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NU 226 > Final > Flashcards

Final Flashcards

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1
Q

Extracellular (ECF)

A
  • Interstitial: part of ECF
  • Blood plasma: part of ECF
  • Transcellular fluid: portion of total body
    water contained within the epithelial-lined
    spaces, also part of ECF
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2
Q

HYPONATREMIA

A

less than 135 mEq/L
* Severe vomiting, diarrhea,
excessive sweating
* Drinking to much water
* Diuretics

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3
Q

hyponatremia manifestations

A
  • Confusion, hypotension
  • N/V, muscle weakness & cramps
  • Less than 115 signs of CNS:
    lethargy, muscle twitching,
    hemiparesis, Seizures and
    permanent neuro damage
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4
Q

hyponatremia treatment

A

Encourage foods with Na+,
Na+ replacement, monitor Na+ level and
specific gravity, Hypertonic IV fluids, H2O
restriction, seizure precautions if severe

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5
Q

hypernatremia

A

greater than 145 mEq/L
- sodium gain or water loss
- Lack of fluids, diarrhea, burns

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6
Q

hypernatremia manifestations

A
  • Thirst (major symptom)
  • Restlessness, weakness, disorientation, delusions, hallucinations, dry
    swollen sticky mucous membranes, fever, tachycardia, postural
    hypotension
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7
Q

hypernatremia treatment

A

Treatment depends on the cause & volume status:
IV fluids without sodium (D5W), restrict sodium, monitor Na+
and specific gravity, diuretics

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8
Q

Hypokalemia

A

< 3.5 mEq/L

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9
Q

Hypokalemia manifestations

A
  • Muscular weakness, leg cramps,
    paresthesia (numbness, tingling)
  • Dysrhythmias, irregular pulse
  • Hypokalemia potentiates digitalis toxicity
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10
Q

hypokalemia treatment

A

Replace K+; include foods rich in
Potassium (i.e., bananas)
* IV irritates veins, mixed by pharmacy, never
give IV push (review policy) up to 40mEq in 1
liter IV bag

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11
Q

Hyperkalemia

A

> 5 mEq/L

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12
Q

Hyperkalemia manifestations

A
  • Cardiac dysrhythmias (lethal)
  • Muscle weakness and paralysis
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13
Q

hyperkalemia treatment

A
  • Mild (< 6 mEq/L): Stopping K intake or K-
    sparing medications
  • Severe: IV & medications: Na+ bicarb, insulin,
    hypertonic dextrose, sodium polystyrene
    sulfonate (Kayexalate) oral or enema, dialysis
    last resort
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14
Q

Hypocalcemia

A

< 8.6 mg/dl

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15
Q

Hypocalcemia manifestations

A
  • Chvostek & Trousseau’s sign
  • Numbness and tingling fingers, mouth, feet, muscle cramps, seizures, pathological
    fractures
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16
Q

Chvostek sign

A

twitching of facial muscles in response to tapping over
the area of the facial nerve

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17
Q

Trousseau’s sign

A

Trousseau’s sign is carpopedal spasm that results from
ischemia, such as that induced by pressure applied to the upper arm from an inflated
sphygmomanometer cuff

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18
Q

hypocalcemia treatment

A

Calcium, seizure precautions if severe, educate about nicotine and alcohol

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19
Q

Hypercalcemia

A

> 10.2 mg/dl

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20
Q

hypercalcemia manifestations

A
  • N/V, constipation, excessive urination, thirst, confusion, lethargy, slurred speech,
    bone pain
  • Severe (>17)=cardiac arrest
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21
Q

hypercalcemia treatments

A

fluids, diuretics, restrict intake of calcium

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22
Q

HYPOMAGNESEMIA

A

<1.5 mEq/L

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23
Q

HYPOMAGNESEMIA manifestations

A

Muscular weakness & tremors, tetany, seizures, hyperactive
Deep Tendon Reflexes (DTRs), mental status changes, cardiac dysrhythmias,
respiratory paralysis

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24
Q

HYPOMAGNESEMIA treatment

Study These Flashcards
A

Replacement of magnesium [foods rich in magnesium (dark leafy
greens, nuts, seeds, fish, beans, whole grains, avocados, yogurt, bananas, dried
fruit, dark chocolate)], seizure precautions, airway support

