exam 1 Flashcards by britt rank

signs and symptoms of heart attack in women

flue like symptoms

feelings of indigestion or heartburn

symptoms for a number of days

heartburn

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Lab Values

Decreased HGB & HCT
Decreased Na
Decreased Serum Osmolality
Decreased BUN

Fluid Volume Excess

HYPERVOLEMIA

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signs and symptoms of heart attack in men and women

heavy chest pain

cold and sweaty

pain in neck or left arm

nausea

sudden onset of symptoms

shortness of breath

more tired than usual

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in fuid volume excess

urine specific gravity

decreased

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Nuts, beans
Canned entrees
Frozen bread, meals
Smoked/cured/canned meat and poultry

are all rich in ______

Sodium

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air in the pleural cavity, resulting in lung collapse

pneumothorax

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in fuid volume defecit

urine specific gravity

increased

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A
S
T
H
M
A

adrenergics (albuterol/beta 2)
steroids 
theophylline 
hydration - IV
mask- 02
anticholinergics

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The nurse is caring for a client with heart failure who has received large doses of diuretic therapy. Assessment reveals flat neck veins, generalized muscle weakness, and fatigue. The nurse suspects hyponatremia, what other clinical manifestations would you anticipate?

a. Hyperactive bowel sounds
b. Increased thirst
c. Decreased urine output
d. Increased urine specific gravity

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pneumothorax is diagnosed by what 2 things

chest xray

ABG’s

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The nurse assigned to a client with hyponatremia would conclude that which of the following factors probably contributed to this electrolyte imbalance. (Select all That Apply)

Diuretic therapy
Fever
Fluid retention
Excessive intravenous infusion of hypertonic fluid
Heart Failure
Nasogastric tube connected to low-intermittent suction.

1
3
5
6

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Cough, marked dyspnea, tight feeling in chest

Wheezing

thick or sticky mucus

Hypoxia, tachycardia

Respiratory alkalosis/acidosis

Severe respiratory distress/ respiratory failure

are clinical manifestations of

asthma

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in fuid volume excess

serum sodium is

below 135

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causes

ruptured BLED

thoracentesis

trauma

secondary infection

pneumothorax

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Caused by any condition decreasing serum calcium levels

Cirrhosis

Malnutrition

Lack of Vitamin D

Decreased production of PTH

Hypoparathyroidism

Hypocalcemia

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contraction of facial muscles that occurs when lightly tapping the front of the ear at facial nerve

Chvostek sign-

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type of IV Solution that

Examples:
0.9%NS
Lactated Ringers (LR)
D5W (note: D5W is the low end of isotonic, this can also be considered hypotonic)

Isotonic

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Oliguria, AKI, CRF,
Glomerulonephritis

are at risk for _______

Fluid Volume Excess

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Loss of water and electrolytes
OR
Isotonic Loss

Fluid Volume Deficit decrease in ECF

Hypovolemia

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Secrete too much urine= ____kalemia

hypo

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potential complications of hypertonic fluid

fluid volume defecit

shrinking cells

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Urine specific gravity normal range

1.005-1.030

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6 causes of Hypercalcemia

Increased calcium intake
Decreased kidney excretion
Prolonged immobilization
Hyperparathyroidism
Decreased calcitonin
Bone disease

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with what IV fluid be cautious with

heart failure
kidney failure
liver disease

isotonic & hypertonic

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interventions ``` Sit up Oxygen Nebulizer Sputum culture Antibiotics Steroids ```

COPD

PULSE OX 89% RESPIRATORY RATE 26 CRACKLES IN LUNGS WEIGHT GAIN is assesment data for _______

fluid volume excess

- Cirrhosis - Heart Failure - Primary hyperaldosteronism are at risk for _______

Fluid Volume Excess

in fuid volume defecit pulse strength

weak and thready

in fuid volume excess | RR

increased

Changes in___ segment reflect oxygenation of the heart

the peripheral resistance against which the left ventricle must pump.

