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NURS 6531 FINAL EXAM STUDY GUIDE / NURS6531 FINAL EXAM STUDY GUIDE(LATEST)| -WALDEN UNIVERSITY
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NURS 6531 FINAL EXAM STUDY GUIDE / NURS6531 FINAL EXAM STUDY GUIDE(LATEST)| -WALDEN UNIVERSITY
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NURS 6531 FINAL EXAM STUDY GUIDE, NURS 6531 FINAL EXAM STUDY GUIDE.
1.) Hydrocele
Definition: an accumulation of fluid within the tunica vaginalis surrounding
the testicle; it may also result from a patent processus vaginalis at birth and
sometimes closes spontaneously within the first 1 to 2 years of life.
Hydroceles are the most common cause of painless scrotal swelling.; in
adults they are often the result of trauma, a hernia, testicular tumor, or
torsion or a complication of epididymitis.
Presenting Symptoms: Usually painless and may be present for long
periods, partially resolve, and recur before the patient seeks medical
attention. Gradual enlargement of the scrotum occurs with marked edema,
which may be uncomfortable because of the added weight. A hydrocele may
occur secondary to a tumor when excess serous fluid accumulates in the
scrotal sac. It will transluminate but may make testicular palpation difficult.
Leik Review:
Hydrocele more common in infants. Serous fluid collects inside the tunica
vaginalis. During scrotal exam, hydroceles are located superiorly and
anterior to the testes Most hydroceles are asymptomatic.
Will glow with transillumination. If new-onset hydrocele in an adult or
enlarging hydrocele, order scrotal ultrasound and refer to urologist.
Differential Diagnoses: Epididymitis, Testicular torsion, epididymal cyst
Review questions:
1. A patient who has had a swollen, nontender scrotum for one week is
found to have a mass within the tunica vaginalis that transilluminates
readily. The family nurse practitioner suspects:
a.) a hydrocele.
b.) a varicocele.
c.) an indirect inguinal hernia.
d.) carcinoma of the testis.
2.) Chronic Kidney failure: (member did not use template, no review
questions received-this is all I got)
Definition: The absence of kidney function. Kidney failure is also known as End
Stage Kidney Disease. It is characterized by anuria and the need for renal
replacement therapy or kidney transplant. The kidneys and urinary tract system no
longer filter blood, create filtrate. Or excrete urine in amounts sufficient to clear
,waste and balance fluid intake with output. Key highlights: Proteinuria or
hematuria, and /or a reduction in the glomerular filtration rate, for more than 3
months duration. The most common causes are diabetes mellitus and hypertension.
Most people are asymptomatic and the diagnosis is determined only by laboratory
studies.
Differential diagnosis: obstructive uropathy, nephrotic syndrome,
glomerulonephritis
3.) Acute tubular necrosis (member did not use template, no review questions
received-this is all I got)
Definition: reversible or irreversible type of renal failure caused by ischemic or
toxic injury to renal tubular epithelial cells. The injury results in cell death or
detachment from the basement membrane causing tubular dysfunction.
A history of hypotension, fluid depletion, or exposure to nephrotic agents is
usually present. In otherwise healthy individuals, when the underlying insult is
corrected, the patient frequently has a good outcome with complete renal recovery.
There is no specific therapy for acute tubular necrosis apart from supportive care.
Differential diagnosis -Prerenal azotemia, intrinsic renal azotemia
Treatment Options: There is no specific treatment apart from supportive care in
maintaining volume status and controlling electrolyte and acid-base abnormalities.
Nephrotoxins should be ceased or if this is not possible, dose should be decreased.
Review questions:
A client had excessive blood loss and prolonged hypotension during surgery. His
postoperative urine output is sharply decreased, and his blood urea nitrogen (BUN)
is elevated. The most likely cause for the change is acute:
A) Prerenal inflammation
Bladder outlet obstruction
C) Tubular necrosis
D) Intrarenal nephrotoxicity
Which of the following is a sign or symptom of acute tubular necrosis (acute
kidney injury)?
answer-Thirst and increased rapid pulse
symptoms of ATN can vary depending on severity. and one may have- problems
waking up, feeling drowsy even during day time , feeling lethargic or physically
drained, being excessively thirsty or experiencing dehydration, urinating very little
or even not at all, retaining fluid or experiencing swelling in body, having episodes
of confusion and experiencing nausea and vomit
, 4. Indirect inguinal hernia
Definition: Indirect inguinal hernia – Indirect inguinal hernia is caused by a birth
defect in the abdominal wall that is present at birth. A scrotal-inguinal hernia
results when a segment of the bowel slips through the internal inguinal ring, where
it may remain in the inguinal canal or pass into the scrotal sac. An inguinal hernia
may occur as a result of a defect in the anterior abdominal wall or because of a
patent process vaginalis. Inguinal hernias predominantly affect men (9:1) and have
the highest incidence in men aged 40 to 59. A hernia may move freely between the
abdomen and the scrotum or can be spontaneously reduced by digital
manipulation. When a hernia becomes strangulated or is unreducible, this
compromises the blood supply and requires emergent surgical reduction.
Strangulation should be suspected when a tender mass is palpated in the scrotum in
addition to redness, nausea, and vomiting
Presenting Symptoms: Scrotal swelling, mild to moderate pain on straining,
scrotal heaviness, and the possible presence of a bulge are common complaints.
Increased edema after standing in an erect position but decreases when the patient
is recumbent.
3 Differential Diagnoses: undescended testis, lymphadenopathy, femoral hernia
Pattern Recognition: Enlarged hemiscrotum or a bulge in the groin area that may
spontaneously reduce when the patient is supine or with manual reduction. The
provider will not be able to move the fingers above the mass, which should be soft
and mushy but painless unless it is incarcerated and ischemic. Scrotal hernias do
not transilluminate. Auscultation of bowel sounds over the mass is significant for
the diagnosis of bowel in the scrotal sac.
Treatment options: If the herniated bowel is reducible, surgical referral for
possible future repair is indicated. Difficulty in reducing a hernia is cause for
urgent surgical intervention. However, pain may indicate incarceration of the
bowel or complete inability to reduce the hernia, which is cause for immediate
emergency department referral and surgical exploration.
Review questions:
1. Mr. S. comes to you with scrotal pain. The examinations of his scrotum, penis,
and rectum are normal. Which of the following conditions outside of the scrotum
may present as scrotal pain?
A. Inguinal herniation and peritonitis **
B. Renal colic and cardiac ischemia
C. Pancreatitis and Crohn ’ s disease
D. Polyarteritis nodosa and ulcerative colitis
Rationale: Conditions outside of the scrotum that may present with scrotal pain are
abdominal aortic aneurysm, inguinal herniation, pancreatitis, renal colic,
peritonitis, intraperitoneal hemorrhage, and polyarteritis nodosa. Keep in mind that
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