Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

MEDSURG 1 2023 > EXAM 2 > Flashcards

EXAM 2 Flashcards

(38 cards)

Start Studying
1
Q

FVD

A

-loss of extracellular fluid exceeds intake of water
-dehydration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Hypovolemia (FVD) causes

A

-vomiting, diarrhea, nasogastric suctioning
-excessive skin loss w/o sodium and water replacement
-diuresis (polyuria), kidney disease, adrenal insufficiency
-third spacing burns
-anorexia, nausea, impaired swallowing, confusion, NPO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

dehydration (FVD) causes

A

-hyperventilation
-prolonged fever
-diabetic ketoacidosis
-diabetes insipidus
-osmotic diuresis
-excessive intake of salt, salt tablets, or hypertonic fluids
-hemorrhage or plasma loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

FVD clinical manifestations

A

-Rapid weight loss
-Tented skin turgor
-oliguria/concentrated urine (late sign)
-postural hypotension (orthostatic hypotension)
-rapid, weak pulse
-hyperthermia
-lack of energy
-thirst
-nausea
-muscle weakness and cramps
-decreased CVP (late sign)
-oliguria
-tachypnea
-hypoxia
-seizures (rapid/severe dehydration)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

FVD lab values

A

-normal: 10:1, FVD: 20:1, >25mg/dl due to hemoconcentration
-increased hematocrit
-sodium >145 meq/L with dehydration
-USG >1.030
-blood osmolarity >295 w/ dehydration/hypernatremia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

FVD nursing management

A

-administer oral/iv fluids
-monitor I/O
-monitor weight every 8 hrs (1 Kg = 1 L fluid loss or gained)
-check skin turgor
-assess for gait stability
-encourage pt to stand up slowly (orthostatic hypotension)
-provide oral care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Hypovolemic shock

A

-occurs when a significant amount of fluid is lost (cells are no longer able to carry oxygen)
-administer oxygen and monitor oxygen
-check v/s q 15 minutes
-provide IV fluids (crystalloids: LR or 0.9% NS) (colloids: PRBCs or plasma)
-administer vasoconstrictors: norepinephrine, phenylephrine, and dopamine
-perform hemodynamic monitoring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

FVE

A

-Fluid overload: excess of fluid causing hemodilution
-decreases hematocrit
-excess of water and electrolytes
-Risk for CHF and pulmonary EDEMA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Hypervolemia causes

A

-heart failure
-kidney disease
-cirrhosis
-an overdose of fluids
-fluid shifts following major burns
-corticosteroids
-severe stress
-hyperaldosteronism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Overhydration causes

A

-water replacement w/o electrolytes, excessive water intake
-SIADH (too much adh)
-excessive administration of IV D5W or hypotonic fluids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

FVE clinical manifestations

A

-tachycardia
-HTN
-Tachypnea
-Edema
-DISTENDED NECK VEINS
-crackles, cough, dyspnea
-bounding pulse
-increased weight and urine output
-increased CVP
-seizures (if severe hyponatremia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

FVE nursing management

A

-Monitor I/O and weight
-assess lung sounds/edema
-promote adherence to fluid restrictions and sodium
-encourage REST (favors diuresis)
-discuss certain meds (some have Sodium)
-fowler’s or semi-fowler position
-turn and reposition pt.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Pulmonary Edema causes

A

-FVE
-clinical manifestations: anxiety, PVCs, dyspnea at rest, change in LOC, restlessness, lethargy, ascending crackles, pink tinged sputum
-put into high-fowlers pos.
-administer oxygen, positive airway pressure
-administer nitrates, morphine, diuretics if possible (BP has to be adequate)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

hyponatremia

A

-< 136 mEq/L
-net gain of water or loss of sodium rich foods
-water moves from ECF to ICF
-caused by:
-adrenal insufficiency
-water intoxication
-SIADH
-vomiting, diarrhea, sweating,
diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

hyponatremia clinical manifestations

A

-poor skin turgor (hypovolemic)
-dry mucosa (hypovolemic)
-decreased salivation (hypovolemic)
-decreased BP and increased HR (hypovolemic)
-headache
-nausea
-abdominal cramping
-neurologic changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

hyponatremia nursing management

Study These Flashcards
A

-encourage intake of foods and fluids high in sodium (beef broth, tomato juice)
-monitor dietary sodium and fluid intake (no more than 12 mEq in 24 hours to prevent neuro dmg demyelination)
-daily weight
-check VS and neuro status

