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Flashcards in Med Surg I Exam 1 Deck (140):
1

Fluid Volume

PLASMA/ INTERSTITIAL/ INTRACELLULAR

PLASMA: 3.5-5.0 L
INTERSTITIAL: 10L
INTRACELLULAR: 25-30L

2

Osmolarity

PLASMA/ INTERSTITIAL/ INTRACELLULAR

PLASMA: 270-300 mOsm
INTERSTITIAL: 270-300 mOsm
INTRACELLULAR: 270-300 mOsm

3

Sodium

PLASMA/ INTERSTITIAL/ INTRACELLULAR

PLASMA: 135-145 mEq/L
INTERSTITIAL: 135-145 mEq/L
INTRACELLULAR: 14 mEq/L

4

Potassium

PLASMA/ INTERSTITIAL/ INTRACELLULAR

PLASMA: 3.5-5.0 mEq/L
INTERSTITIAL: 3.5-5.0 mEq/L
INTRACELLULAR: 140 mEq/L

5

Chloride

PLASMA/ INTERSTITIAL/ INTRACELLULAR

PLASMA: 98-106 mEq/L
INTERSTITIAL: 118 mEq/L
INTRACELLULAR: 4-6 mEq/L

6

Calcium

PLASMA/ INTERSTITIAL/ INTRACELLULAR

PLASMA: 9.0-10.5 mg/dL
INTERSTITIAL: 7-9 mg/dL
INTRACELLULAR: 1-8 mg/dL

7

Magnesium

PLASMA/ INTERSTITIAL/ INTRACELLULAR

PLASMA: 1.3-2.1 mEq/L
INTERSTITIAL: 1.3 mEq/L
INTRACELLULAR: 6-30 mEq/L

8

Protein

PLASMA/ INTERSTITIAL/ INTRACELLULAR

PLASMA: 7-8 g/L
INTERSTITIAL: 2g/L
INTRACELLULAR: 16 g/L

9

QSEN (quality and safety education for nurses)

Validated Institute of Medicine (IOM) competencies for nursing practice and added safety as a separate competency to emphasize its importance

10

Approximated

state of a wound being together

11

Serous Drainage

Clear/ yellowish

12

Serosanguineous Drainage

Water/ blood

13

Sanguineous

Blood

14

Purulent

Pus

15

Best indicator of intestinal activity

flatus

16

Prevention of complications post-op of atelectsis (lung collapse) and pneumonia

deep breathing, cough, incentive spirometry, walking

17

Prevention of complications post-op of hypo- or hyper-volemia

careful monitoring of vitals, I&O, labs, IV fluids

18

Prevention of complications post-op of deep vein thrombosis (DVT)

Walking, SCD (sequential compression device), leg exercises, medications

19

Prevention of complications post op of paralytic ileus

Walking, medications

20

Prevention of complications post op of urinary retention

Monitor I&O, up and to the Bathroom if at all possible

21

Wound dehiscence

A surgical complication in which a wound ruptures along surgical suture.

22

Wound evisceration

Inside tissues/organs protruding through wound (from inside to outside) (internal organs, especially those in the abdominal cavity).

23

The Joint Commission (TJC)

Peer eval. q 3 yrs
Requires health care create culture of safety
NPSGs (national patient safety goals)

24

Estimates for health care errors per year by the (institute for Healthcare Improvement (IHI)

15 million/ year
40,000/ day

25

KSAs

Knowledge, skills, attitudes
SPEAKUP

26

SBAR

Formal communication between health care team
.....Situation
.....Background
.....Assessment
.....Recommendation

27

5 Rights of delegation

Right task...................drug
Right circumstances....time
Right person...............person
Right communication...medication
Right supervision.........route

28

KSAs: Informatics

Emphasis on documentation (Knowledge, skills, attitudes)

29

EHR: Informatics

electronic health record

30

EPR: Informatics

electronic patient record

31

EMR: Informatics

electronic medical record

32

RFID: Informatics

radio frequency identification

33

How much of your body is water?

