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Exam 1 Flashcards

1
Q

What is an example of hypertonic IV solution?
Fluorescent 💚

A

D5% & 0.45% Saline

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2
Q

What is an example of an isotonic solution

Pale 💛

A

Lacerated Ringers

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3
Q

What is an example of a hypotonic solution?
Fluorescent 💚

A

0.45% Saline

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4
Q

What is an example of a colloid solution?
Pale 💛

A

Albumin

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5
Q

Leaving the patient “high & dry” =

A

Heloconcentration/fluid dehydration

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6
Q

Hypovolemic shock😱=

A

Excess loss of 🩸or fluids resulting in organ failure 📉

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7
Q

Hypotonic solution causes?

A

Fluid to move into 👉cell causing it to swell ⭕

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8
Q

Hypertonic solution causes?

A

Fluid 💦to move out 📤of the cell causing it to shrink 🤏🏽

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9
Q

What is inversely related with Calcium?

A

Phosphate

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10
Q

What is important in 💪contraction?

A

Magnesium

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11
Q

What can cause 🫀arrhythmias?

A

Potassium imbalance

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12
Q

Can use calcium, Albuterol😮‍💨, bicarbonate, insulin & dextrose 💊to fix 🔧 this acute imbalance?

A

⬆️ Hyperkalemia

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13
Q

You should push & encourage 💦fluids w/this electrolyte imbalance?

A

Hypercalcemia ⬆️

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14
Q

You can 👀 see
➕Trousseau’s and
➕Chvostek’s
In these 2 imbalances?

A

Hypocalcemia ⬇️
Hypomagnesemia ⬇️

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15
Q

Hyponatremia🧂can be caused by?

A

Ingesting too much 💦 too quickly ⌛

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16
Q

3% 💦saline can be used for this acute imbalance?

A

Hyponatremia ⬇️🧂

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17
Q

Hypernatremia ⬆️🧂can be caused by?

A

Excess 💦⬇️loss or inadequate water intake

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18
Q

20mEq KCI is to be infused ↪️

A

Via central line

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19
Q

💦🥤restrictions🚫can be used in this imbalance?

A

⬇️ Hyponatremia 🧂

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20
Q

Daily📆 weights is an easy way to?

A

Monitor 📝 fluid💦 status

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21
Q

PaCO2 level of 62 can be considered?

