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exam 4 presentaions Flashcards

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1
Q

WHAT DOES WATER DO FOR
OUR BODIES?

A

TRANSPORTS NUTRIENTS TO CELLS AND
WASTE FROM THE CELLS

TRANSPORTS HORMONES, ENZYMES, BLOOD PLATELETS, AND RED AND WHITE BLOOD CELLS

FACILITATES CELLULAR METABOLISM AND PROPER CELLULAR CHEMICAL FUNCTIONING

ACTS AS A SOLVENT FOR ELECTROLYTES AND NONELECTROLYTES

HELPS TO MAINTAIN BODY TEMPERATURE, FACILITATES DIGESTION AND PROMOTE ELIMINATION

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2
Q

DISTRIBUTION OF BODY FLUIDS

A

70% intracellular fluid
(ICF) Fluid inside cells

30% extracellular fluid
(ECF) Fluid outside cells

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3
Q

FLUID BALANCE

ex of intake and out

A

FLUID INTAKE IS REGULATED BY
THIRST MECHANISM

FLUID INTAKE
—- LIQUIDS, FOODS, METABOLIC GENERATION

  • SENSIBLE AND INSENSIBLE LOSS
    —URINATION, SKIN/LUNGS, SWEAT, DEFECATION
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4
Q

fluid volume deficiency is what

A

Low ECF volume

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5
Q

casues of hypovolemia fvd)

A

Dehydration, trauma, vomiting, diarrhea, third- spacing, medical conditions

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6
Q

s/s of hypovolemia fvd)

A

(weak pulse)

skin turgor decreased

Weight loss

Tachycardia (increased HR) Hypotension (low BP)

Decreased salivation (dry mouth)

Increase in hematocrit

weakness

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7
Q

fvd assessment/interventions

whatlooking at

A

vitals-decrease bp/increase hr

monitor I and o

labs-inc hit and specific grsvity

skin-check breaksdwon

weak pulse

check oral mucosa

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8
Q

whos at risk for fvd

A

Elderly,

infants (especially w/ fevers, V/D),

illness,

renal dysfunction,

gross tissue trauma,

burns,

hyponatremic,

bowel obstruction,

ileostomies,

pancreatitis,

ascites,

sepsis,

excessive N/V/D

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9
Q

edcaution for fvd

A

increase fluids

check weight

check skin

s/s electrolyte imbalace

teach dierutcs

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10
Q

fluid volueme excess

A

Excess retention of water/sodium in ECF

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11
Q

causes of hypervolemia

A

cardiac/renal disease

increase fluid

lower exercise

edema

liver cirrhosis

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12
Q

s/s hypervolemia

A

edema

ascites

sob

crackles

wet cough

wt gain

increase rr and bp

bounding pulse

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13
Q

fluid volume excess

assessments what to check

A

monitor I and o

low sodium diet

weight gain

vitals- increase bp and rr

skin-compresion

labs-lower hct

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14
Q

whos at risk fluid volume excess

A

Kidney/renal dysfunction,

excessive fluid intake (IV),

liver cirrhosis,

heart failure,

high Na diet

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15
Q

pt education fluid volume excess

A

low sodium diet

lower fluid intake

s/s electrolyte imbalance

check weight increase

increase le

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16
Q

sodium

labs
abundant in

A

LAB VALUES: 135 – 145 MEQ/L
* BELOW 135 = HYPONATREMIA
* ABOVE 145 = HYPERNATREMIA

MOST ABUNDANT IN ECF

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17
Q

what does sodium do to body

A

CONTROLS AND REGULATES WATER BALANCE = MAINTENANCE OF ECF VOLUME

TRANSMITS IMPULSES IN NERVE AND MUSCLE FIBERS

EXCRETED BY THE KIDNEYS

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18
Q

HYPONATREMIA

A

Sodium Level <135 mEq/L

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19
Q

HYPONATREMIA causes

A

Suctioning

Diarrhea/Vomiting

Low Na intake

Diuretic use

Fluid Shift

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20
Q

hyponatramia s/s

A

Lethargy

Confusion

Hypotension

Seizures

Muscle Twitching

Hemiparesis (loss of strength, unilateral)