afterload

outcomes for ______ Improved pulse oximetry Decreased respiratory rate Decreased phlegm production

COPD

with fluid volume excess, the two places fluid tends to go is ________

lungs lower extremities

volume deficit hypernatremia ketoacidosis use what IV solution

hypotonic

Beta blocker & ace inhibitor to reduce _______

afterload

A 78 year-old client is admitted with dehydration and urinary tract infection. After IV infusion of 750 mL normal saline, the client begins to cough and asks for the head of the bed to be raised to ease breathing. The nurse’s assessment notes jugular vein distention (JVD) and increased respiratory rate. How should the nurse interpret this data? - The fluid volume deficit is worsening. - The patient is developing hypervolemia. - Hypotonic water intoxication is beginning. - The infection is causing respiratory compromise.

The patient is developing hypervolemia.

supply led ischaemia symptoms at rest unpredictable symptoms over short term frequent symptoms

acute coronary syndrome

``` Clinical Manifestations: - Muscle weakness - Constipation - Anorexia, N/V - Dysrhythmias - Neurosis Diminished reflexes Renal calculi (flank pain) ```

Hypercalcemia

Lab Values for ________ - Increased serum osmolality - Increased specific gravity

Hypernatremia

``` ↓ Blood pressure ↓ strength of pulse (1+) ↑ heart rate ↓ weight ↓ urine output ↓ warmth in extremities Dry mucous membranes Mental status changes ``` are signs of _________

Fluid Volume Deficit

interventions Replace fluids!!! Assess, assess, assess! Isotonic solution (stays in the vessels to increase BP) Clinical Dehydration: Oral or IV replacement (Hypotonic solution because of hemoconcentration)

Hypovolemia

in fuid volume defecit serum osmolality is

increased

4 Hyponatremia interventions

Interventions: - Restrict fluid intake (if that is the cause of the hyponatremia) - Replace sodium - Hypertonic IV fluids (infuse slowly) - Seizure precautions

4 things that effect perfusion

Preload- volume (push) Contractility- Heart rate Afterload –resistance

Clinical Manifestations: - F: fever/flushed dry skin - R: restless - I: Increased fluid retention - E: Edema - D: Decreased urine output - Seizures - Irritability/hallucinations - Thirst, sticky mucus membranes

Hypernatremia

3 major types of antihypertensive drugs

beta blockers ace inhibitors calcium antagoinists

``` restlessness confusion orthopnea tachycardia exertional dyspnea fatigue cyanosis proxymal nocturnal dyspnea cough crackles wheezes blood tinged sputum tachypnea ```

left sided heart failure

4 Interventions for Hypernatremia

- Restrict sodium intake in diet - Increased water intake - Dietary education: beware of hidden sodium in foods - Seizure precautions-

For long term blood clotting – A.fib

warfarin

The nurse is caring for the following group of clients considers which client to be at highest risk for developing fluid volume deficit? A 52 year-old female receiving corticosteroid therapy for bronchitis. A 60 year-old male S/P left inguinal herniorrhaphy 12 hours ago. A 76 year-old male who has a nasogastric (NG) tube to intermittent suction following colon resection. A 68 year-old female who is NPO and receiving bowel prep for a flexible sigmoidoscopy procedure.

A 76 year-old male who has a nasogastric (NG) tube to intermittent suction following colon resection

in fuid volume excess | pulse strength

increased

in fuid volume excess heart rate

increased

increased oxygen demand increased contractility increaded heart rate medications can all lead to

increased cardiac output

- reflects when ventricles are pulled and stretched beyond normal – sign of heart failure

BNP

``` Clinical Manifestations: - Fatigue - Anorexia, N/V - Muscle weakness - Decreased GI motility Dysrhythmia Parasthesia Flat T waves on EKG ```

Hypokalemia

Loss of more water than sodium Hypertonic imbalance Water deficit ECV Deficit + Hypernatremia Gastroenteritis (Severe N&V) clinical dehydration

Hypovolemia

may be secondary to chronic pulmonary problems JVD anorexia GI distress weight gain dependent edema fatigue peripheral venous pressure ascites enlarged liver and spleen

right sided heart failure

How well are the lungs excreting CO2?

