy
Cervical Cancer is known as
“silent killer” generally asymptomatic in early stages
How to detect cervical cancer early?
pap smear
Late stage symptoms of cervical cancer
vaginal discharge that becomes dark and foul smelling, vaginal bleeding becomes heavier, pain, weight loss, anemia, cachexia: wasting syndrome (weight and muscle loss)
Cervical Cancer diagnosis
-pap smear
-colonoscopy
-biopsy
Treatment for cervical cancer
-prevention (HPV vaccine)
-Surgery
-Chemotherapy
-Hormone therapy
-Radiation
Surgeries for Cervical Cancer
-hysterectomy: removal of uterus and cervix
-Vulvectomy: remove part or all of the vulva
-Myomectomy: removal of fibroids from the uterus
-Vaginectomy: removal of vagina
Cervical Cancer is usually seen in _ and endometrial cancer is usually seen in
women in reproductive years
Girls & young women
Ovarian Cancer
leading cause of death for reproductive cancers
-epithelial tumors grow on the surface of the ovaries
Risk factors for ovarian cancer
-over 40
-personal or family history of ovarian or breast cancer
-diabetes
-Nulliparity (or first child after 30)
-Infertility
-Early menarche/ late menopause
-Endometriosis
-Obesity or high fat diet
Ovarian Cancer signs/ symptoms
-mild or vague symptoms: nausea, indigestion, gas
-abdominal pain/ swelling
-Late stage:
ascites, pleural effusions, lymphedema, intestinal obstruction, malnutrition
Diagnosis of Ovarian cancer:
-dependent on yearly pelvic examinations
-Can use screening tumor marker CA-125 but it is non specific so it could be an indicator or endometriosis, fibroid, or other benign conditions.
Toxic shock
overstimulation of immune responses by bacterial exotoxins in the blood (can be caused by tampons)
PCOS
polycystic ovarian syndrome
MODULE 2
MODULE 2
BPH (benign prostatic hyperplasia)
When a male ages testosterone levels are decreased and normal estrogen levels increase which increases the activity of dihydroxytestosterone leading to cell growth (prostate growth), growth then usually compresses the urethra leading to partial or complete obstruction
prostate
it is a walnut shaped gland of the male reproductive system that is responsible for production of the fluid component of semen. It surrounds the urethra at the neck of bladder in front of the rectum (had 2 or more lobes/sections)
Occurrence of BPH
Affects approx 50% of men between 51-60 years old effects up to 90% of men older than 80
medications that increase the risk of acute urinary retention in the presence of BPH
decongestants, antihistamines impact the functioning of the muscles bladder making it difficulty to release the urine
BPH risk factors
-age
-obesity
-sedentary life
-alcohol
-erectile dysfunction
-smoking
-diabetes
-1st degree relative
Screening & diagnostics for BPH
-physical exam
-medical tests
-personal & family history
Potential complications of BPH
-retention
-uti
-calculi in the bladder
-hydronephrosis or pyelonephritis can lead to renal failure
Treatment for BPH?
-dietary changes (decreasing caffeine & alcohol)
-avoid decongestant and anticholinergic medications
-minimally invasive procedures
-Surgery TURP & TUIP
-Medications: alpha blockers, PD5 inhibitors, 5-alpha reductase inhibitors, combination.
Minimally invasive procedures that can relieve symptoms and destroy enlarged prostate tissue and widen the urethra?
