Exam 2 Flashcards
(114 cards)
1
Q
Muscle holds onto
A
water
2
Q
What does the ECF (extracellular fluid) contain
A
blood vessels, skin tissues, spinal cord (CSF)
3
Q
Which agents add energy
A
adrenergic agents
4
Q
What do adrenergic agents do
A
add energy
5
Q
Identify the adrenergic target organs & what the cause
A
cardiac: tachycardia
respiratory: bronchial dilation
peripheral: vasoconstriction
ocular: dilation
6
Q
How much urine output should an average person produce per day
A
1ml per kg per hour
7
Q
What are the functions of water
A
- cellular metabolism
- nutrient transportation
- digestion of food
- temp regulation
- maintenance of ECF
- acid-base balance
- waste excretion
8
Q
What percentage of our bodies are made of water
A
50-80%
9
Q
Why is sleep & rest important
A
effects on physical & emotional health
10
Q
What is the circadian rhythm
A
- 24hr day-night cycle
- affects other body functions
- body temp
11
Q
Explain Stage 1 of Sleep Cycle
A
- light sleep
-loss of awareness but easily aroused - muscle twitching
- muscle activity slows down
12
Q
Explain Stage 2 of Sleep Cycle
A
EVERYTHING SLOWS DOWN
- HR & RR slows
- decrease in body temp
- light sleep
13
Q
Which stages are non rem
A
1-4
14
Q
Explain Stage 3
A
-deep sleep begins
- vitals decrease
- slow delta waves
15
Q
Explain Stage 4 of Sleep Cycle
A
- very deep sleep
- eyes move rapidly side to side
- vivid dreaming
- slow waves or deep sleep
16
Q
Explain Stage 5 of Sleep Cycle
A
- REM
- brain waves speed up
- breathing is rapid & shallow
17
Q
What is considered the major sleep center
A
hypothalamus
18
Q
What is the suprachiasmatic nucleus
A
-maintains alertness & awakeness
- sleep regulating area
19
Q
How long does it take to get through the sleep cycle
A
90 mins
20
Q
How many sleep cycles do you go through a night
A
4-6 cycles
21
Q
What is insomnia
A
- difficulty initiating or maintaining sleep, or unrefreshing sleep
- daytime impairment
22
Q
What can insomnia lead to
A
- chronic insomnia
23
Q
What is chronic insomnia
A
- worry about sleep
- have poor sleep behaviors
24
Q
What treatments are available for insomnia
A
- sleeping meds (Ambien)
- hypnotic meds
- cognitive behavioral therapy
25
What is Cognitive Behavioral Therapy (CBT)
- education to change thoughts
- decreases our time in bed
26
What does CBT do
- decrease anxiety
- decrease awake time in bed
- create positive association between bed & sleep
27
What are some relaxation techniques
whitenoise, calm headspace
28
What causes sleep deprivation
- chronic insomnia
- pain
- illness
- disruption in schedule
29
What are consequences of sleep deprivation
- weight gain
-CV disease
- Type 2 diabetes
- memory issues
- sleep walking
- hallucinations
- depression
30
How does someone respond to sleep deprivation
- physical or physcolognical effect
31
Factors that affect sleep
- drugs & substances
- lifestyle
- societal changes
- stress
- sleep environment
- exercise
- food intake
- caffine
32
What kind of assessment is a sleep assessment
subjective assessment
33
What is the goal of a Sleep Assessment
understand sleep habits & any problems that are occurring
34
What are nursing interventions for sleep deprivation
- environment changes (dark cold room)
- having a bedtime routine (same time each day)
- comfort
- stress reduction
- bedtime snacks (carbs help, protein does not)
35
Whats the function of water
- cell metabolism
- transportation of nutrients
- digestion of food
- temp regulation
- ECF maintenance
- acid- base balance
- waste secretion
36
Who holds more water
men
37
1 liter of fluid is equivalent to
2.2 lbs
38
What are some things that are considered output fluids
- diarrhea
- vomit
- sweat
- stool
- urine
39
What does the hypothalamus control for regulating fluid balance
tells you if you're thirsty
40
What is the Nervous System responsible for
- transmission of electrical & chemical impulse
- electrical conduction
- chemical transmission
41
What are the 3 main focuses of the ANS?