Focal Weakness (localized, RA, L face)

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21
Q

hypernatremia

A

Sodium Level > 145 mEq/L

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22
Q

hypernatremia what causes

A

Increased Na Intake

Excess insensible water loss

Fluid Deprivation

Diarrhea

Hyperventilation/burns

Fluid shift

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23
Q

hypernatremia s/s

A

Restlessness

Weakness// Disorientation

Delusion//Hallucinations

Thirsty/Dry Mouth

Hypertension

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24
Q

foods hgh in sodium

A

BUTTER
HAM/BACON
CHEESE
CANNED FOODS
HOT DOGS
PEANUT BUTTER
SOY SAUCE
TABLE SALT
PRESERVATIVES!!! (LUNCH MEAT,ANYTHING INSTANT, ETC)

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25
Q

potassium

A

LAB VALUES: 3.5 – 5.0 MEQ/L

ICF —MOST CRITICAL ELECTROLYTE!

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26
Q

what does potassium do for body

A

TRANSMITS NERVE/ELECTRICAL IMPULSES – CARDIAC IMPULSES

check apical pulse

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27
Q

hypokalemia what causes

A

Vomiting/Diarrhea

GI Suctioning

Alkalosis

Use of diuretics

NPO

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28
Q

hypokalemia s/s

A

Muscle cramps/weakness

Fatigue//Lethargy

Anorexia

Decreased GI motility

Paresthesia (tingling/prickling)

Cardiac dysrhythmia

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29
Q

hyperkalema what causes

A

Renal Failure

Excess Intake

Medication use (ACE inhibitors, NSAIDs, Heparin, KCl, Potassium- sparing diuretics (Spironolactone!!!

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30
Q

hyperkalmia s/s

A

Muscle Weakness/twitches/cramps

Decreased Urine Output

Respiratory Failure

Decreased Cardiac Contractility

Cardiac dysrhythmias leading to cardiac arrest!!!

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31
Q

potassium foods

A

ORANGE JUICE

RAISINS

LEAN BEEF

CHICKEN

BANANAS

POTATOES

SPINACH

AVOCADOS

CANTALOUPE

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32
Q

calcium

A

LAB VALUES: 8.6 – 10.2 MEQ/99%

STORED IN THE SKELETAL SYSTEM

REGULATED BY PARATHYROID HORMONE & CALCITONIN

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33
Q

what does calcium do for body

A

FORMING BONES AND TEETH

TRANSMITTING NERVE IMPULSES

REGULATE MUSCLE contraction

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34
Q

hypocalcemia what causes

A

Nutritional Deficit

Impaired Absorption (needs Vit D)

Excess Calcium Loss

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35
Q

hypocalcemia s/s

A

Muscle cramps

Numbness / tingling of the extremities (Trousseau Sign)

Twitching of facial muscles (Chvostek Sign) and eyelids when facial nerve is touched

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36
Q

hypercalcemia what causes

A

Cancer

Hyperparathyroidism

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37
Q

hypsercalciemua s/s

A

Nausea/Vomiting

Constipation

Bone Pain

Excessive Urination

Thirst

Confusion

Lethargy

Slurred Speech

Cardiac Arrest (SEVERE ONLY!!!!)

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38
Q

calcium fods

A

MILK AND OTHER DAIRY PRODUCTS-yogurt
* BROCCOLI (7%)
* FIGS
* TOFU
* COTTAGE CHEESE

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39
Q

magnesium

A

LAB VALUES: 1.3 – 2.3 MEQ/L

FOUND PRIMARILY IN THE SKELETON AND ICF

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40
Q

what does magnesium do for body

A

OPERATING SODIUM-POTASSIUM PUMP

RELAXING MUSCLE CONTRACTIONS/ TRANSMITTING NERVE IMPULSES

VASODILATOR

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41
Q

hypomagnesemia is caused by

A

Diarrhea

NG Suctioning

Tube Feedings

Burns

Sepsis

Alcohol Withdrawal

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42
Q

hypomagnesemia s/s

A

Tremors

Seizures

Hyperreflexia (Hyperactive DTR)

