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nur 180 > 224 unit 1 > Flashcards

224 unit 1 Flashcards

1
Q

Hypertonic Solution

A

A solution with an osmolality higher than that of serum

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2
Q

Hypotonic Solution

A

A solution with an osmolality lower than that of serum

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3
Q

Isotonic Solution

A

A solution with the same osmolality as serum and other body fluids

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4
Q

Osmosis

A

The process by which fluid moves across a semipermeable membrane from an area of low solute concentration to an area of high solute concentration

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5
Q

Tonicity

A

Fluid tension or the effect that osmotic pressure of a solution with impermeable solutes exerts on cell size because of water movement across the cell membrane

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6
Q

Active Transport

A

hysiologic pump that moves fluid from an area of lower concentration to one of higher concentration; active transport requires ATP for energy

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7
Q

Diffusion

A

The process by which solutes move from an area of higher concentration to one of lower concentration; does not require energy

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8
Q

Homeostasis

A

maintenance of a constant internal quilibrium in a biologic system that involves positive and negative feedback mechanisms

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9
Q

Hydrostatic Pressure

A

The pressure created by the weight of fluid against the wall that contains it.

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10
Q

acidosis

A

imbalance with increase H+ concentration

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11
Q

alkalosis

A

imbalance with reduce H+ concentration

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12
Q

Kidney Functions

A
  • regulation of ECF volume and osmolality by selective retention and excretion of body fluids
  • regulation of normal electrolyte levels in the ECF by selective electrolyte retention and excretion
  • regulation of pH of the ECF by retention of hydrogen ions
  • excretion of metabolic wastes and toxic substances
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13
Q

Hypovolemia (Fluid Volume Defecit)

A

This occurs when loss of ECF volume exceeds the intake of fluid; occurs when water and electrolytes are lost in the same amount as they exist in normal body fluids

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14
Q

Hypovolemia Signs & Symptoms

A
  • acute weight loss
  • decreased skin turgor
  • oligoria (abnormally small amounts of urine)
  • low CVP
  • low BP
  • dizziness
  • weakness
  • thirst/confusion
  • increased pulse
  • muscle cramps
  • sunken eyes
  • nausea
  • increased temp.
  • cool, clammy, pale skin
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15
Q

Hypovolemia Contributing Factors

A
  • vomiting
  • diarrhea
  • fistulas
  • fever
  • excess sweating
  • burns
  • blood-loss
  • GI suction
  • anorexia
  • nausea
  • diabetes insipidus
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16
Q

Hypovolemia Lab Findings

A
  • increased hgB
  • increased hematocrit
  • increased BUN
  • increased creatinine
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17
Q

Hypovolemia Management

A
  • monitor daily weights
  • intake/output
  • vital signs
  • skin turgor
  • mucous membrane assessments
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18
Q

Hypervolemia (Fluid Volume Excess)

A

Abnormal retention of water and sodium; mostly secondary to increase in the total body sodium content

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19
Q

Hypervolemia Signs & Symptoms

A
  • acute weight gain
  • peripheral edema and ascites
  • distended jugular veins
  • crackles
  • elevated CVP
  • shortness of breath
  • increased BP
  • bounding pulse/cough
  • increased respiratory rate
  • increased urine output
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20
Q

Hypervolemia Lab Findings

A
  • decreased hgB

- decreased hematocrit

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21
Q

Hypervolemia Management

A
  • restricted sodium diet
  • intake/output
  • promote rest
  • diuretics
  • daily weight
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22
Q

Serum Sodium Level

A

135-145

  • sodium is the primary determinant of ECF volume and osmolality
  • major role in controlling water distribution throughout the body
  • regulated by ADH, thirst, and the renin-angiotensin-aldosterone system
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23
Q

Patients at risk for sodium imbalance

A

older patients, patients with AIDS, those on mechanical ventilation

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24
Q

Hyponatremia (Sodium Defecit)

A

Serum sodium level less than 135

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25
Q

Hyponametria Contributing Factors

A
  • loss of sodium as in use of diuretics
  • loss of GI fluids
  • renal disease
  • adrenal insufficiency
  • gain of water; excessive admin of D5W and hypotonic feedings
  • head trauma
  • oat-cell lung tumor
  • meds assoc. with water retention (oxytocin)
  • hyperglycemia
  • heart failure
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26
Q

Hyponametria Signs & Symptoms

A
  • anorexia
  • nausea/vomiting
  • headache
  • lethargy
  • dizziness
  • confusion
  • muscle cramps/weakness
  • muscular twitching
  • seizures
  • dry skin
  • increased pulse
  • low BP
  • weight gain
  • edema
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27
Q

Hyponatremia Management

A
  • sodium PO if tolerable
  • lactated ringer’s solution; isotonic saline (0.9%)
  • restricting fluid
  • foods/fluids w/ high sodium content
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28
Q

Hypernatremia (Sodium Excess)

A

Sodium level higher than 145

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29
Q

Hypernatremia Contributing Factors

A
  • water deprivation in patients unable to drink at will
  • hypertonic tube feedings w/o adequate water supplements
  • diabetes insipidus
  • heatstroke
  • hyperventilation
  • watery diarrhea
  • burns
  • diaphoresis (excessive sweating)
  • excess sodium bicarbonate
  • excess sodium chloride administration
  • excess corticosteroids
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30
Q

Hypernatremia Signs & Symptoms

A
  • thirst
  • elevated temp.
  • swollen dry tongue; sticky mucous membranes
  • hallucinations
  • lethargy
  • restlessness
  • irritability
  • seizures
  • pulmonary edema
  • twitching
  • nausea
  • vomiting
  • anorexia
  • increased pulse
  • increased BP
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31
Q

Hypernatremia Interventions

A
  • hypotonic solution (0.3% sodium chloride)
  • isotonic non-saline solution D5W
  • diuretics
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32
Q

Serum Potassium Level

A
  1. 5-5
    - potassium is important neuromuscular function
    - influences both skeletal and cardiac muscle activity
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33
Q

Hypokalemia (Potassium Deficit)

A

-lower than 3.5

34
Q

Hypokalemia Contributing Factors

A
  • diarrhea
  • vomiting
  • gastric suction
  • corticosteroid administration
  • bulemia
  • osmotic diuresis
  • alkalosis
  • starvation
  • diuretics
  • digoxin toxicity
35
Q

Hypokalemia Signs & Symptoms

A
  • fatigue
  • anorexia
  • nausea/vomiting
  • muscle weakness
  • polyuria (large volumes of urine)
  • decreased bowel motility
  • parasthesia
  • leg cramps
  • decreased BP
  • abdominal distention
  • irritability
  • anxiety
  • ECG–tall T waves; prolonged PR interval; absent P waves; ST depression
36
Q

Hypokalemia Interventions

A
  • diets with high potassium content
  • IV therapy
  • potassium supplements
37
Q

Hyperkalemia (Potassium Excess)

A

-serum potassium level higher than 5

38
Q

Hyperkalemia Contributing Factors

A
  • oliguric renal failure
  • Addison’s disease
  • burns
  • stored blood bank transfusions
  • rapid IV admin of potassium
  • NSAIDs, ACE inhibitors
39
Q

Hyperkalemia Signs & Symptoms

A
  • muscle weakness
  • tachycardia–bradycardia
  • dysrhythmia
  • flaccid paralysis
  • parasthesia
  • intestinal colic
  • cramps
  • abdominal distention
  • irritability; anxiety
40
Q

Hyperkalemia Interventions

A
  • intake/output
  • IV therapy
  • monitor vital signs
  • avoid salt substitutes
41
Q

Serum Calcium Levels

A

8.2-10.2

42
Q

Hypocalcemia (Calcium Deficit)

A

serum calcium level lower than 8.6
-calcium plays a major role in transmitting nerve impulses and helps regulate muscle contraction, relaxation, including cardiac muscle

43
Q

Hypocalcemia Contributing Factors

A
  • hypoparathyroidism
  • malabsorption
  • pancreatitis
  • alkalosis
  • vitamin D deficiency
  • massive subcutaneous infection
  • generalized paratonitis
  • diuretic phase of renal failure
  • chronic diarrhea
  • fistulas
  • burns
  • alcoholism
44
Q

Hypocalcemia Signs & Symptoms

A
  • numbness
  • tingling of fingers; toes
  • positive Trousseau’s signs; Chvostek’s sign (contraction of the facial muscles with a light tap)
  • seizures
  • carpopedal spasms
  • hyperactive deep tendon reflexes
  • irritability
  • bronchospasm
  • impaired clotting time
  • decreased prothrombin
  • diarrhea
  • decreased BP
45
Q