PaCO2

Increased excretion of potassium, is the most common cause of hypokalemia Abnormal loss of K+ from either the kidneys or GI tract can all cause

Hypokalemia

type of IV Solution that Caution (do not use in) Cerebral/peripheral edema

Hypotonic

``` Excessive sodium intake Inadequate water intake Diabetes Insipidus Excessive water loss via urination Too little ADH secretion ``` can all cause

Hypernatremia

A client with hypocalcemia has been started on intravenous (IV) corticosteroids. Which of the following findings would indicate to the nurse a further decrease in calcium level in the client? (Select all that apply) ``` Absence of Trousseau sign Tetany Muscle weakness ECG Changes Abdominal distension and hypoactive bowel sounds ```

Tetany | ECG Changes

- Corticosteroid therapy - Cushings disease are at risk for _______

Fluid Volume Excess

Sodium (Normal Value: )

135-145 mEq

Titrate _____ to maintain a certain ptt

heparin

``` Vomiting Diarrhea Gastric suction Overuse of diuretics Hemorrhage / Burns Fluid drainage from wounds ``` can all lead to ________

Fluid Volume Deficit

type of angina where fixed stenosis stable fibrous plaque

stable angina

in fuid volume defecit RR

normal or increased

Most commonly results from a malignancy Increased production of Parathyroid hormone (PTH) Hyperparathyroidism

Hypercalcemia

5 Hypernatremia causes

- Increased salt intake - Hypertonic IV solutions - Decreased renal excretion - Corticosteroids - Water loss

is considered a isotonic solution until inside the body it becomes hypotonic

D5W

type of IV Solution that Uses Intracellular/cellular hydration Fluid management for a patient who is both volume-depleted and hyperosmolar

Hypotonic

``` hypersensitivity URI exercise air pollutants respiratory infection GERD ``` are all triggers for ____

asthma

causes INTAKE Increased fluid intake Rapid isotonic IV fluids Increase consumption of salty foods Output Increased retention of H2O or H2O+ salt Kidney Disease Aldosterone Drugs Corticosteroids Diseases Kidney, heart and liver failure

Fluid Volume Excess HYPERVOLEMIA

Bones – Stones- Groans- Psychiatric overtones-

Hypercalcemia Bones – abnormal bone remodeling and fracture risk Stones- kidney stones Groans- abdominal cramping, nausea, constipation Psychiatric overtones- lethargy, depressed, psychosis, cognitive dysfunction

You are caring for an elderly client, recently experiencing diarrhea due to initiation of enteral feedings. Which of the following interventions does the nurse complete when caring for a client admitted with a sodium level of 152 mEq/L? (Select all that apply) Provide extra blankets for warmth Observe client for nausea and malaise Observe and prepare for possible seizures Restrict additional fluids to 1000 mL per day Monitor serum osmolality Daily weights

B C E F

in fuid volume defecit serum sodium

increased

in fuid volume excess BP is

increased

in fuid volume excess | serum osmolality is

below 285

in fuid volume defecit HCT & BUN

increased

is a procedure in which the bronchi are visualized through a fiberoptic tube Often done at the bedside and gag reflex is sedated Remove secretions, biopsy Assess the CN9&10 after tube is out to assess gag reflex and swallowing

Bronchoscopy

Elevated______ levels the more damage to the heart

troponin

dyspnea anxiety tachycardia pleural pain asymmetrical chest wall expansion decreased breath sounds are all manifestations of

pneumothorax