55-60% body weight children
50-55% body weight healthy older adults
ECF 1/3 body (20% body wt: 15L)
ISF 2/3 body (40% body wt: 25L)

34

Right-sided heart failure

Ventricle too weak
Blood backs up into venous system
Venous hydro pressure rises
Reverse filtration

35

Colloid Osmotic pressure

Proteins increase pressure
.....keeps fluid in cells
.....pulls fluid into cells

36

Body compensates for fluid losses/ gains

by controlling urine retention/ excretion

37

Intracellular ions

phosphorus/ potassium

38

Extracellular ions

Sodium/ chloride

39

If sodium ions stay,

another ion has to go (potassium)

40

Aldosterone

secreted by adrenal cortex when ECF sodium decreases (prevents water/ sodium loss)

41

Antidiuretic hormone (ADH)

Vassopressin, produced in the brian/ stored in posterior pituitary gland
Hypothalamus release control; act on kidney tubules; permeable water reabsorption

42

Natriuretic peptides (NPs)

1. opposes aldosterone
2. secreted in response to increased blood volume/ pressure: stretch in heart tissue
3. inhibited reabsorption Na/ glomerular filtration increased

43

P

3.0-4.5 mg/dl

44

Renin-angiotensin pathway

Blood V monitored by kidney Bp/bv/o2/osmolarity-kidney secrete renin-angiotensinogen conv to angiotensin I-ACE conv to angiotensinogen II

Vasoconstriction

45

Creatinine

Waste and by-products of protein metabolism: kidney

46

BUN

blood urea nitrogen protein breakdown metabolite
kidney or liver

47

RRT (Rapid Response Team)

provide care to patients BEFORE a respiratory or cardiac arrest occurs, intervenes rapidly when needed for pt's who are beginning to decline....does not replace the Code Team who responds to pt arrests

48

3 types of dehydration

Hypotonic
Hypertonic
Isotonic (most common type/ only from the ECF)

49

Renin-angiotensin II pathway is stimulated...

pt is in shock or highly stressed/dehydration (SNS)
Process can be disrupted: ACE inhibitors/ ARBs (angiotensin receptor blockers)

50

What is Na most important use?

cognitive muscle nerve conduction

51

What is K most important use?

cardiac function ( all body functions are affected)

52

What is Ca most important use?

nerve conduction (Parathyroid)

53

How often should you monitor the cardiac and pulmonary status of pt's with dehydration and are receiving IV fluid replacement therapy?

Every hour

54

How often should oral care be performed for pt's with dehydration?

Every 4 hours

55

How often should nurse asses the IV site for a pt receiving IV solution containing K?

Every hour

56

Where should you assess skin turgor on an older pt?

forehead or sternum

57

What can nurse use to determine fluid gains or losses?

daily weights

58

What should nurse assess to be able to evaluate the pt's response to therapy for an electrolyte imbalance?

bowel sounds, heart rate, rhythm, and quality; and muscle strength

59

What is most common invasive therapy administered to hospitalized pt's?

IV therapy

60

phlebitis

the inflammation of a vein caused by mechanical, chemical, or bacterial irritation

61

infiltration

occurs when IV solution leaks into the tissues around the vein

62

nursing diagnoses associated with fluid volume deficit

deficient fluid volume, risk for deficient fluid volume, excess fluid volume, risk for imbalanced fluid volume

63

nursing diagnoses associated with a pt undergoing a bronchoscopy

risk for aspiration (risk factor: temporary loss of gag reflex)
risk for injury (risk factors: complication of pneumothorax and laryngeal edema, hemorrhage)

64

orthopnea

SOB that occurs when lying down but is relieved by sitting up

65

COPD (Chronic Obstructive Pulmonary Disease)

emphysema and chronic bronchitis, characterized by bronchospasm and dyspnea. "Not reversible" and increases in severity over time, eventually leading to respiratory failure

66

Asthma

chronic disease with intermittent "reversible" airflow obstruction and wheezing

67

Characteristics of Bronchial Breath Sounds

Pitch: High
Amplitude: Loud
Duration: InspirationQuality: Harsh, hollow, tubular, blowing
Normal Location: Trachea and larynx

68

Characteristics of Bronchovesicular Breath Sounds

Pitch: Moderate
Amplitude: Moderate
Duration Inspiration=Expiration
Quality: Mixed
Normal location: Over major bronchi where fewer alveoli are located posterior, between scapulae (especially on the right); anterior, around upper sternum in first and second intercostal space.

69

Characteristics of Vesicular Breath Sounds

Pitch: Low
Amplitude: Soft
Duration: Inspiration>Expiration
Quality: Rustling, like the sound of the wind in the trees.
Normal Location: Over peripheral lung fields where air flows through smaller bronchioles and alveoli.

70

Classification of Class I Dyspnea

No significant restrictions in normal activity. Employable, Dyspnea occurs only on more-than-normal or strenuous exertion.

