ch. 12 - fluid volume and electrolytes

Question 1

3.5-5.0

• affect cardiac & skeletal muscle activity, affects acid base balance
• Know what medications the patient is taking (K wasting/sparing diuretics)
• Hypokalemia/hyperkalemia

Answer 1

Potassium

Question 2

severe = cardiac arrest = DEATH

signs and symptoms: leg cramps, muscle weakness, dysrhythmias, inverted T waves, depressed ST segment

Burns, suctioning, diarrhea (laxatives), vomiting, diuretics, decreased magnesium levels

Answer 2

hypokalemia

Question 3

signs and symptoms: dysrhythmias, paresthesia of face, hands, feet, nausea

Answer 3

hyperkalemia

Question 4

Assess your patient before, during, and after a blood transfusion
Each facility might have a different policy regarding transfusing products

• We will usually premedicate with diuretics such as furosemide between units of blood, and give diphenhydramine before the first unit to reduce risk for a reaction
• NURSE HAS TO HAVE CONSENT FULL SIGNED EDUCATED AND EXPLAINED ALL POSSIBILE THINGS

1) Assess baseline labs and baseline vitals before getting blood. Obtain blood consent before picking up blood. You will educate patient on risks associated with transfusion. You should also assess your patient before starting.
2) Correctly identify your patient and verify blood product with two nurses after you verified it with lab personnel
3) Monitor vitals every 15 minutes for the first hour then hourly typically

• HAVE to verfiy product with lab person that gives it to you and with another nurse! so CHECK TWICE before given to patient.
• Make sure IV is good/patent before you pick up blood you only have 4 hours to transfuse blood from the time you get it till it is used
• Assess for reactions like fluid overload, allergic reactions

Answer 4

blood administration

Question 5

• Packed red blood cells (PRBCs), platelets, plasma, and cryoprecipitate
• 1 unit of PRBC= 350cc
• 1 unit of blood can raise hemoglobin 0.5-1 g/dL
• Know your baseline labs
• Supplies: blood transfusion tubing, normal saline, patent IV (20G or bigger), consent
• 4-hour transfusion limit

Answer 5

blood products

Question 6

Excessive thirst, confusion, decreased urine output, weakness, increased urine specific gravity, poor skin turgor, tachycardia, dry mucous membranes, hypotension

Answer 6

fluid volume deficit

Question 7

Edema, dyspnea, anxiety, decreased urine specific gravity, wt gain, tachypnea, crackles, JVD

• Assess I’s & O’s frequently and daily weights. Know how to respond if you think someone is fluid overloaded (stop transfusion, call your doctor)

Answer 7

fluid volume overload