Exam 2: Units 3 and 4 Flashcards
(135 cards)
1
Q
sodium range
A
135-145
2
Q
3 main functions of sodium
A
blood volume maintenance
muscle contraction
nerve impulse
3
Q
sodium mainly hangs out ____ the cell
A
outside the cell
4
Q
sodium imbalances can lead to
A
neuro changes
5
Q
s/s hyponatremia
LOW salt = LOW brain
(brain swelling)
A
lethargy
muscle weakness
n/v
seizures
headache
6
Q
s/s hypernatremia
HIGH salt = DRY brain
(dehydrated)
A
thirst
dry mouth
restlessness
edema
7
Q
this kind of diuretic may contribute to the cause of hyponatremia
A
thiazide diuretics
8
Q
syndrome where the body produces too much antidiuretic hormone (ADH, vasopressin), causing the body to retain too much water
A
Syndrome of Inappropriate Antidiuretic Hormone secretion (SIADH)
9
Q
SIADH may contribute to the cause of ____natremia
A
hyponatremia (hypervolemic)
10
Q
rare disorder where the adrenal glands do not produce enough cortisol and aldosterone
A
Addison’s Disease
11
Q
Since there is a lack of aldosterone in Addison’s Disease, this may contribute to ____natremia
A
hyponatremia
12
Q
this kind of IV fluid should be given to a patient with hyponatremia
A
hypertonic fluids (contain high amounts of salt)
13
Q
food sources of sodium
A
salty and processed foods
14
Q
potassium range
A
3.5 - 5.2
15
Q
main function of potassium
“K+ing of action and contraction”
A
nerve function
muscle contraction
16
Q
potassium is regulated by this organ
A
the kidneys
17
Q
3 IV treatments for Hyperkalemia
A
IV sodium bicarbonate
IV calcium gluconate
D50 then IV insulin + albuterol
18
Q
this procedure may be an option to treat hyperkalemia
A
dialysis
19
Q
s/s hyperkalemia
(tight and contracted)
(overexcited muscles)
A
muscle cramps
cardiac arrest
low HR/BP (decreased contractility)
20
Q
this EKG change may be noted with hyperkalemia
A
tall, peaked T-waves
21
Q
this disease may contribute to hyperkalemia
A
Addison’s Disease
= low levels of aldosterone, so low sodium being reabsorbed (inverse relationship with K+)
22
Q
s/s hypokalemia
(low and slow)
(everything slows down)
A
shallow breathing
muscle weakness
constipation (slowed peristalsis)
23
Q
this EKG change may be noted with hypokalemia
A
flattened T-wave
inversion of the T-wave
24
Q
IV potassium can cause this, so infuse very slowly
A
phlebitis
25
food options for potassium
"POTassium"
POTatoes (with skin)
fruits/veggies
legumes
*GREEN LEAFY VEGETABLES*
26
range for calcium
"call 9-11"
(slightly diff range for this class)
8.2 - 10.2
27
3 B's of calcium function
Bones
Blood
Beats
28
this procedure can help treat hypercalcemia
dialysis
29
this IV medication can be given to treat hypercalcemia
IV phosphate (inverse relations)
30
IV medication to help treat hypocalcemia
IV calcium
31
s/s hypocalcemia
(excitable nerves)
(muscles go wild)
tetany/spasms
numbness
tingling
32
hypocalcemia shows with these two positive signs
Trousseau's
Chvostek's
33
this sign is positive when a slight touch of the face results in a small spasm of the facial muscle
Chvostek's
"Cheeky Chvostek's"
34
this sign is positive when there is a carpal spasm upon the inflation of a BP cuff
Trousseau's
35
hyperparathyroid hormone (PTH) can contribute to the cause of _____calcemia
hypercalcemia
36
thiazide diuretics can contribute to the cause of _____calcemia
hypercalcemia
37
TUMS can contribute to the cause of _____calcemia
hyopercalcemia
38
s/s hypercalcemia
"Swollen and Slow"
"Body slows down + Risk of stones"
bone pain
cardiac arrest (bounding pulse)
renal calculi
muscle weakness
excessive urination
39
EKG change that may be associated with hypocalcemia
QT prolongation
40
food options for calcium
"Cows and Canned Fish"
*GREEN LEAFY VEGETABLES*
Milk, Cheese Yogurt
Canned salmon/sardines (w bone)
Fortified cereals
41
magnesium range
1.8 - 2.6
42
magnesium acts as a
sedative
43
3 main functions of magnesium
"Law and order in the muscles"
