NUR 240 electrolytes Flashcards

1
Q

sodium

A

135-145

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2
Q

potassium

A

3.5-5.0

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3
Q

chloride

A

98-106

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4
Q

calcium

A

9-11

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5
Q

BUN

A

7-20

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6
Q

Creatinine

A

0.6-1.2

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7
Q

albumin

A

3.4-5.4

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8
Q

magnesium

A

1.5-2.5

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9
Q

Phosphorus

A

2.5-4.5

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10
Q

pH

A

7.35-7.45

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11
Q

PaCO2

A

35-45

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12
Q

PaO2

A

80-100

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13
Q

HCO3

A

22-26

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14
Q

ROME

A

respiratory opposite, metabolic equal

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15
Q

Furosemide (lasix) (loop diuretic) and hydrochlorothiazide (thiazide) have what effect on potassium?

A

potassium wasting diuretic

can lead to hypokalemia

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16
Q

Spironolactone has what effect on potassium?

A

potassium sparing diuretic

used to increase the amount of fluid passed from the body in urine, whilst also preventing too much potassium being lost with it

(widely prescribed for hypertension)

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17
Q

serous wound drainage

A

clear watery plasma

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18
Q

sanguineous

A

bright red blood

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19
Q

serosanguineous

A

pale, pink, watery; mixture of clear and red fluid

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20
Q

purulent

A

thick yellowish green, foul odor

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21
Q

types of hypertonic solution

A

5% saline
3% saline
5% dextrose in 0.9% saline (D5NS)
5% dextrose in 0.45% saline (D5 1/2 NS)
5% dextrose in LR (D5LR)
10% dextrose in water (D10W)

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22
Q

use hypertonic solution for

A

cerebral edema
hyponatremia
maintenance fluid
hypovolemia

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23
Q

what are hypErtonic solutions

“Enter the vessel from the cells”

A

more salt in the solution
less water in the solution
the vessels become more concentrated than the cells, water then leaves the cell, cell will shrink

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24
Q

types of Isotonic solution

A

0.9% sodium chloride (NS)
5% dextrose in water (D5W)
Lactated ringers (LR)

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25
Q

use isotonic solutions for

A

blood loss
dehydration
fluid maintenance

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26
Q

normal saline is the ONLY solution that is compatible to use with

A

blood products

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27
Q

what are isotonic solutions

“stays where I put it”

A

same osmolality as body fluids (equal water and particle ratio)

28
Q

types of Hypotonic solutions

A

0.45% saline (1/2 NS)
0.33% saline (1/3 NS)
0.225 saline (1/4 NS)
5% dextrose in water (D5W)

29
Q

use hypotonic solutions for

A

diabetic ketoacidosis (DKA)
helps kidneys excrete excess fluid
hypernatremia
hypervolemia

30
Q

what are hypOtonic solutions?

“Out of the vessel, into the cell (cell swells)”

A

less salt
more water
the vessel becomes less concentrated the cell, water enters the cell, cells swell

31
Q

when patient is on hypotonic fluids monitor for

A

fluid volume overload

32
Q

NEVER use hypertonic fluids for

A

increased intracranial pressure, burns, or trauma

33
Q

Causes of Metabolic alkalosis

A

vomiting (vomiting sounds like- ALKKKK-alosis)
NGT suction
hypokalemia
low K+= alKaLOWsis
compensation: slow and shallow breaths

34
Q

Causes of metabolic acidosis

A

diarrhea- “if it comes out of your ASSidosis”
renal failure - “when the kidneys fall, acid prevails”
diabetic ketoACIDOSIS
lactic acidoSiS
- Shock- low perfusion
- Sepsis- severe infection
compensation: rapid deep respirations

35
Q

hypoventilation

A

low and slow breathing = higher CO2

36
Q

hyperventilation

A

fast breathing = lower CO2

37
Q

respiratory alkalosis (fast RR) causes

A

panic attack
compensation: kidneys excrete less H+ and reabsorb less HCO3

38
Q

Respiratory acidosis causes (low and slow RR)