``` Blood pressure 106/58 Heart rate 120 RR 30 Pulse Ox 88% Expiratory wheeze Productive cough with yellow/green phlegm ```

COPD

To reduce _______ give diuretics & nitroglycerin

preload

6 cause of Hypokalemia

- Diuretics - Diarrhea - Vomiting - Gastric suction - Steroid administration - Bulemia D- drugs (steroids, diuretics, laxatives) I- inadequate intake (nothing by mouth, anorexic) T- too much (water, base, insulin) C- Cushing syndrome H- heavy fluid loss (suctioning)

Resistance left after ventricle must overcome to circulate blood –

afterload

6 Hyperkalemia causes

- Hemolyzed serum sample (in lab) - Oliguria - Acidosis - Renal failure - Addison disease - Multiple blood transfusions

clinical manifestations ``` Thready pulse Decreased BP, Increased HR, Increased RR Decreased Cap Refill, cool clammy skin, poor skin turgor Hypoxia Weak, dizzy Decreased Weight Increased thirst Decreased urine output Confusion, changes in LOC, lethargy (seizures, coma) ```

Hypovolemia

``` A nurse is admitting a client who is experiencing dyspnea, weakness, weight gain of 2 lb. and 1+ bilateral edema of the LE. The client’s temperature is 37.2C (99.0F), pulse 96, blood pressure 152/96, respirations 26, oxygen saturation 94% on O2 at 3L N/C. Which of the following manifestations of FVE should the nurse expect. (Select all that apply) A. Serum osmolality of 301 mOsm/L B. Auscultation of crackles C. Urine specific gravity of 1.003 D. Distended neck veins E. Cool clammy skin F. Hematocrit 55% G. Thready pulse ```

b c d

3 Nursing Management measures of Hypokalemia

Encourage foods high in K+ Oral Potassium Supplements IV Potassium Supplementation NEVER GIVE IV PUSH RECOMMENDED RATE IS 10 mEq/hr. PAIN, INFLAMMATION AT IV SITE

Patients with what fluid volume problem will be Orthostatic | not adequately prefusing

Fluid Volume Deficit

Clinical Manifestations ``` Increased pulse Increased BP Increased RR JVD SOB, crackles, cough, hypoxia (Pulmonary Edema) Increased weight Increased edema Muscle weakness Confusion, lethargy, change in LOC (seizures, coma) ```

HYPERVOLEMIA

Rapid oral ingestion of water Massive replacement of water without Na+ Infusions of D5%W (hypotonic) at excess rate can all cause

Fluid Volume Excess

type of angina where demand led ischaemia preditable symptoms over long time

stable angina

type of angina where dynamic stenosis ruptured or inflamed plaque

acute coronary syndrome

in fuid volume defecit heart rate

increased

Formation of blood clots into atrium – common – may result in stroke common problem for ______

Atrial Fibrillation

``` ↑ pulse (3+) ↑ blood pressure ↑ edema / ↑ ascites ↑ weight ↑ crackles in lungs (SOB) JVD (jugular vein distention) ↑ confusion Headache/seizures ``` are signs of _________

Fluid Volume Excess

type of IV Solution that Examples: 3% NS D5W/0.9%NS D5W/LR

Hypertonic

3 Fluid Volume Excess Populatios at Risk due to Decreased Output

Kidney Disease - Oliguria, AKI, CRF, - Glomerulonephritis Aldosterone Excess - Cirrhosis - Heart Failure - Primary hyperaldosteronism ↑ levels of glucocorticoids - Corticosteroid therapy - Cushings disease

``` Clinical Manifestations: - + Chvostek’s sign - + Trousseau’s sign Numbness/tingling Muscle twitch Cramping Hyperactive reflexes Tetany Seizures ```

Hypocalcemia

3 Hypokalemia interventions

Interventions: -Administer potassium supplement PO can have a bad taste and be irritating to the GI tract IV must be well diluted and NEVER given as a bolus - Assess renal status (UOP) prior to giving supplemental potassium - Encourage foods rich in potassium

Pressure on the right atrium results in Absences of p wave

atrial fibrillation

