NUR 212 Study guide for exam 2

NUR 212 Study guide for exam 2
CKD- What labs are we looking at with this disease? Calcium and potassium
*We want to watch the calcium and potassium in the late stages of CKD*
Know the assessment findings of CKD and what are the clinical Manifestations of this
disease? Prevention/detection of CKD: Monitor BP to detect elevations so that treatment can
be started early.
The manifestations result from retained urea, creatinine, phenols, hormones,
electrolytes, and water. Uremia is a syndrome in which kidney function declines
to the point that symptoms may develop in multiple body systems (Fig. 46.2). It
often occurs when the GFR is 15mL/min or less
-what’s their skin going to look like?
-MANIFESTATIONS INCLUE:
-watch for metabolic acidosis (KUSSMAL’S RESPIRATIONS)
-HTN-(Monitor BP)
-Uremic Fetor=foul breath odor smells like pee
Peritoneal dialysis- that is where they run a catheter into the perineum and run Dialysate through the
catheter into the perineum and let it sit. Then it acts as the kidney and the dialysate sits there for a
prescribed amount of time and then they drain it. Observe the fluid after draining to see the
characteristics of it, is it clear, is it cloudy, are there streaks in it or sediment.
Pt comes into the ER by driving themselves there and they do peritoneum dialysis at home and they
come in c/o abdominal cramping, diarrhea, and fever we suspect peritonitis so we would…..
Obtain peritoneal fluid and send it off to a culture and sensitivity.
Know all your complications of the peritoneal dialysis
The most common complication with peritoneal dialysis is PERITONITIS!
*Obtain fluid from peritoneum and obtain a culture and sensitivity*
-Abdominal pain is the most common symptom of peritonitis
Blood pressure is priority to monitor with any type of dialysis d/t hypotension
If the nurse gets busy and the dwell time is not adhered to then what kind of complications are going
to be anticipated?
Hyperglycemia
Know s/s of acute glomerulonephritis -With these 3 diagnosis they all have edema and anasarca. We
have to be able to know how to manage edema. What all would we do to control it?
-A renal biopsy may be done to confirm the disease.
-symptoms come on suddenly and may be temporary or reversible.
How to manage edema-daily weights, diuretics, monitor intake and output, measure abdominal girth,
monitor those and trend them so we can keep track of the edema and see if its getting better or
worse, elevate extremities, compression socks, limit sodium/salt intake, limit fluid intake, HTN,
monitor bp and give anti-hypertensives, fatigue is a common symptom so provide rest periods for pts
Manifestations include: generalized body edema, hypertension,
oliguria, hematuria, and varying degrees of proteinuria. Fluid
retention occurs because of decreased glomerular filtration. At first,
edema appears in low-pressure tissues, such as those around the
eyes (periorbital edema). Later it progresses to involve the total body,
with ascites or peripheral edema in the legs.
One of the most important ways to prevent APSGN is to encourage early diagnosis and treatment of sore
throats and skin lesions.*** During assessment ask your pt if they have a hx of sore throat or strep
throat***

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