71

Classification of Class II Dyspnea

Independent in essential ADLs but restricted in some other activites. Dyspneic on climbing stairs or on walking on an incline but not on level walking. Employable only for sedentary job or under special circumstances.

72

Classification of Class III Dyspnea

Dyspnea commonly occurs during usual activities, such as showering or dressing, but the patient can manage without assistance from others. Not dyspneic at rest; can walk for more than a city block at own pace but cannot keep up with others of own age. May stop to catch breath partway up a flight of stairs. Is probably not employable in any occupation.

73

Classification of Class IV Dyspnea

Some dependence needed with essential ADLs such as dressing and bathing. Not usually dyspneic at rest. Usually restricted to home. Dyspneic on minimal exertion. Minimal or no activities outside of home.

74

Classification of Class V Dyspnea

Struggles with breathing all the time. Dependent on help for most needs.

75

Discontinuous Adventitious Sounds

Fine crackles, Fine rales, High-pitched rales (all happen either early or late inspiration).
Coarse crackles, Low-pitched crackles (more common on expiration but may be present during early inspiration).

Associated with Asbestosis, Atelectasis, Interstitial fibrosis, Bronchitis, Pneumonia, Chronic Pulmonary Diseases, Tumors, Pulmonary Edema.

76

Continuous Adventitious Sounds

Wheeze (audible during either inspiration, expiration or both).
Rhonchus (Audible during both inspiration and expiration louder during expiration).

Associated with Inflammation, Bronchospasm, Edema, Secretions, Pulmonary vessel engorgement (as in cardiac "asthma", Thick tenacious secretions, Sputum production, Obstruction by foreign body, Tumors.

77

Pleural Friction Rub Adventitious sounds

Heard during both inspiration and expiration generally at the end of inspiration and the beginning of expiration.

Associated with Pleurisy, Tuberculosis, Pulmonary infarction, Pneumonia, Lung Cancer.

78

Impact of Age-Related Changes on Fluid Balance

Skin

Change: Loss of elasticity, Decreased turgor, Decreased oil production

Result: Skin becomes an unreliable indicator of fluid status, especially the back of the hand. Dry, easily damaged skin.

79

Impact of Age-Related Changes on Fluid Balance

Kidney

Change: Decreased glomerular filtration, Decreased concentrating capacity.

Result: Poor excretion of waste products. Increased water loss, increasing the risk for dehydration.

80

Impact of Age-Related Changes on Fluid Balance

Muscular

Change: Decreased muscle mass.

Result: Decreased total body water. Greater risk for dehydration.

81

Impact of Age-Related Changes on Fluid Balance

Neurologic

Change: Diminished thirst reflex

Result: Decreased fluid intake, increasing the risk for dehydration.

82

Impact of Age-Related Changes on Fluid Balance

Endocrine

Change: Adrenal atrophy

Result: Poor regulation of sodium and potassium, predisposing the patient to hyponatremia and hyperkalemia.

83

Important aspects to assess in Respiratory System History

Smoking history
Childhood illnesses (asthma, pneumonia, Communicable disease, Hay fever, Allergies, Eczema, Croup, Cystic fibrosis).
Adult illnesses ( Pneumonia, Sinusitis, TB, HIV and AIDS, Diabetes, Hypertension, Heart disease, Influenza, Surgeries of upper or lower resp. system, Recent weight loss, night sweats, Geographic regions of recent travel, Occupation and leisure activities.

84

Characteristics and Purpose of FVC test (Forced vital capacity)

It records the maximum amount of air that can be exhaled as quickly as possible after maximum inspiration.

Purpose: Gives and indication of respiratory muscle strength and ventilatory reserve. FVC is often reduced in obstructive disease (because of air trapping) and in restrictive disease.

85

Characteristics and Purpose of FEV1 test ( Forced expiratory volume in 1 second).

Records the maximum amount of air that can be exhaled in the first second of expiration.

Purpose: FEV1 is effort dependent and declines normally with age. It is reduced in certain obstructive and restrictive disorders.

86

Characteristics and Purpose of FEV1/FVC test

Is the ratio of expiratory volume in 1 sec to FVC.

Purpose: This ratio provides a much more sensitive indication of obstruction to airflow. This ratio is the hallmark of obstructive pulmonary disease. It is normal or increased in restrictive disease.

87

Characteristics and Purpose of FEF 25%-75% test

Records the forced expiratory flow over the 25%-75% volume (middle half) of the FVC.

Purpose: This measure provides a more sensitive index of obstruction in the smaller airways.

