``` Normal: 7.35 – 7.45 7.45 = Alkalosis Affects the brain Kidneys & Lungs control pH Lungs with CO2 = fast Kidneys with H+, HCO3 =slow ```

module 1 Flashcards by olivia mcnamara

FVE hypervolemia

too much fluid in the vascular space 
causes: 
HF
RF
Too much sodium

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hormonal regulation of fluid volume aldosterone

made in the adrenal glands and retains sodium and water which increases fluid volume. mineralsteriods

Too much aldosterone
CONN syndrome -hyperaldosteronism
Cushings

Not enough aldosterone
Addisons disease

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hormonal regulation of fluid volume ADH

retains water
anti-diuretic hormone

too much ADH
FVE
SIADH
*ADH- think health problems

too little ADH
FVD
DI
*think shock

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vasopressin

desmopression

ADH replacement
causes fluid retention
used for DI, enuresis

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FVE s/s

distended neck veins 
edema 
VS changes: increase CVP, increase BP 
polyuria 
lung sounds wet

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FVE tx

diuretic- hydrochlorothiasize, K sparing
decrease NA
bed rest
IV slowly to elderly pt

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fluid retention

think heart first

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FVD = hypovolemia

causes: loss of fluid from anywhere such as vomiting, diarrhea, bleeding
polyuria
third space- burns, ascites

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FVD s/s

weight loss, decrease skin turgor, dry membranes
decreased uo
VS: D BP, I PULSE, I RR, D CVP
Urine specific gravity: increase

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FVD tx

prevent further loss
replace fluids: mild deficit= oral; severe deficit= IV
monitor for overload
fall precautions

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IV fluids isotonic

goes in and stays
D5W, 0.9 NS, LR, 55 1/4 NS
FOR: fluid loss when they dont have HTN, kidney or heart problems
NOT FOR: HTN, cardiac or kidney problems because it can cause hypernatremia, FVE, HTN

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IV hypotonic

goes into the vascular space then moves OUT to rehydrate
D2.5W, 1/2 NS, 0.33 NS
FOR: clients with HTN, cardiac or kidney problems but need fluid replacement. immunocompromised patient
Will dilute in hypernatremia; good for dehydrated pt
Watch for cellular edema, FVD, Decrease BP

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Normal: 7.35 – 7.45 
< 7.35 = Acidosis
> 7.45 = Alkalosis
Affects the brain 
Kidneys &amp; Lungs control pH 
Lungs with CO2 = fast 
Kidneys  with H+, HCO3 =slow

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burns home safety

Hot h2o heaters
table clothes
ovens attached to walls
cooking pots
electrical socket

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burn patho

tissue damage - plasma seeps (3rd spacing) - FVD/shock - increase pulse - decrease UO - epi and aldosterone compensate

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too much ADH

retain water 
FVE
SIADH
worried about HF
UO = concentrated
blood= dilute

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not enough ADH

losing water - SHOCK 
FVD 
DI 
UO = diluted
blood = concentrated

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concentrated makes the numbers go

urine specific gravy, sodium, and hematocrit

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problems with ADH think

head injury

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basic solution given with blood

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IV hypertonic

enters the vessels and expands the vascular space
D10W, 3% NS, 5% NS, D5LR, TPN, ALBUMIN
FOR: hyponatremia, severe edema, burns, or ascites
watch: FVE, BP, PULSE

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hypermagnesium

causes:
renal failure 
anatacids 
s/s: warm, flushing 
tx: calcium gluconate, dialysis

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hypercalcemia

causes:
too much PTH 
thiazides (retain ca) 
immobilizations 
s/s: brittle bones, kidney stones 
tx: MOVE, fluids, add phos to diet,

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s/s hyper magnesium and calcemia

D DTR
weak muscle tone
arrhythmia YES
D LOC 
D pulse
D RR

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hypomagnesium

causes: diarrhea, alcohol Tx: Mg, check kidney function, seizure precautions

hypocalcemia

caues: not enough PTH; decreases serum Ca Tx: calcium, vitamin D, phosphate binders, IV Ca give slowly since it slows HR and widen QRS

S/S HYPO mag and cal

``` rigid/tight muscle tone seizures +chvosteks or +trousseaus DTR I muscle problems ```

hypernatremia = dehydration

too much sodium and not enough water causes: hyperventilation, heat stroke, DI S/S: dry mouth, thirst, swollen tongue, neuro changes Tx: no Na, dilute client with fluids, I/O, daily weight, hypotonic solutions

sodium problems think

neuro changes

hyponatremia

too much water not enough sodium causes: drinking too much water, SIADH S/S: headache, seizure, coma Tx: Na, restrict water, hypertonic solution

problems with K

arrhythmias

sodium has an inverse relationship with

potassium

where do you want to give potassium

if possible, in the largest site because it burns and hurts the vessels

respiratory acidosis

too much CO2 hypoventilating; slow breathing so retaining co2 tx: give o2, fix the breathing problem

respiratory alk

too little co2 hyperventilation tx: possible sedation, monitor abgs

metabolic acidosis = hyperkalemia

RR will increase causes: DKA, starvation, renal failure kussmaul rr, hyperkalemia

metabolic alk=hypokalemia

too much base | replace with K

RULE OF 9

``` head and neck - 9 front trunk- 18 back trunk - 18 each arm - 9 each leg - 18 genitals - 1 ```

carbon monoxide

hemoglobin binds with o2 carbon monoxide is a lot faster than o2 and will bind with hemoglobin first, client is hypoxic and needs o2 pulse ox is not a good indicator

fluid replacement for burns

crystalloids and colloids (LR and albumin) are used for fluid replacement

what does albumin do

holds onto fluid in the vascular space | alert: cause stress the heart too much so we wanna check CVP to ensure the infusion is not overloading the client

what 2 things in diet will help with burns and promote healing

protein and vitamin c

Eschar

is dead tissue that has to be removed so that new tissue can form. if its not no new tissue will form and can put the client at risk for infections

chemical burns

flush w water or sterile saline for 15-30 mins

electrical burns

put them on a cardiac monitor monitor for v fib can cause neurological deficits

top 5 high alert meds

``` insulin opiates and narcotics potassium chloride or phosphate concentrate IV anticoagulants- heparin sodium chloride solutions about 0.9% ```

FVD

numbers are HIGH sodium, hematocrit, and urine SG because you are dehydrated and this concentrates these numbers

FVE and diseases

cushings, CONN, heart failure, renal failure, SIADH

FVD and diseases

DI, diabetes, addisons, burns, ascites, shock

formula for fluid replacement

2-4 mL of LR X body weight in kg X % of TBSA burned= total fluid requirement for the first 24 hours 1st 8 hours= 1/2 total volume 2nd 8=1/4 total volume 3rd 8 = 1/4 total volume

immunizations for burns

tetanus toxoid: active immunity | immune globulin: passive immunity with provides immediate protection

compare and contrast isotonic and hypertonic solutions

iso- increases fluids in vascular space hyper- pulls fluids from the tissues BOTH increase BP/CO

COMPLICATIONS of burns

muscle damage myoglobin clogs renal tubules renal failure SO give fluids and diuretic so they get rid of all this, mannitol

loop diuretic

pulls fluid from the blood

osmotic diuretic

pulls fluid from intracellular compartments

hydrotherapy

worried about cross contamination and infection so patient needs pain meds and antibiotics

specific indicator of renal function

creatinine

abdominal surgeries

worry about acidosis

when a patient has reduced blood flow

the body cant get rid of alkaline

diarrhea and vomiting

losing acid in the body so becoming alkalosis

module 1 Flashcards

(60 cards)