Hypocalcemia and tetany can occur if parathyroid glands are damaged or removed

Hypocalcemia and tetany can occur if parathyroid

This preview shows page 6 - 8 out of 10 pages.

> Hypocalcemia and tetany can occur if parathyroid glands are damaged or removed. Indications are tingling of toes or around mouth, and muscle twitching. Check for positive Chvostek's and Trousseau's signs. Ensure that IV calcium gluconate or calcium chloride are immediately available. > If no drain is in place, prepare the client for discharge the day following surgery as indicated. However, if a drain is in place, the surgeon will usually remove it, along with half of the surgical clips, on the second day after surgery. The remaining clips are removed the following day before discharge System Specific Assessments - (1) Polycystic Kidney Disease, Acute Kidney Injury and Chronic Kidney Disease: Expected Findings (Chp 59) Expected findings are nausea, fatigue, lethargy, involuntary movement of legs, depression, intractable hiccups In most cases, findings are related to fluid volume overload Serum creatinine gradually increases 1 to 2 mg/dL every 24 to 48 hours or 1 to 6 mg/dL in 1 week 6
Image of page 6
BUN can increase to 80 to 100 mg/dL within 1 week Urine specific gravity greater than 1.000 to 1.010 in postrenal type (1.030 in prerenal) Decreased Hgb & Hct Decreased sodium and calcium and increase in potassium, phosphorus, and magnesium Renal Calculi: Assessing Client Pain (RM AMS RN 10.0 Chp 61, Active Learning Template - System Disorder) Flank pain suggests calculi is in ureters or kidney Flank pain that radiates to the abdomen, scrotum, testes, vulva suggest calculi in ureter or bladder Physiological Adaptation Alterations in Body Systems - (4) Acid-Base Imbalances: Identifying Client at Risk for Metabolic Alkalosis (Chp 45) Continuous suctioning Oral ingestion of excess amount of bases (antacids) Venous administration of bases (blood transfusions, total parenteral nutrition, or sodium bicarbonate) Acid deficit>> loss of gastric secretions (prolonged vomiting, suctioning), potassium depletion (thiazide diuretics, laxative overuse, cushing’s syndrome, hyperaldosteronism), increased digitalis toxicity Asthma: Using a Peak Flow Meter (Chp 18) Stand up, inhale, put to mouth, exhale, record Postoperative Nursing Care: Monitoring for Wound Complications (Chp 96) Observe drainage tubes for patency and proper functioning Check dressings for excessive drainage and reinforce as needed. Report excess drainage to the surgeon. Outline drainage spots with a pen, noting date and time. Report increasing drainage to the surgeon. Encourage the client to consume a diet high in vitamin C, protein, and calories. If wound dehiscence or evisceration occurs, call for help, stay with the client, cover the wound with a sterile towel or dressing that is moistened with sterile saline, do not attempt to reinsert organs, place in a low-fowler’s position with hips and knees bent, monitor for shock, and notify provider immediately.
Image of page 7
Image of page 8

You've reached the end of your free preview.

Want to read all 10 pages?

  • Spring '16

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture