Exam 1: NUR2502/ NUR 2502 (New 2023/ 2024 Update) Multidimensional Care III/ MDC 3 Exam| Questions and Verified Answers| 100% Correct| Grade A- Rasmussen
Exam 1: NUR2502/ NUR 2502 (New 2023/
2024 Update) Multidimensional Care III/
MDC 3 Exam| Questions and Verified
Answers| 100% Correct| Grade ARasmussen
QUESTION
▪ What is the vaccine for cervical cancer?
▪ What age should you give it?
▪ Dose schedule?
▪ Who takes it?
Answer:
Gardasil (protects us from HPV)
▪ 11-13 for both boys and girls
▪ 3 doses total over 6 months
QUESTION
Treatment for Cervical Cancer
Answer:
cervical ablation
QUESTION
Post-cervical ablation care
Answer:
FOR AT LEAST 4 WEEKS
▪ Refraining from sexual intercourse for 2-3 days after the procedure.
▪ Do not use tampons or douche.
▪ Do not take tub baths.
▪ Avoid heavy lifting.
▪ Report vaginal bleeding, foul-smelling drainage, or fever.
▪ Bed rest
QUESTION
Causes: Acute Kidney Injury
Answer:
▪ medications
▪ drugs/alcohol
▪ infarct of kidney, liver, heart
▪ anything that causes decrease in perfusion (dehydration, hypovolemia, shock, cardiac)
▪ Decreased blood flow
▪ Damage to the kidneys by disease processes
▪ Blockage of the urinary tract
QUESTION
Treatment: Acute Kidney Injury
Answer:
▪ dialysis (severe) – ESRD, CKD
▪ treat the underlying cause
▪ fluid replacement for hypovolemia
▪ fluid restriction in low urine output
▪ hemodialysis
▪ diuretics
▪ Kayexalate 30 g – loose BMs is a successful treatment
▪ monitor I&Os and daily weights.
QUESTION
Prevention: Acute Kidney Injury
Answer:
- Avoid dehydration by drinking 2 to 3 L of water daily
- Stop smoking
- Maintain a healthy weight
- Control DM or HTN
- Take all antibiotics prescribed for infections
- Be aware of urine characteristic changes
- Avoid nephrotoxic substances-Antibiotics, Aminoglycosides, NSAIDS, Chemotherapy Drugs
- Potassium restricted foods: avoid dark leafy greens, potatoes, bananas
- exercise
- maintain proper glucose levels
- maintain a good diet
- maintain proper protein levels
QUESTION
Nursing Care: Dialysis
Answer: - Before treatment: Evaluate baseline vital signs, weight, laboratory tests
- Continually monitor patient for respiratory distress, pain, discomfort
- Monitor prescribed dwell time, initiate outflow
- Observe outflow amount and pattern of fluid
▪ monitor for hypotension
▪ daily weight
▪ thrombophlebitis
▪ signs of bleeding
▪ check fistula for thrill and bruit
▪ sterile technique with dressing changes
▪ port site clean with dialysis catheter
QUESTION
Patient Education: Fistula
Answer:
▪ no blood pressure on that side
▪ no blood draws on that side
▪ no IV medications on that side
▪ put on a limb alert bracelet
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▪ chancre, fever, headache, muscle aches, rash
Late:
▪ organ failure, blindness, neuro changes
![Image: ▪ chancre, fever, headache, muscle aches, rash
Late:
▪ organ failure, blindness, neuro changes](https://quizlet.com/cdn-cgi/image/f=auto,fit=cover,h=100,onerror=redirect,w=120/https://o.quizlet.com/Vk.r3YBtZT0hGk9VuBncJQ.jpg)
![Image: C. Syphilis](https://quizlet.com/cdn-cgi/image/f=auto,fit=cover,h=100,onerror=redirect,w=120/https://o.quizlet.com/Vk.r3YBtZT0hGk9VuBncJQ.jpg)
![Image: Primary syphilis](https://quizlet.com/cdn-cgi/image/f=auto,fit=cover,h=100,onerror=redirect,w=120/https://o.quizlet.com/i/uNXOijtLujvVM7XKpA_K_w.jpg)
![Image: Secondary syphilis](https://quizlet.com/cdn-cgi/image/f=auto,fit=cover,h=100,onerror=redirect,w=120/https://o.quizlet.com/Vk.r3YBtZT0hGk9VuBncJQ.jpg)
▪ Penicillin G
▪ What do you ask before giving? “Do you have any allergies?”