(work alongside Ca2+)
Neuromuscular function
Immune function
Bone health
44
this procedure may be used to treat hypermegnesemia
dialysis
45
this diuretic may be given to treat hypermagnesemia
loop diuretics (if kidney function allows)
46
IV medication that can be given to help treat hypermagnesemia
IV calcium gluconate
47
s/s hypermagnesemia
"Calm and Quiet"
(everything sedated)
drowsiness/lethargy
low vitals
low DTRs
48
s/s hypomagnesemia
"Hyperactive/Overstimulated"
(not sedated)
Hyperreflexia
high vitals
twitches
shallow respirations
49
hypomagnesemia (same with hypocalcemia) may show these two positive signs
Trousseau's
Chvostek's
50
overuse of TUMS may contribute to the cause of ____magnesemia
hypermagnesemia
51
Addison's Disease can contribute to the cause of _____magnesemia
hypermagnesemia
52
Hyperkalemia may contribute to the cause of _____magnesemia
hypermagnesemia
53
these 2 EKG changes may be present with hypermagnesemia
widened QT
prolonged PR interval
54
uncontrolled DM may contribute to the cause of _____magnesemia
hypomagnesemia
(lack of insulin to bring potassium to cell, more potassium inside cell, less magnesium)
(K+ and Mg2+ inversely related)
55
these 3 EKG changes may be seen with hypomagnesemia
flat/inverted T wave
prolonged PR interval
widened QRS
56
AKA "Twisting of the Points", this is a type of fast heart rhythm that starts in the ventricles that can lead to cardiac arrest.
Characterized by a "twisting" pattern of QRS complexes
Torsades de Pointes
57
in severe cases of hypomagnesemia, these two findings may occur
Torsades de Pointes
V-fib
58
food options for magnesium
"Greens, Grains, and Nuts"
Plant-based
Spinach
Whole Grains
Black beans
Cashews
Dark chocolate
59
phosphate range
2.7 - 4.5
60
phosphate helps to
maintain body cells and tissue
61
phosphate can bind to this class of medication
antacids
"phosphate binding"
62
IV treatment for hypophosphatemia
IV potassium phosphate
63
class of medication to give for hyperphosphatemia
antacids
64
excessive intake of this vitamin can contribute to hyperphosphatemia
vitamin D
65
hypoparathyroidism may contribute to ___phosphatemia
(remember relationship with calcium)
hyperphosphatemia
66
s/s hyperphosphatemia
(think LOW calcium)
dry/brittle skin and nails
muscle spasms/tetany
seizures
67
hyperphosphatemia may present with these two positive signs
(think low calcium)
Trousseau's
Chvostek's
68
hyperparathyroidism may contribute to the cause of _____phosphatemia
(think high calcium)
hypophosphatemia
69
a deficiency in this vitamin can contribute to the cause of hypophosphatemia
vitamin D
70
s/s hypophosphatemia
"Low and Slow"
(weak everything)
confusion
muscle/bone weakness
numbness
71
food options for phosphate
"Phosphate = Protein"
protein-rich food:
meat
dairy
legumes
fish
eggs
72
phosphate and calcium have this relationship
inverse
73
sodium and potassium have this relationship
(sodium potassium pump)
inverse
74
magnesium and phosphate have this relationship
inverse
75
magnesium and calcium have this relationship
direct
76
magnesium and potassium have this relationship
direct
77
dialysis is recommended when
80% of nephrons are no longer working
78
3 common side effects of hemodialysis
anemia
hypotension
n/v
79
feeling of being not well or having zero energy
malaise
80
this class of medications must be HELD prior to dialysis
antihypertensives (and digoxin)
= to avoid severe hypotension
81
these kinds of vitamins should be held before dialysis
water soluble vitamins: B and C
"There is WATER at the BeaCh"
82
prior to beginning dialysis, nurse must feel for a
thrill
83
prior to beginning dialysis, nurse must ausculate (hear) for a
bruit
84
on a trialysis catheter, these two lumens are used only for dialysis
red and blue lumens
85
the third lumen on a trialysis catheter is used for
IV fluids, medications
86