Hypocalcemia Lab Findings

A

decreased Magnesium levels

46
Q

Hypocalcemia Management

A
  • IV administration
  • monitor BP
  • vitamin D therapy
  • safety precautions for those at risk for seizures
  • avoid cigarette smoking
  • avoid alcohol; caffeine
47
Q

Hypercalcemia (Calcium Excess)

A

-serum calcium levels higher than 10.2

48
Q

Hypercalcemia Contributing Factors

A
  • hyperparathyroidism
  • malignant neoplastic disease
  • prolonged immobilization
  • overuse of calcium supplements
  • vitamin D excess
  • acidosis
  • digoxin toxicity
49
Q

Hypercalcemia Signs & Symptoms

A
  • muscular weakness
  • constipation
  • anorexia
  • nausea/vomiting
  • polyuria; polydipsia (extreme thirst)
  • dehydration
  • flank pain
  • calcium stones
  • deep bone pain
  • hypertension
50
Q

Hypercalcemia Management

A
  • administering fluids to dilute serum calcium and promote excretion by the kidneys
  • IV admin of 0.9% sodium chloride
  • Lasix
  • increasing patient mobility
  • fiber in the diet
  • encouraging fluid intake
51
Q

Serum Magnesium Level

A
  1. 3-2.3
    - magnesium plays a role in both carb and protein metabolism
    - ionized or bound to albumin
52
Q

Hypomagnesia (Magnesium deficit)

A

-serum magnesium level lower than 1.3

53
Q

Hypomagnesia Contributing Factors

A
  • chronic alcoholism
  • malabsorptive disorders
  • hyperparathyroidism
  • diabetic ketoacidosis
  • refeeding after starvation
  • parenteral nutrition
  • diarrhea
  • chronic laxative use
  • acute myocardial infarction
  • heart failure
54
Q

Hypomagneisa Signs & Symptoms

A
  • neuromuscular irritability
  • positive Trousseau’s sign; Chvostek sign
  • insomnia
  • mood changes
  • anorexia
  • vomiting
  • increased tendon reflexes
  • increased BP
55
Q

Hypomagnesia Management

A
  • diet of green leafy vegetables, nuts, seeds, legumes, whole grains, seafood, peanut butter and cocoa
  • magnesium salts PO
  • parenteral admin of magnesium
  • vital signs assessment during therapy (changes in cardiac rate; rhythm
  • screened for dysphasia
56
Q

Hypermagnesia (Magnesium Excess)

A

serum magnesium level higher than 2.3

57
Q

Hypermagnesia Contributing Factors

A
  • oliguric phase of renal failure
  • adrenal insufficiency
  • diabetic ketoacidosis
  • hypothyroidism
58
Q

Hypermagnesia Signs & Symptoms

A
  • flushing
  • hypotension
  • muscle weakness
  • drowsiness
  • hypoactive reflexes
  • depressed respirations
  • cardiac arrest; and coma
  • diaphoresis
  • tachycardia–bradycardia
59
Q

Hypermagnesia Management

A
  • ventilatory support, IV calcium gluconate
  • loop diuretics, sodium chloride or lactated ringer’s IV solution enhances Mg excretion in patients with adequate renal function
  • monitor vital signs, noting hypotension and shallow respirations
  • observe for DTRs, changes in level of consciousness
60
Q

Phosphorous Normal Serum Level

A
  1. 5-4.5
    - phosphorous is essential to the function of muscle and RBC
    - formation of ATP
    - maintenance of acid-base balance
    - metabolism of carbs, proteins, and fat
61
Q

Hypophosphatemia (Phosphorous Deficit)

A

Phosphorous level lower than 2.5

62
Q

Hypophosphatemia Contributing Factors

A
  • can be caused by an intracellular shift of potassium from serum into cells, increased urinary excretion of potassium, or by decreased intestinal absorption of potassium
  • refeeding after starvation
  • alcohol withdrawal
  • diabetic ketoacidosis
  • respiratory and metabolic alkalosis
  • decreased magnesium
  • decreased potassium
  • hyperparathyroidism
  • vomiting
  • diarrhea
  • hyperventilation
  • vitamin D deficiency associated with malabsorptive disorders
  • burns
  • acid-base disorders
  • parenteral nutrition
  • diuretic and antacid use
  • heat stroke
  • poor dietary intake
  • respiratory alkalosis
63
Q