``` hypertension nursing care d i u r e t i c ```

``` Daily weight I&O Urine output Response of BP Electrolyes Take pulses Ischemic episodes Complications:4 Cs ```

Individuals on diuretic therapy give ________

potassium

to Avoid Exacerbations with COPD do what 2 things

Flu/Pneumonia Vaccines ``` Avoid Triggers such as: Allergens Smoke Air Pollutants Exercise ```

in fuid volume defecit | temp is

increased

management of a client with decreased sodium and/ or fluid excess should include an assessment of these seven ares

- 24 hour I&O - urine specific gravity less than 1.010 - bounding pulses - bp & respiratory change - changes in LOC/cerebral edema - daily weights - pitting edema

Lack of access to water or food Inability to eat or drink without assistance Inability to chew Inability to swallow Nausea (decreasing the desire to eat or drink) can all lead to ________

Fluid Volume Deficit

0.9 NS Lactated ringers

isotonic

pressure exerted by proteins, notably albumin, in a blood vessel's plasma (blood/liquid) that usually tends to pull water into the circulatory system

Oncotic pressure, or colloid osmotic pressure

causes Intake Decreased PO intake Decreased Na intake Inability to drink/express thirst Output Diarrhea, vomiting Profuse sweating, drainage Hemorrhage Drugs Diuretics, laxatives Diseases Renal disease Third spacing: burns

Hypovolemia

potassium normal range

3.5- 5.0

When patient is hypernatremia give ________ solution

hypotonic

type of IV Solution that Uses: Treat intravascular dehydration with interstitial or cellular over-hydration Third spacing

Hypertonic

``` Take medications every day –compliance Infection prevention Exercise Stay well hydrated Inhaled corticosteroids ``` this is for

COPD

causes a carpal spasm bringing the index finger and thumb together when blood pressure cuff is inflated above systolic pressure

Trousseau sign

Low BP is a indicator of _________ and poor perfusion

hypernatremia

interventions ``` Restrict Na & H2o Promote excretion Strict I&O Daily weight Assessment (including vital sign, respiratory and skin) Raise HOB Skin care: protect edematous tissue Monitor labs Patient teaching ```

HYPERVOLEMIA

Volume of blood in ventricles at end of diastole –

preload

You need to take phosphorus supplements __ times a day or its not effective

3-4

When patient is hyponatremia/ potential cerebral edema give ________ solution

hypertonic

6 Hypercalcemia interventions

- Decreased calcium intake (no antacids) - Increased fluid intake - Weight bearing exercises - Tx constipation - Renal dialysis if severe - Give calcitonin to decrease calcium level

Pressure in vasculature reflects______

protein

confusion with fluid volume excess hapens because of lack of __________

sodium

is the insertion of a large-bore needle through the chest wall into the pleural space to obtain specimens for diagnostic evaluation, remove pleural fluid, or instill medication into the pleural space

Thoracentesis

Edema Hardening of skin in legs Pulse in legs Wet ulceration Elevate legs Compression stockings

venous insuficency

``` tachypnea decreased PCO2 hypoxia decreased PO2 dyspnea tachycardia hemoptysis sudden sharp chest pain ```

Pulmonary Embolism

``` Clinical Presentation: Tachycardia Pulmonary Edema Tachypnea Confusion Coma ```

