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Blood urea nitrogen
Terms Definitions
slowed movement
difficulty writing
rhythmic contraction and alternate relaxation of a limb that is caused by suddenly stretched position
rapid shaking of the eyes
medication that neutralizes acid that's already been made
difficult poorly articulated speech resulting from interference in the control over the muscles of speech
Monoparesis or Monoplegia:
affecting one limb
Acute complication of cerebral edema:
disease discription
Paroxysmal, uncontrolled electrical discharge of neurons in the brain that interrupts normal function.
What neurological symptoms of hypokalemia would be observed in a patient?
decreased reflexes
Common test for renal caliculi?
CT scan
etiology/ cause
Cause: Localized or generalized inflammatory process of the peritoneum
Primary - blood borne organisms enter peritoneal cavity
Secondary - abd. Organs perforate/rupture & release contents into peritoneal cavity (ex. Appendix rupture)
**Can be fatal!**
disease discription
Polyneuritis: peripheral nerve disease; autoimmune inflammatory response to prior infection.
Acute immune-mediated polyneuropathy d/t damage to myelin sheath of Peripheral Nerves.
s/s fluid overload:
rapid/bounding pulse, distended neck veins, HTN, cough, SOB, crackles, HA, restlessness
s/s of pyleonephritis:
HA, increased BP, facial/periorbital edema, lethargic, low grade temp, wt gain (edema), and protein-, hema-, olgi-, dys- uria
Myasthenic Crisis
an acute exacerbation of disease caused by inadequate amount of meds, infection fatigue or stress.
types of urinary tract caliculi
calcium oxalate (30-45%)
calcium phosphate (8-10%)
struvite (10-15%)
cystine (1-2%)
Mnemonic for Cholinergic Crisis Symptoms:
L- LACRIMATION (tearing)
Unilateral weakness of facial muscles
Pain around ear
Unilateral inability to close eye
Drooping of mouth
Inability to smile, frown, whistle
paralysis that distorts smiling, eye closure, salivation, and tear formation on the affected side.
Distinguishing it from the facial paralysis associated with some strokes, which affect the muscles of the mouth more than those of the eye or forehead.
Complication: Corneal abrasion or ulceration
Residual facial weakness
what is the antidote for a cholenergic medication?
What is glomerulonephritis?
-loss of kidney function
-acute lasts 5-21 days
-chronic after acute phase or slowly over time
Tensilon Test
Used to diagnose MG and to differentiate between myasthenic crisis and cholinergic crisis.
disease discription
Autoimmune dz, progressive degeneration of CNS; the body attacks its own tissues, destroying nerve fibers of the brain and spinal cord (disseminated demyelination)
No Cure
Absence (Petite-Mal) Seizure
usually occurs during childhood and decreases with age. Sudden LOC w/ little or no tonic clonic movement, occurs without warning, and appears a few hours after arising or when pt is quiet.
Signs: vacant facial expression w/ eyes focused straight ahead.
s/s: Risk complications: Swallowing/Arrest
Ptosis, diplopia
Weakness, dysarthria, dysphagia, difficulty sitting up,
Respiratory distress
Eye and periorbital muscles most affected- manifested by diplopia, ptosis, ocular palsies
Sx least evident in the AM and most evident w/effort as the day proceeds
Crisis: Sudden exacerbation of motor weakness putting client at risk for respiratory failure and aspiration:
Pneumonia &
MYASTHENIC CRISIS: Respiratory, and swallowing muscles too weak. Risk complications: Swallowing/Arrest
THYMOMA-A rare neoplasm, usually found in the anterior mediastinum and originating in the epithelial cells of the thymus.
Assess an maintain respiratory, swallowing, atelectasis.
Flaccid paralysis, respiratory failure, GI symptoms, severe muscle weakness, vertigo. Tx: Atropine
Bowel Obstruction:
Dietary modification
**NPO** to prevent obstruction to progress to bowel perforation.
TPN & Bowel rest until obstruction resolved.
speed shock
caused by rush of IV fluid administered; med races to blood-rich heart and brain and floods them w/toxic levels of med
What is decerebrate posturing?
Extensor response:
Hands pushed to sides and body hyper-extended.
