Exam 1

Question 1

Average urine output/day

Answer 1

400-600 ml (30ml/hr)

Question 2

1L fluid loss+=

Answer 2

1kg in weight

Question 3

Both water and electrolytes are lost equally

Answer 3

Isotonic dehydration (Hypovolemia)

Question 4

Water loss exceeds electrolyte loss

Answer 4

Hypertonic dehydration

Question 5

electrolyte loss exceeds water loss

Answer 5

hypotonic dehydration

Question 6

S/S of dehydration/Fluid loss

Answer 6

hyperthermia, tachycardia, THREADY pulse, Hypotension(Orthostatic), dry-furrowed tongue, n/v, anorexia, wt loss, oliguria, tugur/tenting, dysrhthmias, INCREASED rate and depth of respirations

Question 7

Fluid loss labs

Answer 7

H&H, osmolarity, protien, BUN, urine specific gravity, electrolytes

Question 8

Fluid loss intervention

Answer 8

Monitor UA, O2, CBC, electrolytes, I&O

Question 9

excess fluid in extracellular fluid compartment (causes circulatory overload)

Answer 9

Isotonic overhydration (Hypervolemia)

Question 10

Due to excessive sodium intake

Answer 10

Hypertonic overhydration

Question 11

water intoxication (excess fluid moves into intracellular spaces)

Answer 11

Hypotonic overhydration

Question 12

Causes Hypervolemia

Answer 12

heart failure, cirrhosis, gluticosteroids, renal failure, hypertonic fluids/improper iv therepy, burns, age changes, excessive sodium

Question 13

Causes of Hypertonic overhydration

Answer 13

excessive sodium, rapid infusion of hypertonic saline, excessive sodium bicarb therepy

Question 14

Hypotonic overhydration

Answer 14

early kidney disease, heart failure, siadh, replacing isotonic fluid loss with hypotonic fluids, irrigating wounds with hypotonic, improper IV therepy

Question 15

Fluid excess.overload s/s

Answer 15

Tachycardia, BOUNDING PULSES, HTN, tachypenea, confusion, muscle weakness, h/a, WT gain, ascites, dyspnea, orthopenea, crackles, Diminished breath sounds, edema, Distended neck veins, INCREASED RR, but shallow.

Question 16

Fluid excess intervention

Answer 16

Monitor ABG, o2, cbc, cxr, place patient in semi fowlers. daily wt. Lasix- low sodium, increase protein.

Question 17

What to watch for when inserting a central line

Answer 17

Pneumothorax

Question 18

Peripheal IV

Answer 18

Good for 4 days

Question 19

Midline

Answer 19

lasts 1-4 weeks, may use vanco, do not use vesicant drugs, DO not draw blood

Question 20

Central line

Answer 20

placed in centally near superior vena cava, NEED Cxr to confirm placement

Question 21

PICC

Answer 21

CXR to confirm, may have multiple lumens, may use long term

Question 22

Tunneled CVC

Answer 22

portion lies sq tunneled, Used for frequent and long term therepies, has cuff with antibiotic material

Question 23

non tunneled CVC

Answer 23

insert through subclavian in upper chest or jugular vein, tip resides in superior vena cava, CXR to confirm, used in emergency, more short term

Question 24

Implanted port

Answer 24

not visible, place upper chest, need to flush after each use and monthly with heperin, pts need iv therepy longer than 1 yr.

Question 25

Hemodialysis Catheter

Answer 25

Very large lumen, can be tunneled or ot, critical renal management, use heperin flush, not used for other things except in emergency

Question 26

Iso tonic Solutions

Answer 26

NaCL 0.9%, NS w/electrolytes,Normosol R, D5W (ISO in Bag, HYPER in body)

Question 27

Hypertonic Solutions

Answer 27

D5NS, DS 1/2 NS, D5LR,

Question 28

Hypotonic solution

Answer 28

1/2 Normal Saline

Question 29

What fluid do you not use in kidney pts

Answer 29

Lactated Ringers

Question 30

Do not use what in head injury pts (Can cause cerebral edema)

Answer 30

Dextrose

Question 31

what does hypertonic solution do

Answer 31

corrects fluid, electrolyte and acid base by moving water out of cell and into bloodstream

Question 32

what does hypotonic solutions do

Answer 32

moves water into cell and expands them

Question 33

what does isotonic solution do

Answer 33

water does not move in or out of cell, risk for fluid overload.

Question 34

Sodium Lab

Answer 34

135-145

Question 35

Potassium Lab

Answer 35

3.5-5

Question 36

Calcium Lab

Answer 36

9-10.5

Question 37

Magnesium Lab

Answer 37

1.3-2.1

Question 38

Phosphorus Lab

Answer 38

3-4.5

Question 39

Chloride Lab

Answer 39

98-106

Question 40

Hyponatrimia causes

Answer 40

fluid loss or low sodium diet

Question 41

hyponatrimia s/s

Answer 41

*THink Neuro sx, tachy, thready pulses, fatigue, muscle cramps, weakness, decreased DTR's, seizures (With muscle weakness watch for possible resp. compromise)

Question 42

Hypernatimia causes

Answer 42

corticosteroids, sushings, kidney disease, increased sodium

Question 43

Hypernatrimia s/s

Answer 43

*hyperthermia, tachy, Decreased DTR, thirdt, increased motility..pulmonary edema if r/t hypervolemia

Question 44

Hypokalemia s/s

Answer 44

Think Cardiac s/s..

Question 45

Hypokalemia causes

Answer 45

excessive diuretics, digoxin, cushings, vomiting, diarehea, wound drainage, NPO, TPN

Question 46

Hyperkalemia cuases

Answer 46

too much potassium, salt substitutes, kidney disease, sepsis, decreased insulin, ace inhibitors, nsaids

Question 47

Hyperkalemia s/s

Answer 47

think cardiac

Question 48

Hypocalcemia s/s

Answer 48

everything is decreased, muscle twitching, tetany, cramps,

Question 49

Hypercalcemia

Answer 49

Everything is increased. weak muscles, Decreased dtr's, flank pain,

Question 50

Hypomagnesium

Answer 50

same as hypocalcemia- positive trousas, and chvosky sign.

Question 51

hypermag

Answer 51

causes mag containing antiacids, s/s brady, dysrhythemias,

Question 52

hypophosphate

Answer 52

same s/s as hypercalcemia.. decreased everything-cardiac, pulses, breathing,, rhabdo..

Question 53

hyperphoshate

Answer 53

same s/s as hypocalcium.. seizure, muscle twithc, positive traousaus and chevoski

Question 54

Prolonged PR interval, widened QRS complex

Answer 54

Hypermag

Question 55

Tall T wave, depressed ST segment

Answer 55

Hypomag

Question 56

Tall peaked T waves, flat P wavesm Widened QRS, prolonged PR interval

Answer 56

HyperK

Question 57

ST depression, shallow or flat or inverted T waves, prominent U waves

Answer 57

HypoK