88

Characteristics and Purpose of FRC (functional residual capacity) test

Is the amount of air remaining in the lungs after normal exiration. FRC test requires use of the helium dilution, nitrogen washout, or body plethysmography technique.

Purpose: Increased FRC indicates hyperinflation or air trapping, which may result from obstructive pulmonary disease. FRC is normal or decreased in restrictive pulmonary diseases.

89

Characteristics and Purpose of TLC (Total lung capacity) test

is the amount of air in the lungs at the end of maximum inhalation.

Purpose: Increased TLC indicates air trapping associated with obstructive pulmonary disease. Decreased TLC indicates restrictive disease.

90

Characteristics and Purpose of RV (residual volume) test

Is the amount of air remaining in the lungs at the end of a full, forced exhalation.

Purpose: Is increased in obstructive pulmonary disease such as emphysema.

91

Characteristics and Purpose of DlCO (diffusion capacity of the lung for carbon monoxide) test

reflects the surface area of the alveolocapillary membrane. The patient inhales a small amount of CO, holds for 10 sec, and then exhales. The amount inhaled is compared with the amount exhaled.

Purpose: DlCO is reduced whenever the alveolocapillary membrane is diminished, such as occurs in emphysema, pulmonary hypertension, and pulmonary fibrosis. It is increased with exercise and in conditions such as polycythemia and congestive heart disease.

92

Nursing intervention/Rationale for Nasal Cannula

Amount of O2 is 24% for 1L/min. increases 4% each L/min up to 6L/min = 44%.

Ensure that prongs are in the nares properly. A poorly fitting nasal cannula leads to hypoxemia and skin break down.

Apply water-soluble jelly to nares PRN. This prevents mucosal irritation related to the drying effect of oxygen; promotes comfort.

Assess the patency of the nostrils. Congestion or a deviated septum prevents effective delivery of oxygen through the nares.

Assess the pt for changes in respiratory rate and depth. The respiratory pattern affects the amount of O2 delivered. A different delivery system may be needed.

93

Nursing intervention/Rationale for Simple Facemask

40%-5L/min, 45%-50%-6L/min, 55%-60%-8L/min.

Be sure mask fits securely over nose and mouth. A poorly fitting mask reduces the FiO2 (Fraction of inspired oxygen) delivered.

Assess skin and provide skin care to the area covered by the mask. Pressure and moisture under the mask may cause skin breakdown.

Monitor the pt closely for risk for aspiration. Mask limits the pt's ability to clear the mouth, especially if vomiting occurs.

Provide emotional support to the pt who feels claustrophobic. Emotional support decreases anxiety, which contributes to a claustrophobic feeling.

Suggest to the healthcare provider to switch the pt from a mask to the nasal cannula during eating. Use of the cannula prevents hypoxemia during eating.

94

Nursing intervention/Rationale for Partial Rebreather Mask

60-75% at 6-11L/min, a L flow rate high enough to maintain reservoir bag 2/3 full during inspiration and expiration.

Make sure that the reservoir does not twist or kink, which results in a deflated bag. Deflation results in decreased O2 delivered and rebreathing of exhaled air.

Adjust the flow rate to keep the reservoir bag inflated. The flow rate is adjusted to meet the pattern of the pt.

95

Nursing intervention/Rationale for Non-Rebreather Mask

80-95% FiO2 at a liter flow high enough to maintain reservoir bag 2/3 full.

Interventions as for partial rebreather mask; this pt requires close monitoring. Monitoring ensures proper functioning and prevents harm.

Make sure that valves and rubber flaps are patent, functional, and not stuck. Remove mucus or saliva. Valves should open during expiration and close during inhalation to prevent dramatic decrease in FiO2. Suffocation can occur if the reservoir bag kinks or if the o2 source disconnects.

Closely assess the pt on increased FiO2 via non-rebreather mask. Intubation is the only way to provide more precise FiO2. The patient may require intubation.

96

Warning signals associated with Lung Cancer

Hoarseness, Change in resp. pattern, Persistent cough, Blood streaked-sputnum, Rust-colored or purulent sputum, Frank hemoptysis, chest pain or tightness, Soulder, arm, or chest wall pain, Recurring pleural effusion, pneumonia, bronchitis, Dyspena, Fever associated with one or two other signs, Wheezing, Weight loss, Clubbing of fingers.

97

Staging of Cancer- TNM Classification
TABLE 23-6

Primary Tumor (T)
Tx Primary tumor cannot be assessed
T0 No evidence of primary tumor
Tis Carcinoma in situ
T1, T2, T3, T4 Increasing size and/or local extent of the primary tumor.

