Exam 3 Flashcards

Question

Potassium functions

Answer 1

-mainly ingested through dietary sources - kidneys eliminate 90% of K--> CKD pts often have hyperkalemia - plays a role in acid base balance -plays role in neuromuscular function , contraction of cardiac, smooth,&skeletal muscle

Answer 2

<3.5 mEq/L "Low potassium in blood"

Answer 3

"DITCH" -Drugs: laxatives diuretics (furosemide dumps all electrolytes ) -Inadequate intake: diet -Too much water: Dilutes it in blood -Corticosteroids: mineral corticoids cause excretion of K - Heavy Fluid loss : Prolonged vomiting causes loss of HCL --> PH oh the stomach becomes alkaline which causes the exchange of H+ (move out of cell) with Na and K (move in cell)

Answer 4

"6 L's + H" Lethargy (fatigue) Leg Cramps Limp muscles (slow reflexes and paresthesia -->specific to K) Low shallow respiration: k is responsible for muscle contractions so GI will also slow SLow GI motility: nausea, constipation, paralytic ileus Lethal cardiac arrhythmia: heart is sensitive to K fluctuations Hyperglycemia: d/t reduced insulin secretion from pancreas

Answer 5

Prolonged vomiting leads to loss of hydrogen through HCL. The loss of Hydrogen raises the pH in blood (alkalosis) the body will try to correct the blood pH through pulling Hydrogen out of the cells in exchange for moving potassium into the cells. This causes a loss of K in the blood.

Answer 6

K+ is needed by the pancreas to create insulin. When there is low K in the blood there is a reduction in insulin being produced. This means that body cells are not removing glucose from the blood and it remain floating in the intravascular space. Additionally, the Na/K pump plays a role in moving glucose into the cell, and is also stimulated by insulin. So ultimately because K is not available for the pancreas to make insulin, glucose remains in the blood causing Hyperglycemia.

Answer 7

- Assessing muscles reflexes, motor function, respiratory function, heart rhythm, bowel sounds, glucose levels with insulin therapy -for treating the Hyperglycemia, insulin is given but if too much is given, K will be moved into the cell too quickly -->hypokalemia - to avoid this you administer, insulin, dextrose and potassium -withhold laxatives and diuretics

Answer 8

"Potassium + bananas" -Potato -Oranges -Tomato -Avocado -Spinach -Strawberries -raisIns -mUshrooms -bananas

Answer 9

>5 mEq/L Not as common as hypo

Answer 10

-most common cause is renal failure (90% k eliminated by kidney) -excessive intake of k -massive cell destruction (many cells spilling k ions in blood?) -potassium sparing diuretics (spironolactone) -metabolic acidosis (k moves out of cell and H moves in) low blood pH

Answer 11

Acidosis refers to too much H+ in the blood. The body will correct this by moving H+ into the cells. This can only happen if K is pulled out and put into the blood, in exchange. Eventually, excess K will exist in the blood-->hyperkalemia

Answer 12

"LIMP is a FACT" - Loss of muscle tone -Irregular pulse/rhythm. -Muscle weakness -Parasthesia ans reduces reflexes -Fatigue -Abdominal cramping (diarrhea-diff from hypo which is slow and low) -Confusion -Twitching (muscle cramps)

Answer 13

-in mild elevations, withhold k from diet -assess medication use -assess cardiac and muscle function -assess bowel sounds /stool appearance -may need diuretics to promote excretion -assess glucose and k levels with I sulin therapy -

Answer 14

95-105 mEq/L Most abundant anion outside the cell, which is why sodium and chloride have a relationship

Answer 15

-Helps maintain acid base balance -excreted in sweat -Cl is also regulated by the kidneys - don't look at Chloride by itself, look at it in conjunction with Na and K

Answer 16

-GI losses such as vomiting or Prolonged GI suctioning -Diuretics -Medications such as antacids -Fluid volume overload: bc cl resides in ECF fluid overload will water it down but you'll have to compare it with sodium to see if there is a downward trend