17
Q

Severe hyponatremia

Study These Flashcards
A

-can cause comas, resp arrest, seizures
-implement seizure precautions
-give hypertonic oral and IV fluids

18
Q

Hypernatremia

Study These Flashcards
A

->145 mEq/L
-increased sodium levels = increased hypertonicity of blood
-water shifts out of cells, causing dehydration
-caused by:
- water loss > sodium loss
- excess sodium
administration
-diabetes insipidus
-heatstroke
-hypertonic IV solutions
-kidney failure
-aldosteronism
-cushing’s
syndrome/glucocorticoids

19
Q

Hypernatremia clinical manifestations

Study These Flashcards
A

-Thirst
-elevated temperature
-tachycardia
-dry, swollen tongue
-sticky mucosa
-Restlessness,
weakness, muscle
twitching to muscle
weakness, decreased
DTRs, seizures, coma

20
Q

Hypernatremia nursing management

Study These Flashcards
A

 monitor LOC and ensure safety
 Monitor VS and heart rhythm
 Provide oral hygiene and other
comfort measures for thirst
 Monitor I&Os
 Assess for over-the-counter
sources of sodium
 Offer and encourage fluids to
meet needs
 Provide sufficient water with
tube feedings

21
Q

Hypokalemia

Study These Flashcards
A
  • < 3.5 mEq/L
     GI losses- vomiting, gastric suctioning, diarrhea
     Medications- K-losing diuretics, corticosteroids
     Alterations of acid–base balance- due to shifts of H and K ions between cells and ECF
     Hyperaldosteronism- increases renal K wasting
     Poor dietary intake
     Alkalosis
     Water intoxication
22
Q

Hypokalemia clinical manifestations

Study These Flashcards
A

 Dysrhythmias
 Cardiac arrest
 PROMINENT U WAVE
 Fatigue
 Anorexia
N/V, hypoactive bowel sounds, constipation, abdominal distention, paralytic ileus
 Muscle weakness and cramps
 Paresthesias
 Decreased muscle strength
 Decreased deep tendon reflexes
 Respiratory failure

23
Q

Hypokalemia nursing management

Study These Flashcards
A

 Administer prescribed potassium replacement (max 10 mEq/hour; NEVER IV PUSH or IM subq anyone)
 Monitoring of electrocardiogram
 Monitor bowel sounds
 Monitor clients receiving digoxin for toxicity
 Arterial blood gases
 Avocados, broccoli, dairy products, dried fruit, cantaloupe, bananas, juices, melon, salt substitutes
 NO IV BOLUS (risk for arrest)

