Nrnp 6550 Final Exam-With 100% Verified Solutions-

Thyroid nodule: definition, incidence {Ans: Goiter. Majority are benign. Benign: hashimoto thyroiditis, thyroid adenoma, follicular adenoma, thyroid cyst Malignant. Risk for ca: radiation hx, hx of ca Women Older age}Massive transfusion protocol: when, what, monitor, side-effects {Ans: Indication: Pulse greater than 120 BP smaller than 90 (syst) penetrating torso injury FAST positive 2/4 then massive transfusion Stop when bleeding controlled and values improved Give universally compatible RBC (O Rhnegative and O Rh-positive) and thawed plasma Transfuse plasma & PRBCs in 1:1. 1 unit of platelets for 6 RBC's Monitor: INR, PTT, fubrinogen, Hgb/ Hct, platelet, ABG (base deficit) Use blood warmer, frequent monitoring of electrolytes and pH Side effects: hypothermia hyperkalemia hyopcalcemia fluid overload/ ARDS}Intrarenal {Ans: Cause: - Ischemia or nephrotixic injury (rhabdo, multiple myeloma, aminoglycosides, chemo, contrast) - Necrosis (acute tubular necrosis ATN) (prolonged hypotension, low CO, liver disease) - Acute tubulointerstitial nephritis from bacterial pyelonephritis, drug-induced, immunologic disorders - oliguric/ anuric - decreased urine creatinine - no proteinuria - serum creatinine increased - serum K increased - serum phos increased - serum Calcium decreased Low Na+ High H2O Low osmolality (350 and less) Specific gravity: 1,010 Urinary sodium: greater than 20 Sediment: + BUN/ creat