Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Adult Health > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

Cardiac Biomarkers

A

Troponin I or T (cTnI or cTnT)
Creatinine Kinase-MB (CK-MB)
Myoglobin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Priorities of treatment in electrolyte imbalances

A

The priority goals of treatment are to:

  • restore balance
  • correct the underlying condition
  • prevent further complications

Also keep in mind that the treatment will be based upon the instigating cause. Make sure you understand the difference between electrolyte imbalances that stem from dehydration (low blood volume) or solute imbalance (hypervolemia or hypovolemia- either too many/few solutes or too much/few water volume content in the blood).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Sodium Range:

A

135-145 mmol/L

Hyponatremia: 145 mmol/L
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Potassium Range:

A

3.5-5.0 mmol/L

Hypokalemia: 5.0mmol/L
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Magnesium Range:

A

0.75-.1.5 mmol/L

Hypomagnesemia: 1.5 mmol/L
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Calcium Range:

A

8.5-10.5 mEq/L

Hypocalcemia: 10.5 mmol/L
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Fasting Lipid Profile

A

Total Cholesterol
LDL
Triglycerides
HDL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Labs for cardiac profiles

A

Cardiac Biomarkers

Fasting Lipid Profile

Brain Natriuretic Peptide (BNP)

Pro-BNP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Body fluid intake

A

water enters the body through three sources:

  1. orally ingested liquids
  2. water in foods
  3. water formed by oxidation of foods
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

insensible (insensate) loss

A

water lost through the skin or lungs via expelled air that can not be measured.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Maintaining fluid and electrolyte balance

A
  • Kidneys
  • Adrenal glands through the secretion of aldosterone (controls the amount of sodium reabsorbed by the kidneys. RAAS.)
  • Pituitary gland through the secretion of antidiuretic hormone (regulates the amount of water reabsorbed by the kidneys)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Fluid volume deficit description

A

Dehydration occurs when the fluid intake of the body is not sufficient to meet the fluid needs of the body.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Goal of treatment for fluid volume deficit

A

restore fluid volume and replace electrolytes as needed and eliminate the cause of the fluid volume deficit.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Types of fluid volume deficits:

A
  1. isotonic dehydration
  2. Hypertonic dehydration
  3. Hypotonic dehydration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Isotonic dehydration

A

water and dissolved electrolytes are lost in equal proportions. Known as hypovolemia. Results in decreased circulating blood volume and inadequate tissue perfusion.

Caused by:

  • inadequate intake of fluids (thirst mechanism disruption or inability to feed ones self)
  • fluid shifts between compartments
  • excessive losses of body fluids (blood loss)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Hypertonic dehydration

A
  • water loss exceeds electrolyte loss
  • clinical problems that occur result from alterations in electrolyte concentrations
  • cellular dehydration and shrinkage
Caused by:
-conditions that increase fluid loss:
excessive perspiration
hyperventilation
ketoacidosis
prolonged fevers
diarrhea
early stage kidney disease
diabetes insipidus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

hypotonic dehydration

A
  • electrolyte loss exceeds water loss
  • clinical problems that occur result from fluid shifts between compartments, causing a decrease in plasma volume
  • cells swell
Caused by: 
Chronic illness
excessive fluid replacement
kidney disease
chronic malnutrition
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Interventions for fluid volume deficit

A

monitor:

  • Cardiovascular
  • Respiratory
  • Neuromuscular
  • Renal
  • Integumentary
  • Gastrointestinal status

Prevent further fluid losses and increase fluid compartment volumes to normal ranges

Provide oral rehydration if possible and IV fluid replacement if the dehydration is severe. Fluids used depends on type of dehydration.

Monitor intake and output

administer medications as prescribed (antidiarrheal, antimicrobial, etc)

Administer O2 as prescribed

Monitor electrolyte values and prepare to administer medication to treat an imbalance if present.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Fluid volume excess description

A

Fluid intake or fluid retention exceeds the fluid needs of the body.