24
Q

Hyperkalemia

Study These Flashcards
A
  • > 5.0 mEq/L
     Increased risk of cardiac arrest
     Impaired renal function
     Hypoaldosteronism- deficient adrenal hormones lead to Na loss and K retention
     Tissue trauma- burns, crushing injuries, severe infections
     Acidosis- K moved from cell to ECF
     Uncontrolled Diabetes
25
Hyperkalemia Clinical manifestations
 Dysrhythmias (slow irregular pulse, hypotension)  Peaked T waves, widened QRS  Muscle weakness to the point of paralysis  Restlessness, irritability  Potential respiratory impairment  Paresthesias  Anxiety  Oliguria  increased motility, hyperactive bowel sounds, colic, cramps, distention
26
Hyperkalemia nursing management
 Priority: prevent falls, assess for cardiac complications, and health teaching  Assess for muscle weakness  Monitor cardiac rhythm and intervene promptly  Monitor serum potassium levels  Monitor medication effects  Initiate dietary potassium restriction and dietary teaching for patients at risk  Loop diuretics (furosemide)  Beta-2 agonist (albuterol)
27
hypocalcemia
- < 9.0 mg/L (low calcium levels)  Lactose intolerance, malabsorption issues  Diarrhea or steatorrhea Hypoparathyroidism /parathyroid removal  Acute pancreatitis  Alkalosis  Massive transfusion of citrated blood  End-stage kidney disease  Wound drainage  Medications
28
Hypocalcemia clinical manifestations
 Tetany (the most common symptom, caused by neuronal excitability)  Fingers, toes, circumoral/perioral (mouth) numbness  Paresthesias  Painful muscle spasms in the foot or calf charley horses  Hyperactive bowel sounds, diarrhea  Hyperactive DTRs  Trousseau’s sign  Chvostek's sign  Seizures  Respiratory symptoms- bronchospasm  Abnormal clotting  Anxiety  Prolonged QT interval
29
Hypocalcemia Nursing Management
 Administer oral or IV calcium supplements and vitamin D  Implement seizure and fall precautions  Avoid overstimulation  Dairy, canned salmon, sardines, fresh oysters, and dark leafy green vegetables  Weight-bearing exercises to decrease bone calcium loss  Patient teaching related to diet and medications- avoid alcohol, caffeine, overuse of laxatives/antacids
30
Hypercalcemia
- > 10.4 mg/dL o Pathophysiology: malignancy and hyperparathyroidism, bone loss related to immobility, diuretics
31
Hypercalcemia clinical manifestations
-polyuria -thirst -muscle weakness -intractable nausea -abdominal -cramps, -severe constipation, -diarrhea, -peptic ulcer, -bone pain, -ECG changes, -dysrhythmias
32
Nursing management Hypercalcemia
❖Treat underlying cause (Cancer) ❖Administer IV fluids, furosemide, phosphates, calcitonin, bisphosphonates ❖Increase mobility ❖Encourage fluids ❖Dietary teaching, fiber for constipation ❖Ensure safety
33
Hypomagnesemia
- < 1.3 mEq/L o causes  Malnutrition  Alcoholism  NG suction, diarrhea, fistulas  Celiac disease or Chron’s disease  Enteral or parenteral feeding deficient in mg  Aminoglycoside antibiotics, amphotericin  Diabetic ketoacidosis  Rapid administration of citrated blood
34
Hypomagnesemia Clinical Manifestations
 Neuromuscular irritability  Tremors  Positive Trousseau’s and Chvostek’s signs  PVCs, flat/inverted T waves, ST depression, prolongs PR and widened QRS  High BP  Alterations in mood and level of consciousness  Hypoactive bowel sounds, constipation, paralytic ileus
35
Hypomagnesemia nursing management
 Ensure safety- seizures, confusion, dysphagia  Patient teaching related to diet, medications, and alcohol use digitalis toxicity can occur  Dark leafy greens, nuts, whole grains, seafood, peanut butter, cocoa  Nursing care related to IV magnesium sulfate- given by infusion pump
36
Hypermagnesemia
- Serum level greater than 2.6 mg/dL -Pathophysiology: kidney injury, diabetic ketoacidosis, excessive administration of magnesium, extensive soft tissue injury -Rare electrolyte abnormality, because the kidneys efficiently excrete magnesium -Falsely elevated levels with a hemolyzed blood sample
37
Nursing Management of Hypermagnesemia
❖IV calcium gluconate ❖Ventilatory support for respiratory depression ❖Hemodialysis ❖Administration of loop diuretics, sodium chloride, and LR ❖Avoid medications containing magnesium ❖Patient teaching regarding magnesium-containing over-the-counter medications ❖Observe for DTRs and changes in LOC
38

MEDSURG 1 2023 (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions