Adult Health - Module 1

Question 1

Hypovolemic Interventions (Least-Most Invasive)

Answer 1

Mild
 Stop Fluid Loss
 Increase Oral Fluids
 Increase Na
Moderate
 Isotonic IV Fluid
Severe
 LAY patient flat
 Isotonic IV Bolus
 Hypotonic IV

Question 2

Hypervolemic Interventions (Least-Most Invasive)

Answer 2

Mild
 Stop excess fluid (drink a little less)
 Decrease Na
 Limit Oral Fluids
 Thiazide Diuretic
Moderate
 Loop Diuretic
 Restrict Fluids
Severe
 Hypertonic IV Fluid

Question 3

When does cellular dehydration occur?

Answer 3

After 3+ days of n/v/d. This indicates the need for hypotonic fluids

Question 4

What does a Hypervolemic patient look like?

Answer 4

Weight GAIN, edema, crackles
Increased RR, dyspnea
Labs decreased
BP increased

Severe = Hypoxia

Question 5

What does a Hypovolemic patient look like?

Answer 5

Weight LOSS. Decreased urine
Decreased Labs
Decreased BP, Increased HR
Clear Lungs
Weak peripheral pulses, Longer turgor

Question 6

When can you administer Hypotonic fluids?

Answer 6

ONLY if BP > 100 and STABLE. MUST USE ISO even if patient is dehydrated for 3+ Days

Question 7

How to fix a hyper electrolyte

Answer 7

Intake: Increase electrolyte intake
Excretion: Administer a diuretic
Concentration: Increase fluids
Push/Pull: Only for calcium

Question 8

How to fix a hypo electrolyte

Answer 8

Intake: Decrease electrolyte intake
Excretion: Hold the diuretic
Concentration: Decrease fluids
Push/Pull: Only for Potassium3

Question 9

What does a patient with Hyponatremia look like?

Answer 9

LOC! Irritability, confusion, seizures, coma. Cellular swelling

Question 10

What does a patient with Hypernatremia look like?

Answer 10

LOC! Restlessness, seizures, coma, and THIRST

Question 11

What does a patient with Hypokalemia look like?

Answer 11

N/V, Cardiac arrhythmia, fatigue, muscle cramps, shallow respirations

Question 12

What does a patient with Hyperkalemia look like?

Answer 12

Anxious, weakness, abdominal cramps, numbness, cardiac arrhythmias, possible cardiac arrest

Question 13

What does a patient with Hypocalcemia look like?

Answer 13

Depressed, Anxious, Increased reflexes, Chvostek’s sign, Trousseau’s sign, Tingling in fingers, toes, around mouth, Tetany, Seizures

Question 14

What does a patient with Hypercalcemia look like?

Answer 14

Lethargy, slurred speech, polyuria, kidney stones, stupor, coma, confusion, psychosis, depressed reflexes, ECG changes. Death is high if calcium > 15

Question 15

What does a patient with Hypophosphatemia look like?

Answer 15

Decreased cell energy production leading to muscle weakness, cardiac arrhythmia, decreased oxygen, confusion/coma.

Question 16

What does a patient with Hyperphosphatemia look like?

Answer 16

Fatigue, anxiety, confusion, hyperreflexia, tetany, seizures

Question 17

What does a patient with Hypomagnesemia look like?

Answer 17

Confusion, seizures, hyperactive reflexes, cardiac arrythmia

Question 18

What does a patient with Hypermagnesemia look like?

Answer 18

Depressed CNS/Neuromuscular function, N/V, lethargy, loss of deep tendon reflexes, drowsiness, cardiac arrest

Question 19

What does a patient with Hypoproteinemia look like?

Answer 19

Edema, muscle wasting, ascites, pulmonary edema. Think of the malnourished children