Arms are stiffly extended, adducted & hyperpronated. Hyperextension of the legs with plantar flexion of the feet. (May indicate more serious damage.)
"extensor = All E's"
Characteristic of Proteinuria:
foamy urine due to excess protein
While taking Cipro or Levaquin if you experience dizziness, light sensitivity or light-headedness what might this indicate:
CNS toxicity
Clinical Manifestations Bell's palsy
One-sided facial paralysis, Loss of corneal reflex, Loss or impairment of taste, Increased tearing from lachrymal gland
If Macrobid causes pulmonary side effects such as SOB, cough, etc when will they subside?
2-3 days after stopping
s/s: facial pain.
Severe facial pain occurring for brief seconds to mins hundreds of x/day, several x/yryear
Usually occurs unilaterally in area of mouth and rises toward ear &eye
Triggers: areas on the face may initiate the pain- eating, swallowing, talking
Often there is spontaneous remission after years, and then condition recurs with dull ache in between pain episodes.
Assess/monitor pts trigger factors, complications of pain, nutrition, hygiene, oral care, anxiety.
Physical Assessment of Renal System-
Renal System- PERCUSSION:
Tenderness in the flank area may be detected by fist percussion (kidney punch).
Normally a firm blow in the flank area should not elicit pain.
Normally a bladder is not percussible until it contains 150 ml of urine. If the bladder is full, dullness is heard above the symphysis pubis. A distended bladder may be percussed as high as the umbilicus.
Physical Assessment of Renal System-
Because almost all creatinine in the blood is normally excreted by the kidneys, creatinine clearance is the most accurate indicator of renal function. The result of a creatinine clearance test closely approximates that of the GFR.
Bell's Palsy Nursing Interventions:
protect the eyes.
Eyes can be excessively dry or teary.
5 S/S of ICP:
1. Visual changes and headaches.
2. Change in LOC and blown pupil.
3. widened pulse pressure, increased BP, bradycardia, and hyperflexia.
4. Vomiting
5. papilledema (choked eye disc)
Motor changes: opposite side, balance, coordination, gait, proprioception
Sensory Changes: Aphasia, Agnosia, Apraxia, Visual problems, hemianopsia
Cognitive Changes: impaired memory, disoriented
Paralysis, difficulty swallowing, talking, memory, pain.
Assessment includes: glasgow coma scale/LOC
A client is admitted with acute pancreatitis. Which laboratory result should the nurse expect?
1) Creatinine of 4.3 mg/dl
2) ALT of 124 international units/L
3) Amylase of 306 units/L
4) Troponin level of 3.5 mcg/L
3)Pancreatitis involves activation of pancreatic enzymes, such as amylase and lipase. Therefore, serum amylase and lipase levels are elevated in a client with acute pancreatitis.
Serum creatinine levels are elevated with kidney disfunction.
Injury or disease of the liver elevated ALT levels.
Troponin levels are elevated with heart damage such as myocardial infarction.
What are some expected changes that may be seen when assessing pts w/ Brain Herniation as a result of IICP?
IICP Brain Herniation:
- Unilateral dilated pupil.
- sluggish, equal pupil response.
A nurse is assessing a client diagnosed with acute pyelonephritis. Which of the following symptoms does the nurse expect to see?
1) Jaundice and flank pain
2) Costovertebral angle tenderness and chills
3) Burning sensation on urination
4) Polyuria and noc
RATIONALE: 2) Costovertebral angle tenderness and chills are symptoms of acute pyelonephritis (inflammation of the kidney and renal pelvis).
Jaundice indicates gallbladder or liver obstruction.
A burning sensation on urination is a sign of lower urinary tract infection (UTI).
Nocturia is associated with a lower UTI or benign prostatic hyperplasia.
Polyuria is seen with diabetes mellitus, diabetes insipidus, or the use of diuretics.
Daily abdominal girth measurements are prescribed for a client with liver dysfunction and ascites. To increase accuracy, the nurse should use which landmark?
1) Xiphoid process
2) Umbilicus
3) Illiac crest
4) Symphysis pubis
2) The proper technique for measuring abdominal girth involves using the umbilicus as a landmark while encircling the abdomen with a tape measure.
