Exam 2 Flashcards

1
Q

What does a ⬆️ hematocrit and
⬆️ serum sodium mean?

A

Dehydration! 🥵
A concentrated serum sodium lab values ⬆️, because of ⬇️ volume to dilute values

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2
Q

Nursing intervention for “fluid volume excess”

A

Restrict 🧂in diet (+fluid = +sodium)

Sodium is restricted 🚫to allow body to excrete extra water 🌊

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3
Q

What do you do in case of a sodium 🧂level of 110mEq/L?

A

(Anything Lower than 120!)

⚠️Place on seizure 🫨 precautions⚠️

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4
Q

If a patient has numbness & tingling in mouth and tips of fingers, you can assess the Chvosteks sign….

What do you do & what is it a sign of?

A

Tap cheek 2cm anterior to👂lobe

➕= facial twitch= hypocalcemia 👨🏻‍⚕️
➖= no movement

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5
Q

What lab do you assess with 🤮& diarrhea? 🚽

A

Serum potassium 🩸

Potassium imbalances can lead to
🫀 arrhythmias

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6
Q

S & S of Hypernatremia

A

⬆️ serum sodium blood level🩸
⬇️💧intake, 💧 loss, or rarely +🧂

Dehydration symptoms:
Postural Hypotension
Weakness
Tachy 🫀

Replace 💧fluids

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7
Q

Hyponatremia Treatment

A

Low serum sodium level 🩸

If water excess =Fluid restrictions
If fluid loss is cause= +🧂 solutions 💧

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8
Q

Hyperkalemia S & S

A

⬆️serum potassium level🩸
From renal failure, injury/burn, 🦠

Confusion 🤷🏽‍♀️
💪🏽 cramps
Weakness of 🦴muscles

Telemetry 〽️
Dangerous 🫀 = IV calcium gluconate

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9
Q

Hypokalemia S & S

A

⬇️ serum potassium level 🩸
Losses from Kidneys or GI tract 🫄

☠️ ventricular dysthymias
🦴 muscle weakness
Shallow 🫁& arrest
U waves, inverted T waves, Deoressed ST segment

Treatment=IV Potassium chloride & diet 🥔🍊

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10
Q

Calcium imbalances S & S:

(Hypercalcemia ⬆️, Hyperparathyroidism,
Other 2/3 = 🩸, breast, or 🫁 CA)

A

Fatigue
Confusion 🤷
Weakness
Seizures 🫨
🫀dysrhythmias

Treat= loop diuretics
Hydrating with isotonic solution 💧

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11
Q

Hypocalcemia S & S

A

⬇️serum calcium level 🩸
⬇️ parathyroid hormone

💪🏽excitability & tetany
Numbness
Muscle weakness
Laryngeal Stridor ➡️🫁arrest
Prolonged QT interval & ST segment

Treat w/ IV calcium

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12
Q

Hyperphosphatemia S & S

A

⬆️ serum phosphorus level🩸
Acute kidney injury or disease 🥊

🧠muscular irritability
Tetany and calcified in soft tissue 🦴

Treat primary cause

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13
Q

Hypophosphatemia S & S

A

⬇️ serum phosphorus level 🩸
Malnourished or malabsorption syndrome 🚫🌮

Asymptomatic

Treat w/ IV phosphorus

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14
Q

Hypermagnesemia S& S

A

⬆️ serum magnesium level 🩸
Renal insufficiency w/ +mag intake

Hypotension
Facial flushing 🤍
Nausea & 🤮
Loss of deep tendon reflex
🫁 & 🫀 arrest

Treatment is to avoid magnesium foods & IV calcium

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15
Q

Hypomagnesemia S & S

A

Malnutrition states: fasting and starvation 🦴 or +GI or kidney loss
Excessive 🥃🍹

🧠 CNS irritability
Tremors
Seizures 🫨
Confusion🤷

Treatment= 💊 or IV supplements

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16
Q

🫁 acidosis occurs whenever there is…

A

Hypoventillation
Respiratory Failure

⬇️pH, ⬆️PaCO2, HCO3 Normal

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17
Q

🫁 alkalosis happens when there is…

A

Hyperventilation
Hypoxemia
Pulmonary d/o

⬆️pH, ⬇️PaCO2, HCO3 Normal

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18
Q

Who is likely to develop fluid overload? 🫃🏽

A

A patient on RENAL dialysis

A patient with 🫀 failure ⬇️

19
Q

IV calcium gluconate is used for which electrolyte imbalance?