-Transurethral needle ablation: uses heat
-Transurethral microwave therapy: usus microwaves
-high intensity focused ultrasound: uses ultrasound waves
-Transurethral electrovaporization: uss electric current
-water induce thermotherapy: uses heated water
-Prostatic stent insertion: small device to stent the narrowed opening
Surgery for BPH
-TURP: transurethral resection of prostate- most common urological procedure in men
-Laser surgery
-Open prostatectomy
-TUIP: Transurethral incision of the prostate
Medications for BPH alpha blockers
-relax the smooth muscles of the prostate and bladder neck to improve urine flow (improve urethral diameter)
-Terazosin
-Doxazosin
-Tamsulosin
-Alfuzosin
-Sildosin
PD5 inhibitors
-primary use is for erectile dysfunction
-relax lower urinary tract smooth muscles
-Tadafil (cialis)
5 alpha reductase inhibitors
-block the production of DHT
-Finasteride
-Dutasteride
Nursing diagnosis for BPH
-acute pain
-risk for infection
-impaired urinary elimination
BPH nursing interventions
-education
-urinate every 2-3 hours
-catheter education
-uti med complication
-discuss concerns about sexual function
-CBI may be necessary
-blood normal in first 24-36 hours post op but red blood may indicate issues
-may take 2 months for bladder to return to normal capacity be aware and be patient
Adenocarcinomas (Prostate cancer)
-develop from the gland cells that make prostate fluid
-spread by 3 routes: direct extension, through the lymph system, through the blood stream
Prostate Cancer risk factors
-age (increased risk after age 50)
-african american
-diet & obesity
-family history
Prostate Cancer signs & symptoms:
-none in early stages
-Similar to BPH
-Metastatic disease may cause lumbosarcal symptoms
Prostate Cancer treatment
-Surveillance (watch and wait)
-Radiation (possible radiation proctitis)
-Surgery (radical prostectomy the entire gland, seminal vesicles, and part of the bladder neck, lymph removal onny if high risk for metastatic disease)
Adverse outcomes of prostate cancer surgery (Radical prostatectomy)
-Erectile dysfunction & incontinence
-Nerve sparing technique can reduce the risk of ED
-Kegel exercises can help with incontinence encourage in post operative periods
Testicular cancer
-Treatable
-rare type of cancer but most common type of cancer between 15-35 up to 95% obtain complete remission if detected early
Classifications of testicular cancer
-Germ cell: (amount for 95% of cases)
-Seminomas: grow and spread slowly, account for 40-45% of testicular cancer, typically increase human chorionic gonadotropin (hCG) levels
-Non-seminomas: typically increase levels of a feteoprotein (AFP) and hCG
-Leydig cell tumors
-Sertoli cell tumors
Signs and symptoms of testicular cancer
-mass may or may not be accompanied by scrotal swelling
-Dull ache/ heaviness- to pelvis, scrotum, or perianal area
Blood work for testicular cancer blood work
-a-fetoprotein (AFP)
-lactate dehydrogenase (LDH)
-Human chorionic gonadotropin (hCG)
Follow up examination for testicular cancer includes
-a-fetoprotein (AFP)
-human chorionic gonadotropin (hCG) level monitoring
-CXR
-CT
-physical exam
Radiation therapy
-oldest treatment therapies for cancer
-daily M-F for 2-8 weeks
-not for systemic cancer
highly radiosensitive cancers
ovarian, testicular, hodgkin’s & non-hodgkins lymphoma
Moderately radiosensitive cancers
oropharyngeal, esophageal, breast, uterine, cervical, prostate, & bladder
What is most sensitive to chemo and radiation therapies?
intestinal mucosa: nausea, vomitting, diarrhea, mucositis, anorexia common issues. (early management essential)
-skin care is also important for localized skin issues caused by radiation
Erectile dysfunction (ED)
-all men have trouble with erections occasionally but if is progressive or regular then it should be treated
what can ED be a sign of
sign of
-heart disease
-cancer
-diabetes
all underlying causes of ED
-impaired blood flow or nerve damage
-certain cancer treatments
-certain medications
-stress or emotional state
-early sign for serious health issues: arthersclerosis, heart disease, HTN, diabetes.
Risk factors for ED
-Age>50
-HTN
-CAD
-DM
-high cholesterol
-smoking
-obesity
-drug or alcohol overuse
-lack of exercise
-trauma/ ortho injuries
ED can cause emotional disorders which in turn
makes the ED worst causing a vicious cycle
Erectile dysfunction medications
-Sildenafil (viagra)
-Vardenifil (Levitra)
-Tadalafil (Cialisis)
Need to remember for ED medication complications
MIR, Priaprism, hearing loss.
