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Med Surg 2 > Exam 1 > Flashcards

Exam 1 Flashcards

Fluids and electrolytes, Acid-Base, Blood/Heme, nutrition-electrolyte sources

1
Q

Average urine output/day

A

400-600 ml (30ml/hr)

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2
Q

1L fluid loss+=

A

1kg in weight

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3
Q

Both water and electrolytes are lost equally

A

Isotonic dehydration (Hypovolemia)

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4
Q

Water loss exceeds electrolyte loss

A

Hypertonic dehydration

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5
Q

electrolyte loss exceeds water loss

A

hypotonic dehydration

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6
Q

S/S of dehydration/Fluid loss

A

hyperthermia, tachycardia, THREADY pulse, Hypotension(Orthostatic), dry-furrowed tongue, n/v, anorexia, wt loss, oliguria, tugur/tenting, dysrhthmias, INCREASED rate and depth of respirations

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7
Q

Fluid loss labs

A

H&H, osmolarity, protien, BUN, urine specific gravity, electrolytes

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8
Q

Fluid loss intervention

A

Monitor UA, O2, CBC, electrolytes, I&O

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9
Q

excess fluid in extracellular fluid compartment (causes circulatory overload)

A

Isotonic overhydration (Hypervolemia)

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10
Q

Due to excessive sodium intake

A

Hypertonic overhydration

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11
Q

water intoxication (excess fluid moves into intracellular spaces)

A

Hypotonic overhydration

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12
Q

Causes Hypervolemia

A

heart failure, cirrhosis, gluticosteroids, renal failure, hypertonic fluids/improper iv therepy, burns, age changes, excessive sodium

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13
Q

Causes of Hypertonic overhydration

A

excessive sodium, rapid infusion of hypertonic saline, excessive sodium bicarb therepy

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14
Q

Hypotonic overhydration

A

early kidney disease, heart failure, siadh, replacing isotonic fluid loss with hypotonic fluids, irrigating wounds with hypotonic, improper IV therepy

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15
Q

Fluid excess.overload s/s

A

Tachycardia, BOUNDING PULSES, HTN, tachypenea, confusion, muscle weakness, h/a, WT gain, ascites, dyspnea, orthopenea, crackles, Diminished breath sounds, edema, Distended neck veins, INCREASED RR, but shallow.

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16
Q

Fluid excess intervention

A

Monitor ABG, o2, cbc, cxr, place patient in semi fowlers. daily wt. Lasix- low sodium, increase protein.

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17
Q

What to watch for when inserting a central line

A

Pneumothorax

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18
Q

Peripheal IV

A

Good for 4 days

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19
Q

Midline

A

lasts 1-4 weeks, may use vanco, do not use vesicant drugs, DO not draw blood

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20
Q

Central line

A

placed in centally near superior vena cava, NEED Cxr to confirm placement

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21
Q

PICC

A

CXR to confirm, may have multiple lumens, may use long term

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22
Q

Tunneled CVC

A

portion lies sq tunneled, Used for frequent and long term therepies, has cuff with antibiotic material

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23
Q

non tunneled CVC

A

insert through subclavian in upper chest or jugular vein, tip resides in superior vena cava, CXR to confirm, used in emergency, more short term

24
Q

Implanted port

A

not visible, place upper chest, need to flush after each use and monthly with heperin, pts need iv therepy longer than 1 yr.

25
Q

Hemodialysis Catheter

A

Very large lumen, can be tunneled or ot, critical renal management, use heperin flush, not used for other things except in emergency

26
Q

Iso tonic Solutions

A

NaCL 0.9%, NS w/electrolytes,Normosol R, D5W (ISO in Bag, HYPER in body)

27
Q

Hypertonic Solutions

A

D5NS, DS 1/2 NS, D5LR,

28
Q

Hypotonic solution

A

1/2 Normal Saline

29
Q

What fluid do you not use in kidney pts

A

Lactated Ringers

30
Q

Do not use what in head injury pts (Can cause cerebral edema)

A

Dextrose

31
Q

what does hypertonic solution do

A

corrects fluid, electrolyte and acid base by moving water out of cell and into bloodstream

32
Q

what does hypotonic solutions do

A

moves water into cell and expands them

33
Q

what does isotonic solution do

A

water does not move in or out of cell, risk for fluid overload.

34
Q

Sodium Lab

A

135-145

35
Q

Potassium Lab

A

3.5-5

36
Q

Calcium Lab

A

9-10.5

37
Q

Magnesium Lab

A

1.3-2.1

38
Q

Phosphorus Lab

A

3-4.5

39
Q

Chloride Lab

A

98-106

40
Q

Hyponatrimia causes

A

fluid loss or low sodium diet

41
Q

hyponatrimia s/s

A

*THink Neuro sx, tachy, thready pulses, fatigue, muscle cramps, weakness, decreased DTR’s, seizures (With muscle weakness watch for possible resp. compromise)

42
Q

Hypernatimia causes

A

corticosteroids, sushings, kidney disease, increased sodium

43
Q

Hypernatrimia s/s

A

*hyperthermia, tachy, Decreased DTR, thirdt, increased motility..pulmonary edema if r/t hypervolemia

44
Q

Hypokalemia s/s

A

Think Cardiac s/s..

45
Q

Hypokalemia causes

A

excessive diuretics, digoxin, cushings, vomiting, diarehea, wound drainage, NPO, TPN

46
Q

Hyperkalemia cuases

A

too much potassium, salt substitutes, kidney disease, sepsis, decreased insulin, ace inhibitors, nsaids

47
Q

Hyperkalemia s/s

A

think cardiac

48
Q

Hypocalcemia s/s

A

everything is decreased, muscle twitching, tetany, cramps,

49
Q

Hypercalcemia

A

Everything is increased. weak muscles, Decreased dtr’s, flank pain,

50
Q

Hypomagnesium

A

same as hypocalcemia- positive trousas, and chvosky sign.

51
Q

hypermag

A

causes mag containing antiacids, s/s brady, dysrhythemias,

52
Q

hypophosphate

A

same s/s as hypercalcemia.. decreased everything-cardiac, pulses, breathing,, rhabdo..

53
Q

hyperphoshate

A

same s/s as hypocalcium.. seizure, muscle twithc, positive traousaus and chevoski

54
Q

Prolonged PR interval, widened QRS complex

A

Hypermag

55
Q

Tall T wave, depressed ST segment

A

Hypomag

56
Q

Tall peaked T waves, flat P wavesm Widened QRS, prolonged PR interval

A

HyperK

57
Q

ST depression, shallow or flat or inverted T waves, prominent U waves

A

HypoK

Med Surg 2 (1 decks)

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