Tetany (muscle spasms)

Confusion

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43
Q

what causes hypermagnesemia

A

Renal Failure

Too many Antacids

44
Q

hypermagnesemia s/s

A

Hypotension/Bradycardia

Lethargy(tireness)//muscle weakness

Decreased Deep Tendon Reflexes

Flushing

45
Q

magnesium foods

A

DARK GREENS
SEEDS
BEANS
FISH
AVOCADOS

46
Q

chloride lab values

A

LAB VALUES: 97 – 107 MEQ/L

47
Q

what does chloride do for body

A

FUNCTIONS WITH SODIUM TO REGULATE SERUM OSMOLALITY AND BLOOD VOLUME

WHEN SODIUM IS REABSORBED IN THE KIDNEY, CHLORIDE USUALLY FOLLOWS

REGULATES ACID-BASE BALANCE

BUFFER IN OXYGEN-CARBON DIOXIDE EXCHANGE IN RBC’S

48
Q

phosphate lab value

A

LAB VALUES: 2.5 – 4.5 MG/DL

MAJOR ANION IN ICF

ALSO FOUND IN ECF, BONE, SKELETAL MUSCLE, AND NERVE TISSUE

CHILDREN HAVE A HIGHER LEVEL THAN ADULTS

49
Q

what does phosphate do for body

A

FORMING OF BONES AND TEETH

METABOLIZING CARBOHYDRATES, PROTEIN AND FAT

CELLULAR METABOLISM; PRODUCING ATP AND DNA

MUSCLE, NERVE, AND RBC FUNCTION

50
Q

phosphate foods

A

Foods high in protein,

Teas,

sodas,

breakfast bars

51
Q

macronutrients

A

Carbohydrates

Protein

Fat (Lipids

52
Q

micronutirnets

A

Vitamins

Minerals

53
Q

simple carbs

A

Fruits

– Candy bars

– White sugars

– Milk (yes, milk has sugar!)

– Honey,

syrup

54
Q

complex(starches) carbs

A

Breads

– Legumes

– Whole grain pasta

– Vegetables: Corn, potatoes

– Sweet potatoes

55
Q

sugar

A

Recommended Daily Allowance (RDA) – 10%

Look on labels – try to find something without sugar, it is hard if not impossible! Even milk, tomato sauce, and bread has sugar.

Other names for sugar: high-fructose corn syrup, fruit juice concentrate, molasses, honey, and sucrose

can be addictive

56
Q

too much sugar can lead to

A

Weight gain

– Impaired immune system

– Type 2 Diabetes (body cannot keep up)

– Multiple other chronic diseases – Cancer, Fatty liver disease, etc

57
Q

protein

A

Recommended Daily Allowance (RDA) - 10% - 35%

Vital component of every cell
Promote tissue growth and healing (wounds, etc)

58
Q

complete protein

A

high quality

Eggs
– Dairy products
– Meat
– Soy

59
Q

incomplete protein

A

low quality

Grains
– Legumes
– Vegetables
– Beans
– Quinoa
– Rice

60
Q

protein recomendations

A

Recommendation is to eat less animal proteins and more vegetable proteins

Combine 2 or more incomplete proteins to
create a complete = like 2 puzzle pieces put
together.
— Cereal w/ milk
– Peanut butter on whole grain bread
—-Rice and Bean

61
Q

Fats (lipids)

A

Recommended Daily Allowance (RDA) - 10%

95% of lipids in the diet are in the form of triglycerides

Major store of fat in the body / predominant for of fat in food

62
Q

saturated fats

A

Raise cholesterol levels
bad

– Butter
– Cheese
– Creams
– Blue cheese
– Fatty meats
– Oils (palm)

63
Q

unsaturated fats

A

lower cholesterol levels

good

Mono & Poly
– Omega - 3
– Olive oil
– Avocado
– Nuts, almonds
– Beans

64
Q

fats reccomendations

A

AVOID TRANS FAT!!

Raises LDL and lowers HDL!

Partially hydrogenating oils

65
Q

Water-Soluble Vitamins

A

Dissolve in water
* Not stored in the body, so they need to be eaten every day!

