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Health Care exam material, 9 pages. Originally published on StudyMerit.
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What type of antacid to avoid with ESRD AVOID magnesium based antacids to prevent mag toxicity Recommended foods for ESRD - apples, berries, grapes, peaches, & cabbage - Must be lean protein (dairy products, eggs, meats) What meds not to give on day of dialysis Digoxin, Dobutamine What meds to take for Metabolic Acidosis If symptoms are present, give Pt Sodium Bicarbonate or Dialysis Examples of when to use CRRT Pt's who are too hemodynamically UNSTABLE - Septic Pt's, hemorrhaging Blood flow rate of hemodialysis > 200 ml/hr Blood flow rate for CRRT < 200 ml/hr Which type of antibiotic do we not give ESRD Pt's? We do NOT give gentamicin (hard on kidneys) RF for bladder cancer Older white men > 55 smoking exposure CM of bladder cancer Early : painless hematuria late: flank pain (metastasis) complications: UTI Bladder cancer diagnostic test Cystoscopy and biopsy urinary diversion Pathology of pancreatitis The pancreatic duct becomes temporarily obstructed Enzymes enter the bile duct - > activated & together with bile - > Reflux into pancreatic duct Etiology of pancreatitis
Alcoholism , cholelithiasis, peptic ulcers, trauma, hyperlipidemia Diagnostic tests for pancreatitis WBC > 16,000 mm3 Serum glucose Serum amylase Lipase Within 48 hours of hospital admission, FALL in HCT >10% Diagnostic tests for acute pancreatitis Serum lipase (rises within 24 hours of the onset of symptoms) Remains elevated for several days Amylase (rises within 24 hours of onset of symptoms) CT = GOLD STANDARD Risk factors for pancreatic cancer Cigarette smoking Obesity Exposure to chemicals High fat diet & red, processed meats Diabetes Diagnostic tests for pancreatic cancer CT with contrast to localize, if unable to with CT, use endoscopic ultrasound +/ - ERCP CM of pancreatic cancer Pain Jaundice Weight loss Ascites common in end - stage (perform paracentesis, always empty bladder before the procedure) Insulin deficiency signs Back pain that is relieved when sitting up and leaning forward * Food aggravates epigastric pain Nursing management of pancreatic cancer Pain monitor nutrition Skin care (when jaundice is present)
Hospice care for patients living less than 6 months Pathology of peritonitis Primary: Spontaneous bacterial infection (Escherichia coli ** most common bacteria) Secondary: Perforation Tertiary: Immunocompromised CM of peritonitis Early: Pain is diffuse but then becomes constant and localized Movement aggravates pain Rebound tenderness paralytic ileus Oliguria Hypotension Medical management of peritonitis Electrolyte & fluid replacement Antibiotics Phenergan Remove fluid from the abdomen Isotonic solutions Dumping syndrome symptoms Occurs 15 minutes to 2 hours AFTER eating Tachy dizziness sweating nausea/vomiting/Bloating ABD cramping diarrhea What to avoid with dumping syndrome
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