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Flashcards in Module 3 Deck (69):
1

Fluid volume deficit
(Causes)

Vomiting, diarrhea, GI auctioning, sweating, inadequate fluid intake, massive edema (as in initial stage of major burns), ascites (abdominal swelling)

2

Fluid volume deficit
(Symptoms)

Weight loss, decreased skin turgor, oliguria (concentrated urine), dry and sticky mucous membranes, postural hypotension or weak, rapid pulse.

3

Fluid volume deficit
(Laboratory findings)

Elevated BUN ; creatinine, increased serum osmolarity, elevated hemoglobin and hematocrit

4

Fluid volume deficit
(Treatment and nursing care)

Strict I and O, replacement of fluids isotonically (water is hypotonic)

5

Fluid volume overload
(Causes)

Heart failure, renal failure, cirrhosis, liver failure, excessive ingestion of table salt, over hydration with sodium-containing fluid, poorly controlled IV therapy.

6

Fluid volume overload
(Symptoms)

Peripheral edema, increase bounding pulse, elevated BP, distended neck veins and hand veins, dyspnea (moist crackles during auscultation), attention loss, confusion, aphasia, altered level of consciousness

7

Fluid volume overload
(Laboratory findings)

Decreased BUN, decreased hemoglobin and hematocrit, decreased serum osmolality, decreased urine osmolality and specific gravity.

8

Fluid volume overload
(Treatments and nursing care)

Diuretics, fluid restriction, strict I&O, sodium-restricted diet, weight daily, serum K+ monitored

9

Hyponatremia
(Decreased sodium)
Causes

diuretics, GI fluid loss, hypotonic tube feeding, D5W or hypotonic IV fluids, diaphoresis

10

Hyponatremia
(Decrease sodium)
Signs and symptoms

Anorexia, nausea, vomiting, weakness, lethargy, confusion, muscle cramps, twitching, seizures

Na <135 mEq/L

11

Hyponatremia
(Decreased sodium)
Treatment

Restrict fluids, isotonic saline

12

Hypernatremia
(Increased sodium)
Causes

Water deprivation, hypertonic tube feeding, diabetes insipidus, heatstroke, hyperventilation, watery diarrhea, renal failure, cushing syndrome

13

Hypernatremia is
(Increased sodium)
Signs and symptoms

Thirst, hyperpyrexia (Increased fever), sticky mucous membranes, dry mouth, hallucinations, lethargy, irritability, seizures

Na > 145 mEq/mL

14

Hypernatremia
(Increased sodium)
Treatment

Restrict sodium in diet, increase water intake

15

Hypokalemia
Decreased potassium
Causes

Diuretics, diarrhea, vomiting, gastric suctioning, steroid administration, bulimia, Cushing syndrome

16

Hypokalemia
Decrease potassium
Signs and symptoms

Fatigue, anorexia, nausea, vomiting, muscle weakness, decreased GI motility, dysrhythmias, paresthesia, flat T waves on ECG

K < 3.5 mEq/L

17

Hypokalemia
Decreased (potassium)
Treatments and nursing care

Administer potassium supplements, assess renal status, encourage foods high in potassium

18

High potassium foods

Bananas, oranges, cantaloupes, avocados, spinach, and potatoes

19

Hyperkalemia
Increased potassium
Causes

Oliguria, acidosis, renal failure, Addison disease, multiple blood transfusion

20

Hyperkalemia
Increased potassium
Signs and symptoms

Muscle weakness, bradycardia, dysrhythmias, flaccid paralysis, intestinal colic, Tall T waves on ECG

K > 5.0 mEq/L

21

Hyperkalemia
Increased potassium
Treatments and nursing care

Monitor ECG, admin calcium gluconate to protect heart, IV loop may be prescribed, renal dialysis

22

Hypocalcemia
Decreased calcium
Causes

Renal failure, hypoparathyroidism, malabsorption, pancreatitis, alkalosis

23

Hypocalcemia
Decreased calcium
Signs and symptoms

Diarrhea, numbness, tingling of extremities, convulsions, positive trousseau sign, positive sign


Ca < 8.5 mEq/L

24

Hypocalcemia
Decreased calcium
Treatments and nursing care

Admin calcium supplements, admin IV calcium slowly, increase calcium intake

25

Hypercalcemia
Increased calcium
Causes

Hyperparathyroidism, malignant bone disease, prolonged immobilization, excess calcium supplementation

26

Hypercalcemia
Increased calcium
Signs and symptoms

Muscle weakness, constipation, anorexia, nausea, vomiting, polyuria, polydipsia, neurosis, dysrhythmias

Ca > 10.5 mEq/L

27

Hypercalcemia
Increase calcium
Treatments and nursing care

Admin calcitonin, renal dialysis

28

Hypomagnesium
Decreased magnesium
Causes

Alcoholism, malabsorption, diabetic ketoacidosis, prolonged gastric suctioning, diuretics.