25
HYPERMAGNESEMIA
> 2.5 mEq
26
HYPERMAGNESEMIA manifestations
Early signs include flushing, and sense of skin warmth, N/V, loss of DTRs, respiratory depression, lethargy progressing to coma, cardiac arrest
27
HYPERMAGNESEMIA treatment
calcium gluconate, furosemide; hemodialysis in severe cases
28
Hypovolemia
GI losses, burns or hemorrhage, fever, fever, diuretics, decreased oral intake
29
Hypovolemia manifestations
Poor skin turgor, dry mucous membranes * Postural hypotension, tachycardia, weak pulse * Oliguria (<30ml/hr) * Increased hematocrit
30
Hypervolemia
CHF, renal failure, excessive Na+ intake, cirrhosis
31
Manifestations
* Rapid weight gain, edema * Crackles in lungs, neck vein distention * Polyuria, increased BP, bounding pulse * Decreased hematocrit
32
IV Infiltration
* Swelling, pallor, coolness, pain * Discontinue site, raise extremity, wrap in moist towel * Insert new site
33
IV Phlebitis
Redness, acute tenderness, warmth over vein Discontinue infusion, remove IV, and insert in new vein Apply warm, moist, heat compress Peripheral IV sites should be changed every 72-96 hours (CDC recommendations)
34
steps for safety when administering blood products
* Review site/facility policy * Second RN to verify order * Confirm informed consent * Assess vital signs (before, during, and after)
35
Rh factors
Rh-positive individuals can receive both Rh-positive and Rh-negative blood, while Rh-negative individuals should only receive Rh-negative blood to avoid potential
36
blood transfusion Prescriber order (confirmed by second RN):
 Type of blood  Date and rate  Patient
37
Packed Red Blood Cells (PRBCs) usual transfusion time
over 2 hrs (per unit) - May be lengthened to 4 hrs (> 4 hours risk of contamination)
38
preventing fluid overload during blood transfusion
IV push Furosemide (a diuretic, which gets rid of extra fluid through kidneys) may be prescribed before or between PRBCs to prevent fluid overload
39
types of transfusion reactions
Allergic: * Itching, hives, anaphylaxis Febrile: * Fevers, chills, headache Hemolytic (incompatibility): * Fevers, chills, headache, low back pain, shock Overload: * Dyspnea, dry cough
40
Intervention: Transfusion Reaction
* Stop transfusion * Keep IV line open with 0.9% NS * Notify physician * Remain with client & take vital signs every 5 mins * Urine, blood will be obtained and sent to lab * Incident report
41
classifications of surgical procedures
* Elective: Delay of surgery has no ill effects; can be scheduled in advance based on patient’s choice * Urgent: Usually done within 24–48 hours * Emergency/Emergent: Done immediately * Diagnostic: To make or confirm a diagnosis * Ablative: To remove a diseased body part * Palliative: To relieve or reduce intensity of an illness; is not curative * Reconstructive: To restore function to traumatized or malfunctioning tissue may also improve self-concept
42
Preoperative Teaching: Exercises and Physical Activities
* Deep-breathing exercises * Coughing * Incentive spirometry * Turning * Leg exercises * Early mobility
43
Preoperative Teaching: Pain Management
* Meaning of PRN orders for medications * Multimodal pain medication options * Timing for best effect of medications * Splinting incision * Nonpharmacologic pain management options
44
Postoperative Teaching Postanesthesia Care Unit
* Frequent vital signs, assessments (e.g., orientation, movement of extremities, strength of grasp) * Dressings/drains/tubes/catheters * Intravenous lines * Pain medications/comfort measures * Family notification * Sensations * Airway/oxygen therapy/pulse oximetry
45
Postoperative Teaching: Transfer to Unit
* Frequent vital signs * Sensations * Pain medications/nonpharmacologic strategies * NPO, diet progression * Exercises * Early ambulation
46
Postoperative Cardiovascular Complications:
* Hemorrhage * Shock * Thrombophlebitis and thromboembolism * Pulmonary embolus
47
postop Respiratory Complications
* Pulmonary embolism * Atelectasis * Pneumonia
48
Advance directives (ACP)
allow individuals to state in advance what their choices would be for health care should certain circumstances develop
49
Living Will
provide specific instructions about the kinds of health care that should be provided or foregone in particular situations
50
Durable Power of Attorney for Health Care
appoints an agent the person trusts to make decisions in the event of subsequent incapacity
51
whose responsibility is it to obtained informed consent
the person who will perform the diagnostic or treatment procedure or research study.
52
role of nurse in informed consent
Confirm that a signed consent form is present in the patient’s chart and to answer any patient questions about the consent. * As a nurse you sign the consent form as a witness to the patient signing the form (not as having obtained the consent yourself) * Unless you are obtaining consent for a nurse- prescribed and nurse-initiated intervention
53
types of loss
* Actual Loss * Perceived Loss * Maturational Loss * Situational Loss * Anticipatory Loss
54
stages of greif
denial, anger, bargaining, depression, acceptance
55
Types of Grief
* Dysfunctional grief * Unresolved grief * Inhibited grief
56
post mortem care
washing the body, accounting for the client’s possessions, removing invasive devices such as intravenous catheters and indwelling catheters, and placing identification tags in at least two areas - documenting the date and time of death, the name of anyone notified, location of belongings, and where the client's body is moved
57
Localization/Location of Pain
* Cutaneous pain * Somatic pain * Visceral pain * Referred pain
58
pain etiology
* Nociceptive pain * Neuropathic pain * Nociplastic pain
59
symptoms of death
- hallucinations and decreased consciousness, with hearing still intact - death rattle (fluid accumulation in lungs/trach) - mottling of extremities (lack of blood perfusion, causes patchy appearing cold limbs) - increase/decrease in temp - SOB - cheyne stokes - pain

NU 226 (4 decks)

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