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Quiz 5 Flashcards

1
Q

What is a normal lab value of sodium?

A

136-145 mEq/L

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2
Q

What is a normal lab value for potassium?

A

3.5-5 mEq/L

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3
Q

What is a normal lab value for calcium?

A

9-10.5 mg/dL

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4
Q

What is the normal lab value for ionized calcium?

A

4.5-5.6 mg/dL

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5
Q

What is the normal lab value for magnesium?

A

1.3-2.1 mEq/L

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6
Q

What is the normal lab value of chloride?

A

98-106 mEq/L

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7
Q

What is the normal lab value of phosphate?

A

3-4.5 mg/dL

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8
Q

Define fluid volume deficit

A

dry
dehydration
deficit of fluid (hypovolemia)

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9
Q

What can cause fluid volume deficit?

A

vomiting
diarrhea
sweating
- fever
- heat stroke
- thyroid crisis
severe burns
urination
diabetes
diabetic ketoacidosis
diuretics

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10
Q

What will happen as a result of fluid volume deficit? Symptoms

A

increased thirst
urine retention
tachycardia (thready)
fever
hypotension (orthostatic)
weakness
constipation (decreased bowel sounds/motility)

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11
Q

When looking at a patient who is dehydrated, what will the lab values be?

A

increased:
Hct
osmolarity
sodium
BUN
protein
electrolytes
glucose

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12
Q

What are the four organs that output fluid?

A

skin
lungs
GI tract
kidneys

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13
Q

What will be noted in older adults who are dehydrated?

A

reduced thirst mechanism due to less total body water

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14
Q

What are the crystalloid IV solutions?

A

hypotonic
hypertonic
isotonic

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15
Q

What are examples of IV fluids?

A

crystalloid IV solutions
colloids

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16
Q

Define hypotonic

A

increase in fluid

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17
Q

Define hypertonic

A

decrease in fluid

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18
Q

Define isotonic

A

equal fluid gain/loss

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19
Q

What type of fluid is saline?

A

isotonic

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20
Q

What is a half of saline (0.45 instead of 0.9) considered?

A

hypotonic

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21
Q

What is D5 in lactated ringer’s considered?

A

hypertonic

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22
Q

What are the causes of fluid volume overload?

A

renal failure
heart failure
liver disease
infection
burns
cancer

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23
Q

What will happen as a result of fluid volume overload? Symptoms

A

mental status change
headache
hypertension
tachycardia (bounding)
decreased temp
fluid in lungs (crackles)
low respiratory rate
increased urine
increased motility

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24
Q

When looking at a patient who is overhydrated, what will the lab values be?

