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NURS230 > Exam 1 > Flashcards

Exam 1 Flashcards

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1
Q

What is osmosis

A

Diffusion of water to equal out the concentration gradients

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2
Q

Hydrostatic/osmotic water pressure

A

Albumin drawing water back into the vessel + pressure from the heart moving water out of the vessel = fluid balanced

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3
Q

Diffusion

A

Solutes move from area of higher concentration to lower concentration

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4
Q

What is fluid volume deficit

A

-hypovolemia
-low volume of water in the bvs

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5
Q

Signs and symptoms of hypovolemia

A

-decrease BP
-decrease LOC
-decrease urine output
-increase HR
-dizziness
-thirst
LATE SIGNS: neuro changes

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6
Q

Lab findings of hypovolemia

A

Increase BUN, HCT, and concentrated urine

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7
Q

Interventions for hypovolemia

A

-strict I/O’s
-daily weights
-treat nausea, diarrhea, fever
-oral care for dry MM

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8
Q

What is fluid volume excess

A

Hypervolemia
-high volume of water in the bvs
RARELY FROM PO INTAKE

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9
Q

Signs and symptoms of hypervolemia

A

-dyspnea
-crackles
-jugular vein distention
-pulmonary edema
LATE SIGNS: LOC

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10
Q

Lab findings of hypervolemia

A

-very diluted urine
-low sodium, BUN, and specific gravity
-pulmonary congestion

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11
Q

Interventions for hypervolemia

A

-fluid restrictions
-diuretics= increase urine output
-compression socks = decrease lower extremity edema