Important to not take nitroglycerine with ED medications because it can cause
fatal hypotension
Transgender patients transition drugs
MtF: estrogen & androgen- reducing medications
FtM: testosterone
Gender identity
the internal understanding of one’s own gender or the gender to which one identifies
Gender expression
the external presentation of gender
Bacterial sexually transmitted infections
chlamydia, gonorrhea, syphillis
Viral sexually transmitted infections
Genital herpes, Genital warts, HIV, AIDS, Hepatitis B & C, Molluscum contagiosum.
Parasites/ protozoa sexually transmitted infections
Trichomoniasis
HPV types
-Genital warts
-Cancers of the genital tract
-Oropharyngeal cancer
Syphillis different stages
Primary: sores at the original site of the infection sores are usually firm, round, and painless. 10-90 days after infection.
Secondary: systemic infection, skin rash, swollen lymph nodes, fever, general flu like symptoms.
Tertiary syphillis: severe medical problems that can affect the heart, brain, or other organs. 1-20 years after initial infection.
Latent syphillis: asymptomatic syphillis
HPV symptoms
-often none
-growths that are white to gray and pink flesh colored
-can be single or multiple
-large cauliflower like masses
-itching or bleeding with anal warts may occur
Treatment of HPV
-Trichloracetic acid or bichloroacetic acid directly applies to the wart
-Podophyllin resin
-Podfilox liquid or gel for 3 successive days
-Imiquimod cream
-If chemical treatment fails: cryotherapy, electocautery, laser therapy, or surgical excision.
Chlamydia is a what kind of bacteria
gram negative bacteria
Treatment of Chlamydia
-doxycycline or azithromycin
(Avoid sex for 7 days after treatment and until all partners have completed their course )
Homeostasis of the urinary system
-fluid and electrolyte control
-remove waste
-maintain blood pressure
-Acid/ base balance
Components of Urinary System disorders
kidneys, ureters, nephrons, blood vessels, bladder, urethra
urinary incontinence is NOT a
natural consequence of aging
Risk factors of urinary incontinence
female, older, life events, health problems, smoking, birth defects, or structural issues.
Types of urinary incontinence
-Stress: ex. excercise, cough, sneezing, laughing
-Overflow: ex. small amounts leak from full bladder
-Functional: ex. trouble getting to the toilet in time
Management of. urinary incontinence
-education
-biofeedback: uses sensors to make you aware of signals from the body
-lifestyle changes: weight loss, quit smoking, drinking alcohol, less caffeine.
–
Drugs to treat urinary incontinence
Anticholinergic: Tolterodine, Oxybutynin, Solifenacin, Darifenacin.
Urinary tract infections are caused by
high bacterial counts in urine and usually occurs as bacteria from the gut travels up the urethra into the sterile environment of the bladder
Health care caused Infections (HCAIs)
-CAUTIs (catheter associated UTIs)
-VAPs (ventilator acquired penumonia)
-CLABSI (central line associated blood stream infection)
any of these conditions can heave major impacts of the facility because insurance does not cover them
Lower UTis or Complicated UTI’s
lower UTIs involve issues such as obstruction, catheters, DM, imunnosuppressive conditions, recurrent infections, etc.
Complicated infections are at greatest risk of complications such as urosepsis, pyleonephritis, or kidney failure.
Avoiding UTIs
avoid invasive procedures to the bladder whenever possible, take care after sexual intercourse, wipe front to back, good hygiene.
Treatment/ diagnosis
-urinalysis
-urine culture
-blood work
-imaging if obstruction suspected
KIdneys function
fluid balance, electrolyte balance, blood pressure regulation, acid-base balance, erythroprotein production, convert vitamin D to active form.