66
Q

water soluble vitamins examples

A

– Thiamine – B1
– Riboflavin – B2
– Niacin – B3
– Pyridoxine – B6
– Folate (Folic Acid)
– Cyanocobalamin - B12
– Vitamin C (Ascorbic Acid)

67
Q

Thiamine

A

Water-soluble vitamin

Vitamin B1

Converts food into energy & helps the cardiac, brain, and nervous system

People affected with alcoholism are deficien

68
Q

thiamine examples

A

Lean Pork
- Cereals
- Milk

69
Q

Fat-Soluble Vitamins

A

Stored in fat
Can build up in the body for long periods of time because they are stored!

70
Q

fat soluble vitamins examples

A

– Vitamin A
– Vitamin D
– Vitamin E
– Vitamin K

71
Q

Vitamin K

A

Helps with blood clotting!

If deficient, patients could have bleeding irregularities
— Epistaxis (nose bleeds)
—- Excessive ecchymosis (bruising)

72
Q

vitamin k examples

A

Spinach
– Kale
– Cauliflower

73
Q

vitamin

K
A
D
E

what do

A

K-blood clotting, bone health

A-vision,reporoduction,skin,immune system, bone health

D-stregnthend bone, calcium absoroption,immune system

E-immunesystem, flush toxins

74
Q

minerals-macromineralas

A

– Calcium
– Phosphate
– Sodium
– Potassium
– Magnesium
– Chloride
– Sulfur

75
Q

minerals-microminerals

A

– Iron
– Zinc
– Manganese
– Iodine
– Fluoride
– Copper
– Cobalt
– Chromium
– Selenium

76
Q

Iron

A

Micromineral

Supplement: Ferrous Sulfate

  • Needed to form hemoglobin (cells that carry oxygen)
  • Commonly used to treat iron-deficiency anemia

Iron should always be taken with Vitamin C to promote absorptio

77
Q

iron foods

A

Eggs
– Meats
– Spinach
– Kale
– Nuts
– Fortified Breads
– Fortified Cereals

78
Q

Antioxidants (Super Foods)

A
  • Blueberries
  • Kale
  • Walnuts
  • Salmon
  • Sweet potatoes
  • Quinoa
  • Pomegranate
  • Tomatoes
79
Q

Body Mass Index (BMI)

A

Indicates change in body fat stores

Indicates whether weight is appropriate for height

Low BMI or high BMI can indicate poor nutritional status

80
Q

bmi calcuation

A

Weight (lb) / height2 (inches) x 703 = BMI

*Normal is 18.5-24.9

81
Q

percentage of weight loss

A

Divide the new weight by the former weight and then
change to percentage, subtract from 100%

82
Q

Factors Affecting Nutrition

A

Development/Biological Factors

State of Health
– Pregnancy or Lactating
– Illness
– Mental Health
– Medications
– Alcohol

Religion/Culture

Social Determinants

83
Q

nutritional screening tools

MNA

Food diaries

Anthropometric Data

BMI//weight circumference

biochemical data

physical assessment

A

Mini Nutritional Assessment (MNA)-nursing screening tool for malnourishment

Food Diaries-diary of all food-24 hrs, count calories, counts all foods taken in

Anthropometric Data–Weight, height, body mass index (BMI), body circumference (arm, waist, hip and calf), waist to hip ratio (WHR), elbow amplitude and knee-heel length.

Body Mass Index and Waist Circumference-measure BMI and test to see if waist is any different then before

Biochemical Data-labs-Hemoglobin (Hgb), Hematocrit (Hct), Prealbumin, Transferrin, BUN, Creatinine, Urine

Physical Assessment-Appearance, weight, hair, face, eyes, lips, tongue, teeth, gums, glands, skin, nails, skeleton, muscles, extremities, abdomen, nervous system, cardiovascular system, GI system

84
Q

Clear liquid diet:

A

Chicken broth, jello, popsicle, sprite/7up, Gatorade

85
Q
  • Full liquid diet:
A

– Ice cream, prune juice, gelatin

86
Q
  • Puréed diet:
A

– Solids are blenderized to liquids

87
Q
  • Mechanical Soft Diet:
A

– Foods are chopped, ground, mashed, or soft

88
Q

Psychosocial Factors

A

Age

Fluid and food intake

Medications

Muscle tone

Pathologic conditions

*Surgical and diagnostic procedures

89
Q

Physiology of Urinary Elimination

A

Kidneys- Regulates fluid and acid-base balance

Ureters- Junction between the kidney and the bladder

Bladder- Hollow, muscular organ that serves as the
reservoir for urine

Urethra- Extends from bladder to urinary meatus
(opening)

90
Q

Altered Urine Production and treatment

A

Polyuria–Excessive urination

Oliguria–the production of abnormally small amounts of urine.

Anuria–no urine

Treatment= Dialysis

Peritoneal–uses the peritoneum (in abdomen) as the membrane through which fluid and dissolved substances are exchanged with the blood

Hemodialysis– Remove extra salt, water, and waste products so they don’t build up in your body. Keep safe levels of minerals and vitamins in your body

91
Q

Nocturia

A

-night peeing-limit nighttime fluid

92
Q

Urgency

A

-sudden strong need-provide routine for peeing

93
Q

Dysuria

A

-painful-assess constantly

94
Q

Enuresis

A

-bed incontince- regular toileting schedule, providing privacy and comfort during toileting, encouraging adequate fluid intake, assisting with mobility and positioning, monitoring urinary output

95
Q

Urinary Retention

A

–cant empty all urine in bladder-double voiding, schedule, catheter,

96
Q

Neurogenic Bladder-

A

lack bladder control due to a brain, spinal cord or nerve problem-cath,drugs,therapy,manual help

97
Q

Urinary Incontinence

t

e

A

Transient-Acute-urine leakage that is caused by a temporary (transient) situation-

Established-Chronic-loss of bladder control

98
Q

Types of Urinary Incontinence:

A

Reflex-urine leaks without a warning or urge to urinate

Stress- leaking urine during physical activity that increases abdominal pressure, such as coughing, sneezing, laughing, or exercise

Total-bladder cannot store urine at all

Urge-involves sudden compelling urges to void and results in involuntary leakage of urine

99
Q

NI for urinary incontince

A

promoting adequate fluid intake, maintaining normal voiding habits, and assisting with toileting

100
Q

Urine Assessment
Diagnostics

Amount=

Color=

Clarity=

Odor=

Sterility=

pH=

Specific Gravity=

Glucose=
Ketone=
Blood=

A

Amount= 1200-1500ml/day

Color= yellow to light amber

Clarity= clear

Odor= faint aromatic

Sterility= no microorganisms

pH=4.5-8.0

Specific Gravity= 1.010-1.025

Glucose= none
Ketone= none
Blood= none

101
Q

Nursing Interventions urine

A

Good Nutrition

Adequate fluid intake

Assistance with toileting and hygiene

Infection prevention education

Education

Incontinence Management

making urinary retention urinary diversions

102
Q

incontince management

A

Bladder training
2. Kegel exercises
3. Skin care
4. External drainage

103
Q

Urinary diversions

A

Ileal conduit
Continent urinary diversion
Supra pubic

104
Q

Bowel Elimination

A

Stomach

Small Intestine

Large intestine

Rectum
—- Peristalsis
—- Normal
—- Abnormal

105
Q

Factors Affecting Bowel Elimination

A

Age
Diet
Fluid intake
Activity
Psychological
Defecation Habits
Medications
Diagnostic Procedures/Surgery
Pathologic Conditions
Pain

106
Q

Elimination Problems

A

Constipation

Fecal Impaction

Diarrhea

Incontinence

Flatulence

107
Q

Nursing Interventions elimination

non pharm

Emollient
Stimulants
Lubricants
Saline-osmotic

A

Non-pharmacological-bladder training, movements,foods,grains, repositioning, massaging

Pharmacological
Emollient-softener
Stimulants-laxitive-moves bowels faster w/ nerve
Lubricants-keeps moisutere in stool
Saline-osmotic-reatains water

d- nursing Fundamentals (10 decks)

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