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12
Q

Isotonic meds

A

Normal saline
Lactated ringers

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13
Q

Hypotonic meds

A

D5W and 1/2 NS
-causes cellular edema
-these are maintenance fluids, give slowly

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14
Q

Hypertonic meds

A

3% NaCl and D10W/D15W
-cells will shrivel
-can cause necrosis

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15
Q

Sodium normal range

A

135-145

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16
Q

What is sodium

A

-main electrolyte in EXTRA cellular fluid
-distributes water in the body

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17
Q

Causes of Hyponatremia

A

-water gain
-NaCl diluted
-exercise induced

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18
Q

Treatment of Hyponatremia

A

-NO DIURETICS
-fluid restrictions

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19
Q

Signs and symptoms Hyponatremia

A

-coma
-irritability
-headache

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20
Q

Causes of Hypernatremia

A

water moves into the bvs to dilute causing cellular shrinkage

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21
Q

Signs and symptoms of Hypernatremia

A

-thirst UNLESS they have neuro symptoms
-sticky mucous membranes e

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22
Q

High sodium foods

A

-processed foods
-canned foods
-fast food
-chips
-cheese
-lunch meat

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23
Q

Low sodium foods

A

-fruits and vegetables
-oatmeal
-fresh meat/fish

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24
Q

Potassium regular range

A

3.5-5.0

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25
What is potassium
-major INTRA cellular electrolyte -transmission of nerve impulses
26
Causes of hypokalemia
-GI loss -Renal loss (diuretics) -skin loss (sweating) -shift of potassium into cells from alkalosis or high insulin levels
27
Signs and symptoms of Hypokalemia
-bradycardia -muscle weakness -increase risk of digoxin toxicity
28
Treatment of hypokalemia
-oral replacement -be cautious if pt has renal or kidney disease -IV potassium MUST be diluted and you must always use a pump
29
Causes of hyper kalemia
-shift of potassium out of the cells because of cell membrane destruction -burns, trauma, sepsis, alkalosis, renal disease
30
Signs and symptoms of hyperkalemia
-peaked T waves -flaccid paralysis
31
Treatment of hyperkalemia
FIRST obtain ECG -encourage fluid intrake -calcium gluconate can stabilize cardiac rhythm -may require dialysis for removal
32
Magnesium normal range
1.8-2.6
33
What does magnesium do
-regulates muscle contraction -metabolizes carbs and proteins
34
Causes of hypomagnesemia
-GI loss -chronic ETOH -long term PPI use
35
Signs and symptoms of hypomagnesemia
-muscle cramps -tachycardia -tremors -hyperactive DTR
36
Treatment of hypomagnesemia
Must use magnesium sulfate with pump or PO meds
37
Causes of hypermagnesemia
-renal failure -laxatives
38
Signs and symptoms of hypermagnesemia
-muscle paralysis -facial flushing -HTN
39
Treatment of hypermagnesemia
-dilute IV calcium gluconate -cannot remove magnesium without dialysis
40
Calcium normal range
8.8-10.4
41
What is calcium
-99% of calcium is stored in the bones -transmits nerve impulses
42
Causes of hypocalcemia
-diarrhea -alcoholism -chronic kidney disease -citrated blood -hypoparathyroidism
43
Signs and symptoms of hypocalcemia
C: convulsions A: arrhythmias T: tetany S: stridor and spasms -chvosteks sign -trousseau sign
44
Treatment of hypocalcemia
-monitor BP -calcium gluconate
45
Chvosteks sign
contraction of the ipsilateral facial muscles elicited by tapping the facial nerve just anterior to the ear.
46
Trousseau sign
when a carpopedal spasm of the hand and wrist occurs after an individual wears a blood pressure cuff inflated over their systolic blood pressure
47
Causes of hypercalcemia
-tums -cancers -prolonged immobilization
48
Signs and symptoms of hypercalcemia
Usually asymptomatic until they go into cardiac arrest
49
Treatment of hypercalcemia
GOLD STANDARD: biphosphonate causes bone absorption of calcium
50
Phosphate normal range
2.7-4.5
51
what is phosphate
-In the bones/teeth -regulates acid/base balance and metabolism
52
Causes of hypophosphatemia
-malabsorption -diarrhea -ETOH
53
Symptoms of hypophosphatemia
-mostly r/T cellular energy/O2 delivery -osteomalacia -rickets
54
Treatment of hypophosphatemia
Phosphate binders
55
Causes of hyperphosphatemia
-renal failure -excess intake -rhabdomyolysis
56
Signs and symptoms of hyperphosphatemia
Asymptomatic until sever and then Calcified deposits in tissue
57
ROME
Respiratory Opposite (arrows) Metabolic Equal (arrows)
58
Phlebitis
Inflammation of the vein caused but irritation or poorly placed IV
59
Signs and symptoms, treatment, and prevention of phlebitis
-redness, warmth -replace IV proximally or in different arm/vein -hand hygiene, dilute all meds
60
Infiltration
Solution/med has leaked into surrounding tissue
61
Signs/symptoms, treatment, and prevention of infiltration
-swelling, cooling, discomfort -replace IV proximally or in different arm/vein -avoid sites over joints