- regulation of the heart
- regulation of secretory glands
- regulation of smooth muscles: GI tract, bronchioles, blood vessels
42
Describe the Beta 1 adrenergic agent
- vasoconstricts the heart
- increases HR & BP
43
Describe the Beta 2 adrenergic agent
- vasodilates the lungs to relax the airways
44
Describe adrenergic agents in the cardiac system
- we use Epinephrine to get their heart to start
45
Describe adrenergic agents in the Respiratory System
- bronchodilation
- asthma/COPD
46
Describe the adrenergic agents in the Peripheral System
- vasoconstricts
- decreases blood loss & duration of anestetics
47
Describe adrenergic agents role in the Ocular System
- mydriasis
- dilate eyes for diagnostic test (glacoma)
48
ADRs of adrenergic agents
- nervousness
- insomnia
- tachycardia
- HTN
49
What do cholinergic agents do
- rest & digest
- help increase secretion, tone & stimulate bowel function
- promote urinary function
50
What do cholinergic agents do to the colon
stimulate peristalsis
51
What do cholinergic agents do to the bladder
increase bladder tone
52
ADRs of the cholinergic agents (parasympathetic)
- diarrhea
- excessive salivation
- abdominal cramps
- increased gastric secretion
- frequent urination
- blurred vision
- sweating
53
Side effects of anticholinergic agents
can't pee, see shit or spit
54
Mechanism of action for anticholinergic drugs
- dilate pupils
- decreased secretions
- speed up HP
- slow GI tract
55
1L of fluid is how many pounds
2.2 pounds
56
What are the 3 processes that help achieve in fluid balance
fluid intake, absorption & distribution
57
What is distribution
- movement of fluid among extracellular & intracellular components
58
Fluid output occurs in which organs
skin, lungs, GI tract & kidneys
59
Describe intracellular fluid
-helps nurture the cells
- makes up 75% of body fluid
60
Describe extracellular fluid
- transports the cells
- makes up 25% of the body
61
When is the desire for water stimulated
- plasma osmolarity increases
- blood volume decreases
- hypothalamus is stimulated
62
What does the hypothalamus do & contain
- has osmosis receptors that regulate fluid balance
- increased concentration means increased thirst
63
Where does Sodium go
where water goes
64
Describe osmosis
- solution from high concentration to low concentration
65
How do you lose fluid through the GI tract & kidneys
- stool & urination
66
How do you maintain fluid balance
intake vs output
67
What is ADH
- causes renal cells to absorb
- decreases urine volume
- concentrates urine
- more is released when you are dehydrated
68
What kind of hormone is ADH
anti pee hormone
69
What does ADH help regulate
- amt of water in the body
- controls the amt of water absorbed as kidneys filter out wastes from the blood
70
What is hypovolemia
- also called "dehydration"
- decreased fluid volume
71
Signs & Symptoms of Hypovolemia
- decreased urine output & BP
- dry skin
- increased HR
- concentrated urine
72
What causes hypovolemia
- bleeding
- trauma
- diarrhea/vomiting
- diuretics
73
what is hypervolemia
- fluid overload
- acute weight gain of 5%
74
What causes hypervolemia
-heart failure
- kidney failure
- high sodium
75
Signs & symptoms of hypervolemia
- increased weight & BP
- wet lung sounds (rales?)
