Med Surg Exam #3 Study Guide

Med Surg Exam #3 Study Guide Hematology Sickle Cell Anemia - Signs & Symptoms - Fatigue, weakness, pallor - Pain crises (joints, chest, abdomen) - Jaundice, delayed wound healing, frequent infections Discharge Teaching - Sickle Cell Anemia - Stay hydrated - Avoid high altitude & temperature extremes - Prevent infections: vaccines, seek care for fever >101°F - Pain management, genetic counseling Vitamin B12 Deficiency - Findings - Pallor, fatigue, glossitis (red tongue) - Neurological: paresthesias, poor balance, confusion Food Recommendations - B12 Deficiency - Meat, poultry, fish, eggs, milk - Fortified cereals if vegan Deep Vein Thrombosis (DVT) - Assessment: unilateral swelling, pain, warmth, redness - S/S: calf pain, edema, erythema - Risk factors: immobility, surgery, obesity, smoking, contraceptives - Prevention meds: Heparin SQ, Enoxaparin - Education: early ambulation, hydration, no crossing legs - Complication: pulmonary embolism (life-threatening) Iron Deficiency Anemia - History: fatigue, pallor, dyspnea, poor diet, blood loss - Diagnostics: ↓Hgb/Hct, ↓ferritin/iron, microcytic RBCs - Iron supplements: empty stomach, Vitamin C helps, constipation/dark stool, straw with liquid iron Blood Administration - Reaction: fever, chills, back pain, rash, SOB, hypotension - FFP: used for clotting disorders - Platelets: special tubing, transfuse 15–30 min, monitor for fever/chills Safety Fundamentals - Patient ID: 2 identifiers (name, DOB) - Hand hygiene: before/after patient contact Autologous Blood Advantages - No transfusion reaction or infection risk - Maintains patient’s own supply Renal Glomerular Filtration Rate (GFR) - Normal: 90–120 mL/min - <60 = CKD, <15 = ESRD - Decline = renal disease, HTN, diabetes UTI - Higher in females: shorter urethra - Findings: dysuria, urgency, frequency, suprapubic pain - Prevention: wipe front-to-back, fluids, void after sex, avoid perfumed products Renal Calculi - Prevention: fluids, low sodium, diet per stone type - S/S: flank pain, hematuria, N/V, restlessness Pyelonephritis - Findings: recurrent UTIs, fever, chills, flank pain, N/V, CVA tenderness - Discharge teaching: complete antibiotics, fluids, hygiene - Psychosocial: anxiety, depression, sexual discomfort Urinary Retention - Risk: BPH, meds, anesthesia, neurogenic bladder - S/S: bladder distention, discomfort, inability to void - Diagnostics: bladder ultrasound, catheterization BPH & Diagnostics - S/S: hesitancy, weak stream, nocturia - Cystoscopy: visualize obstruction - Kidney biopsy: unexplained renal failure, glomerular disease, risk bleeding Renal System & Acid-Base Balance - Kidneys excrete H+, reabsorb HCO3– - Compensate for respiratory imbalances - Failure → metabolic acidosis/alkalosis Urinalysis - Check: color, clarity, pH (4.6–8), specific gravity (1.005–1.030) - Protein, glucose, ketones (should be negative) - WBC/nitrites = infection, RBCs = trauma/infection/stones Kidney Output - ≥30 mL/hr = adequate perfusion - <30 = risk of AKI Acute Kidney Injury (AKI) - Oliguria/anuria - Fluid overload (edema, crackles) - ↑Creatinine, ↑BUN, ↑K, ↑phosphate, ↓Ca - Uremic symptoms: confusion, N/V, pruritus