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Med Surg2 > Exam 1 > Flashcards

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
Q

Magnesium’s main function

A

Helps 💪🏽& nerve stay healthy regulates energy 🏃🏽‍♀️

Imbalances can lead to:
Sedation 🧠💤

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26
Q

Phosphorus’s main function

A

Maintained 🦷&🦴. Repairs🔧 cells & body tissue 🌀

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27
Q

Chloride’s main function

A

Maintains acid-base balance
Controls 💦levels in cells ⭕

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28
Q

DKA happens most often with?

A

Type 1 Diabetic

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29
Q

DKA has?

A

Keytones

(Breaks down protein & fat, making it Acidotic)

DK(A)= Acidotic

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30
Q

Who is at risk for DKA?

A

Type 1 Diabetic
Illness 🤧 (steroid use)
Stress 😖
Economic (No💰for 💊💉)

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31
Q

Labs to check for Endocrine?

A

Calcitonin- secreted by thyroid, regulates calcium

Cortisol- stress hormone

ADH- amount of H2O in body

Aldosterone- helps balance fluids

32
Q

DKA is?

A

A profound deficiency of insulin

33
Q

DKA is characterized by?

A

Hyperglycemia
ketosis
Acidosis
Dehydration

34
Q

Clinical manifestations of DKA?

A

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
Q

DKA Nursing Management

A

✅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
Q

HHS often occurs in people

A

60+ years w/ Type 2 DM

37
Q

HHS can be caused by?

A

UTIs
PNA
Sepsis
Acute illness
Newly Dx DM2
Inadequate fluid intake
Impaired cognition
Polyuria

38
Q

What’s different about HHS?

A

Ketosis does not accur

39
Q

With HHS, glucose can be

A

Greater than 600 w/ absent keytones

40
Q

With correction of HHS, what is often given?

A

IV dextrose to prevent Hypoglycemia

41
Q

Hypokalemia is not as significant in?

A

Not as significant in HHS as DKA

42
Q

What is DI?

A

Diabetes Insipidus

Caused by ⬇️ADH or ⬇️renal response to ADH

(Dry inside! Dumps urine💛)

43
Q

Causes of DI

A

Brain injury & 🧠Tumor

44
Q

Clinical manifestations of DI

A

Dehydration
⬆️Uribe output
Hypernatremic
Thirsty
Confused
Hypotension

45
Q

DI Nursing management

A

✅SG, I/Os, vitals, LOC🧠
Hypotonic solution
Electrolyte replacement
Desmopressin💊- retains 💦
Thiazide💊 or Indomethacin
Nutrition- ⬇️🧂

46
Q

What is SIADH?

A

Overproduction of ADH

(Soaked Inside- holds onto 💦)

47
Q

Causes of SIADH

A

Tumors/CA, head trauma, lung disease/CA, Pancreatic CA, medications

48
Q

Clinical Manifestations of SIADH

A

⬆️BP, seizure, HA, puffy, crackles, edema, wt gain, neuro, tachycardia, hypoosmolarity, hyponatremic

49
Q

Nursing intervention for SIADH?

A

Fluid restrictions 🚫 800-1000ml/day
Hypertonic solution
Diuretics 💊
Seizure precautions

50
Q

Cushing syndrome is from

A

Excess corticosteroids and glucocorticoids

51
Q

Clinical manifestations of Cushing Syndrome

A

🌜face, thin skin, prolonged healing,
Buffalo 🦬 hump, thin hair, Weight gain, Acne, Purple striae, Atropic arms , ⬆️glucose, ⬇️potassium

52
Q

Nursing intervention for Cushing syndrome

A

Normalize BS & cortisol level

⬇️🧂 in diet
⬆️protein for 💪🏽
⬇️carbs
Exercise
Stress

53
Q

What is Addisons Disease?

A

Adrenal insufficiency

(Cortisol & Aldosterone)

54
Q

Common causes of Addisons disease

A

Autoimmune disorders such as Celiac Disease

55
Q

Clinical manifestations of Addisons Disease

A

Bronze skin🎃
Fatigue
Hyperpigmentation
Orthostatic hypotension
Weight loss irritable

56
Q

Addisons crisis consists of?

A

⬇️🧂levels

⬆️potassium levels

⬇️glucose 🍬 levels

57
Q

ABO compatibility is not needed for?

A

Platelet transfusions

58
Q

🩸Administration Procedure

A

20G IV
Verify patency of IV access
Y-tubing w/filter
Normal saline
🩸product from 🩸bank
Patient identification
2 nurse check
Consents signed ✍🏽

59
Q

When should vital signs be performed for a 🩸transfusion

A

Prior to start (stay w/pt for 1st 15min)
15 min after starting 🩸
Completion
1 hour
4 hours

Observe 👀every 30 min

60
Q

Packed RBC are for?

A

Anemia- ⬆️oxygen
Acute 🩸⬇️

Start w/in 30 min
Complete w/in 4 hours ⏳

61
Q

Platelets are for?

A

Prevent 🩸, serious bleeding

62
Q

FFP- Fresh frozen plasma is for?

A

Liver failure
Infections
Burns

63
Q

Cryoprecipitate is given for?

A

Lack of fibrinogen

64
Q

Albumin is given for?

A

Volume expansion
Hypovolemic shock

65
Q

Nursing management for transfusion reactions

A

🛑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
Q

Examples of chest trauma

A

🔪wounds
Seat belt
GSW
Pneumothorax
Hemothirax
Tension pneumothorax
Flailed chest

67
Q

Rib fracture symptoms

A

Pain with inhalation, shallow breathing

68
Q

Flailed chest symptoms

A

Rapid shallow breathing

69
Q

Pneumothorax symptoms

A

Rapid shallow breathing, poor ventilation

70
Q

Hemothorax symptoms 🩸

A

🩸in pleura space, SOB, dyspnea, diminished 🫁sounds

71
Q

Tension pneumothorax symptoms

A

Trauma, JVD, deviated trachea and 🫀, cyanosis

72
Q

With a hemothorax, If 🩸 is more than? You call the physician

A

200mL in first hour

73
Q

Pre operative assessment for thoracic surgery 🔪

A

Cardio-pulmonary assessment
Support system
🚫smoking
Spirometer teaching
Labs

74
Q

Post op thoracic surgery

A

Pain management 💊
Respiratory status
Fluid balance
Ambulating
Pneumonia prevention
SDCs
Clot prevention, prevent PE
Watch for stroke

75
Q

S&S of PE

A

Hypoxia, Tachycardia, hypotension,
Dyspnea, Hemoptosis, wheezing,
Cough, chest pain, crackles,

Impending doom

Med Surg2 (5 decks)

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