U World Renal-Urinary final NCLEX Urinary-Renal. Comprehensive Last Minute Content to Guarantee Passing the UWorld Renal-Urinary Final Exam.
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U World Renal-Urinary final NCLEX urinary-renal Chronic kidney disease (CKD) have decreased glomerular filtration, resulting in retention of fluid, potassium, and phosphorus. Fluid retention is ini tially treated with sodium restriction and diuretic therapy. Dietary adjustments should also be made to reduce serum potassium and phosphorus. contain high potassium levels: Dairy products (eg, milk, yogurt) and certain fruits (eg, bananas, oranges, coconuts, watermelons, and avocados) Dairy products also contain high phosphorus levels. Examples of allowable foods for CKD clients include apples, pears, grapes, pineapple, blackberries, blueberries, and plums. dietary restrictions. These include the following: 1. Sodium restriction involves avoiding high-sodium foods such as cured meats, pickled foods, canned soups, frankfurters, cold cuts, soy sauce, and salad dressings 2. Fluid intake must be monitored accurately and often is restricted 3. Potassium restrictions will vary depending on kidney function. Raw carrots, tomatoes, and orange juice are high-potassium foods that clients with advanced kidney disease or on hemodialysis should avoid. 4. Low-protein diet (0.6–0.8 g/kg/day) helps prevent kidney disease progression. If the client is already on dialysis, liberal protein intake is recommended to prevent malnutrition. Because renal damage often results in elevated blood pressure, clients with CKD are at risk for uncontrolled hypertension and hypertensive emergencies. Hypertensive encephalopathy is a type of hypertensive crisis characterized by nausea, vomiting, and headache. Treatment is urgent (ie, within 1 hour) to prevent damage to the heart, kidney, and brain. The client should check blood pressure at home, if possible, and then proceed to the emergency department for further assessment and treatment (eg, titration of antihypertensive medication). *Hypertension, elevated serum creatinine level (normal: 0.6-1.3 mg/dL [53-115 µmol/L]), nausea associated with azotemia, and pruritus associated with dry skin are expected for chronic kidney disease clients Potassium chloride (KCL) An electrolyte replacement to correct hypokalemia, is a high-alert drug that is never administered by the Severe hyperkalemia (potassium >7.0 mEq/L) Requires urgent treatment because cardiac muscle cannot tolerate very high potassium levels. Severe Oxybutynin (Ditropan) An anticholinergic medication that is frequently used to treat overactive bladder. Common side effects Saw palmetto A herbal preparation, is often used to treat benign prostatic hyperplasia. St John's wort has been used for SIA a surgical connection of an artery to a vein created to provide vascular access for hemodialysis therapy in takes 2-4 months for it to mature to accommodate the repeated venipunctures necessary for Stress incontinence The highest priority for a client newly diagnosed with stress incontinence is preventing skin breakdown Dialysis treatment Prior, the nurse should assess the client's fluid status (weight, blood pressure, peripheral edema, lung and Dialysis disequilibrium syndrome (DDS) rare but potentially life-threatening complication that can occur in clients during the initial stages of Metabolic acidosis Is due to an increase in the production or retention of acid (eg, lactic acidosis, ketoacidosis, renal failure) Prostatectomy Signs of complications- bleeding, passage of blood clots, a decrease in the urinary stream, urinary Kidney biopsy Involves obtaining a tissue sample for pathological evaluation to determine the cause of certain kidney Renal calculi (ie, kidney stones) Antimuscarinic/anticholinergic medications Tolterodine (Detrol LA), oxybutynin (Ditropan), and solifenacin (Vesicare) Terazosin An alpha-adrenergic blocker that can relieve urinary retention in clients with BPH. Transurethral resection of the prostate (TURP) Peritoneal dialysis Uses the abdominal lining (ie, peritoneum) as a semipermeable membrane to dialyze a client with Prevent recurrent UTIs: Cytoscopy Renal arteriogram Portable ultrasonic bladder scanners Urine culture values >10,000 organisms/mL can suggest UTI. Extracorporeal shock wave lithotripsy (ESWL) Pessary Phenazopyridine hydrochloride (Pyridium) Ketorolac (Toradol) Acute urinary retention Percutaneous nephrolithotripsy Bladder cancer erythropoietin (Epogen/Procrit, epoetin) Scleroderma an overproduction of collagen that causes tightening and hardening of the skin and connective tissue. This is a progressive disease without a cure, and treatment is aimed at managing complications. Renal crisis is a life-threatening complication that causes malignant hypertension (abrupt onset of Show Less