62
Extravasation
Solution has damaged surrounding tissue
63
Signs/symptoms, treatment, prevention of extravasation
-blistering, necrosis -do not immediately take the IV out, you may need an antidote -DO NOT use the same arm to replace the IV
64
Bleeding/oozing
Fresh or pooling blood at site or under dressing -apply site pressure, change IV/dressing if needed
65
Complications of CVAD’s
Pneumothorax CLABSI (central line associated blood stream infection) -PREVENTABLE
66
Pneumothorax signs ands symptoms
-decreased/absent breath sounds -respiratory distress -chest pain -chest asymmetry -occurs right after insertion of subclavian vein
67
Pneumothorax treatment
-apply O2 -place in semi Fowler -notify HCP and prepare for chest tube insertion
68
CLABSI local signs and Symptoms
-redness -warmth -drainage -edema
69
CLABSI local findings
-drainage culture -apply warm compress
70
CLABSI systemic signs and symptoms
-fever -chills -malaise/discomfort
71
CLABSI systemic finding
-blood culture
72
CLABSI bundle for prevention
-alcohol swab for access -hand hygiene/gloves -CHG dressing -assess need for central access -change tubing frequently
73
Knowledge of primary and secondary IV infusions
-first check compatibility -when 2nd is running, primary is stopped -2nd hangs higher than primary
74
pH ranges
Normal: 7.35-7.45 Acidosis: <7.35 Alkalosis: >7.45 Controlled by bicarbonate
75
CO2 ranges
Normal: 35-45 Alkalosis: <35 Acidosis: >45 -controlled by the lungs
76
HCO3 ranges
Normal: 22-26 Acidosis: <22 Alkalosis: >26 Controlled by kidneys
77
Metabolic alkalosis
Too much base, not enough acid -increase pH -increase HCO3 Caused by hypoventilation
78
Respiratory acidosis
Inadequate elimination of CO2 by the lungs -decrease pH -increase CO2
79
Causes of respiratory acidosis
-COPD -drug overdose -pneumonia -Guillian barre syndrome
80
Symptoms of respiratory acidosis
-restlessness -LOC -lethargy
81
Metabolic acidosis
Too much acid or not enough base -decrease pH -decrease HCO3
82
Causes of metabolic acidosis
-hypoxia -starvation -diarrhea
83
Symptoms of metabolic acidosis
-kussmauls respirations -Neuro symptoms
84
Respiratory alkalosis
Excessive elimination of CO2 -increased pH -decrease CO2 Caused by hyperventilation
85
Symptoms of respiratory alkalosis
-light headedness -numbness/tingling
86
Compensation
-if the problem is respiratory, the kidneys will correct it -if the problem is metabolic, the lungs will correct it Lungs are quick to respond and kidneys are slow
87
Full compensation
PH is normal
88
Partial compensation
All 3 ABG values are abnormal
89
Uncompensated
Only 2 out of 3 ABG values are abnormal
90
Hydro morphone (Dilaudid)
-opioid -binds to a receptor to decrease excitability of neurons -side effects: agitation, hallucination, confusion, loss of appetite -nursing interventions: watch for respiratory depression, urinary retention, confusion, or sedation
91
Nalaxone(Narcan)
-opioid antagonist -antagonizes opioid effects by competing for the same receptor site. Emergency treatment of opioid overdose -side effects: goosebumps, crying, agitation, body aches -nursing interventions: more is not always better, administer slowly
92
Promethazine
-phenothiazines -used to treat allergic reaction, as well as a sleep aide and anxiety/tension -side effects: headaches, drowsiness, nightmares, restless, confused -nursing interventions: may interfere with establishment of lactation if given during labor
93
Phenergan (HCl)
Low pH (very acidic) so you need to dilute because it can damage skin cells
94
Potassium chloride
-electrolyte supplement -keeps up the maintenance of intracellular tonicity, transmission of nerve impulses, constriction of all muscles, and maintenance of renal function -side effects: throat irritation, chest pain, stomach pain, respiratory distress, pain/burning of the skin -nursing interventions: administer in liquid form for pt. With delayed GI emptying
95
Calcium gluconate
-antidotes -increases the level of calcium in the blood by binding to excess potassium or magnesium in the blood. Manages hypocalcemia, cardiac arrest, and cardiotoxicity from hyperkalemia/hypermagnesemia -side effects: decrease urine output, swelling, lethargic, light headedness, rapid weight gain -nursing interventions: assess for cutaneous burning sensations and peripheral vasodilation. Monitor ECG to detect hypercalcemia, decrease QT internal, inverted T wave
96
Magnesium sulfate
-osmotic laxative -reduces striated muscle contractions and blocks peripheral neuromuscular transmission by reducing ACh release at the myoneural junction. Immediate control of life threatening convulsions in the treatment of severe toxemias of pregnancy -side effects: confusion, dizziness, low BP, skin infection -nursing interventions: cardiac monitor should be used, have an injectable form of calcium gluconate to reverse paralyzing effects, BP may drop
97
Hematocrit
Percentage of RBC’s in the blood
98
Hemoglobin
-the RBC that is attached to O2 -low Hgb>>bad perfusion
99
Serum creatinine
-evaluates the kidneys function -if elevated than renal failure
100
BUN
Concentration of urea/waste product in the blood

NURS230 (1 decks)

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