Exam 1 Flashcards
K ranges
3.5 - 5.0
Na ranges
135-145
the nursing process
ADPIE ~ Assessment, Diagnosis, Planning, Implementation, Evaluation
BUN ranges
5-20
creatinine ranges
0.6-1.2
glucose ranges
70-100
Ca ranges
8.5-10.5
what measures can we give to decrease K?
- kayexelate PO, assess bowel sounds first!
- insulin, watch glucose
- albuterol, bronchodilator
if Na is < 135, what is that a sign of and what should we give?
fluid overload, give 0.9% NS and fluid restrict.
If Na is > 145, what is that a sign of and what should we give?
dehydration, give 0.9% NS or LR
isotonic solutions
- 0.9% NS
- D5W
- D5W 1/4 NS
- LR
hypotonic solutions
- 0.45% NS (1/2NS)
- 0.225% NS (1/4 NS)
- 0.33% NS (1/3 NS)
hypertonic solutions
- 3% NS
- 5% NS
- D10W
- 5% D in 0.9% NS
- 5% D in 0.45% NS
- 5% D in LR
what would the BUN look like if in renal failure?
> 20
good UO
1-2 mL/kg/hr or 30 mL/hr
prerenal AKI
- before kidneys
- decreased perfusion issue
- indication: decreased MAP (CHF, hypovolemia, dehydration), decreased UO, obstruction (tumor, emboli, clot)
intrarenal AKI
- inside kidneys
- from CT dye or meds like NSAIDs, -mycins (ibuprofen, naproxen, ketorolac), contract, infection, immune system issues
postrenal AKI
- after kidneys
- prostate, stone, tumor
phases of AKI
onset, oliguric, diuretic, recovery
oliguric phase of AKI
- sudden decrease in UO
- dark urine
- signs of excess fluid volume
- restrict fluid!
- give vasopressin
- edema, swollen, fluid overload
diet for AKI
- low to moderate protein
- high carbs
what meds are good at providing “kidney protection” along with other benefits?
- ACE inhibitors (-prils)
- ARBs (sartans)
AEIOU indications for dialysis
- Acidotic (pH < 7.1)
- Electrolytes ~ refractory hyperkalemia
- Intoxication
- Overload ~ CHF
- Uremia ~ uremic pericarditis, uremic encephalopathy
who can authorize a medical proxy to represent the patient if there is no MDPOA?
provider
when is a declaration of medical proxy directive used?
when no MDPOA on file, patient is declining and someone needs to make a decision
which AD is used when there are multiple dates ones available?
the newest one
in what circumstances is a MOST form used?
alert, oriented, in their right mind ~ MDPOA can also fill out
who is automatically the patient’s agent and can make decisions when they become incapable of doing so?
MDPOA
where are ADs kept in a hard copy chart?
in the front in green
function of endocrine glands
maintenance and regulation of vital functions
diabetes insipidus
- excretion of large amounts of dilute urine dried out
- increased Na
- polydipsia
- monitor neuro, CV, electrolyte
- administer vasopressin or desmopressin (ADH)