Exam #3 Flashcards
Hypokalemia
diarrhea, repeated vomiting, use of potassium-wasting diuretics
Hyperkalemia
decreased urine output
Hypocalcemia
acute pancreatitis and neuromuscular excitability
Hypercalcemia
cancer patients
Hypomagnesmia
increases neuromuscular excitability
hypermagnesmia
ESRD, neuromuscular excitability, lethargy, and decreased DTR
Normal value of Potassium
3.5-5
Normal value of Calcium
8.5-10
Normal value of Sodium
135-145
Normal value of Magnesium
1.8-4.8
Normal value for Phosphate
2.8-4.5
Metabolic Acidosis
arises from increase in metabolic acid or a decrease in base (bicarb).
Kidneys are unable to excrete enough metabolic acids, which accumulate in the blood
Results in a decreased LOC
Metabolic Alkalosis
arises from direct increase in base (bicarb) or decrease in metabolic acid
results in increased blood bicarbonate
Respiratory acidosis
-arises from alveolar hypoventilation
-lungs are unable to excrete enough CO2
-excess carbonic acid in the blood decreases pH
Respiratory alkalosis
-arises from alveolar hyperventilation
-lungs excrete too much CO2
-deficit of carbonic acid in the blood increases pH
Who are the most susceptible to fluid imbalances?
the very young and very old
What is the #1 indicator of fluid status?
daily weights
What are the possible IV complications?
fluid overload, infiltration, extravasation, phlebitis, local infection, bleeding at insertion site, and bruising.
Infiltration or Extravasation
when IVF is infusing into tissues outside of the vein
What is the treatment for infiltration and extravasation?
stop IVF, remove IVF catheter, elevate extremity, encourage active ROM, apply warm or cold compress depending on the type of solution, restart IV and IVF proximal to infusion.
How can you prevent infiltration and extravasation?
monitor IV often for light swelling or pain, secure IV well, carefully select site
What is phlebitis?
inflammation of the walls of the vein
What is Thrombophlebitis?
blood clot formation at the site of the inflammation
What is the treatment for phlebitis?
Stop IVF, remove IV catheter, elevate extremity, apply a warm compress 3-4 times daily, restart IV and IVF proximal to infusion or in another extremity, obtain culture of site and culture of IV cath tip if drainage at site.
How can you prevent phlebitis?
monitor IV often for redness and pain, rotate sites every 72 hours or more frequently if policy, avoid lower extremities, use hand hygiene, use surgical aseptic technique.
What is cellulitis?
a bacterial infection that has signs and symptoms similar to that of phlebitis and treatment but cellulitis is more severe
What is the treatment for cellulitis?
similar to that of phlebitis but includes antibiotics, antipyretics, analgesics if needed
What is the nursing assessment related to fluid and electrolyte embalances?
Age, environment (excessively hot?), dietary intake, lifestyle (ETOH intake history), medication, and recent medical history
What is the nursing care while administering a blood transfusion?
-check vitals every 5 minutes
-watch for transfusion reactions
-check and verify blood with at least 2 nurses before a transfusion
-if a reaction occurs stop the transfusion immediately
What are the endocrine functions of the kidney?
BP CONTROL
-Renin causes vasoconstriction when released from the juxtaglomerular cells
-prostaglandin E2 and prostacyclin secretion causes vasodilation
ERYTHROPOIETIN STIMULATES RBC PRODUCTION AND MATURATION in the bone marrow
SYNTHESIS OF VITAMIN D
What problems does poor kidney function cause?
anemia, hypertension, and electrolyte imbalances
What is stress incontinence ?
coughing, sneezing, laughing, or physical activity causing urine leakage
What is urge incontinence ?
a strong need or urge to urinate causing leakage
What is reflex incontinence?
urine leakage due to nerve damage
What is overflow incontinence?
incomplete bladder emptying- overfills when full, leads to leakage
What is functional incontinence?
physical inability to reach the toilet in time