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Medsurg > Electrolytes & Central Lines > Flashcards

Electrolytes & Central Lines Flashcards

Exam 2

1
Q

ELECTROLYTE DISORDERS

A

Hypernatremia/Hyponatremia

Hyperchloremia/Hychloremia

Hyperkalemia/Hypokalemia

Hypermagnesemia/Hypomagnesemia

Hypercalcemia/Hypocalcemia

Hyperphosphatemia/Hypophosphatemia

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2
Q

Sodium: Normal ranges

A

135-145 mEq/L

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3
Q

Sodium: Where is it located?

A

Extracellular

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4
Q

Sodium: What does it control?

A

Controls the distribution of water in the body

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5
Q

Sodium: What is it controlled by?

A

Controlled by thirst, ADH and the renin- angiotensin –aldosterone system

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6
Q

Sodium: What is it made up of?

A

Positively charged and chloride ions are negatively charged

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7
Q

Sodium: When is low sodium seen?

A

Low sodium in hyponatremia and is seen is people who have issues eliminating water.

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8
Q

Sodium: What is the primary result of sodium retention?

A

Edema is the primary result of retention

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9
Q

Sodium: What is hyponatremia?

A

Hyponatremia (less than 135)

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10
Q

Sodium: What are clinical manifestations of hyponatremia?

A

diarrhea,

vomiting,

perspiration,

hyperglycemia

polydipsia,

weight loss,

orthostatic hypotension

Headache,

confusion,

seizures,

lethergy

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11
Q

Hypernatremia: What are clinical manifestations?

A

-neuromuscular irritability
-restlessness
-Coma
-seizures
-signs of dehydration

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12
Q

What are signs of dehydration (Hypernatremia)

A

signs of dehydration

(tachycardia, dry mucus membranes, decrease urine output, flushed skin)

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13
Q

Hypernatremia:

What is the treatment for this?

A

Medical management 0.45 % NaCl or 5 % dextrose

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14
Q

Hypernatremia: Who is at risk of having high sodium?

A

-Diabetes Insipidus,

neoplasms,

hypercalcemia
-lithium,

SSRI
-hyperventilation,

Burns and exercise

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15
Q

Chloride: What are normal values?

A

97 to 107 mEq/L

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16
Q

What does chloride help with?

A

Maintaining pressure within the body

Maintain the osmotic pressure

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17
Q

How is chloride reabsorbed and excreted?

A

Excretion and reabsorption of chloride in the kidney

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18
Q

What are chloride levels parallel with?

A

Low sodium is low chloride ( parallel)

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19
Q

What is treatment for low chloride?

A

Treatment (Normal saline/ half NS)

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20
Q

What causes hypochloremia?

A

Hypochloremia –severe vomiting, burns , chronic respiratory acidosis, nasogastric suctioning and Addison’s disease

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21
Q

What are you monitoring for with hypochloremia?

A

Monitoring for changes in consciousness, respiratory efforts and muscle control

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22
Q

What are clinical manifestations of hyperchloremia?

A

-deep, rapid respirations

-tachypnea

-elevated blood pressure

-decreased cognitive ability

-lethargy

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23
Q

Hyperchloremia:

Nursing management: What needs to be monitored?

A

Changes in neurological
Cardiac changes
Respiratory status
Monitor hypertension

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24
Q

Hyperchloremia:

Nursing management: What actions need to be taken?

A

Adequate hydration

Education to avoid foods like cheese, eggs, canned vegs , processed meat and bananas

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25
Q

Potassium: What are normal values?

A

3.5 to 5.3 mEq/L

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26
Q

Potassium: What controls the movement of potassium?

A

Sodium-potassium pump controls the movement of potassium into and out of cells as needed for neuromuscular functions

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27
Q

What does potassium help with?

A

Protein synthesis

28
Q

What is medical management of high or low potassium?

A

-oral or parental routes (cardiac monitoring )

29
Q

What is normal about IV potassium?

A

It burns

30
Q

How is potassium NEVER administered?

A

Never iv push

31
Q

If someone needs to be on potassium for an extended period of time, what do you have to do?

A

Make sure they are on a cardiac monitor

32
Q

What are signs and symptoms of low potassium?

A

-diarrhea,

vomiting,

anorexia,

bulimia

33
Q

What can cause low potassium/sodium?

A

Medications (loop diuretics, thiazide, steroids, albuterol

excessive enema or laxatives, anorexia, bulimia

34
Q

What are clinical manifestations of low potassium?