Regional Lymph Nodes (N)
Nx Regional lymph nodes cannot be assessed
N0 No regional lymph node metastasis
N1, N2, N3 Increasing involvement of regional lymph nodes

Distant Metastasis (M)
Mx Presence of distant metastasis cannot be assessed
M0 No distant metastasis
M1 Distant mestastasis

98

Nursing Intervention/ Rationale Venturi Mask (Venti Mask)

24-50% FiO2 with flow rates usually 4-10L/min; provides high humidity.

Perform constant surveillance to ensure an accurate flow rate for the specific FiO2. An accurate flow rate ensures FiO2 delivery.

Keep the orifice for the Venturi adaptor open and uncovered. If the Venturi orifice is covered, the adaptor does not function and oxygen delivery varies.

Provide a mask that fits snugly and tubing that is free of kinks. FiO2 is altered if kinking occurs or the mask fits poorly.

Assess the pt for dry mucous membranes. Comfort measures may be indicated.

Change to a nasal cannula during mealtime. O2 is a drug that needs to be given continuously.

99

causes of Chloride imbalances

excessive vomiting, prolonged gastric suctioning

100

Hyponatremia-Causes

<136
GI Causes: vomiting diarrhea
GI Suction
profound sweating
excess water intake (water intoxication)
Low sodium diet
Congestive Heart Failure (dilutes Na+)

101

Hyponatremia S/S

lethargy
muscle cramps
Heart Attack
Decreased LOC-level of consciousness

102

Hypernatremia-S/S

weak irregular pulse
arrhythmia-common cause of death
LOC-from nervous system conduction problems
Muscle weakness (bowel function too)
digoxin effect- K+ defiency enhances dig action
decr K+ makes digoxin more efficient

103

how is chloride used in the body

the major anion of the extracellular fluid (ECF) and works with sodium to maintain ECF osmotic pressure. important in formation of hydrochloric acid in stomach

104

Causes of Hyperkalemia.

Inadequate renal function (normal kidney doesn't allow excess serum K)

K supplements with diuretic therapy

Tissue injury/strenuous exercise-release K from cells

Acidosis- K rises in acidosis so body can excrete H ions.

Cell destruction- burns, tramatic injury, tumor lysis syndrome,tissue catabolism (fever, sepsis).

Hypoaldsteronism and hemolysis

105

Signs and Symptoms of Hyperkalemia

bradycardia,
hypotension,
increased intestinal motility (diarrhea)
respiratory distress
ECG changes
hyperreflexia or areflexia (flaccid)

106

Hypernatremia-S/S

weak irregular pulse
arrhythmia-common cause of death
LOC-from nervous system conduction problems
Muscle weakness (bowel function too)
digoxin effect- K+ defiency enhances dig action
decr K+ makes digoxin more efficient

107

causes of hypomagnesemia

malnutrition, diarrhea, Celiac or Crohn's disease, ethenol ingestion, some drugs (diuretics, some antibiotics, cisplatin)

108

causes of hypermagnesemia

increased mg intake (antacids and laxatives), decreased kidney excretion of mg due to kidney disease

109

causes of hypermagnesemia

increased mg intake (antacids and laxatives), decreased kidney excretion of mg due to kidney disease

110

Hypophosphatemia-Causes

<3.0
decreased absorption of phosphorus
Increased excretion of phosphorus
Intracellular phosphorus shift

111

Hypophosphatemia-S/S

when deficiency is prolonged/severe
related to decreased amounts of ATP (adenosine triphosphate)
decreased energy metabolism
other electrolyte imbalances
elevated Ca+ levels

112

Hypophosphatemia- Manifestations

Cardiac: decr.-stroke volume, cardiac output, peripheral pulse
weak/ineffective contractions
Musculoskeletal: Acute: generalized weakness-skeletal muscles -->muscle breakdown-->respiratory muscles-->respiratory failure
Chronic: most evident in skeletal-->decr in bone density
CNS: noted with severe hypophosphatemia-->irritability-->seizures-->coma

113

Hyperphosphatemia -Causes

>4.5
kidney disease
cancer tx
incr phosphorus intake
hypoparathyroidism

114

hyperphosphatemia-S/S

center on hypercalcemia-incr. membrane excitability

115

Breathing in is?

Active
You need your respiratory muscles to contract
negative pressure occurs

116

Breathing out is?

