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NURS 4700 NURSING CONCEPTS AND INTERVENTIONS EXAM 1 STUDY GUIDE RATED A MARQUETTE UNIVERSITY
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NURS 4700 NURSING CONCEPTS AND INTERVENTIONS EXAM 1 STUDY GUIDE RATED A MARQUETTE UNIVERSITY
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NURS 4700 NURSING CONCEPTS ANDINTERVENTIONS EXAM 1 STUDY GUIDE RATED
A MARQUETTE UNIVERSITY
,What is dialysis? When does it begin
✔✔-External machine that acts as kidney; two methods available include
peritoneal dialysis and hemodialysis
-Begun for uremia failing conservative management and initiated with
GFR <15
What is peritoneal dialysis?
✔✔3 phases:
1. Inflow: prescribed amount of fluid that's infused into peritoneal area
within 10 minutes
2. Dwell: where diffusion and osmosis occurs
3. Drain: takes 15-30 minutes, may have to massage area
-Can do it in comfort of own home
PD: nursing assessment and interventions
✔✔1. Dry weight each morning
2. PD procedure is sterile: connector port is cleaned with iodine
3. Assess catheter and insertion site
3. Assess for complications: *cloudy PD fluid (infection, peritonitis)*,
hernia, lower back problems, bleeding, pulmonary complications, protein
loss
Hemodialysis: AV fistula or graft
✔✔-Post-op: don't sleep on side of affected arm, don't carry heavy objects
with affected arm, assess bruit and thrill
-*In affected arm, NEVER*: take BP, draw blood, insert IV
-If pain or coldness in fingers: notify MD
,Hemodialysis procedure
✔✔-Before treatment: assess fluid status, condition of vascular access,
temperature, patient weight
-During treatment: be alert to changes in condition, perform VS q 30-60
mins, weight patient at end
Hemodialysis complications
✔✔1. Hypotension
2. Muscle cramps: hypotension, hypovolemia, high rate, dialysate rate
3. Loss of blood: tubing, access site, heparin
4. Hepatitis
Continual Renal Replacement Therapy
✔✔-alternative and adjunctive method for treating critically ill patients
with AKI and ARF: hemodynamically unstable, fluid overload, or sepsis
-acid-base status and electrolyte balance adjusted slowly and
continuously
What is shock?
✔✔-Circulatory system abnormality resulting in inadequate tissue
perfusion and decreased cellular metabolism
-*Biggest prevention of shock is being aware of potential risks for shock*
What are the different types of shock?
✔✔1. Cardiogenic
2. Hypovolemic
3. Distributive: neurogenic, anaphylactic, septic
, 4. Obstructive
Cardiogenic shock: patho
✔✔1. Heart with decreased ability to pump blood
2. Decreased SV
3. Decreased CO
4. Decreased tissue perfusion and cell metabolism
Cardiogenic shock: manifestations
✔✔1. Cardiovascular
-Early: *tachycardia*, hypotension, narrowed pulse pressure
-Decreased perfusion in peripheral and renal
2. Respiratory: SOB, crackles, inc RR
3. Integumentary: Cool, clammy, cyanotic
4. Neurological: lethargic, confused, anxious
Hypovolemic shock: patho
✔✔1. Loss of intravascular fluid volume
2. Decreased preload
3. Decreased SV
4. Decreased CO
5. Decreased tissue perfusion and cell metabolism
Types of hypovolemic shock
✔✔1. Absolute hypovolemia: fluid loss
-Hemorrhage, GI loss, Fistula drainage, DI, hyperglycemia, diuresis
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