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Study Guide Final EXAM FALL 2017

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lOMoARcPSD|1418328

Distributing prohibited | Downloaded by arlen nunez ([email protected])

NUR 3180: STUDY GUIDE FOR FINAL EXAM- FALL 2016

The examination will contain 100 multiple questions. Time allotted for this exam will be 2 1/2

hours.

The following study guide is intended to assist you in preparing for the examination and

may not contain all information included on the exam.

The template is as follows: 2 questions related to chronic disorders; 9 questions related to

hematological disorders; 9 questions related to Oncological disorders; 9 questions related to

immunological; 9 questions on Upper IG disorders; 8 questions related to Lower GI

disorders; 8 questions related to Biliary/Pancreas; 9 questions related to Hepatic disorders;

8 questions related to Endocrine disorders; 9 questions related to endocrine-Diabetes

disorders; 8 questions relate to urinary disorders (infectious, obstructive..); 12 questions

related to renal disorders (glomerulonephritis, RF, Cancer..)

Please review the following concepts:

 Chronic disorders:

o Activity and tolerance, levels of activity, outcomes when planning activities/

plan of care chronic conditions.

 Hematological disorders:

o Blood transfusion nursing interventions, rate of first 5-minute infusion.

Electrolytes for patients with polycythemia Vera, Neutropenia, Risk factors of

anemia, B12 deficiency and nurse assessment, iron deficiency anemia, blood

transfusion and reactions

ful

 Oncological disorders:

o Revise Leukemias, lymphoma, myeloma with ss., nursing management,

treatment, radiation and effective nursing interventions, chemotherapy induced

anemia (nursing diagnosis). Revise bone marrow transplant, ATP.

 Immunological disorders:

o Hypersensitivities be able to differentiate them, AIDS and signs and symptoms,

labs, education, RA ss, preoperative and medication assessment by the nurse,

SA labs

 Upper GI disorders

o GERD and patient education, EGD: be able to explain and care after test. Hiatal

hernia, GI bleeding sings, H. Pylori, gastroenteritis and fluid replacement, PUD,

purpose of NGT, duodenal ulcer,

 Lower GI

o Crohns disease, ulcerative colitis, and signs of complication, appendicitis

assessment, diverticulitis, diverticulosis including diagnostic tests, peritonitis,

gastric surgery and diet- education, small and large bowel obstructions

including complications Who may receive TPN?

 Biliary/ Pancreatic/ hepatic

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o Cholecystitis, cholelithiasis signs and symptoms, importance of ambulation

after surgery, pancreatitis, liver cirrhosis including end-stage, general lab

results, jaundice, Whipple procedure, cancer, liver transplant, hepatitis- types

education, ascites, TIPS, complications. Fetor hepaticus.

 Hepatic disorders

o See above, include diet. Blumberg’s sign. Acute and chronic conditions.

o Hepatitis types, ss. education

 Endocrine disorders

o Pituitary hyper-hypo, SIADH nursing interventions, Addison’s disease and

compliance, hyper, hypothyroidism, parathyroid, thyrotoxicosis, surgeries E.g.

Adrenalectomy, thyroidectomy - complications, lab results,

pheochromocytoma, IVF replacement …

 Endocrine- Diabetes

o Diabetes type one, ss, causes, assessment findings by the nurse, priorities,

teaching to diabetic patients both types, incorrect blood glucose? What to do,

DKA, insulins IV, SQ, 50% glucose

 Renal disorders/urinary disorders

o Chronic Kidney Disease

CKD is an umbrella term that describes kidney damage or a decrease in

the glomerular filtration rate (GFR) lasting for 3 or more months.

Untreated CKD can lead to end-stage kidney disease (ESKD).

Risk factors include cardiovascular disease, diabetes, hypertension, and

obesity, with diabetes being the main cause of CKD- anything that

messes with blood flow to kidneys

Main one is diabetes because the kidneys are working harder because

of the high sugar levels

Stages in CKD include (normal GFR is 125 ml/min/1.73):

 Stage 1 GFR>90 mL/min/1.73

 Stage 2 GFR 60-89 mL/min/1.73

 Stage 3 GFR 30-59 mL/min/1.73

 Stage 4 GFR 15-29 mL/min/1.73

 Stage 5 GFR <15 mL/min/1.73**

o In Stage 5, the patient is diagnosed with end-stage

kidney disease and the patient will need renal

replacement therapies, dialysis, or kidney

transplantation

 Clinical manifestations include elevated serum creatinine (0.6-1

is normal), anemia due to decreased erythropoietin production,

metabolic acidosis, edema, and as it progresses abnormalities in

electrolytes, heart failure worsens because you’re not excreting

fluids, and hypertension becomes more difficulty to control.

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o Acute Nephritic Syndrome

Acute nephritic syndrome is a type of renal failure with glomerular

inflammation. Glomerulonephritis is an inflammation of the

glomerular capillaries that can occur in acute and chronic forms- will

have problems with filtering and you’ll go into kidney injury.

Relation with respiratory infections and the cause

 Following some infections (streptococcal infection of the

throat, impetigo, upper respiratory tract infections, mumps,

varicella zoster virus, Epstein-Barr virus, hepatitis B, and HIV),

the antigens outside of the body initiate an antigen-antibody

production that is deposited in the glomerulus of the kidneys

leading to glomerulonephritis and a decreased GFR

 Know it’s upper respiratory

Clinical Manifestations

 Hematuria (RBC casts indicate glomerular injury)

 Edema and some degree of hypertension

 Azotemia (abnormal concentration of nitrogenous wastes in

the blood)

 Proteinuria

 High concentration of Na in urine. 20 is normal in urine.

 Hypoalbuminemia because kidneys aren’t getting the protein

 Hyperlipidemia

 Oliguria

 Decreased GFR

 High creatinine normal 0.6-1.2

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