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Med- Surg > 3 (fluids, electrolytes, acid-base, IV therapy) and 6 (infection prevention) > Flashcards

3 (fluids, electrolytes, acid-base, IV therapy) and 6 (infection prevention) Flashcards

1
Q

control of fluid balance is managed by the receptors: o__ receptors (located in the h__ and provoke the thirst mechanism), b__ receptors (located in the c__ sinus and the a__ arch detect pressure changes stimulating the sympathetic system)

A

osmoreceptors, hypothalamus

baroreceptors, carotid, aortic

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2
Q

control of fluid balance managed by the hormones: A__ (released by the p__ pituitary, controls fluid by urine and reabsorption of water from kidneys), a__ (regulates reabsorption of water and sodium from kidney tubules)

A

ADH, posterior

aldosterone

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3
Q

control of fluid balance managed by the b_ natriuretic peptide (or B-type natriuretic peptide) and a_ natriuretic peptide= both promote loss of water and sodium from kidney tubules and cause vasodilation

A

brain

atrial

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4
Q

3 examples of extracellular fluid (i_, i_, t_)

A

intravascular, interstitial, transcellular

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5
Q

what electrolyte maintains the osmolality of the intracellular fluid

A

K+

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6
Q

what electrolyte controls the osmolality of the extracellular fluid

A

sodium

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7
Q

Movement of fluid and electrolytes; how is fluid moved- what type of transport

A

Passive transport: diffusion, osmosis, filtration

Active transport requires ATP (amino acids, glucose, iron, hydrogen, sodium, potassium, and calcium)

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8
Q

any disease that affects circulation will ultimately affect the distribution and composition of b_ f_

A

body fluids

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9
Q

extra fluid is l_ when the metabolic rate is a_; ex’s

A

lost
accelerated
ex’s: fever, burns, trauma, states of extreme stress

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10
Q

which pt is in need for TPN

A

pt’s who will be unable to take in fluids or food on their own for an extended period

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11
Q

(think down) thirst; poor skin turgor; weight loss; weakness; complaints of dizziness; postural hypotension; decreased urine production; dark, concentrated urine; dry, cracked lips and tongue; dry mucous membranes; sunken, soft eyeballs; thick saliva; dry, scaly skin; flat neck veins when lying down; rapid, weak, thready pulse; elevated temp; increased hematocrite; high urine specific gravity with low volume

A

s/s dehydration

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12
Q

(think up) weight gain; slow, bounding pulse; elevated blood pressure; firm subcutaneous tissues; possible edema; possible crackles in lungs on auscultation; lethargy, possibly seizures; possibly visible neck veins when lying down; decreased serum sodium; decreased hematocrit from hemodilution; low urine specific gravity with high volume

A

s/s overhydration

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13
Q

hydroxyzine
promethazine
prochlorperazine maleate
ondansetron
metoclopramide

A

antiemetics

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14
Q

diphenoxylate atropine
loperamide HCI
kaolin-pectin
bismuth subsalicylate
camphorated opium tincture

A

antidiarrheals

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15
Q

an increase in capillary hydrostatic pressure
loss of plasma proteins
obstruction of lymphatic circulation
increase in capillary permeability
causes of e_

A

general causes of edema

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16
Q

congestive heart failure, liver disease with ascites, and chronic renal failure result in excessive water retention- putting pt’s at risk for which electrolyte imbalance

A

hyponatremia

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17
Q

water loss from fever, respiratory infection, or watery diarrhea, impaired thirst, or restricted access to water- can cause
what is restricted intake for these pt’s

