CHRONIC RENAL FAILURE

STAGE I: POLYURIA AND NOCTURIA

II- OLIGURIA AND SWELLING IN ANKLE
AND LEGS
III DIALYSIS-END STAGE RENAL DISEASE
Acute renal failure
I- oliguria

Strep infection
Heart failure- ventricular gallop -s3
sound is the first sign

RHF
LHF
ACUTE CORONARY SYNDROME-Unstable
angina, myocardial infarction/ischemia
Shock: increase pulse, light headedness,
cold and clammy, high resp
GERD RISK
Sickle cell crisis

Coumadin
Degenerative joint disease- risk of
contractures
Fundus level in pregnancy
2434 weeks, fundal height correlates well
with weeks of gestation

Not infectious after 24hrs of antibiotic

therapy-indicator to be able to care
Sodium 2g/day, fluid restriction, Lasix,
O2,weigh daily, i/o
Best indicator of effective diuretic:
WEIGHT
1pound lost = 500ml
O2, iv access for nitro, morphine, hep,
fibrinolytic
Shock is priority than hypoglycemia,
bleeding, early labour fracture
Caucasian, female, age more than 45,
obese, smoking, NG tube
Hydration then oxygen
Fluids 200cc/hr
Prevent inf .. URI and blood borne
pathogens
Carry cell phone, bandages, dressing
Long term med, incorporate into lifestyle
Keep in functional position
For back pain elevate legs 8-10 inches
Donot use big pillows
10 to 12 weeks fundus slightly above
symphysis pubis
16 weeks fundus halfway between
symphysis pubis and umbilicus
20 to 22 weeks fundus at the level of
the umbilicus
28 weeks fundus three fingerbreadths

above the umbilicus

36 weeks fundus just below ensiform
cartilage
TURP WITH CBI
Urinary retention
Urinary incontinence
Hemolytic reaction: n/v,back pain, high
pulse, low bp, decrease urine output,
hematuria
Body mechanics
Horners syndrome lung tumor that
invades ribs and affects the sympathetic
nerve ganglia
Pancoast tumor first thoracic and 8th
cranial nerve
Pleural tumor
SLE-proteinuria, hyperlipidemia
Pregnancy
Newborn respiration
Parasympathetic nervous system
Constricts and stimulates

Sympathetic nervous system

Dilates and inhibits

p. jairoveci pneumonia-opportunistic
AIDS inf
Crohns disease
Circumcision care

PAIN, leg with cath should be straight

Crede maneuver-cupped hand on
bladder inward and downward pressure
Toilet whn awaken and before and after
meals
Stop infusion, ns iv,o2, airway, Benadryl,
draw blood, urine specimen, send blood
bag to lab
Determine if help required
Then position close to the pt and use
arms and legs and encourage pts to help
Miosis, partial ptosis, anhidrosis of the
affected side
Arm and shoulder pain and atrophy of
arm and hand muscles on affected side
Chest pain, cough, dyspnea, fever,weight
loss
Dec s. complement, positive antinuclear
test, increased anti DNA levels,
positive lupus erth. Cell
Primi: effaces then dilates
Multi: both at same time
Calories, respiratory center, nerves in
brain and chest, patent airway
Constricts pupil, increases heart
rate,constricts bronchi, increases GI
motility and bile secretion, stimulates
saliva, stimulates /contract urine/urine
retention, relaxes rectum
Dilates pupil, slows heart, decreases GI
motility, inhibit saliva, relaxes urinary
muscles, contracts rectum, increases
glucose by liver, epi and nor epi by
kidney, dilates bronchi
Can cause hypoxemia and cyanosis
Corticosteroids, antidiarrheals
Donot give protein, fibre and milk[causes
diarhea]
Should void before discharge
Dont bathe, dont remove crust
Small amount of bleeding expected
Care for 2-4 days required for healing
Lubricant/ Vaseline jelly over glans penis

Nurse client relationship

Sign of prevention of infection in COPD

Sign of infection In COPD
Pulmonary embolism- serious emergency

PNEUMONIA
t.b.
Atrial fibrillation-emergency
Sinus tachy and PVC are not emergency
Hypokalemia
Sprue [celiac disease]

CONTINOUS PASSIVE MOVEMENT DEVICE

Jaundice within 24 hrs- life threatening

Orientation phase:
Realistic limits, trust , rapport
Prepare for termination
Assess client, identify problems, discuss
plan for visit
Identification phase:
Clarification and goal setting
Working phase:
Identify problems
Ask questions
Nurse was beneficial
Termination phase
Problem solved
Reaches established goals,
Relationship ended- sadness normal for
nurse pt.
Dependent personalities require helpreflect on positives and growth
Fear of abandonment,
Decrease in O2 requirements
Increase in O2 req, fever, fatigue,
sputum increase, shortness of breath
Petechia on chest, shortness of breath,
chest pain,anxiety
Give Oxygen first then notify doc. Wil
prescribe hep and analgesics can be
given.
Crackles, pleuritic pain, fever
Anorexia, fever, night sweats, weight
loss
Can cause clots from atria and lead to
stroke
Ventricular tachycardia
Diarrhea and constipation, bloating,
flatulence, no imp vitamins minerals and
nutrition absorbed, malnourished, less
albumin and clotting factors,
GLUTEN FREE DIET: WHEAT, OATS,
RYE, BARLEY, BEER, COUSCOUS,
GRAVY, BROTH, PROCESSED AND
BATTERED FOOD, FLOUR,
SPRUE FOUND MORE IN TROPICAL
REGION
Needed even if physical therapy is given
Prevents adhesions
Bleeding is a complication
Monitor skin intergrity
Can be hemolytic disease, rh /abo

