Gastrointestinal and Renal Care Flashcards

A patient with end-stage renal disease misses dialysis and has peaked T waves on ECG. What is the priority treatment?

Answer: IV calcium gluconate

Peaked T waves indicate hyperkalemia, and IV calcium gluconate stabilizes the cardiac membrane immediately.

Which acid-base disturbance is most characteristic of chronic kidney disease?

Answer: Metabolic acidosis

The failing kidney cannot excrete hydrogen ions or regenerate bicarbonate, causing metabolic acidosis.

A patient develops disequilibrium syndrome during hemodialysis. What causes this?

Answer: Rapid shift of solutes causing cerebral edema

Rapid urea removal creates an osmotic gradient that draws water into brain cells, causing cerebral edema.

Which lab finding best distinguishes prerenal azotemia from intrinsic renal failure?

Answer: BUN-to-creatinine ratio greater than 20:1

A BUN:creatinine ratio over 20:1 suggests prerenal azotemia from hypoperfusion rather than intrinsic damage.

A patient with a small bowel obstruction is at greatest risk for which complication?

Answer: Bowel ischemia and perforation

Increasing intraluminal pressure can compromise blood flow, leading to bowel ischemia and perforation.

Which medication should be administered cautiously in a patient with hepatic failure due to impaired metabolism?

Answer: Acetaminophen

Acetaminophen is hepatotoxic and metabolized by the liver, requiring caution or avoidance in hepatic failure.

A patient with severe diarrhea has a serum bicarbonate of 14 mEq/L. Which acid-base disorder is present?

Answer: Non-anion gap metabolic acidosis

Diarrhea causes loss of bicarbonate, producing a normal anion gap (hyperchloremic) metabolic acidosis.