A

decreased:
Hct
osmolarity
sodium
BUN
urine specific gravity
electrolytes

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25
What will the pulse be for a patient who has fluid volume deficit? Why?
weak, thready due to low fluid volume
26
What will the pulse be for a patient who has fluid volume overload? Why?
bounding due to high fluid volume
27
For a patient with pitting edema, what will the nurse do?
weight the patient
28
How will the lungs sound for a patient with fluid volume overload?
crackles
29
How much water should one intake?
2300 mL/day
30
What is the average output of urine?
30 mL/hour 360 mL/day
31
What is saline or lactated ringers (isotonic) used for?
hypotension hemorrhaging type 1/2 diabetes
32
What is included in a chemistry panel?
potassium calcium sodium magnesium phosphorus
33
What will the nurse do if any of the levels within the chemistry panel are low?
replace them by doing electrolyte therapy
34
What is the function of sodium within the body?
affects the nervous system maintains: BP blood volume pH balance
35
What is hyponatremia?
low sodium levels cells in brain and nervous system swell
36
How does hyponatremia affect the body? Symptoms
SALT LOSS Seizures Abdominal cramping Lethargic Tendon reflexes diminished Loss of urine / appetite Orthostatic hypotension, Overactive bowel sounds Shallow respirations Spasm of muscles
37
What are the causes of hyponatremia?
sweating excess water intake (running in heat) high ADH vomiting diarrhea diuretics low salt diet
38
What is a low sodium diet? What can the nurse do?
no canned or pickled foods ask questions to family of what they are bringing
39
What is hypernatremia?
high sodium levels cells dehydrated
40
What are the symptoms of hypernatremia?
BIG & BLOATED edema flushed skin increased muscle tone swollen dry tongue N/V tachycardia orthostatic hypotension
41
What are the causes of hypernatremia?
low ADH rapid respirations diarrhea loss of thirst
42
What is the function of potassium within the body?
pumps the heart lung function muscle function
43
What is hypokalemia?
low potassium levels
44
What are the symptoms of hypokalemia?
LOW & SLOW symptoms flat T waves ST depression U waves hypotension, irregular pulse muscle issues slow/ shallow respirations
45
What are the causes of hypokalemia?
fluid and electrolyte loss - GI, renal, skin
46
What is hyperkalemia?
high potassium levels
47
What are the symptoms of hyperkalemia? It will ____ the patient
MURDER Muscle weakness Urinary output decreased Respiratory failure Decreased cardiac contractility Early: muscle twitches Rhythm changes: peaked T waves, elevated ST, vfib
48
What are the causes of hyperkalemia?
renal failure low aldosterone diuretics old age
49
What is the function of magnesium within the body?
mellows the muscles
50
What is hypomagnesemia?
low magnesium levels
51
What are the causes of hypomagnesemia?
Crohn's disease Celiac disease GI losses malnutrition
52
What are interventions for hypomagnesemia?
replace magnesium - whole grains - dark green vegetables
53
What are the symptoms of hypomagnesmia?
TWITCH Trousseau/ Chvostek sign Weakness Increased deep tendon reflex Torsades de pointes Calcium and potassium levels low Hypertension
54
What is hypermagnesemia?
high magnesium levels
55
What are the symptoms of hypermagnesemia?
LETHARGIC Lethargic EKG changes Tendon reflexes absent Hypotension Arrhythmias (bradycardia/heart blocks) Red and hot face GI issues (N/V) Confusion
56
What are the causes of hypermagnesemia?
renal failure alcoholism malnourishment
57
What is the function of calcium within the body?
contracts muscles keeps the 3 B's strong: - bone - blood (clotting) - beats (heart)
58
What is hypocalcemia?
low calcium levels
59
What are the symptoms of hypocalcemia?
CRAMPS Convulsions Reflexes hyperactive Arrhythmias Muscle spasms Positive signs (Trousseau's/ Chvostek's) Sensation of tingling (parasthesia)
60
What are the causes of hypocalcemia?
hypoparathyroidism (low calcium) renal failure (chronic kidney disease) vitamin D deficiency
61
What is hypercalcemia?
high calcium levels
62
What are the symptoms of hypercalcemia?
WEAK Weakness of muscles EKG changes (short QT) Absent reflexes, Altered mental status, abdominal distension Kidney stone formation
63
What are the causes of hypercalcemia?
hyperparathyroidism (high calcium) cancer immobility
64
What is a patient at risk for during NG tube suctioning? Electrolytes levels
hypokalemia hypomagnesemia
65
If a patient has low calcium levels, what are they at risk for? Why? What will the nurse do?
high risk for falls due to muscle tremors nurse will place call light within reach if patient needs assistance
66
What are the acid-base regulatory systems?
respiratory system renal system
67
What is the normal range for pH?
7.35-7.45
68
What is the normal range for PaCO2?
35-45 mmHg
69
What is the normal range for HCO3-?
22-26 mEq/L
70
Where is acid found within the body?
stomach and urine
71
Where is base found within the body?
intestines
72
If a patient has a low and slow respiratory rate, what are they at risk for? Why? ABG
respiratory acidosis can't release CO2 build up of CO2
73
If a patient has a fast respiratory rate, what are they at risk for? Why? ABG
respiratory alkalosis releasing too much CO2 (acid), HCO3 (base) will have to compensate
74
If a patient has renal failure or diarrhea, what are they at risk for? Why? ABG
metabolic acidosis renal failure: acid build up diarrhea: releasing too much HCO3, CO2 (acid) will have to compensate
75
If a patient is vomiting or there is excessive NG suctioning, what are they at risk for? Why? ABG
metabolic alkalosis releasing too much CO2 (acid), HCO3 (base) will have to compensate
76
Describe metabolic acidosis
pH: < 7.35 (low) HCO3: < 22 (low)
77
Describe metabolic alkalosis
pH: > 7.45 (high) HCO3: > 26 (high)
78
What are normal lung sounds?
bronchial sounds bronchovesicular sounds vesicular sounds
79
What are adventitious lung sounds? abnormal
crackles wheezing rhonchi stridor
80
What are pharmacologic interventions for bronchospasms?
bronchodilators
81
What are pharmacologic interventions for airway inflammation?
corticosteroids
82
What are pharmacologic interventions for pulmonary congestion?
diuretics nitrates (if heart failure present)
83
What are pharmacologic interventions for anxiety, pain, agitation?
benzodiazepines opioids
84
What are pharmacologic interventions for secretions?
mucolytic agents
85
What are nonpharmacologic interventions for oxygenation?
oxygen therapy artificial airways suctioning hydration spirometer breathing exercises
86
Why would a nurse take a pulse oximetry measurement?
if the capillary refill is not less than 2-3 secs or cold finger
87
What is a sign of oxygen depletion?
clubbing
88
What is the preferred site for injection in older adults?
ventrogluteal
89
What are important measures to take when handling needles?
never recap needle do not shove needles into container put in biohazard use needleless needles if possible
90
If a patient is sleeping, what should the nurse do to promote sleeping/resting?
do not go in patients room flushing toilets or making noise
91
When assessing a patient who has trouble sleeping, what questions should the nurse ask?
assess by asking: "do you have problems falling asleep when driving home?" "Do you have any patterns of sleep disturbances?"
92
What should a nurse educate a patient on if they are trying to sleep more?
do not drink alcohol before sleeping, it is a contraindication to sleep
93
What can an AP do for a patient who has a trach?
take sputum to lab vitals replace cannula if it falls out
94
What can an AP NOT do for a patient who has a trach?
suction auscultate

Fundamentals (7 decks)

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