![Image: ▪ Penicillin G
▪ What do you ask before giving? "Do you have any allergies?"](https://quizlet.com/cdn-cgi/image/f=auto,fit=cover,h=100,onerror=redirect,w=120/https://o.quizlet.com/Vk.r3YBtZT0hGk9VuBncJQ.jpg)
Azithromycin single dose 1 g IM
![Image: Azithromycin single dose 1 g IM](https://quizlet.com/cdn-cgi/image/f=auto,fit=cover,h=100,onerror=redirect,w=120/https://o.quizlet.com/aVJjEXOQQGQmdK7RlVhAvA.jpg)
![Image: ▪ *Abstinence* (7 days) until treatment is completed
▪ *Expedited Partner Therapy (EPT)* - Educate the patient on the importance of contacting their sexual partners to enable them to seek testing and possible treatment.](https://quizlet.com/cdn-cgi/image/f=auto,fit=cover,h=100,onerror=redirect,w=120/https://o.quizlet.com/aVJjEXOQQGQmdK7RlVhAvA.jpg)
![Image: • Wear cotton underwear.
• Always wipe front to back
• Do not douche or use feminine hygiene sprays.
• Do not use scented products.
• Use ice packs to help inflammation](https://quizlet.com/cdn-cgi/image/f=auto,fit=cover,h=100,onerror=redirect,w=120/https://o.quizlet.com/yuCiL8uhFP5nlLXaASuM1Q.png)
▪ iron levels, CBC (H&H), hormone levels, low blood pressure
S/S:
▪ dizziness, weakness, fatigue, SOB
Patient has heavy vaginal bleeding – What are you checking and what manifestations do you expect?
![Image: ▪ iron levels, CBC (H&H), hormone levels, low blood pressure
S/S:
▪ dizziness, weakness, fatigue, SOB](https://quizlet.com/cdn-cgi/image/f=auto,fit=cover,h=100,onerror=redirect,w=120/https://o.quizlet.com/amI3xWu.ZamnpQMh2hGYaQ.jpg)
Patient Education: Urinary Incontinence
![Image: ▪ Kegel exercises
▪ Bladder training
▪ No drinking after 5pm or 6pm
▪ Avoid foods or drinks with caffeine
▪ Skin care
▪ Proper hygiene](https://quizlet.com/cdn-cgi/image/f=auto,fit=cover,h=100,onerror=redirect,w=120/https://o.quizlet.com/eQB4Qo2P1rS5nkkGp.OSlQ.jpg)
▪ distended bladder
▪ visible mass above the symphysis pubis
▪ difficulty initiating urination**
▪ decreased urine stream
▪ urinary hesitancy, frequency, urgency, retention, incontinence
▪ incomplete voiding
▪ dribbling post-void**
▪ nocturia
▪ hematuria
▪ straining with urination
▪ obstruction of urine flow
presents as a uniform, elastic non-tender enlargement**
![Image: ▪ distended bladder
▪ visible mass above the symphysis pubis
▪ difficulty initiating urination**
▪ decreased urine stream
▪ urinary hesitancy, frequency, urgency, retention, incontinence
▪ incomplete voiding
▪ dribbling post-void**
▪ nocturia
▪ hematuria
▪ straining with urination
▪ obstruction of urine flow
presents as a uniform, elastic non-tender enlargement**](https://quizlet.com/cdn-cgi/image/f=auto,fit=cover,h=100,onerror=redirect,w=120/https://o.quizlet.com/4uVzDXc9sYTr.SN8LyC6PA.jpg)
alpha-1 blockers (doxazosin) – better for patients with hypertension too
![Image: alpha-1 blockers (doxazosin) - better for patients with hypertension too](https://quizlet.com/cdn-cgi/image/f=auto,fit=cover,h=100,onerror=redirect,w=120/https://o.quizlet.com/4uVzDXc9sYTr.SN8LyC6PA.jpg)
What medications should patients with BPH avoid?
