NUR 240 electrolytes

Question 1

sodium

Answer 1

135-145

Question 2

potassium

Answer 2

3.5-5.0

Question 3

chloride

Answer 3

98-106

Question 4

calcium

Answer 4

9-11

Question 5

BUN

Answer 5

7-20

Question 6

Creatinine

Answer 6

0.6-1.2

Question 7

albumin

Answer 7

3.4-5.4

Question 8

magnesium

Answer 8

1.5-2.5

Question 9

Phosphorus

Answer 9

2.5-4.5

Question 10

pH

Answer 10

7.35-7.45

Question 11

PaCO2

Answer 11

35-45

Question 12

PaO2

Answer 12

80-100

Question 13

HCO3

Answer 13

22-26

Question 14

ROME

Answer 14

respiratory opposite, metabolic equal

Question 15

Furosemide (lasix) (loop diuretic) and hydrochlorothiazide (thiazide) have what effect on potassium?

Answer 15

potassium wasting diuretic

can lead to hypokalemia

Question 16

Spironolactone has what effect on potassium?

Answer 16

potassium sparing diuretic

used to increase the amount of fluid passed from the body in urine, whilst also preventing too much potassium being lost with it

(widely prescribed for hypertension)

Question 17

serous wound drainage

Answer 17

clear watery plasma

Question 18

sanguineous

Answer 18

bright red blood

Question 19

serosanguineous

Answer 19

pale, pink, watery; mixture of clear and red fluid

Question 20

purulent

Answer 20

thick yellowish green, foul odor

Question 21

types of hypertonic solution

Answer 21

5% saline
3% saline
5% dextrose in 0.9% saline (D5NS)
5% dextrose in 0.45% saline (D5 1/2 NS)
5% dextrose in LR (D5LR)
10% dextrose in water (D10W)

Question 22

use hypertonic solution for

Answer 22

cerebral edema
hyponatremia
maintenance fluid
hypovolemia

Question 23

what are hypErtonic solutions

“Enter the vessel from the cells”

Answer 23

more salt in the solution
less water in the solution
the vessels become more concentrated than the cells, water then leaves the cell, cell will shrink

Question 24

types of Isotonic solution

Answer 24

0.9% sodium chloride (NS)
5% dextrose in water (D5W)
Lactated ringers (LR)

Question 25

use isotonic solutions for

Answer 25

blood loss dehydration fluid maintenance

Question 26

normal saline is the ONLY solution that is compatible to use with

Answer 26

blood products

Question 27

what are isotonic solutions "stays where I put it"

Answer 27

same osmolality as body fluids (equal water and particle ratio)

Question 28

types of Hypotonic solutions

Answer 28

0.45% saline (1/2 NS) 0.33% saline (1/3 NS) 0.225 saline (1/4 NS) 5% dextrose in water (D5W)

Question 29

use hypotonic solutions for

Answer 29

diabetic ketoacidosis (DKA) helps kidneys excrete excess fluid hypernatremia hypervolemia

Question 30

what are hypOtonic solutions? "Out of the vessel, into the cell (cell swells)"

Answer 30

less salt more water the vessel becomes less concentrated the cell, water enters the cell, cells swell

Question 31

when patient is on hypotonic fluids monitor for

Answer 31

fluid volume overload

Question 32

NEVER use hypertonic fluids for

Answer 32

increased intracranial pressure, burns, or trauma

Question 33

Causes of Metabolic alkalosis

Answer 33

vomiting (vomiting sounds like- ALKKKK-alosis) NGT suction hypokalemia low K+= alKaLOWsis compensation: slow and shallow breaths

Question 34

Causes of metabolic acidosis

Answer 34

diarrhea- "if it comes out of your ASSidosis" renal failure - "when the kidneys fall, acid prevails" diabetic ketoACIDOSIS lactic acidoSiS - Shock- low perfusion - Sepsis- severe infection compensation: rapid deep respirations

Question 35

hypoventilation

Answer 35

low and slow breathing = higher CO2

Question 36

hyperventilation

Answer 36

fast breathing = lower CO2

Question 37

respiratory alkalosis (fast RR) causes

Answer 37

panic attack compensation: kidneys excrete less H+ and reabsorb less HCO3

Question 38

Respiratory acidosis causes (low and slow RR)