Passive
Muscles relax
positive pressure occurs

117

S&S of hypomagnesemia

seen in neuromuscular, central nervous, and intestinal systems. hyperactive, deep tendon reflexes, numbness, tingling, psychological depression, psychosis, confusion, constipation, anorexia, nausea, abdominal distention

118

Causes of Hypokalemia

Excessive use of Diuretics, Digitalis
Alkalosis
GI loss: prolonged vomiting, diarrhea, laxative abuse or nasal gastric suctioning (bile and GI secretions are rich in K)
Too much insulin
Steroids promote K excretion and Na retention (aldosterone, Cortisol)
Hyperaldosteronism (save Na to preserve fluid)

119

Signs and Symptoms of Hypokalemia

Weak irregular pulse
Arrhythmia
LOC- from nervous system conduction problems
Muscle weakness (bowel function too)
"Digoxin effect"- K deficiency enhances dig action-toxicity.

120

S&S of hypermagnesemia

stronger than normal stimulus required to elicit a response, Cardiac slows down, bradycardia, peripheral vasodilation, hypotension. drowsy, lethargic, coma

121

Hypocalcemia: total serum Ca levels below 9mg/dL

SIGNS AND SYMPTOMS

1. Painful muscle spasms
2. Neuromuscular changes
...........tingling, numbness (paresthesias)
...........Trousseau's sign/ Chvostek's sign
3. Cardio changes
..........heart rate faster/ slower: thready weak pulse
..........hypotension/ prolonged ST/ QT intervals
4. Intestinal changes
..........increased peristalsis
..........painful abdominal cramping
5. Skeletal changes
..........osteoporosis/ weak bones/ easy fractures
..........decreased height/ collapsing vertebrae

122

Hypocalcemia: total serum Ca levels below 9mg/dL
CAUSES

1. Inadequate oral intake Ca/ vitamin D
2. Kidney complications
3. Diarrhea
4. Malabsorption
5. Wound drainage
6. Hyperproteinemia
7. Alkalosis/ citrate/ mithramycin/ penicillamine
8. Immobility/ parathyroid destruction

123

Hypercalcemia: total serum Ca levels above 10.5mg/dL

SIGNS AND SYMPTOMS

1. Cardio changes
..........increased heart rate/ blood pressure
..........dysrhythmias
2. Neuromuscular changes
..........muscle weakness
..........confusion/ lethargy/ coma
3. Intestinal changes
..........decreased peristalsis
...........const., anorexia, nausea, vomiting, pain

124

Hypercalcemia

CAUSES

1. Excessive oral intake of calcium
2. Excessive oral intake of vitamin D
3. Kidney failure
4. Use of thiazide diuretics
5. Hyperparathyroidism
6. Malignancy
7. Hyperthyroidism
8. Immobility
9. Dehydration

125

SIADH (syndrome of inappropriate antidiuretic hormone): 2 drug options

conivaptan (Vaprisnol)
tolvaptan (Samsca)
Can be used to alleviate hyponatremia due to fluid excess.

126

Hypervolemia: drug therapy

Furosemide: high ceiling loop diuretic

127

Hyponatremia caused by inappropriate secretion of ADH: 2 ADH antagonizers

Lithium
demeclocycline (Declomycin)

128

Drug therapy for hyponatremia and dehydration

Hypotonic IV solution 0.225% sodium chloride
Furosemide and bumetadine (Bumex): when caused by poor Na secretion by kidney

129

Diuretics pull

Potassium

130

Steroids aldosterone and cortisol influence what ions?

K excretion/ Na retention

131

Insulin does what for potassium?

Aids transport into cell/ binds to decrease serum level

132

What influence does higher K levels have on digoxin?

Makes digoxin increases more efficient

133

Potassium sparing diuretics

spironolactone (Aldactone, Novospiroton)
triamterene (Dyrenium)
amiloride (Midamor)

134

Calcium and phosphorus have what type relationship?

Inverse

135

Parathyroid controls blood calcium levels by activating:

Osteoblasts and osteoclasts

136

Diuretics enhancing calcium excretion

furosemide (Lasix, Furoside

137

Calcium chealators (binders)

plicamycin (Mithracin)
penicillamine (Cuprimine, Pendramine)

138

Prevent calcium resorption from bone

Phosphorus, calcitonin (Calcimar), biphosphonates (etidronate), prostaglandin synthesis inhibitors (aspirin, NSAIDs)

139

What is most often exchanged with chloride?

Bicarbonate HCO3

140

SMART

..specific
..measurable
..attainable
..realistic
..timed