MED SURG exam 2

BUN lab value

10-20mg/dl

BUN stands for

blood urea nitrogen- evaluates kidney function

BUN lab measures

the amount of nitrogen in your blood that comes from the waste product urea

creatinine lab value

0.6-1.3mg/dl

creatinine lab measures

creatinine is a waste product, it's filtered out of the blood by the kidneys- evaluates kidney function

GFR lab value

90-120

GFR lab measures

how much blood passes through the glomeruli each minute- evaluates kidney filtering

urine specific gravity lab value

1.005-1.03

urine specific gravity measures

the concentration of solutes in urine, it reflects the kidneys ability to filter urine

the BUN, creatinine, GFR, specific gravity will be elevated when the kidneys are

not filtering

urinalysis UA

tests urine properties

KUB stands for

kidneys, ureters, and bladder x-ray

renal biopsy

a small piece of the kidney is removed and examined under a microscope

cytoscopy

a thin tube with a camera (cystoscope) is inserted through the urethra into the bladder to visualize the urinary tract

a full bladder is required for

a bladder ultrasound

benign prostatic hyperplasia BPH

non-cancerous enlargement of the prostate gland

S/S of BPH

nocturia, weak stream, hesitancy, dribbling urine, incomplete bladder emptying

coude catheter

type of urinary catheter with a slightly curved, stiff tip that goes through a narrowed or obstructed urethra, especially around the prostate

a foley catheter cannot be used in patients with

BPH

suprapubic catheter

a urinary catheter inserted directly into the bladder through the lower abdominal wall, just above the pubic bone

continuous bladder irrigation

sterile fluid usually saline, is continuously flushed through a three-way urinary catheter to keep the bladder clear of blood clots, debris, or sediment

if continuous bladder irrigation is bright red

continue irrigating until lighter color

transurethral resection of the prostate TURP

surgical procedure used to treat BPH by removing part of the enlarged prostate gland through the urethra

S/S UTI

urgency, hematuria, dysuria, cloudy urine, nocturia, fever, confusion/delirium, flank pain

unsweetened cranberry juice is preventative of UTI’s not

curative

fluid consumption for UTI

3-4L/day- void every 3-4hrs

pyelonephritis is a

kidney infection

complication of UTI

pyelonephritis

kidney stones (calculi)

hard deposits in kidney

kidney stones are more common in

men

most kidney stones come from

calcium

S/S kidney stones

occur with obstruction- urgency, dysuria, flank pain, hematuria

kegel exercises

strengthen the pelvic floor muscles

interstitial cystitis IC

also known as painful bladder syndrome, inflammation or irritation of the bladder wall

interstitial cystitis IC is

autoimmune

S/S of interstitial cystitis

bladder tenderness, urgency, void 60+ times/day, nocturia

interstitial cystitis can be treated with

pain meds, surgery

S/S of bladder cancer

painless intermittent hematuria (most common), urge, dysuria

major risk factor of bladder cancer

smoking

urinary diversion

procedure to reroute urine flow when the bladder is removed or no longer functional

notify HCP of blue or purple

stoma- decreased bloodflow

level of consciousness LOC

a person’s state of awareness of themselves and their environment

cranial nerve I

olfactory- smell- sensory

cranial nerve II

optic- vision- sensory

cranial nerve III

oculomotor- eye movement- motor

cranial nerve IV

trochlear- eye movement- motor

cranial nerve V

trigeminal- face sensation/chewing- both

cranial nerve VI

abducens- eye movement- motor

cranial nerve VII

facial- taste, tears, expression- both

cranial nerve VIII

vestobulocochlear- hearing- sensory

cranial nerve IX

glossopharyngeal- taste/swallowing- both

cranial nerve X

vagus- swallwoing/speech- both

cranial nerve XI

accessory- shoulder/neck muscles- motor

cranial nerve XII

hypoglossal- tongue- motor

glasgow coma scale

assess a person’s level of consciousness after a brain injury or in any altered mental state

high glasgow coma scale

alert and oriented

low glasgow coma scale

deep coma

seizure

excessive electrical discharge of neurons in brain

seizures cause

involuntary movement, rensory phenomenon, unusual behaviors

serizure disorder (epilepsy)

recurring seizures- 2 or more within 24 hr with no underlying problem

epilepsy seizure S

loss of consciousness, convulsive movements, senory phenomena

seizures from systemic or metabolic issues

are not epilepsy if seizures stop after underlying problem is treated

low and very high glucose levels can cause

seizures

abnormal serum electrolytes can cause

seizures

lack of sleep/alcohol withdraw can cause

seizures

seizure triggers

hunger, lack of sleep, hyperventilation, odors, stress

cerebral angiography

diagnostic imaging procedure that visualizes the blood vessels in the brain

single photon emission computed tomography SPECT

nuclear medicine imaging technique that provides 3D images of blood flow and activity in brain

focal seizures

seizures that start in one specific area of the brain and affect a limited part of the brain

tonic-clonic seizure

generalized seizure that affects the entire brain

tonic seizure

characterized by sudden, sustained muscle stiffening and rigidity, usually lasting a few seconds to about 20 seconds

clonic seizure

repetitive, rhythmic jerking movements of muscles

myoclonic seizure

brief, sudden, shock-like muscle jerks usually on both sides of the body

atonic seizure

sudden loss of muscle tone, leading to weakness and collapse

simple focal seizure

tungling, slurred speech, remain conscious

complex focal seizure

repetitive activites, chewing, lipsmacking

with generalized seizures there is always

loss of consciousness and bilateral symptoms

generalized seizures

tonic-clonic, absence, myoclonic, tonic, clonic, atonic

status epilepticus SE

state of continuous seizure activity

status epilepticus is any seizure lasting longer than

5 min

treatment of status epilepticus

lorazepam (ativan)

do not open mouth or insert into airway during

seizure- can damage mouth

delirium

state of temporary confusion

delirium is

acute onset

dementia is

gradual onset

delirium lasts

hours-weeks

alzheimers disease

neurodegenerative dementia (most common)

vascular dementia

results from reduced blood flow to the brain, often due to strokes

mini clog

3 unrelated words, clock drawing, repeat words

mini mental state examination

date, repeat 3 words, name objetcs, reading and doing