Polycystic kidney disease
An inherited disorder in which fluid-filled cyst develop in the nephrons
Each cystic may weigh about how many pounds
10 pounds
What is the top priority for caring for a patient with PKD
Controlling Hypertension because if not it can lead to further kidney damage
Abdominal or flank pain, Hypertension, Nocturia, Increased abdominal girth, Constipation, bloody or cloudy urine, and kidney stones are all symptoms of
PKD
Sharp intermittent pain occurs in PKD when
The cyst ruptures or a stone is present
Dull, aching pain in PKD is caused by
Increased kidney size with discretion or by infection within the cyst
When a cyst ruptures
The patient may have bright red or cola colored urine
Infection in PKD is suspected if the urine is
Cloudy or foul smelling or if their is dysuria
Which PKD is the most common
Autosomal Dominant Trait
Which PKD is most rare
Autosomal Recessive Trait
Which diagnostic test is used for PKD
Urinalysis, Serum Creatine, Blood Urea Nitrogen, Renal Sonography, Computed Tomography, Magnetic Resonance Imaging
What are the six interventions for a patient with PKD
Pain management, Prevention of Infection, Prevention of Constipation, Controlling hypertension, Preventing end-stage kidney disease
Acute infections that occur in the urethra, bladder, and Prostatitis is called
Urethritis, Cystitis, Prostatitis
What is the cystitis
Inflammation of the bladder. It can be caused by irritation
What should women avoid to prevent UTI
Irritating substances, bubble bath, nylon underwear, and scented toilet tissue.
What type of underwear should women wear in order to prevent UTI
Wear loose-fitting cotton underwear
Low colony counts in a urinalysis indicates
That the specimen is contaminated
What can help decrease irritation during cystitis
Avoid caffeine, carbonated beverages, Tomato products
What comfort measure would you use for a patient with a UTI
A warm sitz bath taken 2 to 3 times a day for 20minutes
What can happen to a pregnant women with a UTI
It can lead to acute pyelonephritis during pregnancy and can cause preterm labor
What syndrome causes a massive loss of protein, edema formation, and decreased albumin levels
Nephrotic Syndrome
Massive proteinuria, Hypoalbuminemia, Edema, Lipiduria, Hyperlididemia, Reduced Kidney Function and hypertension
Nephrotic syndrome
Which drug can reduce protein loss for patients suffering from Nephrotic Syndrome
Ace Inhibitors
If GFR is normal
Dietary intake of comple
What are the access sites for a Hemodialysis patient
Subclavian or internal Jugular Vein.
If only one or two HD treatments are needed what site can be used
Femoral
What type of complications should you monitor
Pneumothorax, Subcutaneous Emphysema(Swelling and crackling of tissue around site)
Hemodialysis is checked before use by
x-ray
A Permcath, made of silicone is used for
Long term access
A Mahurkar catheters are used for
Short term access
Transurethral needle ablation
Low radio-frequency energy shrinks the prostate
Transurethral microwave therapy
High temperatures heat and destroy excess tissue
Interstitial laser coagulation
Laser energy coagulates excess tissue
Electro vaporization of the prostate
High frequency electrical current cuts and vaporizes excess tissue
A straight line or wavy line of the cardiac monitor
Asystole
Sinus impulses are delayed, but all eventually reach the ventricles
First Degree AV Block
Rapidly Fatal if not corrected in 3 to 5 minutes
Ventricular Fibrillation
Complete Heart Block
Third degree heart block
Results in asynchrony of atrial contraction and decreased cardiac output
Atrial Fibralation
May result from sympathetic nervous system stimulation of the heart or vagal inhibition
Sinus tachy
Rapid atrial depolarization occurring at a rate of 250 to 350 times per minute
Atrial Flutter
Causes the ventricles to quiver resulting in absence of Cardiac Output
Ventricular Fibrillation
First degree AV Block is
All sinus impulses eventually reach ventricles
What are the six steps to ECG rhythm analyzer
Determine HR
Determine Rhythm
Analyze P wave
Analyze PR interval
Analyze QRS
Interpret
Where is the heart located
In the mediastinum between the lungs
What is the heart protected by
Pericardium
Each heart beat pumps out
60 ml of blood or 5L/Min
The right atrium receives
Deoxygenated blood which is returned from the body through superior venal cavae
The left atrium receives
Oxygenated blood from the lungs and pumps the remaining blood volume into the left ventricle
Right Ventricle
Tricuspid
Left Ventricle
Mitral valve
Blood pressure is regulated through
Parasympathetic and sympathetic nervous system of the autonomic nervous system
what is the ability to generate an electrical impulse spontaneously, and repetitively
Automaticity
What is the ability to generate an electrical impulse spontaneously, and repetitively
Automaticity
What is the ability of non pacemaker heart cells to respond to an electrical impulse that begins in pacemaker cells and to depolarize
Excitability
What is the ability to send electrical stimulus from membrane to cell membrane
Conductibility
Mechanical activity of the heart
Contractibility
Depolarization
Means the heart is rest
Means the heart is doing something.
...
P-Wave
0.06- 0.12
PR interval
0.12 - 20
QRS
0.04-0.12
T-Wave
16 seconds
Depolarization
K+ from outside the cell goes inside
Re polarization
When Sodium outside the cell goes back inside
AV Junctional
40-60 BPM
Hypokalemia
Tall T Wave
Hypercalcemia
Short QT interval
Hypocalcaemia
Prolonged Qt interval less than 40seconds
What does T Wave inversion mean
Myocardial infarction, Electrolyte Imbalance,
Abnormal Qwave
Myocardial infarction
What are the 3 causes of left sided heart failure
Hypertension, Coronary Artery disease, Valvular disease
Cardiac output is the
Amount of blood pumped from the Left ventricle each minute
Heart Rate
The # of times the ventricles contract each minute
Stroke Volume
The amount of blood ejected by the left ventricles during each contraction
Preload
The degree of myocardial fibers stretch at the end of diastole just b4 contraction
Afterload
Pressure or resistance that the ventricles must overcome to eject blood through the semilunar valves + into the
Monitor and weight which patient everyday
Heart failure
What is considered the best tool in diagnosing heart failure
Echocardiography
What test are used to diagnose heart failure
Electrocardio, EchoCardio, Chest X-ray, radio nuclei de study, multi gated Angio, Invasive pressure
What do you teach patients who are taking ace inhibitors or Arbs
Change position slowly to avoid orthostatic hypotension,
What are early signs of pulmonary edema
Crackles in the lung bases, dyspnea at rest , disorientation, confusion
Patients on beta blockers should be monitored for
Hypotension and Bradycardis
A patient with CAD is going to have which diagnostic markers
Troponins and myoglobin
Altered tissue promotes local inflammation by attracting cytokines and other
Benigns Prostatic Hyperplasia
PKD Pain comfort techniques
Apply dry heat, Cipro/Bactrim, Needle aspiration, stool softener. avoid aspirin
What are turp complications
Hyponatremia, Fluid overload, water intoxication.
Which lab test indicates possible bone metastasis in prostate cancer
Serum alkaline phosphate
What are the labs for BPH
Culture and sensitivity, CBC, BUN and Serum Creatine levels elevated.