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Fundamentals > Quiz 5 > Flashcards

Quiz 5 Flashcards

1
Q

What is a normal lab value of sodium?

A

136-145 mEq/L

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2
Q

What is a normal lab value for potassium?

A

3.5-5 mEq/L

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3
Q

What is a normal lab value for calcium?

A

9-10.5 mg/dL

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4
Q

What is the normal lab value for ionized calcium?

A

4.5-5.6 mg/dL

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5
Q

What is the normal lab value for magnesium?

A

1.3-2.1 mEq/L

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6
Q

What is the normal lab value of chloride?

A

98-106 mEq/L

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7
Q

What is the normal lab value of phosphate?

A

3-4.5 mg/dL

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8
Q

Define fluid volume deficit

A

dry
dehydration
deficit of fluid (hypovolemia)

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9
Q

What can cause fluid volume deficit?

A

vomiting
diarrhea
sweating
- fever
- heat stroke
- thyroid crisis
severe burns
urination
diabetes
diabetic ketoacidosis
diuretics

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10
Q

What will happen as a result of fluid volume deficit? Symptoms

A

increased thirst
urine retention
tachycardia (thready)
fever
hypotension (orthostatic)
weakness
constipation (decreased bowel sounds/motility)

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11
Q

When looking at a patient who is dehydrated, what will the lab values be?

A

increased:
Hct
osmolarity
sodium
BUN
protein
electrolytes
glucose

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12
Q

What are the four organs that output fluid?

A

skin
lungs
GI tract
kidneys

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13
Q

What will be noted in older adults who are dehydrated?

A

reduced thirst mechanism due to less total body water

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14
Q

What are the crystalloid IV solutions?

A

hypotonic
hypertonic
isotonic

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15
Q

What are examples of IV fluids?

A

crystalloid IV solutions
colloids

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16
Q

Define hypotonic

A

increase in fluid

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17
Q

Define hypertonic

A

decrease in fluid

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18
Q

Define isotonic

A

equal fluid gain/loss

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19
Q

What type of fluid is saline?

A

isotonic

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20
Q

What is a half of saline (0.45 instead of 0.9) considered?

A

hypotonic

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21
Q

What is D5 in lactated ringer’s considered?

A

hypertonic

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22
Q

What are the causes of fluid volume overload?

A

renal failure
heart failure
liver disease
infection
burns
cancer

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23
Q

What will happen as a result of fluid volume overload? Symptoms

A

mental status change
headache
hypertension
tachycardia (bounding)
decreased temp
fluid in lungs (crackles)
low respiratory rate
increased urine
increased motility

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24
Q

When looking at a patient who is overhydrated, what will the lab values be?

A

decreased:
Hct
osmolarity
sodium
BUN
urine specific gravity
electrolytes

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25
Q

What will the pulse be for a patient who has fluid volume deficit? Why?

A

weak, thready

due to low fluid volume

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26
Q

What will the pulse be for a patient who has fluid volume overload? Why?

A

bounding

due to high fluid volume

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27
Q

For a patient with pitting edema, what will the nurse do?

A

weight the patient

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28
Q

How will the lungs sound for a patient with fluid volume overload?

A

crackles

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29
Q

How much water should one intake?

A

2300 mL/day

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30
Q

What is the average output of urine?

A

30 mL/hour
360 mL/day

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31
Q

What is saline or lactated ringers (isotonic) used for?

A

hypotension
hemorrhaging
type 1/2 diabetes

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32
Q

What is included in a chemistry panel?

A

potassium
calcium
sodium
magnesium
phosphorus

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33
Q

What will the nurse do if any of the levels within the chemistry panel are low?

A

replace them by doing electrolyte therapy

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34
Q

What is the function of sodium within the body?

A

affects the nervous system

maintains:
BP blood volume
pH balance

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35
Q

What is hyponatremia?

A

low sodium levels

cells in brain and nervous system swell

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36
Q

How does hyponatremia affect the body?
Symptoms

A

SALT LOSS

Seizures
Abdominal cramping
Lethargic
Tendon reflexes diminished

Loss of urine / appetite
Orthostatic hypotension, Overactive bowel sounds
Shallow respirations
Spasm of muscles

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37
Q

What are the causes of hyponatremia?

A

sweating
excess water intake (running in heat)
high ADH
vomiting
diarrhea
diuretics
low salt diet

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38
Q

What is a low sodium diet? What can the nurse do?

A

no canned or pickled foods

ask questions to family of what they are bringing

39
Q

What is hypernatremia?

A

high sodium levels

cells dehydrated

40
Q

What are the symptoms of hypernatremia?

A

BIG & BLOATED

edema
flushed skin
increased muscle tone
swollen dry tongue
N/V
tachycardia
orthostatic hypotension

41
Q

What are the causes of hypernatremia?

A

low ADH
rapid respirations
diarrhea
loss of thirst

42
Q

What is the function of potassium within the body?

A

pumps the heart
lung function
muscle function

43
Q

What is hypokalemia?

A

low potassium levels

44
Q

What are the symptoms of hypokalemia?

A

LOW & SLOW symptoms

flat T waves
ST depression
U waves

hypotension, irregular pulse
muscle issues
slow/ shallow respirations

45
Q

What are the causes of hypokalemia?

A

fluid and electrolyte loss
- GI, renal, skin

46
Q

What is hyperkalemia?

A

high potassium levels

47
Q

What are the symptoms of hyperkalemia?
It will ____ the patient

A

MURDER

Muscle weakness
Urinary output decreased
Respiratory failure
Decreased cardiac contractility
Early: muscle twitches
Rhythm changes: peaked T waves, elevated ST, vfib

48
Q

What are the causes of hyperkalemia?

A

renal failure
low aldosterone
diuretics
old age

49
Q

What is the function of magnesium within the body?

