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Questions and Answers
What is the primary purpose of hemodialysis?
What is the primary purpose of hemodialysis?
Peritoneal dialysis can involve complications such as peritonitis, leakage, and bleeding.
Peritoneal dialysis can involve complications such as peritonitis, leakage, and bleeding.
True
What is the normal range of urine specific gravity?
What is the normal range of urine specific gravity?
1.005 to 1.025
The primary type of access used in hemodialysis is an __________.
The primary type of access used in hemodialysis is an __________.
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Match the type of dialysis with its characteristics:
Match the type of dialysis with its characteristics:
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Which of the following methods is NOT typically used in hemodialysis?
Which of the following methods is NOT typically used in hemodialysis?
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Creatinine clearance is a method used to assess kidney function.
Creatinine clearance is a method used to assess kidney function.
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What is considered a normal daily protein excretion in urine?
What is considered a normal daily protein excretion in urine?
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The maximum osmolality of urine is __________ mOsm/kg.
The maximum osmolality of urine is __________ mOsm/kg.
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Match the types of dialysis with their respective definitions:
Match the types of dialysis with their respective definitions:
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What level of serum sodium is considered normal?
What level of serum sodium is considered normal?
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Hyperkalemia occurs when serum potassium levels are greater than 5.0 mEq/L.
Hyperkalemia occurs when serum potassium levels are greater than 5.0 mEq/L.
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What is a common cause of hypocalcemia?
What is a common cause of hypocalcemia?
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Levels of serum potassium below ______ mEq/L indicate hypokalemia.
Levels of serum potassium below ______ mEq/L indicate hypokalemia.
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Match the following electrolyte imbalances with their associated serum levels:
Match the following electrolyte imbalances with their associated serum levels:
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Which of the following is a clinical manifestation of hypercalcemia?
Which of the following is a clinical manifestation of hypercalcemia?
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Thirst and elevated temperature are clinical manifestations of hyponatremia.
Thirst and elevated temperature are clinical manifestations of hyponatremia.
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What treatment is recommended for emergent hypocalcemia?
What treatment is recommended for emergent hypocalcemia?
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Hypomagnesemia is defined by a serum magnesium level less than ______ mg/dL.
Hypomagnesemia is defined by a serum magnesium level less than ______ mg/dL.
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What is the primary treatment for metabolic acidosis?
What is the primary treatment for metabolic acidosis?
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Fluid volume deficit and dehydration are the same condition.
Fluid volume deficit and dehydration are the same condition.
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Name two causes of fluid volume excess.
Name two causes of fluid volume excess.
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In metabolic acidosis, pH levels are typically _____ than 7.35.
In metabolic acidosis, pH levels are typically _____ than 7.35.
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Match the following treatments with their corresponding fluid imbalances:
Match the following treatments with their corresponding fluid imbalances:
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Which clinical manifestation is most likely associated with fluid volume deficit?
Which clinical manifestation is most likely associated with fluid volume deficit?
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Heart failure can be a contributing factor for hypervolemia.
Heart failure can be a contributing factor for hypervolemia.
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What should the nurse monitor closely in a patient with metabolic acidosis?
What should the nurse monitor closely in a patient with metabolic acidosis?
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The normal range for bicarbonate in plasma is _____ mEq/L.
The normal range for bicarbonate in plasma is _____ mEq/L.
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Which of the following is a primary nursing management strategy for fluid volume deficit?
Which of the following is a primary nursing management strategy for fluid volume deficit?
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Which type of diuretic is Spironolactone?
Which type of diuretic is Spironolactone?
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Furosemide is a thiazide diuretic.
Furosemide is a thiazide diuretic.
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Which of the following factors can increase the risk of urinary tract infections (UTIs)?
Which of the following factors can increase the risk of urinary tract infections (UTIs)?
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What is the primary concern when using an indwelling catheter?
What is the primary concern when using an indwelling catheter?
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Menopause can lead to increased susceptibility to UTIs due to changes in estrogen levels.
Menopause can lead to increased susceptibility to UTIs due to changes in estrogen levels.
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The medical term for an enlarged prostate is __________.
The medical term for an enlarged prostate is __________.
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What should individuals do to help flush bacteria out of the urinary tract?
What should individuals do to help flush bacteria out of the urinary tract?
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Match the following nursing interventions with their corresponding purpose:
Match the following nursing interventions with their corresponding purpose:
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To maintain proper hygiene and prevent UTIs, always wipe from front to _____ after using the toilet.