![Image: anticholinergics](https://quizlet.com/cdn-cgi/image/f=auto,fit=cover,h=100,onerror=redirect,w=120/https://o.quizlet.com/4uVzDXc9sYTr.SN8LyC6PA.jpg)
▪ phosphodiesterase – 5 (PDE-5) inhibitors (ex: sildenafil, vardenafil, tadalafil)
Pharmaceutical Treatment: Erectile Dysfunction
![Image: ▪ phosphodiesterase - 5 (PDE-5) inhibitors (ex: sildenafil, vardenafil, tadalafil)](https://quizlet.com/cdn-cgi/image/f=auto,fit=cover,h=100,onerror=redirect,w=120/https://o.quizlet.com/dgw.QoJoLh0eHDJtpwuWWQ.jpg)
▪ Stress**
▪ Increasing age**
▪ Smoking**
▪ Obesity
▪ Hypertension**
▪ Medications such as antihypertensives**
▪ Endocrine disorders (Diabetes mellitus, thyroid)**
▪ Chemotherapy
▪ Alcohol and drug abuse**
▪ Trauma or surgery to the pelvic area**
▪ Lumbosacral injuries
▪ Pelvic fractures
▪ Neurological diseases (Parkinson’s and multiple sclerosis)
▪ Inflammation of seminal vesicles, urethra, and prostate
▪ Prostatectomy, TURP**
▪ Poor overall health that prevents sexual intercourse
▪ DVT, PE**
▪ Cardiac issues**
![Image: ▪ Stress**
▪ Increasing age**
▪ Smoking**
▪ Obesity
▪ Hypertension**
▪ Medications such as antihypertensives**
▪ Endocrine disorders (Diabetes mellitus, thyroid)**
▪ Chemotherapy
▪ Alcohol and drug abuse**
▪ Trauma or surgery to the pelvic area**
▪ Lumbosacral injuries
▪ Pelvic fractures
▪ Neurological diseases (Parkinson's and multiple sclerosis)
▪ Inflammation of seminal vesicles, urethra, and prostate
▪ Prostatectomy, TURP**
▪ Poor overall health that prevents sexual intercourse
▪ DVT, PE**
▪ Cardiac issues**](https://quizlet.com/cdn-cgi/image/f=auto,fit=cover,h=100,onerror=redirect,w=120/https://o.quizlet.com/dgw.QoJoLh0eHDJtpwuWWQ.jpg)
▪ respect to privacy, nonjudgmental, open ended Qs
![Image: ▪ respect to privacy, nonjudgmental, open ended Qs](https://quizlet.com/cdn-cgi/image/f=auto,fit=cover,h=200,onerror=redirect,w=240/https://o.quizlet.com/i/6sglDYReJYg5BSW30sAegw.jpg)
Prostate Cancer – Where is the most common site for metastasis?
![Image: bone](https://quizlet.com/cdn-cgi/image/f=auto,fit=cover,h=200,onerror=redirect,w=240/https://o.quizlet.com/i/9OuJP6mxrz8AERDkYgpLAw.jpg)
Blood levels that might be elevated if prostate CA has metastasized to the bone
(SATA?)
![Image: Phosphorus (>4.5)
Potassium (> 5.0)
Magnesium (> 2.5)
Calcium (>10.5)
Creatinine (> 1.2)
BUN (> 20)
Liver enzymes](https://quizlet.com/cdn-cgi/image/f=auto,fit=cover,h=200,onerror=redirect,w=240/https://o.quizlet.com/i/9OuJP6mxrz8AERDkYgpLAw.jpg)
▪ PSA
▪ age 40 (risk), 50 (non risk) + prostate exam
What do we use to screen prostate CA? And when should this start?