Metabolic Acidosis

6 Hyperkalemia interventions

Interventions: - Eliminate parenteral potassium - Kayexalate - Monitor EKG - Administer calcium gluconate to protect the heart - IV loop diuretics - Renal dialysis

treating congestive heart failure ``` u n l o a d ``` f a s t

``` Upright position Nitrates Lasix Oxygen Ace inhibitors Diagoxin ``` Fluids (decreased) Afterload (decreased) Sodium restriction Test (dig, level,ABG,potassium)

The nurse anticipates the client with which condition would be most at risk to develop hyperkalemia? (Select all that apply) Chronic renal failure Newly diagnosed cirrhosis A client involved in a trauma in which a crush injury was sustained A client with a severe MRSA infection of the skin Partial bowel obstruction requiring nasogastric suctioning Diarrhea for the last 4 days

Chronic renal failure A client involved in a trauma in which a crush injury was sustained A client with a severe MRSA infection of the skin

lab values ``` Increased Na Increased HGB & HCT Increased serum osmolality Increased BUN Increased urine specific gravity ```

Hypovolemia

5 lab values that will be increased with Fluid Volume Deficit

``` ↑ Hct ↑ BUN & creatinine ↑ Na+ ↑ Serum osmolality ↑ Urine specific gravity ```

with what IV fluid be cautious with injury to brain head trama increased ICP

hypotonic

A 78 year-old client is admitted with dehydration and urinary tract infection. After IV infusion of 750 mL normal saline, the client begins to cough and asks for the head of the bed to be raised to ease breathing. The nurse’s assessment notes jugular vein distention (JVD) and increased respiratory rate. How should the nurse interpret this data? The fluid volume deficit is worsening. The patient is developing hypervolemia. Hypotonic water intoxication is beginning. The infection is causing respiratory compromise.

The patient is developing hypervolemia.

``` hypertension tobacco abnormal blood lipid levels physical inactivity obesity type 2 diabetes ``` can all lead to

heart disease

is an abnormal collection of fluid in this space. Chronic disease – changes in oncotic pressure Fluid in pleural space not in lung Diminished – absent breath sounds Treatment – thoracentesis

Pleural effusion

``` High fever with chills fatigue leukocytosis Dyspnea, tachypnea, tachycardia--Oxygen deficit Pleural pain Rales Productive cough Confusion and disorientation ``` are all Manifestations of

Pneumonia

Results from excessive intake of water(oral or intravenous) Subsequent retention of water Loss of sodium containing fluids SIADH An impairment in renal water excretion Too much ADH secretion. can all cause

Hyponatremia

the volume of blood in the ventricles at the end of diastole before the next contraction.

preload

hyponatremia increased ICP use what IV solution

hypertonic

PaCO2 normal range

34-45

5 Hyponatremia causes

causes: - Diuretics - GI fluid loss - Hypotonic tube feedings - Hypotonic IV fluids - Diaphoresis

measure lung volumes and airflow.

Pulmonary function tests (PFTs)

EF reflects degree of

heart diease

– reflects concentration of solutes in vasculature

Serum osmolality

PaO2 normal range

80-100

``` irregular heart beat pulmonary emboli high blood pressure heart failure acute coronary syndrome ``` can all lead to

decreasing cardiac output

The nurse determines that a client with a serum calcium level of 12 mg/dL understands client teaching when the client makes which statement? “If my stomach becomes upset, I can just take more Tums.” “I will need to take my phosphorus supplements once a day.” “I will need to be on strict bed rest to help with this problem.” “I will need to drink many more fluids than I have been, even up to two to three liters each day.”

“I will need to drink many more fluids than I have been, even up to two to three liters each day.”

Calcium (Normal Value: )

9-10.5 mEq

``` Weight loss low grade fever night sweat cough anorexia ``` are signs and symptoms of

Tuberculosis

``` wheezing pursed lip breathing chronic cough barrel chest dyspnea easy fatigue orthopnic ``` are clinical manifestations of

COPD

``` Dry sores Shiny skin Hairless Thick toe nails No pedal pulse Cold skin ```

peripheral atrery disease

pneumothorax is treated by what 2 things

chest tube | oxygen

Serum osmolality normal range

285-295

with hypotensive dehydration use what IV solution

isotonic

DIURETIC Administration RESTRICT SALT RESTRICT FLUID are interventions for

fluid volume excess

Which of the following statements by the client indicates a need for further instruction regarding treatment for hypokalemia? “I will eat more bananas and cantaloupes for breakfast.” “I will eat more bran flakes to increase my potassium level.” “I will take my potassium in the morning after breakfast so it does not upset my stomach.” “I will tell my primary care provider if I start having muscle cramps or weakness.”

