Exam 1 Flashcards
term:
response to trauma. surgery, severe illness, or body cavity
physiologic stress
flight or flight response
sympathetic response
during a sympathetic response what happens to blood vessel?
vasoconstriction
when in flight or flight what happens to pupils?
Dialation
rest and digest
Parasympathetic
what happens to blood vessels during a parasympathetic response?
Vasodilation
fluid moves to what area of the body?
interstitial tissue
fluid shifts result in
peripheral edema and fluid accumulation around the surgical or trauma site
where does Na flow?
Na follows water
during surgery is sodium high or low?
High because in surgery you are always given fluids and sodium will always follow
What is the normal sodium range?
*know for acid base imbalance
135 - 145
What is the normal range for potassium
3.5 - 5.0
potassium will most likely only go up during what
renal problem or kidney failure
what happens to potassium?
It gets excreted
during surgery what occurs for Na and K?
Na goes up
K goes down
why is the passing of K important?
excretion of potassium
if K is not in the normal range, you cannot shock a person back during arrhythmias.
K helps with electricity
what does the EKG tracing show for low K
Shows a “U”
Post surgery where are some areas we can expect to see fluid build up?
at the site of the surgery (Appendectomy, for example)
feet, ankles, shins, hands, face, and maybe even above the eyes
Why is fluid accumulation / edema around the eyes bad?
it can cause damage to the cornea and the eyeball itself
what happens when a vein gets hit and / or a large bone?
Lots of blood loss very rapidly
- Femur, blood marrow, hips, pelvis, and tibia for example
when you loose blood what is also going to happen?
Hypotension, hypovolemia, and thirst
“Low blood volume”
Hypovolemia
taking bp while sitting down, standing up, and laying down
orthostatic hypotension
what does ACTH affect?
Our cortisol levels
sodium and water retention
and potassium excretion
what does this mean for the nurse?
less urine produced
increased blood volume
increased blood pressure
inability to reabsorb sodium and excrete potassium due to compromised renal regulation
if a patient has increased water retention, what happens with blood pressure?
BP goes up slightly
At what point (systolic value) do you stop perfusing your kidneys and you are in danger
Kidneys stop perfusing at 70 systolic
if a patient is struggling to urinate after surgery and look at the surgical notes:
You read that during the procedure the patients blood pressure fell to 70 systolic, why is this important?
because at 70 systolic - you stop perfusing your kidneys. So it would be “normal” to have a delayed urination
what gland releases an AntiDiuretic hormone?
pituitary gland
prior to surgery a patient had a blood pressure of 120/80
after surgery the monitor reads 130/84
why did it increase?
The fluid shift
cortisol affects
glucose
What is a possible glucose level after an open heart surgery (very invasive and stressful procedure) think about cortisol..
It’s not uncommon to see over 700
what is a normal glucose level?
7.5
vasopressin causes
kidneys to conserve water and is a vascular pressor
what population is more susceptible to high cortisol levels?
older clients and female
involves an increased level of endogenous hepatic glucose production while insulin-stimulated peripheral glucose uptake is reduced
stress hyperglycemia (acute response)
is diabetes chronic or an acute condition?
Chronic
too much stress can cause a gastric ulcer. how?
damage to the stomach mucosal barrier
what causes stomach ulcers, what increases and decreases?
bile salts increases and blood flow decrease
what to do to prevent stomach ulcers
raise the head of the bed (better oxygenation and also prevents from gastrics coming up) and give IV Push ProTonics
NG tube patients must never lay in what position
Laying flat - aspiration is highly if flat
What is an IV Push of Protonics
it’s a proton pump inhibitor to help from developing a stomach ulcer
What are some symptoms of a stress ulcer?
- dull stomach paining
- heartburn
-bloating and feeling full
-nausea