![Image: ▪ PSA
▪ age 40 (risk), 50 (non risk) + prostate exam](https://quizlet.com/cdn-cgi/image/f=auto,fit=cover,h=200,onerror=redirect,w=240/https://o.quizlet.com/i/9OuJP6mxrz8AERDkYgpLAw.jpg)
![Image: ▪ often asymptomatic - if you're not getting screened you won't know!
late: hematuria, bone pain, scrotal edema](https://quizlet.com/cdn-cgi/image/f=auto,fit=cover,h=200,onerror=redirect,w=240/https://o.quizlet.com/i/9OuJP6mxrz8AERDkYgpLAw.jpg)
▪ sperm banking, self examination
Patient Education: Testicular Cancer
![Image: ▪ sperm banking, self examination](https://quizlet.com/cdn-cgi/image/f=auto,fit=cover,h=200,onerror=redirect,w=240/https://o.quizlet.com/68j22nZERkUUfHINlhXiQw.jpg)
Non-modifiable
▪ Increased age – primary risk factor for both men and women
▪ Genetics (mutations in BRCA1 and BRCA2)**
▪ Family history
▪ Late menopause
▪ Early menarche
Modifiable
▪ Lack of exercise
▪ Diet
▪ Alcohol consumption
▪ Obesity
▪ Lack of breastfeeding
▪ Breast implants
▪ Smoking
▪ Medications such as birth control and hormone therapy
▪ nulliparity**
![Image: *Non-modifiable*
▪ Increased age - primary risk factor for both men and women
▪ Genetics (mutations in BRCA1 and BRCA2)**
▪ Family history
▪ Late menopause
▪ Early menarche
*Modifiable*
▪ Lack of exercise
▪ Diet
▪ Alcohol consumption
▪ Obesity
▪ Lack of breastfeeding
▪ Breast implants
▪ Smoking
▪ Medications such as birth control and hormone therapy
▪ nulliparity**](https://quizlet.com/cdn-cgi/image/f=auto,fit=cover,h=200,onerror=redirect,w=240/https://o.quizlet.com/oevdi0nsih9Hi11CMGyxeQ.jpg)
If a patient comes in and found a breast lump, what is the process after that?
![Image: mammogram -> breast biopsy](https://quizlet.com/cdn-cgi/image/f=auto,fit=cover,h=200,onerror=redirect,w=240/https://o.quizlet.com/oevdi0nsih9Hi11CMGyxeQ.jpg)
monthly self-examination
yearly mammograms – start at age 45
![Image: monthly self-examination
yearly mammograms - start at age 45](https://quizlet.com/cdn-cgi/image/f=auto,fit=cover,h=200,onerror=redirect,w=240/https://o.quizlet.com/oevdi0nsih9Hi11CMGyxeQ.jpg)
surgical
▪ total hysterectomy, salpingo-oophorectomy
non-surgical
▪ chemo and/or radiation
Treatment: Endometrial (Uterine) CA
Post-surgical care (ex: hysterectomy)
B. Heavy vaginal bleeding with clots
A client returns from surgery after a laparoscopic total abdominal hysterectomy. On initial assessment, which finding by the nurse requires immediate intervention?
A. Decreased bowel sounds in all quadrants
B. Heavy vaginal bleeding with clots
C. Temperature of 99 F (37.2 C)
D. Client statement that pain is a 4 on a scale of 0 to 10
Gardasil (protects from HPV)*
▪ 11-13 for both boys and girls
▪ 3 doses total over 6 months
![Image: FOR AT LEAST 4 WEEKS
▪ **Refraining from sexual intercourse for 2-3 days after the procedure.**
▪ **Do not use tampons or douche.**
▪ **Do not take tub baths.**
▪ Avoid heavy lifting.