A

mellows the muscles

50
Q

What is hypomagnesemia?

A

low magnesium levels

51
Q

What are the causes of hypomagnesemia?

A

Crohn’s disease
Celiac disease
GI losses
malnutrition

52
Q

What are interventions for hypomagnesemia?

A

replace magnesium
- whole grains
- dark green vegetables

53
Q

What are the symptoms of hypomagnesmia?

A

TWITCH

Trousseau/ Chvostek sign
Weakness
Increased deep tendon reflex
Torsades de pointes
Calcium and potassium levels low
Hypertension

54
Q

What is hypermagnesemia?

A

high magnesium levels

55
Q

What are the symptoms of hypermagnesemia?

A

LETHARGIC

Lethargic
EKG changes
Tendon reflexes absent
Hypotension
Arrhythmias (bradycardia/heart blocks)
Red and hot face
GI issues (N/V)
Confusion

56
Q

What are the causes of hypermagnesemia?

A

renal failure
alcoholism
malnourishment

57
Q

What is the function of calcium within the body?

A

contracts muscles

keeps the 3 B’s strong:
- bone
- blood (clotting)
- beats (heart)

58
Q

What is hypocalcemia?

A

low calcium levels

59
Q

What are the symptoms of hypocalcemia?

A

CRAMPS

Convulsions
Reflexes hyperactive
Arrhythmias
Muscle spasms
Positive signs (Trousseau’s/ Chvostek’s)
Sensation of tingling (parasthesia)

60
Q

What are the causes of hypocalcemia?

A

hypoparathyroidism (low calcium)
renal failure (chronic kidney disease)
vitamin D deficiency

61
Q

What is hypercalcemia?

A

high calcium levels

62
Q

What are the symptoms of hypercalcemia?

A

WEAK

Weakness of muscles
EKG changes (short QT)
Absent reflexes, Altered mental status, abdominal distension
Kidney stone formation

63
Q

What are the causes of hypercalcemia?

A

hyperparathyroidism (high calcium)
cancer
immobility

64
Q

What is a patient at risk for during NG tube suctioning?

Electrolytes levels

A

hypokalemia
hypomagnesemia

65
Q

If a patient has low calcium levels, what are they at risk for? Why? What will the nurse do?

A

high risk for falls

due to muscle tremors

nurse will place call light within reach if patient needs assistance

66
Q

What are the acid-base regulatory systems?

A

respiratory system
renal system

67
Q

What is the normal range for pH?

A

7.35-7.45

68
Q

What is the normal range for PaCO2?

A

35-45 mmHg

69
Q

What is the normal range for HCO3-?

A

22-26 mEq/L

70
Q

Where is acid found within the body?

A

stomach and urine

71
Q

Where is base found within the body?

A

intestines

72
Q

If a patient has a low and slow respiratory rate, what are they at risk for? Why?

ABG

A

respiratory acidosis

can’t release CO2

build up of CO2

73
Q

If a patient has a fast respiratory rate, what are they at risk for? Why?

ABG

A

respiratory alkalosis

releasing too much CO2 (acid), HCO3 (base) will have to compensate

74
Q

If a patient has renal failure or diarrhea, what are they at risk for? Why?

ABG

A

metabolic acidosis

renal failure: acid build up
diarrhea: releasing too much HCO3, CO2 (acid) will have to compensate

75
Q

If a patient is vomiting or there is excessive NG suctioning, what are they at risk for? Why?

ABG

A

metabolic alkalosis

releasing too much CO2 (acid), HCO3 (base) will have to compensate

76
Q

Describe metabolic acidosis

A

pH: < 7.35 (low)
HCO3: < 22 (low)

77
Q

Describe metabolic alkalosis

A

pH: > 7.45 (high)
HCO3: > 26 (high)

78
Q

What are normal lung sounds?

A

bronchial sounds
bronchovesicular sounds
vesicular sounds

79
Q

What are adventitious lung sounds?

abnormal

A

crackles
wheezing
rhonchi
stridor

80
Q

What are pharmacologic interventions for bronchospasms?

A

bronchodilators

81
Q

What are pharmacologic interventions for airway inflammation?

A

corticosteroids

82
Q

What are pharmacologic interventions for pulmonary congestion?

A

diuretics
nitrates (if heart failure present)

83
Q

What are pharmacologic interventions for anxiety, pain, agitation?

A

benzodiazepines
opioids

84
Q

What are pharmacologic interventions for secretions?

A

mucolytic agents

85
Q

What are nonpharmacologic interventions for oxygenation?

A

oxygen therapy
artificial airways
suctioning
hydration
spirometer
breathing exercises

86
Q

Why would a nurse take a pulse oximetry measurement?

A

if the capillary refill is not less than 2-3 secs
or
cold finger

87
Q

What is a sign of oxygen depletion?

A

clubbing

88
Q

What is the preferred site for injection in older adults?

A

ventrogluteal

89
Q

What are important measures to take when handling needles?

A

never recap needle
do not shove needles into container
put in biohazard
use needleless needles if possible

90
Q

If a patient is sleeping, what should the nurse do to promote sleeping/resting?

A

do not go in patients room flushing toilets or making noise

91
Q

When assessing a patient who has trouble sleeping, what questions should the nurse ask?

A

assess by asking:
“do you have problems falling asleep when driving home?”
“Do you have any patterns of sleep disturbances?”

92
Q

What should a nurse educate a patient on if they are trying to sleep more?

A

do not drink alcohol before sleeping, it is a contraindication to sleep

93
Q

What can an AP do for a patient who has a trach?

A

take sputum to lab
vitals
replace cannula if it falls out

94
Q

What can an AP NOT do for a patient who has a trach?

A

suction
auscultate

Fundamentals (7 decks)

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