To maintain proper hygiene and prevent UTIs, always wipe from front to _____ after using the toilet.
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Match the medical condition with its impact on UTI susceptibility:
Match the medical condition with its impact on UTI susceptibility:
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Which of the following medications can falsely decrease PSA levels?
Which of the following medications can falsely decrease PSA levels?
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Which of the following practices is recommended to prevent UTIs?
Which of the following practices is recommended to prevent UTIs?
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Cranberry products have been conclusively proven to prevent urinary tract infections.
Cranberry products have been conclusively proven to prevent urinary tract infections.
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Name two lifestyle factors that can exacerbate UTI symptoms.
Name two lifestyle factors that can exacerbate UTI symptoms.
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Wearing _____ underwear can help keep the genital area dry and ventilated.
Wearing _____ underwear can help keep the genital area dry and ventilated.
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Which group of people is considered at high risk for developing urinary tract infections?
Which group of people is considered at high risk for developing urinary tract infections?
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Study Notes
Fluid and Electrolyte Imbalances
- Sodium levels: 135-145 mEq/L; both hypoonatremia and hypernatremia affect neurological function.
Hyponatremia
- Defined as serum sodium <135 mEq/L.
- Causes include fluid overload, vomiting, diarrhea, diuretics, certain medications, and adrenal insufficiency.
- Clinical signs: dry mucosa, headache, confusion, low blood pressure, nausea.
- Nurse interventions: sodium replacement, water restriction, monitoring intake/output, assessing neurological status.
Hypernatremia
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Defined as serum sodium >145 mEq/L.
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Causes include fluid deprivation and diabetic insipidus.
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Clinical signs: thirst, elevated temperature, flushed skin, irritability, and edema.
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Nurse interventions: gradual sodium reduction, diuretics, and monitoring neurologic status.
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Potassium levels: 3.5-4.5 mEq/L; hypokalemia and hyperkalemia significantly affect cardiac function.
Hypokalemia
- Defined as serum potassium <3.5 mEq/L.
- Causes: GI losses, diuretics, hyperaldosteronism.
- Clinical manifestations include ECG changes, muscle weakness, and fatigue.
- Nurse management includes potassium replacement and ECG monitoring.
Hyperkalemia
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Defined as serum potassium >5.0 mEq/L; linked to renal function compromise.
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Causes: renal failure, rapid potassium administration, tissue trauma.
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Clinical manifestations include dysrhythmias and muscle weakness.
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Nurse interventions: monitor ECG, lab values, and assess vital signs.
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Calcium levels: 8.6-10.4 mg/dL; both hypocalcemia and hypercalcemia influence neuromuscular function.
Hypocalcemia
- Serum calcium <8.6 mg/dL; affected by parathyroid hormone levels.
- Causes: hypoparathyroidism, malabsorption, and excessive transfusion of citrated blood.
- Clinical signs: tetany, seizures, and Trousseau/Chvostek signs.
- Nurse management: calcium supplementation and seizure precautions.
Hypercalcemia
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Serum calcium >10.4 mg/dL; mild cases can be asymptomatic.
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Causes: malignancy, hyperparathyroidism, and bone demineralization.
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Clinical signs: muscle weakness, polyuria, abdominal cramps.
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Nurse interventions include treating the underlying cause and dietary education.
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Magnesium levels: 1.8-2.6 mg/dL; imbalances can affect neuromuscular excitability.
Hypomagnesemia
- Defined as serum magnesium <1.8 mg/dL; may coexist with hypokalemia and hypocalcemia.
- Causes: alcoholism and GI losses.
- Clinical signs: neuromuscular irritability and ECG changes.
- Nurse management includes IV magnesium and dietary modification.
Hypermagnesemia
- Serum magnesium >2.6 mg/dL; rare due to efficient renal excretion.
- Causes include renal failure and excessive magnesium administration.
- Clinical signs: muscle weakness, low blood pressure, and reflex changes.
- Nurse interventions: calcium gluconate and monitoring ventilatory support.
IV Fluids Management
- Assess patient prior to administration: monitor fluid intake/output, prepare appropriate IV fluids.
- Fluid gain includes oral intake and IV administration; loss includes urinary and respiratory losses.
- Hypovolemia results from fluid losses exceeding intake; dehydration signifies water loss alone.
Fluid Volume Deficit (FVD)
- Causes: diarrhea, excessive urination, inadequate intake, diabetes insipidus.
