Exam 2 Flashcards
What does a ⬆️ hematocrit and
⬆️ serum sodium mean?
Dehydration! 🥵
A concentrated serum sodium lab values ⬆️, because of ⬇️ volume to dilute values
Nursing intervention for “fluid volume excess”
Restrict 🧂in diet (+fluid = +sodium)
Sodium is restricted 🚫to allow body to excrete extra water 🌊
What do you do in case of a sodium 🧂level of 110mEq/L?
(Anything Lower than 120!)
⚠️Place on seizure 🫨 precautions⚠️
If a patient has numbness & tingling in mouth and tips of fingers, you can assess the Chvosteks sign….
What do you do & what is it a sign of?
Tap cheek 2cm anterior to👂lobe
➕= facial twitch= hypocalcemia 👨🏻⚕️
➖= no movement
What lab do you assess with 🤮& diarrhea? 🚽
Serum potassium 🩸
Potassium imbalances can lead to
🫀 arrhythmias
S & S of Hypernatremia
⬆️ serum sodium blood level🩸
⬇️💧intake, 💧 loss, or rarely +🧂
Dehydration symptoms:
Postural Hypotension
Weakness
Tachy 🫀
Replace 💧fluids
Hyponatremia Treatment
Low serum sodium level 🩸
If water excess =Fluid restrictions
If fluid loss is cause= +🧂 solutions 💧
Hyperkalemia S & S
⬆️serum potassium level🩸
From renal failure, injury/burn, 🦠
Confusion 🤷🏽♀️
💪🏽 cramps
Weakness of 🦴muscles
Telemetry 〽️
Dangerous 🫀 = IV calcium gluconate
Hypokalemia S & S
⬇️ serum potassium level 🩸
Losses from Kidneys or GI tract 🫄
☠️ ventricular dysthymias
🦴 muscle weakness
Shallow 🫁& arrest
U waves, inverted T waves, Deoressed ST segment
Treatment=IV Potassium chloride & diet 🥔🍊
Calcium imbalances S & S:
(Hypercalcemia ⬆️, Hyperparathyroidism,
Other 2/3 = 🩸, breast, or 🫁 CA)
Fatigue
Confusion 🤷
Weakness
Seizures 🫨
🫀dysrhythmias
Treat= loop diuretics
Hydrating with isotonic solution 💧
Hypocalcemia S & S
⬇️serum calcium level 🩸
⬇️ parathyroid hormone
💪🏽excitability & tetany
Numbness
Muscle weakness
Laryngeal Stridor ➡️🫁arrest
Prolonged QT interval & ST segment
Treat w/ IV calcium
Hyperphosphatemia S & S
⬆️ serum phosphorus level🩸
Acute kidney injury or disease 🥊
🧠muscular irritability
Tetany and calcified in soft tissue 🦴
Treat primary cause
Hypophosphatemia S & S
⬇️ serum phosphorus level 🩸
Malnourished or malabsorption syndrome 🚫🌮
Asymptomatic
Treat w/ IV phosphorus
Hypermagnesemia S& S
⬆️ serum magnesium level 🩸
Renal insufficiency w/ +mag intake
Hypotension
Facial flushing 🤍
Nausea & 🤮
Loss of deep tendon reflex
🫁 & 🫀 arrest
Treatment is to avoid magnesium foods & IV calcium
Hypomagnesemia S & S
Malnutrition states: fasting and starvation 🦴 or +GI or kidney loss
Excessive 🥃🍹
🧠 CNS irritability
Tremors
Seizures 🫨
Confusion🤷
Treatment= 💊 or IV supplements
🫁 acidosis occurs whenever there is…
Hypoventillation
Respiratory Failure
⬇️pH, ⬆️PaCO2, HCO3 Normal
🫁 alkalosis happens when there is…
Hyperventilation
Hypoxemia
Pulmonary d/o
⬆️pH, ⬇️PaCO2, HCO3 Normal
Who is likely to develop fluid overload? 🫃🏽
A patient on RENAL dialysis
A patient with 🫀 failure ⬇️
IV calcium gluconate is used for which electrolyte imbalance?
⬆️Hypermagnesia
⬇️Hypocalcemia
D5NS and 3% saline are what types of solutions? 💧
Hypertonic 🫨
What can you notice in a patient with a massive 🔥 injury & possible hypovolemia?
