Exam 1: NUR265/ NUR 265 (New 2024/ 202 5 Update) Advanced Med -Surg | Complete Guide with Questions and Verified Answers| 100% Correct - Galen QUESTION Hemodialysis Answer: - advanced CKD - not cure - Tx is intermittent - 3-4 hrs QUESTION Hemodialysis Complications pg 1400 Answer: **hypotension**, - dialysis disequilibrium (dizziness, N/V, restlessness, HA) - cardiac event (dysrhythmias) NI: - VS (temp) Quintin: central venus cath (jugular) Permi cath: tunnled in chest QUESTION peritoneal dialysis Answer: - free from machine - high dextrose concentrate making it hypertonic --> pulls water into cavity **no change in creatinine** **done everyday** QUESTION peritoneal dialysis complications Answer: - peritonitis (ridged abd, cloudy dyalsilate, SEND CULTURE) - pain - leaking/ bleeding NI: - stool softener - Supine/ high fowlers when inserted - albumin (inc vascular volume) QUESTION NI prior to dialysis Answer: - check labs - baseline weight/ VS - Cath/ Graft site assessment - meds - hold BP meds QUESTION Liver Answer: - Stores vitamins (ADEK) - Stores glycogen - Protects through Kupffer cells (immunity) - Synthesizes plasma proteins (**albumin**, prothrombin and fibrinogen) - clotting factors - Metabolizes amino acids to remove ammonia and Glycogen QUESTION Cirrhosis Answer: The scarring of the liver forming scar tissue - low sodium - high carb - high protein QUESTION Causes of Chirrhosis Answer: - Alcohol ingestion - Viral hepatitis (A,B,C) - Gall bladder disease - Autoimmune hepatitis - Drugs and chemical toxins (NSAID) - Cardiovascular disease - Steatohepatitis (from fatty liver) QUESTION Fluid/Electrolyte Sxs of liver failure Answer: - Ascites related to albumin leaking into abdominal cavity - Decreased intravascular volume, Low K+ due to diarrhea, aldosterone, diuretics - Low Na+ dilutional due to ADH, Renin -Angiotensin - Low Ca+ due to decreased dietary intake, decreased absorption of vitamin D - Low Mg++ due to inability of liver to store Mg++ QUESTION GI sxs of Liver Failure Answer: -Decreased appetite: malnutrition, Diarrhea, Bleeding, N&V - Portal HTN - caused by high pressure within the portal venous system. - tea colored urine QUESTION Sxs of Cirrhosis Answer: Early - Fatigue, Weight loss, Anorexia, Abdominal Pain Late: - Jaundice and icterus - Dry skin - Pruritis - rashes - petechiae/ ecchymosis - palmar erythemia - spider angioma - **ascites** - peripheral edema - vitamin deficient (ADEK) QUESTION Tx of Portal HTN LEADS TO Varices COMPLICATION OF CIRRHOSIS Answer: Octreotide - decreases blood flow to abd organs (varices) -Acid blockers (varices) - Beta Blockers: propranolol (portal HTN) - Antibiotics - an infection can lead to a variceal bleed. QUESTION
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