Gastrointestinal and Renal Care Flashcards

A patient with acute pancreatitis has a serum calcium of 7.0 mg/dL. What causes this finding?

Answer: Fat saponification binding calcium

Released lipase causes fat necrosis that binds calcium (saponification), lowering serum calcium.

Which sign indicates worsening intra-abdominal hypertension toward abdominal compartment syndrome?

Answer: Decreased urine output with elevated peak airway pressures

Rising intra-abdominal pressure reduces renal perfusion and compresses the diaphragm, causing oliguria and high airway pressures.

A patient on peritoneal dialysis develops cloudy effluent. What does this most likely indicate?

Answer: Peritonitis

Cloudy peritoneal dialysis effluent is the classic sign of peritonitis from infection.

Which finding indicates a patient with chronic kidney disease has developed uremic pericarditis?

Answer: Pericardial friction rub

A pericardial friction rub is a hallmark of uremic pericarditis caused by retained uremic toxins.

A patient with liver failure has a prolonged INR and active bleeding. Which treatment addresses the underlying coagulopathy?

Answer: Vitamin K and fresh frozen plasma

Impaired hepatic synthesis of clotting factors is treated with vitamin K and fresh frozen plasma to replace factors.

Which assessment is most important after placement of a sengstaken-Blakemore (esophageal balloon) tube?

Answer: Monitor for airway obstruction from balloon migration

An esophageal tamponade balloon can migrate and obstruct the airway, so airway protection is the priority.

A patient with acute tubular necrosis enters the diuretic phase. What is the primary nursing concern?

Answer: Fluid and electrolyte depletion from polyuria

During the diuretic phase, excessive urine output can cause dehydration and electrolyte losses requiring close monitoring.