Answer 17

<105 mEq/L

Answer 18

-associated with excess sodium intake or sodium and Chloride IVF (you don't usually see this in hospital but it is possible with saline even though it's isotonic) -CKD: kidneys arnt excreting Cl -Fluid volume deficit will increase the concentration

Answer 19

8-12 mg/dL

Answer 20

-high protein intake -excess protein breakdown -CKD -fluid volume deficit: reduced BV from dehydration-->kidneys don't have enough fluid to remove waste products **Urea is a byproduct of protein breakdown by the liver. It is converted to ammonia(contains N) and combines with H, O, C to make uneasy and travels to kidneys to be excreted**

Answer 21

-Liver failure:impaired ability to convert ammonia into Urea -low protein diet -fluid volume excess: BUN gets diluted

Answer 22

-assess protein levels and hydration status -assess other kidney and liver function tests: BUN alone can tell you something about liver and kidney function but to determine which, you'd need to look at liver enzymes and na cl

Answer 23

0.8-1.2 mg/dL It's a waste product from protein digestion and normal muscle break down -Amount of creatinine is proportional to the mass of skeletal muscle -filtered by glomerulus at constant rate so it is a sensitive indicator of kidney function. If you compare this value to BUN it will tell you if the issue is kidney

Answer 24

-kidneys are damages and not filtering it -acute MI: breakdown of heart muscle "Rhabdomylosis" -high protein intake -fluid volume deficit

Answer 25

Low protein intake

Answer 26

Enema -increases osmotic pressure and draws water into the colon

Answer 27

-Laxative and antacid -it's osmotically active in the GI tract but not as much as the hyperosmotics NI: Shake before administering; doesn't have fluid/electrolytes so it may cause imbalances

Answer 28

Bowel preparation -osmotically active NI: Has to be refrigerated; may cause Fluid and electrolyte imbalances can occur

Answer 29

Stimulant Laxative -it stimulates the intestinal nerves to increase peristalsis and water in the colon Ni: may become habbit forming; -available orally or as a suppository -may cause imbalances -reduces peristalsis

Answer 30

Right Patient Right Medication Right Dosage Right Time Right Route Right Documentation Right Reason Right Form Right Response

Answer 31

Patient name Medication name Dose with unit Frequency Route Proscribers signature Note that the indication for use may not be there if it's a PRN med

Answer 32

Failure to Assess & Evaluate Failure to Ensure Safety Medication Errors Fraud

Answer 33

Proscribing: script is written from provider (PCP, NP, DO, pharmacist) its a clinical decision based on drug choice and regimen Transcribing: the order is received through eMAR. RN responsible for checking the order and if rational os correct Dispensing: Pharmacist does the data entry and screening and mixes or compounds if necessary, and send to omicel/pixus (rendonda vaught) Administration: RN prepares the drug for administration, verifies the order, administers the drug and documents in eMAR

Answer 34

-Refers to injury that can occur from a drug that can prolong hospital stay, cause disability, be life threatening and cause death. -could be an adverse drug reaction (SE) or from a medication error

Answer 35

-This falls under ADE -formerly called side effects -they are unexpected, undesirable, may or may not be preventable, and occur at therapeutic dosages Ex: constipation from Iron supplement

Answer 36

-Two or more drugs that enhance or diminish the effect of another -a type of ADR Ex: being on two antihypertensives

Answer 37

-another ADR -it's a reaction that can be predictable, and may need another med to manage the symptoms. The issues go away when the med is stopped Ex: Someone on an opioid taking a stool softener to manage constipation

Answer 38

-another ADR - this is a hypersensitivity and immune response that can be preventable or non preventable. The body releases histamine and prostaglandin. Undesirable and unexpected

Answer 39

-ADR -It's unpredictable and unexpected -not always listed on the drug guide -it's not allergy related, but is rare and peculiar - can be mild or life threatening You have no idea why it's happening

Exam 3 Flashcards

(64 cards)