NCLEX-RN 이것만이라도 보고 가자! : Emergency / Critical Care │ Nurse Haley

날짜:

NCLEX-RN 이것만이라도 보고 가자! : Nephrology & Urology part │ Nurse Haley

날짜:

💧 Nephrology & Urology by Nurse Haley

Renal Disorders · Electrolytes · Dialysis · Urinary Care 핵심 요약


안녕하세요! 오늘의 간호사 Haley 입니다 🌿 이번 포스트는 **Nephrology / Urology (신장·비뇨기계)** 파트로, NCLEX-RN에서 출제율이 매우 높은 질환들과 간호 포인트만 압축했습니다.

📖 Table of Contents

💧 Acute & Chronic Renal Disorders

Disorder Key Features Nursing Focus
1️⃣ Acute Kidney Injury (AKI) Sudden ↓ in kidney function → fluid & waste retention.
Phases: Oliguric → Diuretic → Recovery. 		• Monitor I/O, daily weight.
• Limit K⁺, Na⁺, fluids during oliguric phase.
• Avoid nephrotoxic drugs (NSAIDs, contrast).
• Watch for hyperkalemia (peaked T waves).
• Diuretic phase → dehydration risk!
2️⃣ Chronic Kidney Disease (CKD) Progressive, irreversible nephron loss → uremia.
Common causes: DM, HTN, glomerulonephritis. 		• Restrict Na⁺, K⁺, phosphorus, protein (if not on dialysis).
• Erythropoietin for anemia.
• Monitor for uremic frost, confusion, itching.
• Control BP, blood glucose.
• Prepare for dialysis education.

⚡ Electrolyte Imbalances (AKI/CKD 관련)

Electrolyte Manifestations Nursing Management
Hyperkalemia (K⁺↑) Peaked T waves, muscle weakness, cardiac arrest risk. • IV insulin + D50, calcium gluconate, sodium polystyrene.
• Restrict dietary K⁺.
• Prepare for dialysis if severe.
Hypocalcemia / Hyperphosphatemia Chvostek/Trousseau sign, tetany, bone pain. • Administer phosphate binders with meals (Sevelamer).
• Vitamin D supplement (Calcitriol).
• Monitor QT prolongation.
⚠️ NCLEX 핵심포인트:
- K⁺ > 6.0 → monitor ECG immediately.
- Ca–P inverse relationship 기억하기!
- Oliguria = fluid restriction priority.

🌀 Dialysis Nursing

Type Key Points Pre/Post Care
Hemodialysis Removes waste via AV fistula or graft.
Rapid correction of electrolytes. 		• Check bruit/thrill at fistula site.
• No BP/IV on access arm.
• Hold antihypertensives pre-dialysis.
• Watch for disequilibrium syndrome (↓ LOC, HA).
• Monitor for hypotension, cramps.
Peritoneal Dialysis Uses peritoneal membrane as filter.
Slower but continuous process. 		• Warm dialysate before infusion.
• Aseptic technique!
• Cloudy outflow = peritonitis.
• Monitor inflow/outflow balance.
• Fiber diet for constipation prevention.

🚻 Urologic Disorders

Disorder Key Findings Nursing Management
1️⃣ UTI / Pyelonephritis Dysuria, frequency, flank pain, fever, cloudy urine. • Encourage 3L/day fluid (if not contraindicated).
• Wipe front to back, void after sex.
• Antibiotics (Bactrim, Nitrofurantoin).
• Avoid caffeine, alcohol, citrus.
2️⃣ Renal Calculi (Kidney Stone) Severe flank pain radiating to groin, hematuria. • Strain all urine (catch stone).
• IV fluids, pain control.
• Lithotripsy → monitor for hematuria.
• Encourage ambulation post-op.
3️⃣ BPH (Benign Prostatic Hyperplasia) Hesitancy, weak stream, retention, nocturia. • Meds: Tamsulosin, Finasteride.
• Post-TURP → continuous bladder irrigation (CBI).
• Monitor for bladder spasms, clots.
• Urine = pink-tinged OK, bright red = report.
💡 Exam Tip:
- CBI = maintain light pink urine, no clots.
- If bladder spasms → check for obstruction.
- Encourage early ambulation to prevent DVT.

정리: 오늘의 간호사 Haley

📌 본문 내용은 오늘의 간호사 Haley의 저작물로 무단 복제·배포를 금합니다.

#NCLEX #Nephrology #Urology #AKI #CKD #Dialysis #UTI #BPH #RNexam #간호요약