▪ **Report vaginal bleeding, foul-smelling drainage, or fever.**
▪ **Bed rest**](https://quizlet.com/cdn-cgi/image/f=auto,fit=cover,h=200,onerror=redirect,w=240/https://o.quizlet.com/65SnY3k2MTniruF8abQpNA.jpg)
![Image: ▪ medications
▪ drugs/alcohol
▪ infarct of kidney, liver, heart
▪ **anything that causes decrease in perfusion (dehydration, hypovolemia, shock, cardiac)**
▪ Decreased blood flow
▪ Damage to the kidneys by disease processes
▪ Blockage of the urinary tract](https://quizlet.com/cdn-cgi/image/f=auto,fit=cover,h=200,onerror=redirect,w=240/https://o.quizlet.com/Hg7oFQDryEJVT.AzEB5jog.png)
Treatment: Acute Kidney Injury
![Image: ▪ **dialysis (severe) - ESRD, CKD**
▪ **treat the underlying cause**
▪ **fluid replacement for hypovolemia**
▪ fluid restriction in low urine output
▪ hemodialysis
▪ diuretics
▪ Kayexalate 30 g - loose BMs is a successful treatment
▪ monitor I&Os and daily weights.](https://quizlet.com/cdn-cgi/image/f=auto,fit=cover,h=200,onerror=redirect,w=240/https://o.quizlet.com/Hg7oFQDryEJVT.AzEB5jog.png)
• *Avoid dehydration by drinking 2 to 3 L of water daily*
• Stop smoking
• Maintain a healthy weight
• Control DM or HTN
• Take all antibiotics prescribed for infections
• Be aware of urine characteristic changes
• Avoid nephrotoxic substances-Antibiotics, Aminoglycosides, NSAIDS, Chemotherapy Drugs
• Potassium restricted foods: avoid dark leafy greens, potatoes, bananas
• *exercise*
• *maintain proper glucose levels*
• *maintain a good diet*
• *maintain proper protein levels*
Prevention: Acute Kidney Injury
![Image: • **Avoid dehydration by drinking 2 to 3 L of water daily**
• Stop smoking
• Maintain a healthy weight
• Control DM or HTN
• Take all antibiotics prescribed for infections
• Be aware of urine characteristic changes
• Avoid nephrotoxic substances-Antibiotics, Aminoglycosides, NSAIDS, Chemotherapy Drugs
• Potassium restricted foods: avoid dark leafy greens, potatoes, bananas
• **exercise**
• **maintain proper glucose levels**
• **maintain a good diet**
• **maintain proper protein levels**](https://quizlet.com/cdn-cgi/image/f=auto,fit=cover,h=200,onerror=redirect,w=240/https://o.quizlet.com/Hg7oFQDryEJVT.AzEB5jog.png)
• Before treatment: Evaluate baseline vital signs, weight, laboratory tests
• Continually monitor patient for respiratory distress, pain, discomfort
• Monitor prescribed dwell time, initiate outflow
• Observe outflow amount and pattern of fluid
▪ *monitor for hypotension*
▪ *daily weight*
▪ *thrombophlebitis*
▪ *signs of bleeding*
▪ *check fistula for thrill and bruit*
▪ *sterile technique with dressing changes*
▪ *port site clean with dialysis catheter*
![Image: • Before treatment: Evaluate baseline vital signs, weight, laboratory tests
• Continually monitor patient for respiratory distress, pain, discomfort
• Monitor prescribed dwell time, initiate outflow
• Observe outflow amount and pattern of fluid
▪ **monitor for hypotension**
▪ **daily weight**
▪ **thrombophlebitis**
▪ **signs of bleeding**
▪ **check fistula for thrill and bruit**
▪ **sterile technique with dressing changes**
▪ **port site clean with dialysis catheter**](https://quizlet.com/cdn-cgi/image/f=auto,fit=cover,h=200,onerror=redirect,w=240/https://farm2.staticflickr.com/1311/1215796693_0a90546bbc.jpg)
![Image: ▪ no blood pressure on that side
▪ no blood draws on that side
▪ no IV medications on that side
▪ put on a limb alert bracelet](https://quizlet.com/cdn-cgi/image/f=auto,fit=cover,h=200,onerror=redirect,w=240/https://o.quizlet.com/5i9v7e44XyPvhFNw4-QGuQ.jpg)
D. Check for a bruit and thrill by auscultation and palpation over the site.
A 70-year-old woman with chronic kidney disease and a history of type 2 diabetes had surgery two weeks ago to place a vascular graft access for hemodialysis. Which precaution will the nurse follow to ensure the function of the AV graft?