A

sleep apnea
head trauma “knocked out”
post-operative
drugs (CNS depressants)
- opioid overdose
- alcohol intoxication
- benzodiazepines (Diazepam)
Pneumonia
COPD or asthma attack
compensation: kidneys excrete H+ (acid) and retain HCO3 (base)

39
Q

key manifestations of respiratory alkalosis

A

Key manifestations= low PaO2, Low HCO3

40
Q

key manifestations of respiratory acidosis

A

Key manifestations: mental status changes, high PaCO2, high HCO3

41
Q

the nurse expects which client to be in respiratory acidosis ?

a. Morphine overdose
b. panic attack
c. sleep apnea
d. COPD
e. asthma attack
f. alcohol intoxication

A

a. Morphine overdose

c. sleep apnea
d. COPD
e. asthma attack
f. alcohol intoxication

42
Q

how does the nurse expect the client to show compensation for the following ABG values?

pH= 7.20 PaO2= 82 PaCO2= 37 HCO3= 15

a. decreased RR
b. Increased RR
c. increased renal retention of H+
d. decreased renal excretion of HCO3

A

this is metabolic acidosis

patient will compensation with an increased respiratory rate (b)

43
Q

hyperkalemia s/s

A

MURDER

Muscle cramps and weakness***
Urine abnormalities
Respiratory distress
Decreased cardiac contractility (decreased HR and BP)
ECG changes - tall peaked waves, widened QRS complex)
Reflexes (Increased DTR)

44
Q

Management of hyperkalemia

A

monitor ECG
administer IV calcium glucante and IV sodium bicarb
discontinue IV and PO potassium
K restricted diet

45
Q

hypokalemia s/s

A

thready weak irregular pulse
orthostatic hypotension
shadow respirations
anxiety

46
Q

management of hypokalemia

A

potassium sparing diuretic
liquid potassium chloride

47
Q

administration route for potassium
what do we never do

A

NEVER push potassium!!!!!!!
no IV pus, IM, or subQ

do: dilute iv potassium and administer with an infusion device

48
Q

hyponatremia s/s

A

seizures, nausea, lethargy

49
Q

hypernatremia s/s

A

changes in LOC, agitation, restlessness, edema

50
Q

hypophosphatemia s/s

A

changes in LOC, numbness, weakening of the bones

51
Q

hyperphosphatemia s/s

A

diarrhea, muscle weakness, decreased deep tendon reflex

52
Q

hypocalcemia s/s

A

tetany, positive trousseaus sign, positive chvosteks sign

53
Q

positive chvosteks sign

A
54
Q

positive trousseaus sign

A
55
Q

hypercalcemia s/s

A

bone pain, kidney stones, muscle weakness

56
Q

hypomagnesemia s/s

A

increased everything (BP, HR, RR, DTR)

57
Q

hypermagnesemia s/s

A

decreased everything aka SEDATED ((BP, HR, RR, DTR, energy)

58
Q

calcium and phosphorus relationship

A

inverse
increase Ca+ = decrease PO4

59
Q

magnesium and calcium relationship

A

same
increase in mag = increase in Ca+

60
Q

Potassium and sodium relationship

A

inverse
increase K = decreased in Na

61
Q

osmosis

A

when solute moves from a HIGHER concentration to a LOWER concentration

62
Q

recommended amount of fluids per day

A

2,500 mL/day of fluid.

63
Q

over use of antacids can lead to

A

metabolic alkalosis

64
Q

primary extracellular electrolytes are

A

sodium, chloride and bicarb

65
Q

Which IV solutions would the nurse expect to be ordered for a client who has hypovolemia? Select all that apply.

A

0.9% NaCl (normal saline)
Lactated Ringer’s solution
5% dextrose in 0.9% NaCl

66
Q

lab data indicating infection

A

elevated WBC count- norm is 5,000-10,000
increased lymphocytes and neutrophil levels
increase eosinophils= allergic response or parasitic infection
elevated ESR= inflammation is present