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ATI MED SURG PROCTORED STUDY GUIDE 2021/2022 - Correct Questions & Answers with Rationales $18.49   Add to cart
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ATI MED SURG PROCTORED STUDY GUIDE 2021/2022 - Correct Questions & Answers with Rationales
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  • ATI PHARMACOLOGY
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  • Chamberlain College Of Nursing

ATI MED SURG PROCTORED STUDY GUIDE 2021/2022 client receiving peritoneal dialysis. monitor client for adverse effects peritonitis Rationale: Peritonitis is an adverse effect of peritoneal dialysis. Prevention requires using sterile technique, and frequent assessment of catheter exit site. Obtain cu...

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  • April 21, 2022
  • 198
  • 2021/2022
  • Exam (elaborations)
  • Questions & answers

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  • ati med surg proctored study guide
  • client receiving peritoneal dialysis monitor client for adverse effects peritonitis rationale peritonitis is an adverse effect of peritoneal dialysis prevention r

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  • Chamberlain College Of Nursing
  • ATI PHARMACOLOGY
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ATI MED SURG PROCTORED STUDY GUIDE 2021/2022
client receiving peritoneal dialysis. monitor client for adverse effects
peritonitis
Rationale: Peritonitis is an adverse effect of peritoneal dialysis. Prevention requires using sterile
technique, and frequent assessment of catheter exit site. Obtain cultures of dialysate outflow, or
effluent, if peritonitis is suspected Diarrhea increase fiber intake to prevent constipation, which
can reduce dialysate flow Increased serum albumin Decreased serum albumin is adverse effect
of peritoneal dialysis. Protein can be lost thru dialysis exchange, resulting in protein wasting. A
decreased serum albumin level is a manifest of protein wasting Hypoglycemia Hyperglycemia
is adverse effect that can occur in clients who have diabetes mellitus and clients who absorb
glucose from dialysate.

client w/ chronic kidney disease. instructions include
limit fluid intake
Rationale: Limit fluid intake to prevent hypervolemia, or excessive fluid overload Limit caloric
intake increase caloric intake so that body can use protein for protein synthesis instead of energy
consumption. Using protein for energy can lead to a negative nitrogen balance and malnutrition
Eat diet high in phosphorus limit phosphorus intake bc kidneys are unable to excrete it Eat
diet high in protein not eat excessive protein to prevent build-up of protein waste products and
uremia.

client receiving peritoneal dialysis. Notes client’s dialysate output is less than input &
abdomen is distended. actions take
change client's position
Rationale: Client is retaining dialysate solution after dwell time. Ensure that clamp is open and
tubing is not kinked, and reposition client to facilitate drainage of solution from peritoneal cavity
Insert an indwelling urinary catheter Peritoneal dialysis is used for clients who have acute or
chronic kidney disease. An indwelling urinary catheter will not relieve client’s discomfort
Administer pain med to client retaining dialysate solution after dwell time. Pain med will not
correct cause of client’s discomfort Place drainage bag above client's abdomen position
drainage bag lower than client’s abdomen to promote gravity drainage.

Teaching client about UTI's. manifests include
back pain
Rationale: Back pain and flank pain are manifests of a UTI. Other manifests include
frequency, urgency, and cloudy, foul-smelling urine Weight gain manifest of acute kidney
injury and fluid overload Vaginal discharge manifest of vaginal infection Muscle cramps
manifest of uremia

client w/ acute pyelonephritis. instructions include in teaching
you should complete entire cycle of antibiotic therapy
Rationale: Take full prescription of antibiotic therapy to decrease chance of regrowth of
causative organism "Maintain complete bed rest until manifests decrease." balance rest
and

,activity. Ambulation can prevent complications of bed rest such as constipation and urinary
stasis “Drink 1,000 milliliters of fluid per day." drink at least 2,000 mL per day, unless
otherwise contraindicated "Use NSAIDs for pain." NSAIDs can reduce blood flow to kidneys
and lead to further renal impairment. Take acetaminophen for pain and fever associated w/
pyelonephritis.

teaching client w/ history of UTIs. statements indicate need for additional teaching
I will use a vaginal douche daily
Rationale: Avoid vaginal douches, bubble baths, and any substances that can increase risk for
UTIs. use mild soap and water to wash perineal area "I will empty my bladder every 4 hrs"
empty bladder every 4 hr to prevent urinary stasis, which can cause UTIs "I will drink 2 liters
of fluids per day" maintain a daily fluid intake of 2 to 3 L to flush kidneys and prevent urinary
stasis "I will wear cotton underwear" wear loose-fitting cotton underwear to prevent irritation

teaching client pre-op prior to transurethral resection of prostate. understanding of info
I will feel urge to urinate following this procedure
Rationale: Client will feel urge to urinate. Reassure that he will receive analgesics to help
relieve this discomfort. “I will not need to have a urinary catheter after procedure." require
an indwelling urinary catheter after procedure to monitor urine output and bleeding "I will
expect my urine to be cloudy after having this procedure." Cloudy urine can be a manifest
of retrograde ejaculation or infection. "At least I won't have leakage of urine after having
this procedure." temporary dribbling and leakage of urine after procedure. reassure client that
these manifests will resolve

client post-op transurethral resection of prostate. Continues urinary catheter, findings
report to provider
decreased urine output
Rationale: A decrease in urine output after TURP indicates obstruction to urine flow by a clot or
residual prostatic tissue and reported to provider Pink-tinged urine blood clots are expected
findings for several days Report of burning upon urination along w/ urinary frequency are
expected findings and decrease after several days Stress incontinence expected findings d/t poor
sphincter control

client pre-op for a renal biopsy. statements make
you will need to be on bed rest following procedure
Rationale: Renal biopsy involves a tissue biopsy thru needle insertion into lower lobe of kidney.
maintain bed rest in a supine position w/ back roll for support for 2 to 24 hr after procedure to
reduce risk for bleeding. Elevate head of bed "You will be NPO for 8 hrs after procedure."
NPO for 4 to 8 hr prior to procedure; food and fluids can resume after procedure "An allergy to
shellfish is a contraindication to this procedure." allergy to shellfish is not a contraindication
to this procedure, bc contrast media is not used "A creatinine clearance is needed prior to
procedure." Bc of risk for post-procedure bleeding, preliminary lab tests include coagulation

,studies such as platelet count and prothrombin time. Tests for anemia are done to evaluate
whether a pre-procedure blood transfusion is needed.

