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Principles of Nursing > Exam 1 Focus > Flashcards

Exam 1 Focus Flashcards

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1
Q

What is hypovolemia

A

fluid volume deficit

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2
Q

Causes of hypovolemia

A

Insufficient intake
Excessive loss: bleeding, excessive sweating, diuretics, vomiting/diarrhea, renal failure

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3
Q

S&S of hypovolemia

A

Confusion, dizziness, dry mucous membranes, tachycardia, concentrated urine, headache, orthostatic hypotension, weight loss

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4
Q

Medication treatment of hypovolemia

A

Isotonic crystalloid solutions
Replace fluids, LR or 0.9 NS

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5
Q

Nursing interventions of hypovolemia

A

Weight
> amount of fluid
VS
Skin color, temp, and moisture
Active bleeding
Sources of fluid loss

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6
Q

What is hypoervolemia

A

Fluid volume excess

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7
Q

Causes of hypervolemia

A

Excess of isotonic fluid in extracellular
Excessive intake: IV’s, high water intake, blood or plasma transfusion
Excessive retention: hyperaldosterone, High Na
Shifting: Hypertonic fluids, use of albumin or other colloids

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8
Q

S&S of hypervolemia

A

Excess of isotonic in extracellular
Blood test

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9
Q

Medical treatment of hypervolemia

A

Low Na diet, fluid restrict
Medications: diuretic

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10
Q

Nursing interventions of hypervolemia

A

Elevate HOB
I&O
Oral care and skin care
Daily weight
Monitor edema

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11
Q

Types of peripheral catheters

A

Angiocath
Butterfly
Midline

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12
Q

Angiocath

A

Catheter inserted directly into the vein for drug administration

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13
Q

Butterfly

A

A small need with two plastic wings attached which are squeezed together to form a tab that is used to manipulate the needle
Purpose of drawing a blood sample

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14
Q

Midline catheter

A

Any catheter placed between the antecubital area and the head of the clavicle

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15
Q

What is a PICC
Where is it inserted

A

Peripherally inserted central catheters
Tip is in superior vena cava
Stay in place for up to a year

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16
Q

Tunneled catheter

A

A catheter that is tunneled through the skin and subcutaneous tissue to a central vessel; the entrance point of the catheter is distant from the entrance to the vascular system.

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17
Q

Non-tunneled catheter

A

A catheter that is inserted through the skin directly into a central vessel

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18
Q

Intraosseous catheter

A

Peds, emergency, and trauma
No longer than 24 hours

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19
Q

When to use peripheral vs central

A

Type/amount of fluid
Anticipated duration of therapy
Pt condition
Venous condition

20
Q

What is phlebitis

A

vein inflammation

21
Q

Clinical manifestations of phlebitis

A

Redness, warmth, pain

22
Q

Intervention of phlebitis

A

Discontinue

23
Q

What is infiltration

A

Fluid enters surrounding tissue

24
Q

Causes of infiltration

A

Tip of the catheter slips out of the vein, passes through the wall of the vein, long term use = wall of vein weakens, dislodged catheter

25
Q

Clinical manifestations of infiltration

A

Paleness, coolness, no blood return

26
Q

Interventions of infiltration

A

Elevate and remove it

27
Q

What is extravasation

A

Medications leak into surrounding tissue

28
Q

Clinical manifestations of extravasation

A

Cell death
Redness and swelling

29
Q

Interventions of extravasation

A

Antidote and discontinue

30
Q

VAD maintenance (Ventricular assist device)

A

Changed every 72-96 hours

31
Q

What are crystalloids

A

small molecules

32
Q

Hypotonic crystalloids
Ex.
Use

A

0.45 normal saline
D5W
Effects: hydrate

33
Q

Isotonic crystalloids
Ex.
Use

A

0.9 NS
Lactated ringer
Effects: vascular expansion

34
Q

Hypertonic crystalloids

A

3%-5% saline
D5 0.9 NS
D5 0.45 NS
Effects: vascular expansion, electrolyte replacement

35
Q

What are colloids

A

Large molecules

36
Q

Albumin colloid
What is it
Use
Moa

A

Blood product
Helps with perfusion
Volume expansion, moderate protein replacement

37
Q

Dextran colloids
MOA
What is it?
Use

A

Volume expansion
Synthetic
Treats shock

38
Q

Hydroxyl-ethal starches
AKA
What is it?
Use

A

AKA hetastarch
synthetic
Volume replacement following major surgery or major burns

39
Q

Nursing considerations of administering colloids

A

18-gauge or larger to infuse
S/S of hypervolemia
Monitor I&O
Elevate HOB

40
Q

Purpose of TPN
What is it for?

A

Restore of maintain nutrition
For debilitating illnesses

41
Q

TPN order

A

Replace every 24 hours.
Good breeding ground for bacteria
Day to day basis

42
Q

Nursing considerations for TPN

A

Start tubing with each new bag
Gradual start–>increase
Requires filter
Don’t run with other fluids or meds
Accuchecks
Frequent oral care
Strict I&O

43
Q

What is PRBC
When to give
Administration considerations

A

Packed red blood cells
HGB < 7 or symptomatic
Given in 4 hours of less. Large gauge needle (18-20).
Prime with 0.9 NS. After admin check pt for 15 min

44
Q

Platelet
Purpose
Administration consideration

A

Treat bleeding due to low platelet count
Given over shorter period of time

45
Q

Fresh frozen plasma
Purpose
Administration consideration

A

Treat post of hemorrhage
Correct coagulation deficiencies
Shorter period of time

Principles of Nursing (3 decks)

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