Kidneys info
-approx 4-5 inches long
-2 in the body
-FIlter approx 125 ml/min (180 L per day)
-1-3 L excreted as urine
-Remainder reabsorbed into the body
-Reabsorbs glucose to approx 220 ml/dL glucose is in urine after that
Kidney stones risk factors
-male
-family history
-personal history
-20-55 years old
Renal=
kidney
Calculus=
stone
Lithiasis=
stone formation
Colic=
pain
What to know about kidney stones
-keeping urine dilute helps reduce risk
-pH may play a role
Pyelonephritis
inflammation of the kidney and collecting system, usually results from a complicated UTI NOT being treated or adequately treated
Risks of Polynephritis
Pre-existing factors include: BPH, stones, or CAUTIs
Symptoms of polyenphritis include
fever, flank pain, nausea, vomitting, burning, foul smelling urine, urgency, dysuria.
Hydronephrosis
-swelling of the kidney caused when urine cannot drain
-children are usually diagnosed in infancy
symptoms of hydronephrosis
(asymptomatic at times)
pain in side or back, pain with urination, dysuria, urgency, N/V, fever, failure to thrive in infants
Pyelonephritis verses hydronephrosis
Pyelonephritis: medication administration, comfort, education, consults (if appropriate)
Hydronephrosis: treat the underlying cause, education condition related, seek treatment.
Polycystic Kidney disease risk
genetic affects 600,000 people in the US
Polycystic Kidney disease pathophysiology
cysts grow in the renal cortex or medulla as they grow they compress and destroy surronding tissue and structure leads to significant kidney injury bilaterally
Diseases/ disorders associated with PKD
polycystic liver disease, valvular disease of the heart, diverticulosis, and aneurysms
Diagnosing Polycystic Kidney Disease
-Physical examination
-Clinical presentation
-Family history
-CT or ultrasound
Treatment of Polycystic Kidney Disease
aimed at managing manifestations, surgery may be indicated when serious problems exist, dialysis, kidney transplat.
Management/ nursing care
-diet modifications
-fluid restriction
-Treat other effects : HTN, UTIs
-assist and educate patient and family on coping with chronic/ progressive disease
-Prepare for progress of disease
-Genetic counseling
Acute kidney injury is defined as
-Increase of creatine >0.3 mg/dL within 48 hours
-Increase in creatine >1.5 x baseline
-Urine output less than 0.5 ml/kg/hr >6 hrs
Types of Acute Kidney Injuries (3)
-Prerenal
-Intrarenal
-Postrenal
Postrenal
-Injury to the kidney caused by interruption/ disruption of flow OUT of the kidney
-can be reversed
-obstruction
-BPH or prostate cancer
-Trauma
-Renal calculi
-UTI
Prerenal
-Injury to the kidney caused by interruption/ disruption of flow TO the kidney
-This is reversible
-Hypovolemia
-MI
-Hypotension
-Dehydration
-Renal artery stenosis
-Bleeding or clotting in renal blood vessels
Intrarenal
-damage to the internal structures of the kidney
-sepsis
-nephrotoxic drugs
-Glerulonephritis
-Acute tubular necrosis
-Prolonged prerenal ischemia
-bleeding in the kidney
-PKD, pyelonephritis
-Thrombus
-Cancers
-Toxin
Three phases of acute kidney injury
-Oliguric (constricting kidney blood vessels & activating RAAS & releasing ADH)
-Diuretic
-Recovery (BMP returns to normal)
Perenal
(GFR <65 mmHg) is the most common cause of AKI
Signs & symptoms: Oliguria (the most common INITIAL sign of AKI) urine output <400 ml/day Azotemia
Management of Acute Kidney Injury (AKI)
-Eliminate the cause
-Monitor and manage signs & symptoms
-Prevent complications: monitor and treat electrolye abnormalities: sodium, potassium, calcium abnormalities common, monitor for metabolic acidosis
Steps for managing Acute Kidney Injury
- ensure adequate volume give fluids
- diuretics not usually indicated until after fluid status improved
- monitor I&Os closely
- cardiac monitor for signs of electrolyte issues
- RRT (Renal replacement therapy)
Chronic Kidney Disease (CKD)
is damage to the kidney or functional loss >3 months
Risk factors for CKD
-Older adults >60
-Ethnicity
-DM
-HTN
sources;
https://www.gcu.edu/
https://yaveni.com/
https://www.rasmussen.edu/