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Med Surg 1 > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

What does a ⬆️ hematocrit and
⬆️ serum sodium mean?

A

Dehydration! 🥵
A concentrated serum sodium lab values ⬆️, because of ⬇️ volume to dilute values

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2
Q

Nursing intervention for “fluid volume excess”

A

Restrict 🧂in diet (+fluid = +sodium)

Sodium is restricted 🚫to allow body to excrete extra water 🌊

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3
Q

What do you do in case of a sodium 🧂level of 110mEq/L?

A

(Anything Lower than 120!)

⚠️Place on seizure 🫨 precautions⚠️

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4
Q

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?

A

Tap cheek 2cm anterior to👂lobe

➕= facial twitch= hypocalcemia 👨🏻‍⚕️
➖= no movement

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5
Q

What lab do you assess with 🤮& diarrhea? 🚽

A

Serum potassium 🩸

Potassium imbalances can lead to
🫀 arrhythmias

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6
Q

S & S of Hypernatremia

A

⬆️ serum sodium blood level🩸
⬇️💧intake, 💧 loss, or rarely +🧂

Dehydration symptoms:
Postural Hypotension
Weakness
Tachy 🫀

Replace 💧fluids

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7
Q

Hyponatremia Treatment

A

Low serum sodium level 🩸

If water excess =Fluid restrictions
If fluid loss is cause= +🧂 solutions 💧

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8
Q

Hyperkalemia S & S

A

⬆️serum potassium level🩸
From renal failure, injury/burn, 🦠

Confusion 🤷🏽‍♀️
💪🏽 cramps
Weakness of 🦴muscles

Telemetry 〽️
Dangerous 🫀 = IV calcium gluconate

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9
Q

Hypokalemia S & S

A

⬇️ 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 🥔🍊

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10
Q

Calcium imbalances S & S:

(Hypercalcemia ⬆️, Hyperparathyroidism,
Other 2/3 = 🩸, breast, or 🫁 CA)

A

Fatigue
Confusion 🤷
Weakness
Seizures 🫨
🫀dysrhythmias

Treat= loop diuretics
Hydrating with isotonic solution 💧

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11
Q

Hypocalcemia S & S

A

⬇️serum calcium level 🩸
⬇️ parathyroid hormone

💪🏽excitability & tetany
Numbness
Muscle weakness
Laryngeal Stridor ➡️🫁arrest
Prolonged QT interval & ST segment

Treat w/ IV calcium

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12
Q

Hyperphosphatemia S & S

A

⬆️ serum phosphorus level🩸
Acute kidney injury or disease 🥊

🧠muscular irritability
Tetany and calcified in soft tissue 🦴

Treat primary cause

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13
Q

Hypophosphatemia S & S

A

⬇️ serum phosphorus level 🩸
Malnourished or malabsorption syndrome 🚫🌮

Asymptomatic

Treat w/ IV phosphorus

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14
Q

Hypermagnesemia S& S

A

⬆️ 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

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15
Q

Hypomagnesemia S & S

A

Malnutrition states: fasting and starvation 🦴 or +GI or kidney loss
Excessive 🥃🍹

🧠 CNS irritability
Tremors
Seizures 🫨
Confusion🤷

Treatment= 💊 or IV supplements

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16
Q

🫁 acidosis occurs whenever there is…

A

Hypoventillation
Respiratory Failure

⬇️pH, ⬆️PaCO2, HCO3 Normal

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17
Q

🫁 alkalosis happens when there is…

A

Hyperventilation
Hypoxemia
Pulmonary d/o

⬆️pH, ⬇️PaCO2, HCO3 Normal

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18
Q

Who is likely to develop fluid overload? 🫃🏽

A

A patient on RENAL dialysis

A patient with 🫀 failure ⬇️

19
Q

IV calcium gluconate is used for which electrolyte imbalance?

A

⬆️Hypermagnesia

⬇️Hypocalcemia

20
Q

D5NS and 3% saline are what types of solutions? 💧

A

Hypertonic 🫨

21
Q

What can you notice in a patient with a massive 🔥 injury & possible hypovolemia?

A

Low blood pressure

Example: 90/40 mm Hg

22
Q

If it comes out your 🍑,
You are…

A

Acidotic

23
Q

K imbalances =

A

Kardiac 🫀

24
Q

Magnesium think muscle …

A

Hypomagnesemia = 💪🏽muscle cramps 🦵🏽

Hypermagnesemia= too much muscle relaxation 🛌🥱

25
Q

Na imbalances =

A

Neuro 🧠

26
Q

Hypocalcemia =

A

Tetany
➕Chvostek
➕ Trousseaus

27
Q

Palliative care

A

Holistic approach to care or treatment that focuses on reducing severity of disease symptoms 🥺♥️

28
Q

Nursing care plan for CA

A

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)

29
Q

Cataracts 👀 S & S

A

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 🌊

30
Q

Glaucoma S & S 🌊👁️

A

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

31
Q

Glaucoma care

A

Routine eye visits 👨🏻‍⚕️

Rx 💊= pilocarpine & Timoptic

Surgical intervention 💉to improve drainage

32
Q

Otosclerosis

A

Hereditary 🧬
Starts in adolescents or early 🧒

Tinnitus 🔔
Progressive hearing ⬇️
👂Background noises
Vertigo 🫨

Hearing aid
Sodium fluoride
Surgery w/prosthesis 🔪👂🏼

33
Q

Meniere’s Disease 👂🏼

A

Disorder of inner 👂🏼
Excess of endolymph
Rotary vertigo 🫨
Whirling vertigo 🌊
Tinnitus 🔔
Unilateral hearing loss

34
Q

Treatments for Meniere’s Disease

A

💊 Atropine or Valium
Antivert
Compazine or vistaril
Lasix
🔪 surgery
Low 🧂diet
🚫🍹🥤caffeine, or 🚬🚭

35
Q

Don’t give DW5 fluids to…

A

🤕Head injury patients
Infants 👶🏾🍼

May cause cerebral edema

36
Q

Isotonic solutions

A

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

37
Q

Hypertonic Solutions

A

Will pull a less concentrated solution into self
D5NS
3% saline
D10W

Treats:
Hypoglycemia 🍬
Severe hyponatremia 🧂

38
Q

Hypotonic Solutions

A

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

39
Q

What are the Anions and their ranges?

A

Bicarbonate (HCO3-) 22-26 mEq/L

Chloride (Cl-). 98-106 mEq/L

Phosphate (PO43-). 3.0-4.5 mg/dL

40
Q

What are the Cations and their ranges?

A

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

41
Q

ABG pH range

A

7.35 - 7.45

Less than 7.35 = acidosis

More than 7.45 = alkalosis

42
Q

Metabolic 🩸 acidosis

A

Lactic acid accumulation
Kidney disease
Severe diarrhea 💩

⬇️pH, PaCO2 Normal, ⬇️ HCO3

43
Q

Metabolic 🩸alkalosis

A

Prolonged vomiting 🤮
Gastric suctioning
Gain of bicarbonate

⬆️pH, PaCO2Normal , ⬆️HCO3

Med Surg 1 (5 decks)

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