Also called overhydration or fluid overload.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Goal of treatment for fluid volume excess

A

restore fluid balance, correct electrolyte imbalances if present, and eliminate or control the underlying cause of the overload.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Types of fluid volume excess

A
  1. Isotonic overhydration
  2. Hypertonic overhydration
  3. Hypotonic overhydration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

isotonic overhydration

A

Hypervolemia. results from excessive fluid in the extracellular space that does not shift between the extracellular and intracellular compartments.

leads to:
circulatory overload
interstitial edema

Caused by:
inadequately controlled IV therapy
Kidney disease
Long term corticosteroid therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Hypertonic overhydration

A

Rare. Caused by excessive sodium intake.

Fluid is drawn from the intercellular fluid compartment, the extra cellular fluid volume expands, and the intracellular fluid volume contracts.

Caused by:
Excessive sodium injestion
Rapid infusion of hypertonic saline
Excessive sodium bicarbonate therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Hypotonic overhydration

A

Water intoxication.

Excessive fluid moves into the intracellular space and all body fluid compartments expand.

Results in electrolyte imbalances=over dilution

Caused by:
Early kidney disease
Heart failure
Syndrome of inappropriate antidiuretic hormone secretion
inadequately controlled IV therapy
Replacement isotonic fluid loss with hypertonic fluids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Interventions for fluid volume excess

A

Monitor:

  • cardiovascular
  • respiratory
  • neuromuscular
  • renal
  • integumentary
  • GI status

Prevent further fluid overload and restore normal fluid balance.

Administer diuretics; osmotic diuretics typically are prescribed first to prevent severe electrolyte imbalances

Restrict fluid and sodium intake as prescribed

Monitor intake and output/weight

Monitor electrolyte values and prepare to administer medication to treat an imbalance if present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Hyponatremia description

A

Severe sodium level lower than 135 mEq/L

Usually associated with fluid volume imbalances

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Causes of hyponatremia

A

Increased sodium excretion:

Inadequate sodium intake

Dilution of serum sodium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

increased sodium excretion causes

A
  • excessive sweating
  • diuretics
  • vomiting
  • diarrhea
  • wound drainage, especially GI
  • Kidney disease
  • decreased secretion of aldosterone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Inadequate sodium intake causes

A
  • fasting, NPO

- low salt diet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Dilution of serum sodium causes

A
  • excessive injestion of hypotonic fluids or irrigation with hypotonic fluids
  • kidney disease
  • freshwater drowning
  • syndrome of inappropriate antidiuretic hormone secretion
  • hyperglycemia
  • heart failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Interventions for hyponatremia

A

Monitor:

  • cardiovascular
  • respiratory
  • neuromuscular
  • cerebral
  • renal
  • GI status

If accompanied by a fluid volume deficit, IV saline infusions are administered to restore sodium content and fluid volume

If accompanied by fluid volume overload, osmotic diuretics are administered to promote the excretion of water rather than sodium

If caused by excessive secretion of antidiuretic hormone, medications that antagonize ADH may be administered

Instruct the client to increase oral sodium intake and inform the client about the foods to include in the diet

If the client is taking lithium, monitor the lithium level, because hyponatremia can cause diminished lithium excretion, resulting in toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Hypernatremia description

A

Serum sodium level that exceeds 145 mEq/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Causes of hypernatremia

A

Decreased sodium excretion

Increased sodium intake: excessive oral sodium injestion or excessive administration of sodium containing IV fluids

Decreased water intake: fasting, NPO status

Increased water loss

34
Q

Causes of decreased sodium excretion

A
  • corticosteroids
  • cushing’s syndrome
  • Kidney disease
  • Hyperaldosteronism
35
Q

Causes for increased water loss

A
  • increased rate of metabolism
  • fever
  • hyperventilation
  • infection
  • excessive diaphoresis
  • watery diarrhea
  • diabetes insipidus
36
Q

Interventions for hypernatremia

A

Monitor:

  • cardiovascular
  • respiratory
  • neuromuscular
  • cerebral
  • renal
  • integumentary

If caused by fluid loss, prepare to administer IV infusions

If caused by inadequate renal excretion of sodium, prepare to administer diuretics that promote sodium loss

Restrict sodium and fluid intake as prescribed

37
Q

Hypokalemia description

A

Serum potassium lover than 3.5 mEq/L.