Low blood pressure
Example: 90/40 mm Hg
If it comes out your 🍑,
You are…
Acidotic
K imbalances =
Kardiac 🫀
Magnesium think muscle …
Hypomagnesemia = 💪🏽muscle cramps 🦵🏽
Hypermagnesemia= too much muscle relaxation 🛌🥱
Na imbalances =
Neuro 🧠
Hypocalcemia =
Tetany
➕Chvostek
➕ Trousseaus
Palliative care
Holistic approach to care or treatment that focuses on reducing severity of disease symptoms 🥺♥️
Nursing care plan for CA
Hand washing 🧼
🚫fresh, unwashed 🍓🍇🥗🥕
No plants 🪴
😷 mask if you have a cold 🤧
Monitor urine and temperature 🤒
🩸transfusion
Monitor for bleeding, soft🪥
Mouth care
Wigs (self body image)
Cataracts 👀 S & S
Common in 👵🏽👴🏼
Lenses is cloudy
Affects near & far vision
Difficult of adjest light & dark
Treat- surgically w/lens implant
🚫 rubbing of 👁️
🚫💨 conditions
🚫👵🏽🚗🛣️ for 48hrs
🚫🏊🏼♂️👙for 3 months 🌊
Glaucoma S & S 🌊👁️
Lading cause 📈of blindness 😎
Notice when it’s too late
Open angle = common type
⬆️ internal pressure=
Pressure on optic nerve 🪢
⬇️peripheral vision
Mild HA 🤕
Unable to 👀 in dark
🔘Halo around light
Glaucoma care
Routine eye visits 👨🏻⚕️
Rx 💊= pilocarpine & Timoptic
Surgical intervention 💉to improve drainage
Otosclerosis
Hereditary 🧬
Starts in adolescents or early 🧒
Tinnitus 🔔
Progressive hearing ⬇️
👂Background noises
Vertigo 🫨
Hearing aid
Sodium fluoride
Surgery w/prosthesis 🔪👂🏼
Meniere’s Disease 👂🏼
Disorder of inner 👂🏼
Excess of endolymph
Rotary vertigo 🫨
Whirling vertigo 🌊
Tinnitus 🔔
Unilateral hearing loss
Treatments for Meniere’s Disease
💊 Atropine or Valium
Antivert
Compazine or vistaril
Lasix
🔪 surgery
Low 🧂diet
🚫🍹🥤caffeine, or 🚬🚭
Don’t give DW5 fluids to…
🤕Head injury patients
Infants 👶🏾🍼
May cause cerebral edema
Isotonic solutions
Normal Saline (0.9%)
Lactated Ringer
D5W (on shelf)
Stays in bloodstream or intravascular
Treatment:
Maintain fluid volume 💧
Hypovolemia & fluid loss
Replace Na and Cl
Hypernatremia 🧂
Hyperkalemia
Hypertonic Solutions
Will pull a less concentrated solution into self
D5NS
3% saline
D10W
Treats:
Hypoglycemia 🍬
Severe hyponatremia 🧂
Hypotonic Solutions
Will shift & flow into a more concentrated solution
1/2 NS (0.45%)
DW5 (once metabolized)
Treats:
Expands intracellular compartment
Replaces free water 💧
DW5- Hypernatremia
What are the Anions and their ranges?
Bicarbonate (HCO3-) 22-26 mEq/L
Chloride (Cl-). 98-106 mEq/L
Phosphate (PO43-). 3.0-4.5 mg/dL
What are the Cations and their ranges?
Calcium total (Ca2+) 9.0-10.5mg/dL
Calcium ionized 4.5-5.6 mg/dL
Magnesium (Mg2+) 1.3-2.1 mEq/L
Potassium (K+) 3.5-5.0 mEq/L
Sodium (Na+) 136-145 mEq/L
ABG pH range
7.35 - 7.45
Less than 7.35 = acidosis
More than 7.45 = alkalosis
Metabolic 🩸 acidosis
Lactic acid accumulation
Kidney disease
Severe diarrhea 💩
⬇️pH, PaCO2 Normal, ⬇️ HCO3
Metabolic 🩸alkalosis
Prolonged vomiting 🤮
Gastric suctioning
Gain of bicarbonate
⬆️pH, PaCO2Normal , ⬆️HCO3
