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NCLEX > F/E 2 > Flashcards

F/E 2 Flashcards

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1
Q

Isotonic Fluid

A

NS, LR, D5W, D5 1/4 NS

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2
Q

Do not use isotonic fluids with these 3 things

A

Renal disease, Heart Disease, HTN

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3
Q

Hypotonic solutions

A

D 2.5W, 0.45% NS, 0.3% NS

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4
Q

Hypotonic acts how?

A

Shifts fluid out of the vascular space

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5
Q

What kind of fluid to give to heart disease/renal disease/HTN

A

hypotonic

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6
Q

Hypertonic solutions

A

D10W, 3-5% NS, D5LR, D5 ½ NS, D5 NS, TPN, Albumin

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7
Q

Monitor in ICU setting with what kind of fluids?

A

Hypertonic

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8
Q

What 2 electrolytes act like sedatives with increased amounts?

A

Mg, Ca - Think muscles first

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9
Q

Causes of Hypermagnesemia

A

Renal failure - Excreted there (can be lost through GI too)

Antacids - Contain Mg

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10
Q

S/S ^Mg

A

DECREASE: DTR, P, R

Muscle weakness

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11
Q

Mg does what to the blood vessels?

A

Causes vasodilation, resulting in flushing and warmth

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12
Q

Tx of ^Mg

A

Calcium Gluconate - Antidote that must by given slowly!
Dialysis
MV

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13
Q

Causes of Hypercalcemia

A

Hyperparathyroidism

Immobilization

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14
Q

How does PTH affect Ca?

A

When serum Ca is low, PTH pulls Ca from the bones and into the blood stream, causing bones to be brittle and kidney stones to develop

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15
Q

What kind of diuretic retains Ca

A

Thiazide

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16
Q

Treatment of ^Ca

A 
MOVE to keep Ca in the bones
FLUID to prevent stones
Phosphate binders - P inverse to Ca
Vitamin D so the body can utilize Ca
Foods high in P - Organ meats, nuts, seeds
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17
Q

Causes of LOW Magnesium

A

Diarrhea - Lots of Mg in our stomach
Alcohol
* We get most of our Mg through food, so if we have diarrhea, we lose it; If we drink alcohol, we aren’t hungry so we aren’t getting it from food; also alcohol causes diuresis

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18
Q

S/S of LOW Mg and LOW Ca in muscles

A 
NOT ENOUGH SEDATIVE
Muscle tone: rigid and tight
Smooth muscle-airway: Stridor/larygngospasm
Sm muscle-esophagus: Swallowing problems
Cardiac muscle: Arrhythmias
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19
Q

Other S/S LOW Mg and LOW Ca

A 
SEIZURE
Chevostek's - Cheek twitch
Trousseaus - BP cough w/ tremor
Increase in DTR
Mind changes
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20
Q

Treatment of LOW Mg

A

Give Mg - give slowly
Seizure precautions
Eat Mg - Greens and seeds

21
Q

Precaution of giving Mg

A

Check kidney function before and during infusion and stop if kidney function appears to be declining or a reaction appears

Even if there are MINOR changes, you need dos top the Mg

22
Q

Causes of Hypocalcemia

A

Hypoparathyroidism
Radical neck, Thyroidectomy - These may cause the doctor to accidentally clip part of the parathyroid gland, thus causing a decrease in PTH secretion

23
Q

S/S LOW Ca

A

NOT ENOUGH SEDATIVE

Rigid muscles with swallowing, breathing, arrhythmias, Chevosteks, Trousseau’s, mind changes

24
Q

Treatment of LOW Ca

A

Vitamin D so we can use the Ca
Phosphate binders - Ca Acetate, sevelamer: Make P^ so Ca goes down
IV Ca - Need to give slowly and with a heart monitor

25
Q

When taking about Na changes, think of what changes

A

NEURO

26
Q

Sodium leves depend on what

A

Amount of water

27
Q

With high Na, think _______

A

Dehydration and low K

28
Q

Causes of ^Na

A 
Hyperventilation (insensible fluid low)
Heat Stroke - sweating
DI (diurese a lot)
Vomiting and diarrhea
Feeding tube pt - May need to call MD to increase water intake after feeding
29
Q

S/S of LOW Na

A

Dry mouth
Thirsty (already dehydrated)
SWOLLEN TONGUE
Neuro changes

30
Q

Tx of LOW Na

A

Restrict Na and dilute pt with fluids
Daily wt, I/O
Labs

31
Q

With low Na, think ______

A

Dilution

32
Q

Causes of Hyponatremia

A

Replacing fluid by drinking water
Psychogenic polydipsia
SIADH - retain water
D5W - Sugar and water

33
Q

S/S LOW Na

A

HA, seizure, coma

34
Q

Tx of LOW Na - pt needs Na but not water

A

Hypertonic saline (3-5% NS)

35
Q

K is secreted by the _____

A

Kidneys

36
Q

____ K : _____ Na

A

Low K : High Na

37
Q

We have lots of K where?

A

Our stomach

38
Q

Causes of ^K

A

Decrease renal function
Spironolactone
ACEI

39
Q

S/S ^K

A

Muscle twitching –> weakness –> paralysis
Peak T wave, longer PR, wide QRS
Arrythmias

40
Q

Treatment of ^K

A

Dialysis
Ca Gluconate - decreases arrhythmia
Na polystyrene sulfonate (Kayexelate) exchanges K for Na in Gi tract

Insulin & glucose - bring K out of vast space

41
Q

Anytime you give IV insulin, worry about _____ and _______

A

Low glucose and Low K

Insulin carries glucose and K into the cells s when giving insulin, we worry about LOW K and LOW GLUCOSE

42
Q

Causes of LOW K

A

Vomiting, suction (Remember that there is a lot of K in our stomach)
Diuretics
Not eating

43
Q

S/S of LOW K

A

Muscle cramps –> weakness

Arrhythmias

44
Q

Tx of LOW K

A

Give K
Spironolactone
Eat more K - greens, veggies, fruit

45
Q

SE of oral K? How to relieve?

A

GI upset

Take with food

46
Q

SE of IV K?

A

Burning –> Will “eat” at peripheral veins

47
Q

What to check before/during IV potassium? How do we give it IV?

A

UO
On a PUMP and MIXED WELL - NEVER IVP
Watch IV sites

48
Q

Need to check what when giving IV K

A

Kidney function

NCLEX (23 decks)

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