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Renal and Gastrointestinal Disorders: Nursing Concepts and Applications, Exams of Nursing

Hondros CollegeNursing

A comprehensive overview of key concepts and clinical applications related to renal and gastrointestinal disorders. It covers essential information on glomerulonephritis, acute kidney injury (aki), chronic kidney disease (ckd), hemodialysis, peritoneal dialysis, inflammatory bowel disease (ibd), multiple sclerosis (ms), myasthenia gravis, and parkinson's disease. Definitions, symptoms, causes, treatments, nursing interventions, and important considerations for patient care. It is a valuable resource for nursing students and professionals seeking to enhance their understanding of these complex conditions.

Typology: Exams

2024/2025

Available from 02/17/2025

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Normal creatinine levels? - Male: 0.6-1.2 Female:
0.5-1.1
Normal GFR? - 90-120ml/min
At which GFR level does dialysis begin? - 15
S/S of acute glomerulonephritis? - Headache, increased BP, facial edema, malaise, low grade fever,
weight fain, proteinuria, hematuria, and oliguria
S/S of chronic glomerulonephritis? - Proteinuria and hematuria
Lab findings for glomerulonephritis? - Increased BUN, CR Decreased
albuminin
Common s\e of hemodialysis? - Hypotension due to all of the blood and fluids leaving the body
Nephrotic syndrome s\s - SEVERE proteinuria
MASSIVE edema
Hypertension, foamy urine, anasarca, ascites
Why might medication doses be decreased for a patient with kidney issues? - Due to medications
not being excreted through kidneys
Prerenal causes - Due to decreased blood flow to kidneys
Cardiovascular disorders, hypovolemia, peripheral vasodilation, renal vascular obstructions,
severe vasoconstriction
Intrarenal causes - Due to damage to the gumeruli, interstitial tissue or tubules (parynchymal
damage)
Acute tubular necrosis, exposure to nephrotoxins, acute GNP, SLE, obstetric complications, and
malignant hypertension
Post renal causes - Obstruction to the urine collecting system BPH
Phases of AKI - Oliguric
Diuretic
Recovery (if not then CKD may develop)
NUR 212 ACTUAL EXAM 2 (NEWLY UPDATED) VERIFIED
QUESTIONS (100% SOLVED) GUARANTEED PASS
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Normal creatinine levels? - Male: 0.6-1.2 Female: 0.5-1. Normal GFR? - 90 - 120ml/min At which GFR level does dialysis begin? - 15 S/S of acute glomerulonephritis? - Headache, increased BP, facial edema, malaise, low grade fever, weight fain, proteinuria, hematuria, and oliguria S/S of chronic glomerulonephritis? - Proteinuria and hematuria Lab findings for glomerulonephritis? - Increased BUN, CR Decreased albuminin Common s\e of hemodialysis? - Hypotension due to all of the blood and fluids leaving the body Nephrotic syndrome s\s - SEVERE proteinuria MASSIVE edema Hypertension, foamy urine, anasarca, ascites Why might medication doses be decreased for a patient with kidney issues? - Due to medications not being excreted through kidneys Prerenal causes - Due to decreased blood flow to kidneys Cardiovascular disorders, hypovolemia, peripheral vasodilation, renal vascular obstructions, severe vasoconstriction Intrarenal causes - Due to damage to the gumeruli, interstitial tissue or tubules (parynchymal damage) Acute tubular necrosis, exposure to nephrotoxins, acute GNP, SLE, obstetric complications, and malignant hypertension Post renal causes - Obstruction to the urine collecting system BPH Phases of AKI - Oliguric Diuretic Recovery (if not then CKD may develop)

NUR 212 ACTUAL EXAM 2 (NEWLY UPDATED) VERIFIED

QUESTIONS (100% SOLVED) GUARANTEED PASS

Oliguric Phase - Urinary changes (output less than 400ml/day) Lasts 10- 14 days Neck veins distended, bounding pulse, edema, hypertension Increased potassium (causing heart issues!) Diuretic Phase - Daily urine output 1 - 3 liters may reach 5L or more Monitor for hyponatremia, hypokalemia, and dehydration as well as hypotension This phase may last 1-3 weeks Why would calcium gluconate be given to a patient with AKI? - Due to hyperkalemia, calcium gluconate raises the threshold at which dysrhythmias occur therefor protecting the heart Nursing interventions for almost all kidney patients - Fluid restriction Daily weights If there is abdominal pain during hemodialysis what should the nurse do? - Decrease the flow rate What is given to excrete potassium? - Kayexelate What is an important thing to remember for the process of peritoneal dialysis? - It must be completely STERILE What is a major complication from peritoneal dialysis? - Peritonitis If patient begins to have pain or cramping during peritoneal dialysis what should the nurse do?