“I will eat more bran flakes to increase my potassium level.”

``` cough mucus SOB wheezing increased CO2 retention chest tightness retractions ```

asthma

``` Clinical Manifestations: - Muscle weakness - Bradycardia Dysrhythmias Flaccid paralysis Intestinal colic Tall T waves on EKG ``` ``` M-muscles weakness U- urine output decreased R- respiratory failure D- decreased cardiac contractility E- early muscle twitching R- rhythem changes ```

Hyperkalemia

A nurse is caring for an elderly adult in a long-term care facility. The client has become weak and confused. The client’s temperature is 38.3C (100.9F), pulse, 92, respirations 20/min, and blood pressure 108/60. He has lost ¾ of a pound and reports dizziness when assisted to the bathroom. He also has a non-productive cough with diminished breath sounds in the right lower lobe. Which of the following actions should the nurse take. a. Initiate fluid restrictions and monitor urine output. b. Observe for signs of peripheral edema. c. Encourage the client to ambulate to promote oxygenation. d. Monitor for orthostatic hypotension

Monitor for orthostatic hypotension

Hematocrit reflects _____ NORMAL RANGES men: ______ women: _______

volume men: 48-55 women: 35- 43

3 Hypocalcemia interventions

- Increased calcium and Vitamin D - Seizure precautions - Quiet environment

Clinical Manifestations : - Anorexia, N/V - Weakness - Lethargy - Confusion, headache - Muscle cramps/twitching - Seizures - Coma

Hyponatremia

type of IV Solution that ``` Uses: Correct fluid volume deficit in the vascular system Treatment of vascular dehydration Fever Labor Running ```

Isotonic

in fuid volume defecit BP is

decreased

asthma peak flow zones red: yellow: green:

red: <50% yellow: 50-80% green: >80%

in fuid volume excess | HCT & BUN

decreased

type of IV Solution that Examples 0.2% NS 0.45% NS D5W

Hypotonic

Kidney problems = ____ potassium

high

``` Blood pressure 86/58 Heart rate 120 Dry mucous membranes Weight loss Low urine output ``` is assesment data for ______

Fluid Volume Deficit

Fluid Administration Oral or intravenous Correction of the underlying problem are interventions for _______

Fluid Volume Deficit

HCO3 normal range

22-26

potential complications of hypotonic fluid

cerebral edema

Lab Values: - Decreased serum osmolality - Decreased urine specific gravity

Hyponatremia

retain sodium and water | - stimulate excessive aldosterone

Corticosteroid

type of IV Solution that Caution: Should be used with extreme caution Used cautiously in patients with cardiac and renal failure

Hypertonic

which 5 lab values that wil be decreased with Fluid Volume Excess

``` ↓ Hct (dilutional) ↓ BUN (dilutional) ↓ Serum osmolality ↓ Urine specific gravity ↓ Serum Na+ ```

with urine specific gravity- higher SG the greater the ________

concentration

Water seal – allows air to comes out without going back in- fluctuating is normal, bubbling means there is a leak Suction- the more water the greater the suction, 20mm or suction Water suction- assess flow / dry suction – assess flow Never clamp Unit below the chest, tubing uncoiled Drainage – 25 ml a shift

chest tube

Almost all patients with persistent hyperkalemia have impaired renal excretion of potassium. Acidosis / Cell Injury Medications these can all cause

Hyperkalemia

D5NS is a _________ solution

hypertonic

_________- tracheal deviation – away from affected side – more severe

tension pneumothorax

BUN normal range

10-20