FUNDAMENTALS/MANAGEMENT Flashcards
ISOtonic IVFs
- NS (0.9% NaCl)
- Lactated Ringers (LR) –> burns!!
- D5W
used for: dehydration, blood loss, NPO pts, burns
HYPOtonic IVFs
- 0.45% NS/NaCl
- 0.33% NS/NaCl
- D2.5W
used for: DI, DKA, HHNS, HyperNA
HYPERtonic IVFs
- 1.5/3/5% NS/NaCl
- D5NS
- D5 LR
- D10W
used for: SIADH, HypoNA, cerebral edema, hypoCL
hypoK
- Cushing’s Disease
- Vomiting
- Suctioning
- Alkalosis
- Steroids, Diuertics, Laxatives
- NPO
- Too much IVF
- Anorexia + Bulemia Nervosa
- Prominent U waves!
- Tx: IV K (bananas, avocados, potatoes, beans, milk) + K-wasting Diuretics + Cardiac Telemetry
hyperK
- Addison’s Disease (hypoaldosteronism)
- Burns
- Acidosis / DKA
- Renal Failure
- ACE-Inhibitors, K-Sparing Diuretics
- Tall, peaked T waves!
- Tx: D5W with Regular Insulin, Kayexalate, Loop/Thiazide Diuretics, + NO K+
hypoNA
- Addison’s Disease
- ALL Diuretics (except osmotic)
- TOO MUCH water
- SIADH
- Polyuria + Diarrhea
- Suction
- Vomiting
- NPO
- Sweating
- Tx: give Na (salt), IVF (NS), NO water, Osmotic Diuretics (Mannitol)
** Increase Na SLOWLY –> cerebral edema (seizures)
hyperNA
- Cushing’s Disease
- TOO MUCH salt + hypertonic IVF
- LITTLE water + Fluid Loss
- Steroids
- Osmotic Diuretics
- DI, DKA, Dehydration
- Burns
- Tx: LR or water (NO NS), Loop Diuretics (-ide), STOP Na,
** Lower Na SLOWLY –> cerebral edema (seizures)
hypoCA
HIGH EVERYTHING!!
- hypoP + hypoPARATHYROIDism + LOW Vit. D
- Chvostek’s (cheek spasm) + Trousseau’s (BP cuff spasm) signs!!
- post-THYROIDECTOMY!
- Celiac Disease + Crohn’s Disease
- Alcohol
- Malabsorption + Malnutrition
- Renal Failure
- Bulemia Nervosa
- Pancreatitis
- Tx: give Ca and Vit. D
hyperCA
LOW EVERYTHING!!
- hyperP + hyperPARATHYROIDism + HIGH Vit. D
- DVT!
- Addison’s Disease
- Steroids
- Diuretics
- Immobility
- Bone Cancer
- Tx: NO Ca or Vit. D, IVF (NS), Loop Diuretics (-ide), + Dialysis (if really bad)
Assessments
- ALL assessments: inspection, palpation, percussion, auscultate
- GI assessment: (IAPP) inspection, auscultation, percussion, palpation
Contact Precautions
“SEWER” + VRE
- Skin infections
- Eye infections
- Wound infections
- Enteric (C. Diff) + E. Coli
- Rotavirus + RSV
- VRE
** gloves + gown!
Droplet Precautions
“PIMP DRE”
- Pertussis
- Influenza (flu)
- Meningitis, Mumps
- Pneumonia
- Diphtheria
- Rubela
- Epiglottitis
** surgical mask!
** pt wear mask when transporting
** private room (door can be open)
Airborne Precautions
“MTV” + Shingles
- Measles
- TB
- Varicella (chickenpox)
- Shingles
** N-95 mask!
** pt wear mask when transporting
** private NEGATIVE pressure room with door CLOSED!
Ear Drops
- ages 0-3 = pinna down + back
- ages 3+ = pinna up + back
Jewish / Judaism
- KOSHER Diet = NO dairy + meat together!
- NO pork, fish without scales
- silverware WRAPPED!
- belief in prolongation of life = do NOT remove life-support, NO autopsies, + NO cremations!
Jehovah’s Witness
NO BLOOD products!!
- except in EMERGENCY situations for CHILDREN!
Islam
- NO pork, meat, alcohol, gelatin
- Ramadan = refuses food from sun-up to sun-down
- belief in HOB always above head at ALL times!
Buddhism
- NO meat or alcohol
- belief in NO pain meds!
Hinduism
NO beef or pork!
Muslim
ONLY halal foods! = killed by a Muslim and prayed over!
Mormons
NO coffee, tea, or alcohol!
Seventh-Day Adventists
NO animal products, alcohol, or caffeine!
Blood O-
universal DONOR = emergency blood!
Blood AB+
universal RECIPIENT