29

Hypomagnesium
Decreased magnesium
Signs and symptoms

Anorexia, distinction, neuromuscular irritability, depression, disorientation

Mg < 1.5 mEq/L

30

Hypomagnesium
Decreased magnesium
Treatments and nursing care

Administer MgSO4, encourage foods high in magnesium

31

Foods high in magnesium

Meats, nuts, legumes, fish, and vegetables

32

Hypermagnesium
Increased magnesium
Causes

Renal failure, adrenal insufficiency, excess replacement

33

Hypermagnesium
Increased magnesium
Signs and symptoms

Flushing, hypotension, drowsiness, lethargy, hypoactive reflexes, depressed respirations, bradycardia.

Mg > 2.5 mEq/L

34

Hypermagnesium
Increased magnesium
Treatments and nursing care

Restrict intake of magnesium

35

Hypophosphatemia
Decreased phosphorus
Causes

Refereeing after starvation, alcohol withdraw, diabetic ketoacidosis, respiratory alkalosis

36

Hypophosphatemia
Decreased phosphorus
Signs and symptoms

Paresthesias, muscle weakness, muscle pain, mental changes, cardiomyopathy, respiratory failure

pH <2.0 mEq/L

37

Hypophosphatemia
Decreased phosphate
Treatments and nursing care

Admin vitmian D

38

Hyperphosphatemia
Increased phosphorus
Causes

Renal failure, excessive intake

39

Hyperphosphatemia
Increased phosphorus
Signs and symptoms

pH > 4.5 mEq/L

40

Isotonic

Osmolality close to extra cellular fluid, do not cause red blood cells to swell or shrink, indicated for intravascular dehydration

Treats: dehydration caused by running, labor, fever

41

Isotonic solutions

Normal saline (0.9% NS), lactated ringer’s solution (LR), 5% dextrose in Water (D5W)

42

Hypotonic

Osmolality lower than extracellular fluid, causes fluid to move extracellularly to intracellularly, used in hypernatremia, or hyperglycemia.

43

Hypotonic solutions

0.5% normal saline (HNS or 0.45% NS), 2.5% dextrose in 0.45% saline (D25 45% NS)

44

Hypertonic

Osmolality higher than extracellular fluid

45

Hypertonic solutions

5% dextrose in lactated ringer’s (D5LR), 5% dextrose in 0.45% saline, 5% dextrose in 0.9% saline (D5NS), 10% dextrose in water (D10W)

46

Phlebitis

Vein inflammation

47

Infiltration

Solution leaks into the tissue surrounding the IV.

48

Chvostek

Contraction of facial muscles in response to a light tap over the facial nerve in front of the ear

49

Trousseau

A carpal spasm induced by inflating a blood pressure cuff above the systolic pressure for a few minutes

50

Chloride levels

96 - 106 mEq/L

51

Hypernatremia

Increased sodium

52

Potassium

Effects cardiac

53

Lasix

Inhibits the reabsorption of sodium and chloride, Increases renal excretion of water, sodium, chloride, magnesium, potassium, and calcium

54

spironolactone

Causes loss of sodium bicarbonate and calcium while saving potassium and hydrogen ion

55

Decrease hydrogen

Alkalosis

56

Increase hydrogen

Acidosis

57

Hypoventilation

Respiratory acidosis, hypoxia, rapid/shallow respirations, decrease blood pressure with vasodilation, dyspnea, headache, dysrhythmias because of increased potassium, drowsiness, dizziness, disorientation, muscle weakness

58

Hyperventilation

Metabolic acidosis, headache, decreased BP, warm flushed skin, nausea, vomiting, diarrhea, changes in LOC, kussmal respirations

59

Respiratory alkalosis

Seizures, deep/rapid breathing, hyperventilation, tachycardia, decreased or normal BP, numbness and tingling in extremities, lethargy, confusion, light headedness, nausea vomiting

60

Metabolic alkalosis

Restlessness followed by lethargy, dysrhythmias, compensatory hypoventilation, confusion, nausea, vomiting, diarrhea, tremors, muscle cramps

61

ROME

Respiratory - opposite
Metabolic - equal

62

Normal pH

7.35 - 7.45

63

Lower pH

Acidotic

64

Higher pH

Alkalosis

65

PaCO2

35 to 45

66

Normal HCO3

22 to 28

67

Fully compensated

pH is normal

68

Uncompensated

CO2 or HCO3 normal

69

Partially compensated

Nothing is normal