Teaching nurse about caring for client w/ left arteriovenous fistula. statements make
avoid taking bp on client's left arm
Rationale: Avoid taking blood pressure measurements on client's left arm, which can decrease
blood flow and cause clotting "Check fistula site daily for a vibration." assess every 4 hr for
blood flow "Instruct client to restrict movement of left arm." perform range-of-motion
exercises of left arm "Instruct client to sleep on left side." Sleeping on top of extremity w/
access site can cause impairment of blood flow and possible clotting.

Client’s diagnosis of renal calculi and reports severe flank pain. priority nursing action
relieve client's pain
Rationale: Pain associated w/ renal calculi is severe and can lead to shock; therefore, this
priority action Encourage client to increase fluid intake maintain adequate fluid volume and
blood flow to kidneys Monitor client's I&O monitor for obstruction Strain client's urine
obtain stone fragments for lab analysis

collecting a 24-hr urine specimen for creatinine clearance. instructions include
place signs in bathroom as a reminder about test in progress
Rationale: Place signs in bathroom and alert family members of test in progress so that everyone
saves specimens appropriately throughout test Include first voided specimen at start of
collection period void first thing in morning, discard specimen, and collect all subsequent
specimens for 24 hr Discard last voided specimen at end of collection period include last
voided specimen at end of collection period Instruct client to increase exercise during 24-hr
period avoid vigorous exercise, cooked meat, tea, and coffee during 24-hr period

client 1 wk post-op a living donor kidney transplant. findings of acute kidney rejection
blood pressure 160/90 mmHg
Rationale: Due to kidney’s role in fluid and blood pressure regulation, client experiencing
rejection can have hypertension Creatinine 0.8 mg/dL Manifests of acute kidney rejection can
include an increase in serum creatinine Sodium 137 mg/dL Manifests of acute kidney rejection
can include an increase in sodium Urinary output 100 mL/hr Manifests of acute kidney
rejection can include decreased urine output; anuria, or no urine output; oliguria, or less than 30
mL/hr; and weight gain.

client in oliguric-anuric stage of acute kidney injury. client reports diarrhea, a dull
headache, palpitations, and muscle tingling and weakness. actions take first
check client's electrolyte values
Rationale: Check client’s most recent potassium value bc these findings are manifests of
hyperkalemia, which can lead to cardiac dysrhythmias Admin an analgesic to client dull

, headache is important to manage client’s pain Measure client's weight monitor client’s fluid
balance Restrict client's protein intake manage client’s acute kidney injury

client brought to ED after motor-vehicle crash. findings manifest bladder trauma
hematuria
Rationale: Manifests of bladder trauma include hematuria, or blood in urine; blood at urinary
meatus; pelvic pain; and anuria, or absence of urine Stress incontinence Leakage of urine during
coughing, jogging, or lifting, also known as stress incontinence, is caused by weakened pelvic
muscles Pyuria WBCs in urine, manifest of urinary tract infection Fever manifest of infection

teaching to client w/ late-stage chronic kidney disease. nutrients to increase in their diet
calcium
Rationale: Develop hypocalcemia d/t reduced production of active vitamin D, which is needed
for calcium absorption. supplement dietary calcium Phosphorous hyperphosphatemia bc
excretion of phosphorous by kidneys is reduced Potassium hyperkalemia bc excretion of
potassium by kidneys is reduced Sodium hypernatremia bc excretion of sodium by kidneys is
reduced.

Teaching client about prostate-specific antigen test. statements make
you should not ejaculate for 24 hrs prior to PSA test
Rationale: PSA is a glycoprotein that is manufactured in prostate and is used to screen for
prostate cancer. Ejaculation within 24 hrs prior to test can cause falsely elevated levels of PSA "
Fast for 8 hrs after PSA test." Fasting is not required after this procedure "Annual PSA
screening begin at age 40." American Cancer Society recommends that all men begin annual
PSA testing at age of 50. Men who have a family history of prostate cancer or men of African
descent discuss w/ their provider possible benefits of initiating testing at age 45 "Expected PSA
values will decrease as you get older." Expected PSA values increase w/ age.

client pre-op for a cystoscopy. statements make
expect to have pink-tinged urine after this procedure
Rationale: Cystoscopy is a procedure in which a scope is inserted into urethra to diagnose or
treat bladder problems. After procedure, pink-tinged urine is expected "You will need to keep
sutures clean after this procedure." There are no surgical incisions made during a cystoscopy;
therefore, no sutures are used "You will be placed on your left side for this procedure."
placed in a lithotomy position. This position provides exposure of genitalia and facilitates
insertion of cystoscope "Expect to be on bed rest for 24 hrs after this procedure." undergo a
cystoscopy as an outpatient. Bed rest for 24 hr is not indicated.

monitoring client undergoing extracorporeal shockwave lithotripsy. findings priority
dysrhythmias
Rationale: Extracorporeal shockwave lithotripsy is application of sound, laser, or dry shock
wave energies to break a kidney stone into small pieces. shock waves are initiated during R wave

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