Potassium deficit is potentially life threatening because every body system is affected

38
Q

Assessment findings of hyponatremia

A

CV: vary with changes in vascular volume

  • normovolemic: rapid pulse rate, normal bp
  • hypovolemic: thready, weak pulse rate. Hypotension, flat neck veins, normal or low central venous pressure
  • hypervolemic: rapid, bounding pulse. blood pressure normal or elevated, elevated central venous pressure

Respiratory: shallow ineffective respiratory movements is a late manifestation related to skeletal muscle weakness

Neuromuscular: Generalized skeletal muscle weakness that is worse in the extremeties. Diminished deep tendon reflexes.

Central Nervous System: Headache, personality changes, confusion, seizures, coma

GI: Increased motility and hyperactive bowel sounds, nausea, abdominal cramping and diarrhea

renal: increased urinary output

Integumentary: dry mucus membranes

Labs: serum sodium less than 135 mEq/L and decreased urinary specific gravity

39
Q

Assessment findings of hypernatremia

A

CV: heart rate and blood pressure respond to vascular volume status

Respiratory: pulmonary edema is hypervolemia is present

Neuromuscular: Early-spontaneous muscle twitches, irregular muscle contractions. Late-skeletal muscle weakness; deep tendon reflexes diminished or absent

CNS: altered cerebral function is the most common manifestation of hypernatremia. Normovolemia or hypovolemia: aggitation, confusion, seizures.
Hypervolemia- lethargy, stupor, coma

GI: extreme thirst

Renal: decreased urinary output

Integumentary: dry and flushed skin, Dry and sticky tongue and mucus membranes. Presence or absense of edema, depending on fluid volume changes.

Labs: serum sodium level that exceeds 145 mEq/L and increased urine specific gravity

40
Q

Causes of hypokalemia

A

Actual total body potassium loss

Inadequate potassium intake

Movement of potassium from the extracellular fluid to the intracellular fluid

Dilution of serum potassium

41
Q

causes of total body potassium loss

A

excessive use of medications such as diuretics or corticosteroids

Increased secretion of aldosterone (cushing’s syndrome)

vomiting/diarrhea

wound drainage, particularly GI

prolonged nasogastric suctioning

excessive sweating

kidney disease impairing reabsorption of potassium

42
Q

Cause of inadequate potassium intake

A

fasting or NPO status

43
Q

Causes of movement of potassium from the extracellular fluid to the intracellular fluid

A

Alkalosis

Hyperinsulinism

44
Q

Causes of dilution of serum potassium

A

water intoxication

IV therapy with potassium deficient solutions

45
Q

Assessment findings of hypokalemia

A

CV: Thready, weak, irregular pulse. Weak peripheral pulses. Orthostatic hypotension

Respiratory: shallow, ineffective respirations that result from profound weakness of the skeletal muscles of respirations. Diminished breath sounds.

Neuromuscular: anxiety, lethargy, confusion, coma. Skeletal muscle weakness, leg cramps. Loss of tactile discrimination. Parethesias. deep tendon hyporeflexia.

GI: decreased motility, hypoactive or absent bowel sounds. Nausea/vomiting, constipation, abdominal distension, paralytic ileus.

Lab findings: serum potassium level lower than 3.5 mEq/L. electrocardiogram changes: ST depression, shallow, flat, or inverted T wave, and prominent U wave.

46
Q

Interventions for hypokalemia

A

Moniter

  • cardiovascular
  • respiratory
  • neuromuscular
  • GI
  • renal

Place client on cardiac monitor

Monitor electrolyte values

Administer potassium supplements orally or IV as prescribed

Institute safety measures for the client experiencing muscle weakness

If the client is taking a potassium depleting diuretic, it may be discontinued. A potassium retaining diuretic may be prescribed

Instruct the patient about foods that are high in potassium content

47
Q

Notes on potassium suppliments

A

Oral K supplients may cause nausea and vomiting so they should not be taken on an empty stomach.

If the client complains of abdominal pain, distention, nausea, vomiting, diarrhea, or GI bleeding, the supplement may need to be discontinued.

Liquid potassium chloride has an unpleasant taste and should be taken with juice or another liquid.