- Clinical signs: dry skin, increased heart rate, reduced urine output, confusion.
- Treatment includes oral rehydration or IV fluids for severe cases.
- Nursing management involves monitoring vital signs and daily weights.
Fluid Volume Excess (FVE)
- Hypervolemia results from abnormal fluid retention mostly due to heart or kidney issues.
- Clinical signs: edema, elevated blood pressure, and respiratory difficulty.
- Treatment involves diuretics, dialysis, and patient education on sodium intake.
- Nursing management includes tracking fluid balance and lung assessment.
Acid-Base Imbalances
- Metabolic acidosis is characterized by low pH (<7.35) and low bicarbonate levels (<22 mEq/L).
- Causes: renal failure, diabetic ketoacidosis, and salicylate poisoning.
- Clinical signs include headache, confusion, and rapid respiration.
- Nurse management includes bicarbonate administration and monitoring potassium levels.
Dialysis
- Hemodialysis is utilized for acute kidney failure and chronic kidney disease management; it extracts toxins from blood.
- Vascular access is achieved through arteriovenous fistulas or grafts.
Peritoneal Dialysis
- Aimed at removing toxins and restoring fluid balance using the peritoneal membrane.
- Types include continuous ambulatory and continuous cyclic peritoneal dialysis.
- Complications such as peritonitis must be monitored closely.
Urinary Function and Health
- Normal urine findings include 150 mg/day protein and specific gravity of 1.005-1.025.
- Risk factors for UTIs include poor hygiene, certain contraceptives, and conditions suppressing the immune system.
Prevention Techniques
- Encourage proper hygiene, adequate fluid intake, regular urination, and managing underlying health issues.
- Urinate post-intercourse and consider avoiding irritants.
Aging and Urinary Function Changes
- Aging affects bladder capacity and renal function; awareness of normal variations is key to patient care.### Nursing Interventions
- Patient education is essential for effective nursing care, especially regarding catheter management.
- Continuous bladder irrigation is only indicated when medically necessary.
- Catheter care includes emptying the drainage bag every 8 hours using strict sterile techniques.
- Secure the catheter to prevent displacement and conduct frequent inspections of urine for color, odor, and consistency.
- Perform daily perineal care using soap and water to maintain hygiene.
- A closed system must be maintained to minimize the risk of infection.
- Follow manufacturer's instructions for utilizing the catheter port in urine specimen collection.
- Discontinue catheter use as soon as it is no longer required.
Diuretic Types and Applications
- Spironolactone: A potassium-sparing diuretic primarily utilized for hypertension, heart failure, edema, primary hyperaldosteronism, ascites, and prevention of hypokalemia.
- Furosemide: A loop diuretic indicated for situations requiring removal of excess fluid and electrolytes from the body; marketed as Lasix.
- Hydrochlorothiazide: A widely used thiazide diuretic, effective in conditions where fluid and electrolytes need to be excreted.
Male Reproductive Disorders
- Benign Prostate Hyperplasia (BPH): Also known as enlarged prostate; leads to urinary obstruction, retention, and infections.
- Symptoms of BPH develop slowly and include dysuria, hesitancy, and sensations of incomplete bladder emptying, depending on severity.
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Management:
- Medical treatment typically involves alpha-adrenergic blockers such as finasteride and tamsulosin (Flomax).
- Important to note that these medications can cause false decreases in PSA levels; digital rectal exams remain essential for cancer screening.
Other Male Reproductive Conditions
- Testicular Torsion: A surgical emergency requiring immediate diagnosis and intervention.
- TURP Management: Transurethral resection of the prostate (TURP) is a common procedure for BPH management.
- Phimosis: The inability to retract the foreskin, may require medical intervention.
- Priapism: A prolonged and painful erection requiring urgent medical treatment.
- Erectile Dysfunction: PDE5 inhibitors are effective treatments; patient education on use and potential side effects is crucial.
- Testicular Cancer: Regular screening and self-examinations are key for early detection.
- Epididymitis: Inflammation of the epididymis, often treated with antibiotics and analgesics.
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Description
Prepare for your NSG 3313 Exam 1 with this comprehensive study guide focusing on Chapter 10, which covers fluid and electrolyte imbalances, specifically sodium levels. You'll explore the causes, manifestations, and treatments for both hyponatremia and hypernatremia, along with important nursing considerations. Ace your exam by mastering these essential concepts!