A

-weakness, constipation, nausea/vomiting, abdominal cramps, ST depressions, palpitations (PVC)

35
Q

Severe hypokalemia can result in what?

A

sudden death results from ventricular fibrillation

36
Q

What may cause hyperkalemia?

A
  1. Acute/ chronic renal failure,
  2. medications or
  3. excessive intake of potassium
37
Q

NSAIDs +renal insuffiency can cause

A

Hyperkalemia

38
Q

What drugs can cause hyperkalemia?

A

NSAIDs

Digoxin

Beta blockers

39
Q

What food have a lot of potassium?

A

Bananas, tomatoes oranges in patient with renal impairmentW

40
Q

What are clinical manifestations of hyperkalemia?

A

-generalized fatigue,

muscle cramps,

paresthesia,

palpitations

41
Q

What are clinical manifestations of hyperkalemia having to do with the heart?

A

-bradycardia, heart blocks

-ST depression and shortened QT interval

42
Q

What is medical management of hyperkalemia?

A

-In end stage renal patient dialysis should be prompt

43
Q

What is IV calcium used for in hyperkalemia?

A

IV calcium will not reduce potassium but reverse ECG changes

44
Q

Hyperkalemia: If high potassium leads to metabolic acidosis, what should be given?

A

If the event result from metabolic acidosis IV insulin and NS can be used

45
Q

Solutions Used in Infusion Therapy:

A

Crystalloid
Colloid
Isotonic, hypotonic, hypertonic

46
Q

What are crystalloid solutions composed of?

A

crystalloid solutions are composed of electrolytes dissolved in water and includes dextrose solutions sodium chloride an alkaline or acidifying solution

47
Q

What are colloid solutions composed of?

A

Colloidal solutions are composed of large molecules usually proteins are starch suspended in a fluid.

48
Q

What are colloid solutions frequently referred to as?

A

frequently referred to as plasma volume expanders.

49
Q

Isotonic solutions are similar to plasma why?

A

Isotonic solutions have the same or nearly the same osmolarity as plasma.

50
Q

What kind of movement does isotonic solutions cause?

A

they cause no movement of fluid into or out of the cell

51
Q

How do hypotonic solutions work?

A

hypotonic solutions have a lower solution concentrate than plasma and

cause fluid to move from the intravascular space into both the intracellular and interstitial spaces

52
Q

What do hypotonic solutions cause to happen?

A

cause fluid to move from the intravascular space into both the intracellular and interstitial spaces

53
Q

How are hypertonic solutions?

A

Hypertonic solutions have concentrations higher than plasma and

cause fluid to move from the cells into the intravascular space.

54
Q

What do hypertonic solutions cause to happen?

A

cause fluid to move from the cells into the intravascular space.

55
Q

What are crystalloids?

A

dextrose dissolved in water.

56
Q

What are colloids?

A

Colloid- larger molecules with usually proteins that are suspended in the fluid

57
Q

What are the types of Intravenous Access Devices

A

Peripheral

Central

58
Q

INTRAVENOUS ACCESS DEVICE (IVAD) TYPES:

Central venous access device (CVAD):

What are the types?

A

Nontunneled percutaneous central catheters (jugular or subclavian)

Tunneled catheters (exit the skin from a site distal from where they enter)

Implanted ports (uppe chest wall)

Peripherally inserted central catheters (PICCs)

59
Q

INTRAVENOUS ACCESS DEVICE (IVAD) TYPES (cont’d):

Central venous access device (CVAD)

Nontunneled percutaneous central catheters

A

jugular or subclavian)

60
Q

INTRAVENOUS ACCESS DEVICE (IVAD) TYPES (cont’d):

Central venous access device (CVAD)

Tunneled catheters

A

(exit the skin from a site distal from where they enter)

61
Q

INTRAVENOUS ACCESS DEVICE (IVAD) TYPES”:

Implanted ports

A

Implanted ports (upper chest wall)

62
Q

NUTRITION AND TEACHING:

Administration of total parenteral nutrition (TPN)

When is it used?

A

Use only when oral or enteral routes are not possible

63
Q

NUTRITION AND TEACHING:

Administration of total parenteral nutrition (TPN)

Why is it used carefully?

A

Increased risks to the patient and greater costs

64
Q

NUTRITION AND TEACHING:

Administration of total parenteral nutrition (TPN):

What does it provide?

A

Provide the major macronutrients along with required micronutrients

65
Q

NUTRITION AND TEACHING:

Patient teaching prior to IVAD insertion

What should patients understand?

A

Patient should understand why IVAD is required

Alternatives to the selected device

What to expect

Medsurg (21 decks)

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