A

⬆️Hypermagnesia

⬇️Hypocalcemia

20
Q

D5NS and 3% saline are what types of solutions? 💧

A

Hypertonic 🫨

21
Q

What can you notice in a patient with a massive 🔥 injury & possible hypovolemia?

A

Low blood pressure

Example: 90/40 mm Hg

22
Q

If it comes out your 🍑,
You are…

23
Q

K imbalances =

A

Kardiac 🫀

24
Q

Magnesium think muscle …

A

Hypomagnesemia = 💪🏽muscle cramps 🦵🏽

Hypermagnesemia= too much muscle relaxation 🛌🥱

25
Na imbalances =
Neuro 🧠
26
Hypocalcemia =
Tetany ➕Chvostek ➕ Trousseaus
27
Palliative care
Holistic approach to care or treatment that focuses on reducing severity of disease symptoms 🥺♥️
28
Nursing care plan for CA
Hand washing 🧼 🚫fresh, unwashed 🍓🍇🥗🥕 No plants 🪴 😷 mask if you have a cold 🤧 Monitor urine and temperature 🤒 🩸transfusion Monitor for bleeding, soft🪥 Mouth care Wigs (self body image)
29
Cataracts 👀 S & S
Common in 👵🏽👴🏼 Lenses is cloudy Affects near & far vision Difficult of adjest light & dark Treat- surgically w/lens implant 🚫 rubbing of 👁️ 🚫💨 conditions 🚫👵🏽🚗🛣️ for 48hrs 🚫🏊🏼‍♂️👙for 3 months 🌊
30
Glaucoma S & S 🌊👁️
Lading cause 📈of blindness 😎 Notice when it’s too late Open angle = common type ⬆️ internal pressure= Pressure on optic nerve 🪢 ⬇️peripheral vision Mild HA 🤕 Unable to 👀 in dark 🔘Halo around light
31
Glaucoma care
Routine eye visits 👨🏻‍⚕️ Rx 💊= pilocarpine & Timoptic Surgical intervention 💉to improve drainage
32
Otosclerosis
Hereditary 🧬 Starts in adolescents or early 🧒 Tinnitus 🔔 Progressive hearing ⬇️ 👂Background noises Vertigo 🫨 Hearing aid Sodium fluoride Surgery w/prosthesis 🔪👂🏼
33
Meniere’s Disease 👂🏼
Disorder of inner 👂🏼 Excess of endolymph Rotary vertigo 🫨 Whirling vertigo 🌊 Tinnitus 🔔 Unilateral hearing loss
34
Treatments for Meniere’s Disease
💊 Atropine or Valium Antivert Compazine or vistaril Lasix 🔪 surgery Low 🧂diet 🚫🍹🥤caffeine, or 🚬🚭
35
Don’t give DW5 fluids to…
🤕Head injury patients Infants 👶🏾🍼 May cause cerebral edema
36
Isotonic solutions
Normal Saline (0.9%) Lactated Ringer D5W (on shelf) Stays in bloodstream or intravascular Treatment: Maintain fluid volume 💧 Hypovolemia & fluid loss Replace Na and Cl Hypernatremia 🧂 Hyperkalemia
37
Hypertonic Solutions
Will pull a less concentrated solution into self D5NS 3% saline D10W Treats: Hypoglycemia 🍬 Severe hyponatremia 🧂
38
Hypotonic Solutions
Will shift & flow into a more concentrated solution 1/2 NS (0.45%) DW5 (once metabolized) Treats: Expands intracellular compartment Replaces free water 💧 DW5- Hypernatremia
39
What are the Anions and their ranges?
Bicarbonate (HCO3-) 22-26 mEq/L Chloride (Cl-). 98-106 mEq/L Phosphate (PO43-). 3.0-4.5 mg/dL
40
What are the Cations and their ranges?
Calcium total (Ca2+) 9.0-10.5mg/dL Calcium ionized 4.5-5.6 mg/dL Magnesium (Mg2+) 1.3-2.1 mEq/L Potassium (K+) 3.5-5.0 mEq/L Sodium (Na+) 136-145 mEq/L
41
ABG pH range
7.35 - 7.45 Less than 7.35 = acidosis More than 7.45 = alkalosis
42
Metabolic 🩸 acidosis
Lactic acid accumulation Kidney disease Severe diarrhea 💩 ⬇️pH, PaCO2 Normal, ⬇️ HCO3
43
Metabolic 🩸alkalosis
Prolonged vomiting 🤮 Gastric suctioning Gain of bicarbonate ⬆️pH, PaCO2Normal , ⬆️HCO3