- edema
76
Nursing interventions of hypervolemia
- low sodium diets
- sit them up
- check daily weights
- diuretics
77
Examples of output
- diaphoresis (sweating)
- stool
- vomit
- urine
- blood loss
- wound drainage
78
Examples of intake
- IV fluids
- oral fluids
- blood transfusions
- irrigation
79
Increased secretion of ADH does what
kidneys hold excess water
80
Decreased secretion of ADH does what
kidneys can't hold water
81
ADH causes the blood vessels to
constrict
82
What happens if ADH constricts
- increases BP & blood volume
- kidneys release LESS water
- decreases urine secretion
83
ADH is secreted by the
posterior pituitary gland
84
Aldosterone is secreted by
the adrenal cortex
85
Aldosterone is controlled by
RAAS system
86
Increased secretion of Aldosterone does
- sodium & water retention
- potassium loss
87
Decreased secretion of Aldosterone does
- sodium & water loss
- potassium retention
88
What does a sterile field do
limits # of microbes & prevents infection
89
Nursing considerations for sterile field
- open packages AWAY from body
- open packages on a FLAT surface
- objects held ABOVE waist
- sterile can only touch sterile
90
Don'ts for sterile field
- wet field is a contaminated field
- NEVER turn away from the sterile field
- avoid touching items when u can
91
The neurotransmitter for the PNS is
acetylcholine
92
The neurotransmitter for SNS is
epinephrine & norepinephrine
93
Side effects of anticholinergics
-"can't see, pee, spit, or shit"
- blurred vision
- dry mouth, no sweat
- urinary retention
- constipation
94
Where is intracellular fluid located
fluid inside the cell
95
Where is extracellular fluid located
fluid outside the cell
96
Lab values for hypokalemia
less than 3.5-5.0 mEq
97
Risk factors of hypokalemia
- vomiting
- diarrhea
- loop or thiazide diuretics
- NPO diet
98
Signs & symptoms of hypokalemia
- weak muscles
- shallow breathing
- constipation
- decreased reflexes
- low BP
- nausea
99
Lab values for hyperkalemia
greater than 3.5- 5.0
100
Signs & symptoms for hyperkalemia
"MURDER"
- muscle cramps & weakness
- urine abnormalities
- respiratory distress
- decreased cardiac: decreased HR & BP
- EKG changes
- reflexes (decreased)
101
Risk factors for hyperkalemia
- too much K+
- tissue damage
- adrenal gland issues
- high levels of acid in blood (acidosis)
- NSAIDs
102
Lab values for hyponatremia
- less than 135-145 mEq
103
Lab values for hypernatremia
- greater than 135-145 mEq
104
Signs & symptoms of hyponatremia
"SALT LOSS"
- stupor/coma
- anorexia (nausea/vomiting)
- lethargy (weakness)
- tachycardia
- limp muscles
- orthostatic hypotension
- seizures.headaches
- stomach cramping (hyperactive bowels)
105
Risk factors of hyponatremia
loss of soDium
- diaphoresis
- diarrhea & vomiting
- diuretics
- dilution
- drains (NGT suction)
106
Risk factors of hypernatremia
- increased sodium intake
- excess admin of IV fluids w/ sodium
- loss of fluids.....fever, burns, infection
107
Signs & symptoms of hypernatremia
"FRIED SALT"
- flushed skin
- restlessness, anxious, confused, irritable
- increased BP & fluid retention
- edema (pitting)
- decreased urine output
- skin is dry
-agitation
- low grade fever
- thirst (dry mucous membranes)
108
What is Potassium
major intracellular cation
109
Whats the function of Potassium
- transmission of nerve impulses: cardiac & skeletal
110
Potassium is a carrier for
glucose & insulin
111
Nursing interventions for hyperkalemia
- monitor blood levels
- monitor signs & symptoms
- dialysis
- avoid IV & oral intake
-Lasix (causes K+ loss)
- insulin & dextrose infusion
112
Nursing interventions for hypokalemia
- stop loss
- monitor blood level, signs & symptoms
- more fruits - dried
- no IV push
- oral med NEED to be taken WITH food
113
Nursing interventions for hypernatremia
- stop the cause
- monitor blood level, signs & symptoms
- replace water w/ 5% D/W until sodium returns to normal
114
Nursing interventions for hyponatremia
- stop the cause
- monitor blood level, signs & symptoms
- decrease water intake
- replace fluids w/ sodium (oral & IV)
- irrigate NG tube w/ NaCl