A. Insert an IV and run saline at 10 mL/hr.
B. Keep the patient’s arm elevated on two pillows.
C. Monitor blood pressure and radial pulses in both arms.
D. Check for a bruit and thrill by auscultation and palpation over the site.
![Image: D. Check for a bruit and thrill by auscultation and palpation over the site.](https://quizlet.com/cdn-cgi/image/f=auto,fit=cover,h=200,onerror=redirect,w=240/https://o.quizlet.com/5i9v7e44XyPvhFNw4-QGuQ.jpg)
▪ flank pain
▪ fever
▪ N/V
▪ difficulty urinating
▪ elevated WBC
S/S: Urolithiasis and Pyelonephritis
![Image: ▪ flank pain
▪ fever
▪ N/V
▪ difficulty urinating
▪ elevated WBC](https://quizlet.com/cdn-cgi/image/f=auto,fit=cover,h=200,onerror=redirect,w=240/https://o.quizlet.com/i/CDYXgk42eUCqoIG_euaj_w.jpg)
Since the s/s of urolithiasis and pyelonephritis are so similar, how you diagnose the difference?
![Image: ▪ pyelonephritis is the result of **repeated upper UTIs** in patients with anatomy abnormalities of the urinary tract
▪ imaging, like a CT scan](https://quizlet.com/cdn-cgi/image/f=auto,fit=cover,h=200,onerror=redirect,w=240/https://o.quizlet.com/i/CDYXgk42eUCqoIG_euaj_w.jpg)
B. 27-year-old female with urinary reflux
![Image: B. 27-year-old female with urinary reflux](https://quizlet.com/cdn-cgi/image/f=auto,fit=cover,h=200,onerror=redirect,w=240/https://o.quizlet.com/MfM9sBsWK5kcKxmf0X7j6g.png)
A 35-year-old patient is admitted to the ED with fever, chills, and severe right flank pain. His heart rate is 112/min and respiratory rate is 32/min. He was recently treated for a urinary tract infection. Assessment reveals tenderness of the right costovertebral angle (CVA).
What diagnosis does the nurse expect?
▪ fatigue
▪ anergia
▪ *hematuria*
▪ *proteinuria*
▪ nocturia
▪ *decreased urination*
▪ altered urinary elimination
▪ *painful urination
▪ weight loss
▪ N/V
▪ dyspnea
▪ edema lower extremities
▪ *elevated BP*
▪ jugular vein distention
▪ anemia from reduced production of erythropoietin
▪ hypercholesterolemia
▪ *“cardiac complications”*
![Image: ▪ fatigue
▪ anergia
▪ **hematuria**
▪ **proteinuria**
▪ nocturia
▪ **decreased urination**
▪ altered urinary elimination
▪ **painful urination*
▪ weight loss
▪ N/V
▪ dyspnea
▪ edema lower extremities
▪ **elevated BP**
▪ jugular vein distention
▪ anemia from reduced production of erythropoietin
▪ hypercholesterolemia
▪ **"cardiac complications"**](https://quizlet.com/cdn-cgi/image/f=auto,fit=cover,h=200,onerror=redirect,w=240/https://o.quizlet.com/uKiS1czusF1ax82MgdpcNQ.jpg)
Risk Factors: Polycystic Kidney Disease
![Image: **Genetics**
▪ autosomal dominant, which usually appears between the ages of 30 to 50
▪ autosomal recessive, which has a childhood onset and progresses rapidly to end-stage kidney disease.](https://quizlet.com/cdn-cgi/image/f=auto,fit=cover,h=200,onerror=redirect,w=240/https://o.quizlet.com/CM3gMBViRkD5HPvAygTP3A.jpg)
S/S: Polycystic Kidney Disease
![Image: ▪ **pain - first symptom**
▪ **CVA tenderness**
▪ constipation
▪ cyst bleeding
▪ changes in urine color or frequency
▪ hypertension
▪ headaches
▪ abdominal distention and pain
▪ dysuria
▪ hematuria
▪ nocturia
▪ kidney stone formation](https://quizlet.com/cdn-cgi/image/f=auto,fit=cover,h=200,onerror=redirect,w=240/https://o.quizlet.com/CM3gMBViRkD5HPvAygTP3A.jpg)
Nursing Interventions
▪ Administer medications as prescribed (antihypertensives) to *reduce cardiovascular complications* and slow the disease progression.