48
Q

Electrocardiograph changes in hypocalcemia

A

prolonged ST segment

prolonged QT interval

49
Q

ECT changes in hypercalcemia

A

Shortened ST segment

Widened T wave

50
Q

ECT changes in hypokalemia

A

ST depression
Shallow or flat or inverted T wave
Prominent U wave

51
Q

ECT changes in hyperkalemia

A

Tall peaked T wave
Flat P wave
Widened QRS complex
Prolonged PR interval

52
Q

ECT changes in hypomagnesemia

A

Tall T waves

Depressed ST segment

53
Q

ECT changes in hypermagnesemia

A

Prolonged PR interval

Widened QRS complex

54
Q

Hyperkalemia description

A

serum potassium level that exceeds 145 mEq/L

55
Q

pseudohyperkalemia

A

a condition that can occur due to methods of blood specimen collection and cell lysis. If an increased serum value is obtained in the absence of clinical symptoms, the specimen should be redrawn and evaluated.

56
Q

Causes of hyperkalemia

A

Excessive potassium intake

Decreased potassium excretion

Movement of potassium from the intracellular fluid to the extracellular fluid

57
Q

Causes of excessive potassium intake

A

Over ingestion of potassium containing foods or medications such as potassium chloride or salt substitutes.

Rapid infusion of potassium containing IV solutions

58
Q

Causes of decreased potassium excretion

A

potassium retaining diuretics

Kidney disease

Adrenal insufficiency, such as addison’s disease

59
Q

Causes of movement of potassium from the intracellular fluid to the extracellular fluid

A

Tissue damage

Acidosis

Hyperuricemia

Hypercatabolism

60
Q

Assessment findings of hypercalcemia:

A

CV: Increased heart rate in the early phase, bradycardia that can lead to cardiac arrest in late phase. Increased blood pressure. Bounding, full peripheral pulses.

Respiratory: Ineffective respiratory movements as a result of profound skeletal muscle weakness.

Neuromuscular: Profound muscle weakness. Diminished or absent deep tendon reflexes. Disorientation, lethargy, coma.

Renal: urinary output varies depending on the cause. Formation of renal calculi, flank pain.

GI: Decreased motility and hypoactive bowel sounds. Anorexia, nausea, abdominal distention, constipation.

Labs: Serum calcium that exceeds 10 mg/dL. Electrocardiogram changes: shortened ST segment, widened T wave

61
Q

Assessment findings of hyperkalemia

A

CV: slow, weak, irregular heart rate. Decreased blood pressure.

Respiratory: profound weakness of the skeletal muscles leading to respiratory failure

Neuromuscular: Early-muscle twitches, cramps, parethesias (tingling and burning followed numbness in the hands and feet and around the mouth) Late-profound weakness ascending flaccid paralysis in the arms and legs. (trunk, head, and respiratory muscles become affected when the serum potassium level reaches a lethal level)

GI: Increased motility, hyperactive bowel sounds. Diarrhea

Labs: serum potassium level that exceeds 5.0 mEq/L. ECG changes: tall peaked T waves, flat P waves, widened QRS complex, and prolonged PR intervals

62
Q

Interventions for hyperkalemia

A

Monitor:

  • cardiovascular
  • respiratory
  • neuromuscular
  • renal
  • GI status

Place patient on cardiac monitor

Discontinue IV potassium and hold potassium supplements

Initiate a potassium restricted diet

Prepare to administer potassium excreting diuretics if renal function is not impaired

If renal function is impaired prepare to administer sodium polystyrene sulfonate

Prepare the client for dialysis if potassium levels are critically high

Prepare for the administration of IV calcium if hyperkalemia is severe to avert myocardial excitability