Jaundice after 24-72 hrs

ACIDOSIS
ALKALOSIS

Nurse practice act

Involuntary admission

Advanced directive

Neck radiation

Internal pelvic radiation

Internal radiation
Head
Externalradiation
Pyelonephritis: infection from blood,
cath, procedures

Myxedema coma [hypothyroidism]

Diabetes insipidus[pyelonephritis]
BIOPHYSICAL PROFILE[USG]

incompatability, sepsis
Physiologic jaundice
Hyperkalemia: during periods of
hyperglycemia K leaves the cell along
with glucose
Hypokalemia: when the treatment is
initiated and the glucose goes back to
the cell K also goes back causing
hypokalemia-watch out for arrhythmiasv.tach
Regulates the scope of nursing practice
enacted and outlined by state legislature
Harm to self /others
Should have a suicide plan
Threatening to kill
Schizos with hallu and delu are ok to live
alone
Includes living will
Should be reviewed with doc at every
admission
Should be informed at admission and
taken
Dysgeusia: absence of taste
Xerostomia: dry mouth and
xerophthalmia
Stomatitis: irritation of oral mucosa
Cystitis
Leukopenia, thrombocytopenia
Cognitive decline
Nausea, infertility, hair loss, dry skin,
pink sore skin, lymphedema, gastric
ulcers,
Give more fluids
Acid ash diet-prune, cranberrry,tomato,
buillon,
no milkand citrus fruits-orange and
lemon
No sitz bath
Resp depressed so patent airway impmost critical
Severe hypothermia: gradual heating or
will cause vasodilation and shock
Bradycardia- prolonged QT interval
Thyroid replacement given IV
Deficient volume related to inability to
conserve water
Non stress test, fetal tone, fetal
movement, amniotic fluid volume

1st trimester
2nd n 3rd trimester
Rheumatic fever-non pruritic rash, fever,
joint pain
HYPOGLYCEMIA

Epidural anesthesia

Hypophsysectomy

Parkinsons crisis-confined to bed, risk for

pneumonia and aspiration
PARKINSONISM
Akasthisia
BIB BABY SYNDROME
Bone marrow
HCG
Relaxin
Progesterone
Estrogen
Stoma after surgery: danger signs
-Edema in 24hrs if ok
Most common complication of influenza
Hypocalcemia

Crown rump length for gestational age

Biparietal diameter, femur length for
gestational age
Ask previous sore throat with strep
Not infectious
Affects heart, joints and CNS
If confused but conscious give orange
juice
If unconscious glucagon IM or dextrose
50%
RESPIRATORY DISTRESS-CNS
DEPRESSION-decreased heart rate and
blood pressure,
Decreased sensation to the lower
extremities
Urine retention, hypotension, allergic
reaction,
Head elevated, no coughing, sneezing,
blowing nose for sutures, increase fluid
because of diabetes insipidus and visual
disturbances
Ineffective airway clearance related to
drooling[airway obstruction]
Shuffling gait, stooped posture, drooling,
muscle rigidity, flat face, tremors
Inability to stay still, pacing, restlessness
Reason: insulin acts as a growth
hormone for fetus
Depression in 7-14 days noticed
Recovery in 21-28days
Maintains pregnancy till placenta intact
Monitored for knowing the status of
pregnancy
Makes mommy tired to seek rest
Thickens the uterine lining before
pregnancy and nurtures the fetus during
pregnancy-supportive envt
For breast tissues and breast feeding and
nurturing the fetus
Dusky stoma
Stomal protrusion out of the skin
Abdominal rigidity and pain
Pneumonia-bacterial /influenza
Others-exacerbation of COPD, reye
syndrome, myositis
Trousseau sign, cardiac arrhythmias,
diarrhea, increased clotting time,

Rombergs test
Rinne test
Pulmonary emboli risk factors
Mononucleosis- flu, sore throat, fever
Premature labour control
Sickle cell crisis
Hyperglycemia
Burns
ECT
Multiple myeloma
Chronic bronchitis
Medication administration in
infant[liquid]

Hemolytic reaction

Insulin administration

Herniated disc

UPPER GI ENDOSCOPY
Lower endoscopy
Mother negative baby positive

irritation, anxiety, pathological fractures,

Assess cerebellar function
Air and bone conduction
Immobility, pelvic fractures, obesity
No contact for 3months, no need of
isolation, no sharing of cups and glasses
Hydration
Hydration, o2
Fluid volume deficit
Fluid volume deficit
Vitals for every 15mins for first 1hr, left
side position for aspiration, orientation,
no ambulation until oriented and awake
Preventing bone injuries, hydration, pain
control
Diaphragmatic pursed lip breathingexhalation more than inhalation to
prevent collapse of bronchioles
Verify order
Right drug , dose, route, time
Right pt.
Position in the crook and raise 45 degree
head
Give through the corner of the mouth
b/w gums and cheek
Stop transfusion,
give NS,
Notify doc,
collect urine sample,
send blood to lab
air in syringe
air in NPH
air in regular
withdraw regular then NPH
Dont shake but rotate gently, not need
to keep in fridge
Comfortable position
Give pain med
Assess and teach non pharmacological
measures
Notify doc if pain unrelieved
Nbm for 6-12hrs
Conscious sedative
Gag and cough reflex gone for 2hrs
GI cleansing with enema and golytely
Clear liquid diet
Rh immunization at 28 weeks and after

Negative rubella antibodies during

pregnancy
Hypoxia test
Cardiac tamponade
Insulin unit
Apothecary system
Avoirdupois system
Metric

within 72 hrs-no antibodies will b formed

if given
Immediate rubella vaccine post delivery
and counseling
ABG
Decrease in amplitude of QRS complex
Its a measure of effect and not standard
weight or quantity
Grain and minim
Ounce and pound
Liter, gram