Answer 38

sleep apnea head trauma "knocked out" post-operative drugs (CNS depressants) - opioid overdose - alcohol intoxication - benzodiazepines (Diazepam) Pneumonia COPD or asthma attack compensation: kidneys excrete H+ (acid) and retain HCO3 (base)

Question 39

key manifestations of respiratory alkalosis

Answer 39

Key manifestations= low PaO2, Low HCO3

Question 40

key manifestations of respiratory acidosis

Answer 40

Key manifestations: mental status changes, high PaCO2, high HCO3

Question 41

the nurse expects which client to be in respiratory acidosis ? a. Morphine overdose b. panic attack c. sleep apnea d. COPD e. asthma attack f. alcohol intoxication

Answer 41

a. Morphine overdose c. sleep apnea d. COPD e. asthma attack f. alcohol intoxication

Question 42

how does the nurse expect the client to show compensation for the following ABG values? pH= 7.20 PaO2= 82 PaCO2= 37 HCO3= 15 a. decreased RR b. Increased RR c. increased renal retention of H+ d. decreased renal excretion of HCO3

Answer 42

this is metabolic acidosis patient will compensation with an increased respiratory rate (b)

Question 43

hyperkalemia s/s

Answer 43

MURDER Muscle cramps and weakness*** Urine abnormalities Respiratory distress Decreased cardiac contractility (decreased HR and BP) ECG changes - tall peaked waves, widened QRS complex) Reflexes (Increased DTR)

Question 44

Management of hyperkalemia

Answer 44

monitor ECG administer IV calcium glucante and IV sodium bicarb discontinue IV and PO potassium K restricted diet

Question 45

hypokalemia s/s

Answer 45

thready weak irregular pulse orthostatic hypotension shadow respirations anxiety

Question 46

management of hypokalemia

Answer 46

potassium sparing diuretic liquid potassium chloride

Question 47

administration route for potassium what do we never do

Answer 47

NEVER push potassium!!!!!!! no IV pus, IM, or subQ do: dilute iv potassium and administer with an infusion device

Question 48

hyponatremia s/s

Answer 48

seizures, nausea, lethargy

Question 49

hypernatremia s/s

Answer 49

changes in LOC, agitation, restlessness, edema

Question 50

hypophosphatemia s/s

Answer 50

changes in LOC, numbness, weakening of the bones

Question 51

hyperphosphatemia s/s

Answer 51

diarrhea, muscle weakness, decreased deep tendon reflex

Question 52

hypocalcemia s/s

Answer 52

tetany, positive trousseaus sign, positive chvosteks sign

Question 53

positive chvosteks sign

Question 54

positive trousseaus sign

Question 55

hypercalcemia s/s

Answer 55

bone pain, kidney stones, muscle weakness

Question 56

hypomagnesemia s/s

Answer 56

increased everything (BP, HR, RR, DTR)

Question 57

hypermagnesemia s/s

Answer 57

decreased everything aka SEDATED ((BP, HR, RR, DTR, energy)

Question 58

calcium and phosphorus relationship

Answer 58

inverse increase Ca+ = decrease PO4

Question 59

magnesium and calcium relationship

Answer 59

same increase in mag = increase in Ca+

Question 60

Potassium and sodium relationship

Answer 60

inverse increase K = decreased in Na

Question 61

osmosis

Answer 61

when solute moves from a HIGHER concentration to a LOWER concentration

Question 62

recommended amount of fluids per day

Answer 62

2,500 mL/day of fluid.

Question 63

over use of antacids can lead to

Answer 63

metabolic alkalosis

Question 64

primary extracellular electrolytes are

Answer 64

sodium, chloride and bicarb

Question 65

Which IV solutions would the nurse expect to be ordered for a client who has hypovolemia? Select all that apply.

Answer 65

0.9% NaCl (normal saline) Lactated Ringer’s solution 5% dextrose in 0.9% NaCl

Question 66

lab data indicating infection

Answer 66

elevated WBC count- norm is 5,000-10,000 increased lymphocytes and neutrophil levels increase eosinophils= allergic response or parasitic infection elevated ESR= inflammation is present