Monitor renal function

when blood transfusions are prescribed, the client should receive fresh blood

Teach to avoid potassium in foods

63
Q

Hypocalcemia description

A

serum calcium level lower than 8.6 mg/dL

64
Q

Hypocalcemia causes

A

Inhibition of calcium absorption from the GI tract

Increased calcium excretion

Conditions that decrease the ionized fraction of calcium

65
Q

Causes of inhibition of calcium absorption from the GI tract

A

Inadequate oral intake of calcium

Lactose intolerance

Malabsorption syndromes such as celiac or crohn’s

Inadequate intake of vitamin D

End stage kidney disease

66
Q

Causes of increased calcium excretion

A

kidney disease

diarrhea

steatorrhea

wound drainage, especially GI

67
Q

Conditions that decrease the ionized fraction of calcium

A

Hyperproteinemia

Alkalosis

Medications such as calcium chelators or binders

Acute pancreatitis

Hyperphosphatemia

Immobility

Removal or destruction of the parathyroid glands

68
Q

Assessment findings of hypocalcemia

A

CV: decreased heart rate, hypotension, diminished peripheral pulses

Respiratory: Not directly affected , however respiratory failure or arrest can result from decreased respiratory movement because of respiratory muscle tetany or seizures

Neuromuscular: Irritable skeletal muscles. Twitches, cramps, tetany, seizures. Painful muscle spasms in the calf or foot during periods of inactivity. Paresthesia followed by numbness that may affect the lips, nose, and ears in addition to the limbs. Positive trousseaus and chvostek’s signs. Hyperactive deep tendon reflexes. Anxiety, irritability.

Renal: urinary output varies depending on the cause

GI: Increased gastric motility, hyperactive bowel sounds. Cramping diarrhea

Labs: serum calcium levels less than 8.6 mg/dL ECG changes: prolonged ST intervals, prolonged QT interval

69
Q

Interventions of hypocalcemia

A

Monitor:

  • cardiovascular
  • respiratory
  • neuromuscular
  • GI status

Place client on a cardiac monitor

Administer calcium suppliments orally or calcium intravenously

When administering IV, warm the injection solution to body temperature and administer slowly. Monitor for ECG changes observe for infiltration, monitor for hypercalcemia

administer medications that increase calcium absorption/vitamin D

Provide a quiet environment to reduce environmental stimuli

Initiate seizure precautions

move the client carefully and monitor for signs of a pathological fracture

Keep 10% calcium gluconate available for treatment of acute calcium deficit

Instruct the client to consume foods high in calcium

70
Q

Hypercalcemia descriptions

A

serum calcium level that exceeds 10 mg/dL

71
Q

Causes of hypercalcemia

A

Increased calcium absorption

Decreased calcium excretion

Increased bone resorption of calcium

Hemoconcentration

72
Q

Causes of increased calcium absorption

A

excessive oral intake of calcium or vitamin D

73
Q

Causes of decreased calcium excretion

A

Kidney disease

Use of thiazide diuretics

74
Q

Causes of increased bone resorption of calcium

A

Hyperparathyroidism

Hyperthyroidism

Malignancy (bone destruction from metastic tumors)

Immobility

Use of glucocorticoids

75
Q

Causes of hemoconcentration

A

Dehydration

Use of lithium

Adrenal insufficiency

76
Q

Interventions of hypercalcemia

A

Monitor:

  • Cardiovascular
  • Respiratory
  • Neuromuscular
  • renal
  • GI status

Place client on a cardiac monitor

Discontinue IV infusions of solutions containing calcium and oral medications containing calcium or vitamin D

Discontinue thiazide diuretics and replace with diuretics that enhance the excretion of calcium

administer medications as prescribed that inhibit calcium resorption

Prepare the client with severe hypercalcemia for dialysis if medications do not work

Move the client carefully and monitor for signs of a pathological fracture

Monitor for flank or abdominal pain and urinary stones

Instruct the client to avoid foods high in calcium

77
Q

Hypomagnesmia description

A

serum magnesium level lower than

78
Q

Phosphate Range:

A

2.5-4.5 mmol/L

Hypophosphatemia: 4.5 mmol/
79
Q

Clinical Manifestations of Hyponatremia

A

Tachycardia, thready pulse
Fatigue
Muscle cramps, especially abdominal, and muscle weakness
Nausea, vomiting, dizziness
Postural hypotension (possibly from hypovolemia) or hypertension
Headache, confusion, or seizures (from swelling of brain cells)
Weight changes
Personality changes
Dry mucous membranes and cool, clammy skin

80
Q

Clinical Manifestations of Hypernatremia

A

Restlessness, agitation, twitching, coma, seizures
Decreased central venous pressure
Weight loss or changes in weight
Intense thirst with dry, rough mucous membranes
Flushed skin

Adult Health (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions