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Registered Nurse (RN)
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HESI®
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HESI®-RN Comprehensive Review
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Renal System

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HESI®-RN Comprehensive Review | Registered Nurse (RN) School Study Aid

Renal System
22 Picmonics to Learn | 43 mins
Normal Electrolyte Lab Values
Potassium (K+)
3.5 to 5.0 mEq/L
Calcium (Ca2+)
8.5 to 10.5 mg/dL
Phosphate (PO43–)
2.5 to 4.5 mg/dL
Magnesium (Mg2+)
1.5 to 2.5 mEq/L
Sodium (Na+)
135 to 145 mEq/L
Chloride (Cl)
95 to 105 mEq/L
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2 mins
BUN (Blood Urea Nitrogen) Lab Values
10-20 mg/dL
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40 secs
Creatinine Lab Values
Measures Renal Function
0.6 - 1.3 mg/dL
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1 min
Hyperkalemia
Assessment
> 5.0 mEq/L K+
Abdominal Cramps
Muscle Weakness
Diarrhea
Arrhythmia
Tall, Peaked T Waves
Interventions
IV Calcium
Infusion of Glucose and Insulin
Loop or Thiazide Diuretics
Kayexalate
Dialysis
Prevention Education
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2 mins
Hyponatremia
Assessment
< 135 mEq Na+
Nausea and Vomiting
Decreased LOC
Confusion / Lethargy
Seizures
Priority Interventions
Assess Airway
Reduce Diuretic Dosage
Fluid Excess Hyponatremia
Mannitol (Osmitrol)
Fluid Restriction
Fluid Deficit Hyponatremia
Hypertonic Solution (3% or 5% NaCl)
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2 mins
How to Interpret Acid Base Disorders
pH, pCO2, HCO3 (Bicarbonate)
Step 1
pH
Acidosis
Alkalosis
Step 2
pCO2
Opposite Direction As pH
Respiratory Acidosis
Respiratory Alkalosis
Step 3
HCO3 (Bicarbonate)
Same Direction As pH
Metabolic Acidosis
Metabolic Alkalosis
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3 mins
Chronic Kidney Disease Early Symptoms Assessment
Characteristics
GFR < 60mL/min
Accumulation of Waste Products
Clinical Features
General Malaise
Hypertension
Proteinuria
Hyperkalemia
Mineral and Bone Disorders
Neuropathy
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2 mins
Chronic Kidney Disease Late Symptoms Assessment
Metabolic Acidosis
Severe Uremia
Arrhythmias
Edema
CNS Depression
Anemia
Oliguria
Pruritus
Considerations
End Stage Renal Disease (ESRD)
GFR < 15mL/min
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2 mins
Dialysis
Hemodialysis
Rapid Shifts of Fluid and Electrolytes
Disequilibrium Syndrome
Hypotension
NO BP IN ARM with Shunt or Fistula
Assess for Thrill and Bruit
Peritoneal Dialysis
Slow Process
Peritonitis
Loss of Protein
Hyperglycemia
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3 mins
Albumin Lab Value
3.5 - 5.5 g/dL
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49 secs
Therapeutic Diets
Common Therapeutic Diets
High Fiber
Low Residue (Fiber)
Low Sodium
Low Cholesterol
Diabetic
Renal
Dysphagia
Nursing Considerations
Diet Education
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2 mins
Urinary Tract Infection Symptoms
More Common in Elderly
Most Common in Females and Babies
Change in LOC
Dehydration
Fever
Urgency
Urethral Infection
Burning
Smelly Urine
Dark Cloudy Urine
Frequency of Urination
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2 mins
Urinary Tract Infection Prevention and Treatment
Prevention
Shower after Sex
Urinate after Sex
Wipe front to Back
Treatments and Considerations
I and Os with Daily Weights
Increase Water Intake
Antibiotics
Avoid Caffeine
Dr Appointment in 2 Weeks
Void every 2 - 4 hours
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2 mins
Chronic Kidney Disease Interventions
Interventions
Daily Weights
Strict I/O
Renal Diet
Strict Medication Regimen
Erythropoietin
Manage Hyperkalemia
Manage CKD-MBD
Dialysis
Kidney Transplant
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2 mins
Erythropoietin
Mechanism
Stimulates RBC Production
Indications
Chronic Renal Failure
Anemia
Side Effects
Increased Risk of Thrombosis
Pelvic and Limb Pain
Hypertension
Considerations
Do Not Shake
Monitor Hemoglobin (Hgb) Weekly
May Accelerate Tumor Progression
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2 mins
Airway and Lungs Assessment
Inspection
Examine Back of Chest
Determine Respiratory Rate for 1 Minute
Assess for Abnormalities with Uneven Movement or Use of Accessory Muscles
Inspect Skin, Nails and Mucous Membrane
Palpation
Palpate for Crepitus, Tenderness, Alignment, Masses or Retraction
Palpate for Tactile Fremitus
Check Chest-Wall Symmetry and Expansion
Note Resonance, Hyperresonance, Dullness and Tympany
AUSCULTATION
Use Diaphragm of Stethoscope to Listen to Full Inspiration and Full Expiration
Ask Patient to Breathe Through Mouth
Normal Breath Sounds
Abnormal Breath Sounds
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5 mins
Pain Assessment
Types of Pain
Acute Pain
Chronic Pain
OPQRST Mnemonic
Onset
Provoking or Palliative
Quality
Radiation
Severity
Timing
Nursing Considerations
Subjective Findings
Objective Findings
Reassessment of Pain
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2 mins
Renal Calculi Assessment
Cause/Mechanism
Hypercalcemia (Most Commonly)
Signs and Symptoms
Flank Pain
Radiates Toward Bladder
Renal Colic
Urinary Tract Infection
Urinary Retention
Hematuria
Considerations
Stone Recurrence
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2 mins
Renal Calculi Interventions
Interventions
Increase Fluid Intake
Opioids
NSAIDs
Antibiotics
Lithotripsy
Surgical Stone Removal
Considerations
Identify Type CT-KUB
Low Sodium Diet
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2 mins
Benign Prostatic Hyperplasia (BPH) Assessment
Assessment
Men Over 50
Enlarged Prostate Gland
Urinary Retention
Weak Urine Stream
Frequency
Urgency
Nocturia
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1 min
Benign Prostatic Hyperplasia (BPH) Interventions
Interventions
Timed Voiding
Decreased Caffeine Intake
Catheterization
Medications
Finasteride (Proscar)
Tamsulosin (Flomax)
Surgical Interventions
TURP Procedure
Open Prostatectomy
Continuous Bladder Irrigation (CBI)
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2 mins
Benign Prostatic Hyperplasia (BPH) Diagnosis and Treatment
Diagnosis
Digital Rectal Exam
Urinalysis to Detect Infection or Blood
Treatment
Alpha-1 Antagonists
Tamsulosin
5 Alpha Reductase Inhibitors
Finasteride
TURP (Transurethral Resection of Prostate)
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1 min

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