▪ Implement a low sodium diet.
▪ Monitor strict intake and output to assure adequate intake.
▪ Implement multimodal pain management strategies to include both pharmacological and non-pharmacological interventions.
Patient Education
▪ Get *genetic counseling* before you try to have children
▪ *Monitor blood pressure* and daily weight.
Nursing Care/Patient Ed.: Polycystic Kidney Disease
![Image: *Nursing Interventions*
▪ Administer medications as prescribed (antihypertensives) to **reduce cardiovascular complications** and slow the disease progression.
▪ Implement a low sodium diet.
▪ Monitor strict intake and output to assure adequate intake.
▪ Implement multimodal *pain management* strategies to include both pharmacological and non-pharmacological interventions.
*Patient Education*
▪ Get **genetic counseling** before you try to have children
▪ **Monitor blood pressure** and daily weight.](https://quizlet.com/cdn-cgi/image/f=auto,fit=cover,h=200,onerror=redirect,w=240/https://o.quizlet.com/CM3gMBViRkD5HPvAygTP3A.jpg)
![Image: B. Blood pressure of 170/90](https://quizlet.com/cdn-cgi/image/f=auto,fit=cover,h=200,onerror=redirect,w=240/https://o.quizlet.com/CM3gMBViRkD5HPvAygTP3A.jpg)
▪ an immunologic kidney disorder in which *glomerular permeability increases* so larger molecules pass through the membrane into the urine and then excreted.
▪ This process causes a massive loss of protein into the urine, edema formation, and decreased plasma albumin levels.
▪ Most common cause is altered immunity with inflammation
![Image: nephrotic syndrome](https://quizlet.com/cdn-cgi/image/f=auto,fit=cover,h=200,onerror=redirect,w=240/https://o.quizlet.com/i/gkzNibB8liDTZthCx6rOZA.jpg)
Lab Values to Watch: Nephrotic Syndrome
![Image: ▪ GFR](https://quizlet.com/cdn-cgi/image/f=auto,fit=cover,h=200,onerror=redirect,w=240/https://o.quizlet.com/i/gkzNibB8liDTZthCx6rOZA.jpg)
![Image: 90-120 mL/min
• "Normal glomerular filtration rate (GFR) averages 125 mL/min, totaling about 180 L daily."](https://quizlet.com/cdn-cgi/image/f=auto,fit=cover,h=200,onerror=redirect,w=240/https://o.quizlet.com/yo-PfO4vqcu1Fvi4tsMotA.png)
▪ low protein diet (for an elevated GFR)
▪ maintain normal diet (for a normal GFR)
![Image: ▪ low protein diet (for an elevated GFR)
▪ maintain normal diet (for a normal GFR)](https://quizlet.com/cdn-cgi/image/f=auto,fit=cover,h=200,onerror=redirect,w=240/https://o.quizlet.com/i/gkzNibB8liDTZthCx6rOZA.jpg)
A. Assess heart rate and rhythm.
Patients with ESKD experience significant fluid and electrolyte imbalances that are managed with medications and dialysis. Hyperkalemia can be a life-threatening event. In patients with kidney disease, the myocardial response (heart rate and rhythm) to hyperkalemia should be assessed to effectively determine appropriate treatment. High sodium can increase the patient’s risk for seizures, excessive fluid balance will negatively effect breathing, and patients with ESKD experience acid-base imbalances from an inability to synthesize bicarbonate.
A patient with end-stage kidney disease (ESKD) has this serum laboratory analysis
K+ 5.9 mEq/L
Na+ 152 mEq/L
Creatinine 6.2 mg/dL
BUN 60 mg/dL
What is the priority nursing intervention?
A. Assess heart rate and rhythm.
B. Implement seizure precautions.
C. Assess the patient’s respiratory status.
D. Evaluate the patient’s acid-base balance.