Using the xiphoid process, the iliac crest, or the symphysis pubis as a landmark would yield inaccurate measurements.
What is the difference between and ischemic & hemorrhagic stroke?
ISCHEMIC STROKE- results from inadequate blood flow to the brain from partial or complete occlusion of an artery. They are further divided into thrombotic and embolic.
**Warning sign is usually a TIA and happens during or after sleep, slower progression, and recurrence is common.
HEMORRHAGIC STROKE- results from bleeding into the brain tissue itself (intracerebral or intraparenchymal hemorrhage) or into the subarchnoid space or ventricles (subarachnoid hemorrhage or intraventricular hemorrhage).
**Warning sign is usually a headache and happens during activity, sudden onset and fatality more likely with presence of coma.
A client is diagnosed with cystitis. Client teaching aimed at preventing a recurrence should include which instruction?
- 1. Bathe in a tub.
- 2. Wear cotton underwear.
- 3. Use a feminine hygiene spray.
- 4. Limit your intake of cranberry juice.
RATIONALE: 2) Cotton underwear prevents infection because it allows for air to flow to the perineum. Women should shower instead of taking a tub bath to prevent infection. Feminine hygiene spray can act as an irritant. Cranberry juice helps prevent cystitis because it increases urine acidity; alkaline urine supports bacterial growth, so cranberry juice intake should be increased, not limited.
A client with renal insufficiency is admitted with a diagnosis of pneumonia. He's being treated with IV antibiotics, which can be nephrotoxic. Which laboratory value(s) should be monitored closely?
- 1. Blood Urea Nitrogen (BUN) and creatinine levels
RATIONALE: 1) BUN and creatinine levels should be monitored closely to detect elevations due to nephrotoxicity. ABG determinations are inappropriate for this situation. Platelets and potassium levels should be monitored according to routine.
A client, with cirrhosis of the liver, develops asciteis. The nurse should expect the physician to write which of the following orders.
1) Restrict fluid to 1,000ml per day
2) Ambulate 100ft, TID
3) High Sodium diet
4) Maalox 30 mg PO BID
RATIONALE: Restrict fluids decreases in the amount fluid present in the body, thus decreasing the amount of fluid, accumulation in the peritoneal space.
Other temp. treatments include a restriction of physical activity, a low-sodium diet. And the use of diuretics.
A nurse is caring for a client diagnosed with diverticulous. Which should be the nurse expect to institute?
1) Low Fiber diet and fluid restriction
2) Total parenteral nutrition and bed rest.
3) High fiber diet and administration of psyllium
4) Administe
RATIONALE: 3) Diverticulosis is characterized by an out-pouching of the colon. The client needs a high fiber diet and psyllim (bulk laxative) administration to promote normal soft stools.
A low fiber diet, decreased fluid intake, bed rest, analgesics, and some antacids can lead to constipation.
A nurse is advising a client with a colostomy who reports problems with flatus. Which food should the nurse recommend?
1) Peas
2) Cabbage
3) Broccoli
4) Yogurt
4)High fiber food stimulate peristalsis and thus, flatulence.
Tell the client to include yogurt in his diet to reduce gas formation. Other helpful foods include crackers and toast.
Peas, cabbage, and broccoli are all gas forming foods.
if pt is on acid-ash diet to decrease pH of urine what will it include:
bread, cereal, whole grains, cranberries, legumes, tomatoes,oysters, fish, poultry, pastries
A client has undergone a colostomy for a ruptured diverticulum. The nurse is assessing the client's colostomy stoma 2 days after surgery. Which assessment finding should the nurse report to the physician?
1) Blanched stoma
2) Edematous stoma
3) Reddish pi
4) A brownish black stoma color indicates a lack of blood flow to the stoma, and necrosis is likely.
A blanched or pale stoma indicates possible decreased blood flow and should be assessed regularly.
2 days postoperatively, the stoma should be edematous and reddish pink.
ICP: What are some expected changes in vital signs when a patient shows signs of increased ICP?
Cushing's triad (3 sx) = may present over time or present suddenly.
1. Widening pulse pressure= SPB increases, but DBP stays same.
2. Bradycardia
3. Hypertension
Temperature will also increase if hypothalamus is impacted.
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