benefit of using a trialysis catheter
allows for dialysis and IV therapy simultaneously
87
adverse complication of hemodialysis
Dialysis Disequilibrium Syndrome (DDS)
88
DDS is caused by a rapid removal of
urea
89
This can be a complication of peritoneal dialysis
peritonitis
90
patients may experience ____glycemia with hemodialysis
hypoglycemia
91
patients may experience ___glycemia with peritoneal dialysis
hyperglycemia
92
this procedure is preferred for patients who cannot withstand normal hemodialysis but needs some sort of renal replacement therapy
Continuous Renal Replacement Therapy (CRRT)
93
CRRT requires a
central line
94
4 labs to monitor while using CRRT
Coagulation studies (PT, aPTT, INR)
Electrolytes
Kidney Function
Protein levels
95
first choice for catheter insertion
right internal jugular vein
96
second choice for catheter insertion
femoral vein
97
third choice for catheter insertion
left internal jugular vein
98
last choice for catheter insertion
subclavian vein (preference to dominant side)
99
this is a hybrid form of dialysis and CRRT which still runs at a slow rate but is intermittent
Sustained Low Efficiency Dialysis (SLED)
100
SLED would be indicated for a patient if they are
hemodynamically unstable but don't want the continuous aspect of CRRT
101
a basic metabolic panel (BMP) tests this many different substances in the blood
8
102
a complete metabolic panel (CMP) tests for this many different substances in the blood
14
103
body pH range
7.35 - 7.45
104
pCO2 range
35-45
105
HCO3- range
22-26
106
if your pH is high, you are
alkalotic
107
if your pH is low, you are
acidotic
108
CO2 and H+ ions are
acidic
109
HCO3- (bicarbonate) is
basic
110
pH is regulated by the
lungs and kidneys
111
paCO2 is regulated by the
lungs
112
HCO3- is regulated by the
kidneys
113
hypoventilation, or a low RR, can lead to
acidosis
=low RR retains CO2 in the body
114
DKA makes the body
acidotic
115
severe diarrhea can cause the body to be
acidotic
=Base out the butt
116
sepsis can cause the body to be
acidotic
117
hyperventilation causes the body to be
alkalotic
=too much CO2 being exhaled from the body
118
overuse of antacids can cause the body to be
alkalotic
119
any sort of gastric suctioning can lead the body to be
alkalotic
120
pregnancy can cause the body to be
alkalotic
121
this is caused by a remarkable lack of insulin, forcing the body to disorders of carbohydrate, protein, and fat metabolism
Diabetic Ketoacidosis (DKA)
122
3 main clinical features of DKA
Hyperglycemia
Dehydration + Electrolyte loss
Acidosis
123
3 P's of DKA
polyuria (urination)
polydipsia (thirst)
polyphagia (hunger/appetite)
124
hyperglycemia can cause these 3 findings
blurred vision
weakness
headache
125
this in the mouth may occur with elevated ketone levels
acetone breath (fruity breath)
126
during DKA, blood glucose levels may rise up to this range
250-800 mg/dL
127
is the severity of DKA associated with the blood glucose level?
not always
128
since the patient is dehydrated in DKA, these levels may be elevated
creatinine
BUN
hematocrit
129
if a patient with DKA is rehydrated and creatinine/BUN/hematocrit levels remain elevated, this may indicate
an underlying renal injury
130
the acidosis that occurs in DKA is reversed with
regular IV insulin
131
in the body, H+ ions and K+ have this kind of relationship
inverse relationship
132
hypokalemia causes the body to be
alkalotic
= low levels of potassium cause cells to take H+ from the bloodstream, spitting out K+ in return. This causes the pH in the blood to rise due to the lack of acidic H+
133
the pH will be _____ if the pH is out of range and either the CO2 or HCO3 is still in range
uncompensated
134
the pH will be _____ if the CO2, HCO3, and pH are all out of range
partially compensated
135
the pH will be ______ if the pH is within range and both buffers are out of range
fully compensated