A

⬆️Hypercapnia or

⬆️Hypercarbia

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22
Q

Sodium 🧂 main function

A

Helps maintain 🩸volume & BP

Imbalances can lead to:
🧠changes

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23
Q

Potassium main function

A

Helps 💪🏻to contract, including♥️

Imbalances can lead to:
🫀Dysrhythmias

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24
Q

Calciums main function

A

Helps w/🫀 function, 🩸clotting, & 🦴formation

Imbalances can lead to:
⬆️Risk for 🦴fractures

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25
Magnesium’s main function
Helps 💪🏽& nerve stay healthy regulates energy 🏃🏽‍♀️ Imbalances can lead to: Sedation 🧠💤
26
Phosphorus’s main function
Maintained 🦷&🦴. Repairs🔧 cells & body tissue 🌀
27
Chloride’s main function
Maintains acid-base balance Controls 💦levels in cells ⭕
28
DKA happens most often with?
Type 1 Diabetic
29
DKA has?
Keytones (Breaks down protein & fat, making it Acidotic) DK(A)= Acidotic
30
Who is at risk for DKA?
Type 1 Diabetic Illness 🤧 (steroid use) Stress 😖 Economic (No💰for 💊💉)
31
Labs to check for Endocrine?
Calcitonin- secreted by thyroid, regulates calcium Cortisol- stress hormone ADH- amount of H2O in body Aldosterone- helps balance fluids
32
DKA is?
A profound deficiency of insulin
33
DKA is characterized by?
Hyperglycemia ketosis Acidosis Dehydration
34
Clinical manifestations of DKA?
Early- lethargic & weak Dehydration Tachycardia Orthostatic Hypotension Kussmaul respirations (Deep/fast) Abdominal pain Fruit breath Labs: Glucose- 250+ pH less than 7.30 Bicarb less than 16 +ketones in urine or serum
35
DKA Nursing Management
✅for: fever, N/V, Diarrhea, AMS, cause of DKA Fluid balance: 0.45% or 0.9% to⬆️BP & restore urine output ✅potassium Telemetry for potassium imbalance Assess 🧠status Goal: don’t correct too quick correct electrolytes Monitor for fluid overload Reduce glucose by 36-54mg/dl/hr (cerebral edema)
36
HHS often occurs in people
60+ years w/ Type 2 DM
37
HHS can be caused by?
UTIs PNA Sepsis Acute illness Newly Dx DM2 Inadequate fluid intake Impaired cognition Polyuria
38
What’s different about HHS?
Ketosis does not accur
39
With HHS, glucose can be
Greater than 600 w/ absent keytones
40
With correction of HHS, what is often given?
IV dextrose to prevent Hypoglycemia
41
Hypokalemia is not as significant in?
Not as significant in HHS as DKA
42
What is DI?
Diabetes Insipidus Caused by ⬇️ADH or ⬇️renal response to ADH (Dry inside! Dumps urine💛)
43
Causes of DI
Brain injury & 🧠Tumor
44
Clinical manifestations of DI
Dehydration ⬆️Uribe output Hypernatremic Thirsty Confused Hypotension
45
DI Nursing management
✅SG, I/Os, vitals, LOC🧠 Hypotonic solution Electrolyte replacement Desmopressin💊- retains 💦 Thiazide💊 or Indomethacin Nutrition- ⬇️🧂
46
What is SIADH?
Overproduction of ADH (Soaked Inside- holds onto 💦)
47
Causes of SIADH
Tumors/CA, head trauma, lung disease/CA, Pancreatic CA, medications
48
Clinical Manifestations of SIADH
⬆️BP, seizure, HA, puffy, crackles, edema, wt gain, neuro, tachycardia, hypoosmolarity, hyponatremic
49
Nursing intervention for SIADH?
Fluid restrictions 🚫 800-1000ml/day Hypertonic solution Diuretics 💊 Seizure precautions
50
Cushing syndrome is from
Excess corticosteroids and glucocorticoids
51
Clinical manifestations of Cushing Syndrome
🌜face, thin skin, prolonged healing, Buffalo 🦬 hump, thin hair, Weight gain, Acne, Purple striae, Atropic arms , ⬆️glucose, ⬇️potassium
52
Nursing intervention for Cushing syndrome
Normalize BS & cortisol level ⬇️🧂 in diet ⬆️protein for 💪🏽 ⬇️carbs Exercise Stress
53
What is Addisons Disease?
Adrenal insufficiency (Cortisol & Aldosterone)
54
Common causes of Addisons disease
Autoimmune disorders such as Celiac Disease
55
Clinical manifestations of Addisons Disease
Bronze skin🎃 Fatigue Hyperpigmentation Orthostatic hypotension Weight loss irritable
56
Addisons crisis consists of?
⬇️🧂levels ⬆️potassium levels ⬇️glucose 🍬 levels
57
ABO compatibility is not needed for?
Platelet transfusions
58
🩸Administration Procedure
20G IV Verify patency of IV access Y-tubing w/filter Normal saline 🩸product from 🩸bank Patient identification 2 nurse check Consents signed ✍🏽
59
When should vital signs be performed for a 🩸transfusion
Prior to start (stay w/pt for 1st 15min) 15 min after starting 🩸 Completion 1 hour 4 hours Observe 👀every 30 min
60
Packed RBC are for?
Anemia- ⬆️oxygen Acute 🩸⬇️ Start w/in 30 min Complete w/in 4 hours ⏳
61
Platelets are for?
Prevent 🩸, serious bleeding
62
FFP- Fresh frozen plasma is for?
Liver failure Infections Burns
63
Cryoprecipitate is given for?
Lack of fibrinogen
64
Albumin is given for?
Volume expansion Hypovolemic shock
65
Nursing management for transfusion reactions
🛑transfusion Change tubing Start NS Notify Dr & 🩸bank Re✅tags Monitor VS Treat symptoms 💊 Save 🩸bag & tubing Collect blood samples (distal to site) ✍🏽document reactions in chart
66
Examples of chest trauma
🔪wounds Seat belt GSW Pneumothorax Hemothirax Tension pneumothorax Flailed chest
67
Rib fracture symptoms
Pain with inhalation, shallow breathing
68
Flailed chest symptoms
Rapid shallow breathing
69
Pneumothorax symptoms
Rapid shallow breathing, poor ventilation
70
Hemothorax symptoms 🩸
🩸in pleura space, SOB, dyspnea, diminished 🫁sounds
71
Tension pneumothorax symptoms
Trauma, JVD, deviated trachea and 🫀, cyanosis
72
With a hemothorax, If 🩸 is more than? You call the physician
200mL in first hour
73
Pre operative assessment for thoracic surgery 🔪
Cardio-pulmonary assessment Support system 🚫smoking Spirometer teaching Labs
74
Post op thoracic surgery
Pain management 💊 Respiratory status Fluid balance Ambulating Pneumonia prevention SDCs Clot prevention, prevent PE Watch for stroke
75
S&S of PE
Hypoxia, Tachycardia, hypotension, Dyspnea, Hemoptosis, wheezing, Cough, chest pain, crackles, Impending doom
76
Hyperkalemia
Cardiac arrhythmias Abdominal cramping Leg cramping Peak T waves Paralasis of skeletal muscles 🚨Impairs ammonia excretion and leads to acidosis
77
Hypokalemia
Cause by 🤮or ⬇️kidney function PVC, VT, VF 🫀 Parallitic illius 🫁depression from impaired skeletal muscle function
78
How to fix potassium imbalances
Slowly No🚫IV pushes or bolus
79
Potassium monitoring
Telemetry Respiratory LOC
80
Hyperkalemia treatment See (C) A BIG Potassium (K) Level (L) Decrease (D)
Calcium- Chloride/Gluconate Albuterol Bicarbonate Insulin Glucose/Dextrose Kayexalate Loop Diuretics Dialysis
81
Hypercalcemia symptoms
Groans- constipation, N/🤮 Moans- fatigue, deoression Bones- pain Stones- kidney 🗿 Overtones- psych, depres😭, confus Muscle weakness & coordination issues
82
Hypocalcemia symptoms
Tetanus: Chvostoks sign Trouddeaus sign Stridor Parathesia In ✋, 🦶, and mouth
83
Hypocslcemia causes
Hypoparathyoid Renal insufficiency ⬆️Phosohate ⬇️Magnesium
84
Treating Hypocalcemia
⬆️ calcium in diet Calcium gluconate Tums
85
Hypercalcemia treatment
Fix PTH issues ⬇️calcium in diet 3-4L hydration/day Exercise Loop diuretics

Med Surg2 (5 decks)

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