  • Slow down the infusion rate At what temperature is peritoneal dialysis given? - Must be warmed to body temperature What medication can cause an IBS flare up? - Sulfasalazine (anti-inflammatory medication) Treatment goals for CKD? - Treat hyperkalemia, HTN, and mineral/bone disease Potassium enriched foods? - Bananas, tomatoes Why would a patient with CKD have pruritus? - Due to uremic frost (urea crystallizes on skin) cure for ulcerative colitis - illiostomy, removal of colon, J-pouch issues for Crohns can happen from where? - From mouth to anus
  1. culture
  2. antibiotics What does the term anasarca mean? - edema of the whole ass body Where does edema start for glomerularnephritis? - edema starts at the eye nephrotoxic meds? - - mycins
  • lasix
  • contrast dye
  • aminoglycosides Pt is having crohns exacerbation and dehydration and diarrhea for 4 - 5 days, what are we worried about? - hypokalemia What is hemodialysis biggest infection risk? (from the nurse) - hepatitis Hemodialysis Complications - Hypotension Muscle cramps Loss of blood Hepatitis Sepsis Disequilibrium syndrome (headache, twitching, cerebreal edema, nausea, vomiting) Someone comes in with IBD exacerbation, what kind of diet is patient put on? - NPo, advances to clear liquid Someone with guillaine barre syndrome with tube feed, how do you start it? - trickle it in and then slowly advance, due to GI mobility complications. Goodpasture syndrome clinical manifestations? - flu-like symptoms with pulmonary symptoms: cough, mild shortness of breath, hemoptysis, crackles, rhonchi, pulmonary insufficience, hematuria, weakness, pallor, anemia, renal failure goodpasture syndrome causes? - causes lung cancer and kidney diease, causes bleeding into the lungs and glomerulonephritis What kind of temperatures may cause an exacerbation for MS? - hot or extreme temperatures What is the pathohysiology of MS? - damage to the myelin sheath Age of onset of MS - 20 - 40, more common in women Can myelin sheath regenerate? what is this called? - yes it can, it is called remission

Clinical manifestations for MS - blurred or double vision muscle weakness blowel/bladder dysfunction paralysis numbness and tingling speech impediment extreme fatigue Medications for treatment of MS - - B-interferon - self injection (may cause flu-like symtoms, take acetametaphin) helps regulate body

  • dimethyl furmarate - immunosuppresant
  • ACTH - corticosteroid
  • Bethanechol - cholergenic, used for symptom management s/s cholergenic crisis (increased with cholergenic meds, decreased with anticholergenic meds) - S - salivation L - Lacrimation U - urination D
  • Defecation G - GI motility E - Emesis Cholergenic meds needs tapered Patient teaching for newly diagnosed MS patient, patient is concerned and asks "am I going to be like this forever" what is the nurses response? - not necessarily, MS can get better overtime with adherence tomedication What kind of vision changes is a MS patient at risk for? - Blurred vision double vision red-green color distortion blindness in one eye Newly diagnosed patient with MS what should we assess for at home? - asses for fall risk at home When should a patient with MS contact their doctor? - If symptoms worsen or any respiratory distress myasthenia gravis - a chronic autoimmune disease that causes serious weakness of voluntary muscles, caused by antibodies attacking ACH receptors. s/s of myasthenia gravis - - diplopia (double vision)
  • ptosis (eyelid drooping)
  • sleepy appearance
  • dysphagia, choking, dysphasia
  • Ultimate confirmation of the disease is a positive response to antiparkinsonian drugs Carbidopa/Levodopa - - Antiparkinson Agent
  • effects may take several weeks to months
  • S/E mental status changes, dyskinesia, palpitations, severe nausea vomiting, difficulty urinating Drugs used for parkinsons disease? - anticholinergic carbidopa/levodopa deep brain stimulation - can be used to treat tremors and uncontrolled movements for parkinsons disease. Electrodes are surgically placed in the brains and connected to neurostimulator in the chest Diet for parkinsons - - adequate fiber and fruit
  • 6 small meals a day
  • thickened liquids if patient has dysphagia What can impair levodopa absorption? - protein, limit protein intake to evening meals to decrease this problem guillain barre - characterized by an autoimmune process that occurs a few days or weeks following a viral or bacterial infection When does Guillain Barre present? - ascending , rapidly progressive, symmetric weakness of the limbs. maximal weakness is reached in 4 weeks, can fully recover from this. First symptoms of Guillain Barre? - pain, parasthesia (numbness and tingling), and hypotonia (reduced muscle tone) of the limbs. Areflexia (lack of reflexes), and paralysis. Most serious complication of GBS? - Respiratory Failure, patient may need intubated Possible complications from patient being intubated and immobilized? - - respiratory infection (intubation)
  • UTI (foley)
  • Pressure ulcers/DVT (immobilzation)
  • peg tube/ feeding tube (due to paralysis) When is immunoglobulin most effective, when treating Guilain Barre? - if administered within the first 2 weeks of symptom onset Pt comes in with crohns exacerbation, what do we anticipate being part of the care plan? - - skin care
  • NPO
  • small sips of clear liquids (bowel rest)

Rhabdomyolysis - in which damaged skeletal muscle breaks down rapidly, releasing myoglobin into the kidneys, in which the kidneys are unable to filter due to size of the protein leading to AKI. Are you always on dialysis with an AKI and a CKD? - AKI - no, can get better CKD - yes Does hospice accept dialysis patients? - no, if continuing dialysis need to do palliative care, must stop dialysis to do hospice Main population at risk for CKD? - African Americans Leading causes of CKD? - diabetes, hypertension Uremia - decline in kidney function, causing blood to be more acidic Urinary changes in patient with CKD - - early on patient will not have changes in output

  • polyuria may be present
  • difficulty with fluid retention
  • after dialysis pt may develop anuria (no pee) lab changes in CKD? - GFR decreases BUN/Creatnine
  • increase Metabolic changes in patient with CKD? - - mild/moderate hyperglycemia
  • hyperinsulinemia (may not need as much insulin before dialysis)
  • hyperkalemia
  • increase in triglycerides
  • anemia (due to decreased production od erythropoietin) - give pt iron
  • platelet/WBC levels dont change but wont function as well What is the most common cause of death in a patient with CKD? - CV disease GI symptoms in a patient with CKD? - stomatitis metallic taste uremic factor anorexia nausea vomiting weightloss malnutrtion Neuro symptoms in a patient with CKD? - depressed Restless leg syndrome tired/fuzzy peripheral neuropathy
  • when hypertension develops abruptly could be renal artery stenosis
  • tx is treat hypertension