A

hypernatremia

sodium

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18
Q

what type of solution shifts fluid into the cell, rehydrating them

A

hypotonic

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19
Q

what type of solution causes fluid to shift from the intracellular

A

hypertonic

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20
Q

which type of fluid is infused to a pt getting blood

A

0.9% NSS

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21
Q

important to keep the s_ sterile when changing the intravenous tubing

A

spike

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22
Q

cool, pale, pain, and edema are symptoms of IV i_

A

infiltration

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23
Q

How does a pt receive TPN: c_ v_ c_

A

central venous catheter

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24
Q

infusion of medications or chemicals into tissues that can cause injury: e_

A

extravasation

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25
Q

infusion of IV fluids into tissues

A

infiltration

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26
Q

inflammation of the vein caused by a clot

A

thrombophlebitis

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27
Q

caused by too-rapid infusion of medications

A

speed shock

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28
Q

when is TPN begun; how is TPN delivered

A

when nutrition cannot be delivered by oral intake and PPN or by enteral feedings
PICC- peripherally inserted central catheter

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29
Q

h_ alters the way digitalis is metabolized in the body and predisposes the pt to d_ t_

A

hypokalemia
digitalis toxicity

30
Q

fatigue, anorexia, headache, blurred vision, yellow-green halos around lights, nausea, diarrhea, and cardiac dysrhythmias: signs of d_ t_

A

digitalis toxicity

31
Q

Lactated Ringer’s solution is: isotonic, hypotonic or hyptertonic

A

isotonic

32
Q

sterile water is: isotonic, hypotonic, hypertonic; can cause what; how is it used

A

hypotonic

hemolysis

used to reconstitute powdered medications

33
Q

0.9% saline, lactated Ringer solution, dextrose 5% in water, and dextrose 5% in 0.225% saline- isotonic, hypotonic or hypertonic

A

isotonic

34
Q

sodium normal range = think odd numbers

A

135-145

35
Q

potassium normal range = think bananas

A

3.5-5

36
Q

BUN = bunions

A

5-20

37
Q

creatinine = think nine

A

0.6-1.2

38
Q

glucose = energy

A

70-100

39
Q

calcium = milk

A

8.5 - 10.5

40
Q

chloride = chlorine (hot tub)

A

95-105

41
Q

bicarbonate = think carbonation/ soda x2

A

23-29

42
Q

-approx 1/3 of total body water
-transports water, nutrients, oxygen, waste, and more to and from the cells
-regulated by renal, metabolic, and neurologic factors
-high in sodium content

A

extracellular fluid includes

43
Q

-fluid within the blood vessels
-consists of plasma and fluid within blood cells
-contains large amounts of protein and electrolytes

A

intravascular fluid

44
Q

-fluid in the spaces surrounding the cells
-high in sodium content

A

interstitial fluid

45
Q

includes aqueous humor; saliva; cerebrospinal, pleural, peritoneal, synovial, and pericardial fluids; gastrointestinal secretions; and fluid in the urinary system and lymphatics

A

transcellular fluid
(because it transports)

46
Q

-about 2/3 of total body fluid
-fluid contained within the cell walls; most cell walls are permeable to water
-high in potassium content

A

intracellular fluid

47
Q

what non-fluid sensation can also cause the pituitary to release ADH: p_, n_, s_

A

pain, nausea, stress

48
Q

primary triggers for ADH are:
d_ p_ or i_ c_ of blood

A

decreased pressure or increased concentration of blood

49
Q

when ECF volume is low or sodium concentration is decreased the adrenal cortex releases a_, causing r_ of sodium from renal tubules

A

aldosterone
reabsorption

50
Q

what system regulates release of aldosterone

A

renin-angiotensin-aldosterone system

51
Q

baroreceptors in the atrium of the heart detect fluid o_ and stimulate the myocardium to release A_ , which increases s_ excretion

A

overload, ANP, sodium

52
Q

what nonelectrolytes contribute to the osmolality of body fluids: p_, g_, b_, c_, u_

A

protein, glucose, bilirubin, creatinine, urea

53
Q

acyclovir is which type of antimicrobial drug

A

antifungal
along with: amantadine, azidothymidine, oseltamivir phosphate, peramivir, saquinavir, zanamivir

54
Q

lypressin is which type of medication

A

vasopressor

55
Q

removing ppe

A

gloves, goggles, gown, mask, hand hygeine

56
Q

pt’s who are more susceptible to infection include: 5

A

pt’s who:
-are already weakened by illness
-have drainage tubes, intravenous catheters, other invasive devices for monitoring or treatment
-very old or very young
-have had recent surgery
-are immunocompromised