Hypophosphatemia Lab Findings

A
  • glucose/insulin may slightly decrease serum levels
  • PTH increased in hyperparathyroidism
  • serum Mg may decrease due to increased urinary secretions
64
Q

Hypophosphatemia Signs & Symptoms

A
  • paresthesias
  • muscle weakness
  • bone pain/tenderness
  • chest pain
  • confusion
  • cardiomyopathy
  • respiratory failure
  • seizures
  • tissue hypoxia
  • increased susceptibility to infection
  • nystagmus “dancing eyes”
65
Q

Hypophosphatemia Management

A

-encourage foods such as milk/milk products, organ meats, fish, nuts, poultry, and whole grains

66
Q

Hyperphosphatemia (Phosphorous Exces

A

Serum level that exceeds 4.5

67
Q

Hyperphosphatemia Contributing Factors

A
  • renal failure
  • increased intake, decreased output
  • shift from the intracellular to extracellular space
  • excessive vitamin D intake
  • admin. of total parenteral nutrition
  • chemotherapy for neoplastic disease
  • hypoparathyroidism
  • metabolic/respiratory acidosis
  • diabetic ketoacidosis
  • acute hemolysis
  • high phosphate intake
  • profound muscle necrosis
68
Q

Hyperphosphatemia Signs & Symptoms

A
  • tetany
  • tachychardia
  • anorexia
  • nausea/ vomiting
  • muscle weakness
  • signs/symptoms of hypocalcemia
  • hyperactive reflexes
  • tissue calcifications in lungs, heart, kidneys, and cornea
69
Q

Hyperphosphatemia Management

A
  • avoid hard cheeses, cream, nuts, meats, whole-grain cereals, dried fruits, dried vegetables, kidneys, sardines, sweetbreads, and foods made with milk
  • monitor for changes in urine output
70
Q

Chloride Normal Serum Level

A

97-107

  • chloride is contained in gastric and pancreatic juices
  • produced in the stomach
71
Q

Hypochloremia (Chloride Deficit)

A

-serum chloride level below 97

72
Q

Hypochloremia Contributing Factors

A
  • GI tube drainage
  • gastric suctioning
  • gastric surgery
  • severe vomiting
  • diarrhea
  • low sodium intake
  • metabolic alkalosis
  • massive blood transfusions
  • diuretic therapy
  • burns
  • fever
  • admin. of ACTH, corticosteroids, bicarbonate, or laxatives
73
Q

Hypochloremia Signs & Symptoms

A
  • agitation
  • irritability
  • tremors
  • muscle cramps
  • hyperactive deep tendon reflexes
  • hypertonicity
  • tetany
  • slow shallow respirations
  • seizures
  • dysrhythmias
  • coma
74
Q

Hypochloremia Lab Findings

A
  • low serum sodium levels
  • increased pH
  • increased bicarbonate
  • increased total carbon dioxide content
  • decreased serum potassium
75
Q

Hypochloremia Management

A
  • 0.9% sodium chloride
  • 0.45% sodium chloride
  • monitor intake/output
  • arterial blood gas values
  • changes in consciousness
  • muscle strength/movement
  • vital signs and respiratory rate
  • high chloride content foods
76
Q

Hyperchloremia (Chloride Excess)

A

-serum chloride level higher than 107

77
Q

Hyperchloremia Contributing Factors

A
  • excessive sodium chloride infusions w/ water loss
  • head injury
  • hypernatremia
  • renal failure
  • corticosteroid use
  • dehydration
  • severe diarrhea (loss of bicarbonate)
  • respiratory alkalosis
  • administration of diuretics
  • overdose of salicylates
  • metabolic acidosis
78
Q

Hyperchloremia Signs & Symptoms

A
  • tachypnea
  • lethargy
  • weakness
  • deep rapid respirations
  • decline in cognitive status
  • decreased cardiac output
  • dyspnea
  • tachycardia
  • pitting edema
  • dysrhythmia
  • coma
79
Q

Hyperchloremia Lab Findings

A
  • increased serum potassium
  • increased serum sodium
  • decreased pH
  • decreased bicarbonate
80
Q

Hyperchloremia Management

A
  • admin hypotonic solutions
  • monitor vital signs
  • monitor ABG
  • intake/output

nur 180 (20 decks)

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