57
Q

speed of action in innate immunity is r_, and occurs in s_ h_

A

rapid, several hours

58
Q

pt’s will be more c_ with therapy if they understand the purpose of the treatment

A

compliant

59
Q

latent phase of any communicable disease: pt is a_ to transmit the disease to others, s/s are o_ n_ present, pt may n_ feel ill or have general malaise

A

able
often not
not

60
Q

Body’s protective and defensive mechanisms against infection: f_, n_, a_, a_, b_, l_, p_, m_, l_

A

fever
nutrition
antigens
antibodies
bone marrow
liver cells
leukocytosis
phagocytosis
macrophages

61
Q

Body’s mechanisms of defense:
Adaptive immunity-
a_-m_ i_ r_ (B lymphocytes)
c_-m_ i_ r_ (T lymphocytes)

Innate immunity-
i_ s_, n_ f_, m_ m_, GI tract, GU tract, i_, phagocytosis by white blood cells, f_

A

antibody-mediated immune response
cell-mediated immune response

intact skin
normal flora
mucous membranes
inflammation
fever

62
Q

-decreased: skin turgor and greater skin friability,
elasticity and atherosclerosis of peripheral vessels, GI tract motility as muscles weaken, acid production, immune response because bone marrow does not produce new blood cells as rapidly, ciliary action from smoking or exposure to air pollution
-calcification of heart valves
-stiffness of thorax from arthritis or aging changes
- weakened respiratory muscles
-prostate changes, bladder prolapse, and urethral strictures

A

changes in natural defense mechanisms that occur with age

63
Q

Airborne precautions: disease (MTv’s)

A

measles, tuberculosis, varicella-zoster (chickenpox and shingles, and variola (smallpox), SARS (severe respiratory syndrome)

64
Q

Contact precautions: ABCDEF

A

-abscess- large and major drainage
-bronchiolitis- RSV and parainfluenza
-cutaneous- herpes zoster, varicella, herpes simplex, impetigo, lice, major pressure/ decubitus ulcers, —scabies, major staph/strep, skin wounds/burns, —-diphtheria
-diarrhea- c. diff, norovirus, rotavirus, hep a
-eyes- conjunctivitis -acute, viral
-funky/feisty- MDRO’s

65
Q

droplet precautions- MY PERfect MUM FLU a Dozen STRong MEN on a PLAne to a PARk in GERMANY to ADd a NEW EPIc RHINO

A

mycoplasma pneumonia (walking pneumonia)
pertussis (whooping cough)
mumps
flu
diptheria (pharyngeal)
streptococcus
meningitis
plague (pneumonic)
parvovirus B 19 (5th disease)
german measles (rubella)
adenovirus
pneumonia
epiglottitis
rhinovirus

66
Q

Contact:
Mode of transmission
PPE
Room type

A

prevent transmission of infections spread by direct or indirect contact with the pt or pt’s environment

gown and gloves

single-pt room

67
Q

Droplet:
Mode of transmission
PPE
Room type

A

prevent transmission of infections spread via air droplets by coughing, sneezing, talking, or close contact with respiratory secretions/mucous membranes

surgical mask

single-pt room

68
Q

Airborne:
Mode of transmission
PPE
Room type

A

prevent transmission of infections that remain infectious over long distances when suspended in the air

N95 or higher level respirators

airborne infection isolation room
negative pressure, special ventilation

69
Q

What is sepsis

S/S to watch with pt’s at risk for sepsis (systemic inflammatory response syndrome SIRS)

conditions that can lead to sepsis

A

infection enters bloodstream

change in mental status, tachycardia, tachypnea, changes in bp, decreased urine output, fever, elevated WBC

pneumonia, UTI, and post-surgical wound infections

70
Q

what is shock, what can it lead to

A

circulatory failure causing inadequate perfusion of the tissues - there’s an underlying process preventing us from delivering adequate oxygenated blood to tissues and organs- can lead to tissue hypoxia, cell death, organ failure

Med- Surg (8 decks)

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