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Med Surg > Med Surg Exam 2 > Flashcards

Med Surg Exam 2 Flashcards

1
Q

Normal pH range

A

7.35-7.45

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2
Q

Normal CO2 range

A

35-45 mmHg

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3
Q

Normal HCO3 range

A

22-26 mEq/L

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4
Q

Normal sodium range

A

135-145 mEq/L

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5
Q

Normal potassium range

A

3.5-5.0 mEq/L

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6
Q

Normal calcium range

A

8.6-10.2 mEq/L

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7
Q

Normal magnesium range

A

1.3-2.3 mEq/L

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8
Q

Normal phosphate range

A

2.5-4.5 mEq/L

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9
Q

Normal Chloride range

A

97-107 mEq/L

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10
Q

For respiratory acidosis or alkalosis, which two components are needed?

A

pH and CO2

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11
Q

For metabolic acidosis or alkalosis, which two components are needed?

A

pH and BCO3

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12
Q

high pH and high HCO3 equals what?

A

metabolic alkalosis

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13
Q

low pH and low HCO3 equals what?

A

metabolic acidosis

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14
Q

low pH and high CO2 equals what?

A

respiratory acidosis

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15
Q

high pH and low CO2 equals what?

A

respiratory alkalosis

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16
Q

Normal pO2 ranges

A

80-100 mmHg

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17
Q

Normal O2 saturation

A

95-100%

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18
Q

Example of a hypotonic IV solution? (hint: percentage)

A

0.45% sodium chloride solution

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19
Q

Two examples of isotonic IV solution?

A

0.9% sodium chloride, lactated Ringer’s solution

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20
Q

Three examples of hypertonic IV solution?

A

5% dextrose in 0.9% sodium chloride solution,
3% normal saline solution,
Dextrose 10% in water

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21
Q

When should hypotonic solution be used? (3)

A

dehydration, gastric fluid loss, cellular dehydration from excessive diuresis

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22
Q

When should isotonic solution be used? (4)

A

diabetic ketoacidosis, early treatment of burns, adrenal insufficiency, frequently used during surgical procedures

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23
Q

When should hypertonic solution be used? (2)

A

Treat severe hyponatremia, provide calories for energy

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24
Q

What is osmosis

A

MOVEMENT OF WATER from area of low solute concentration to area of high solute concentration

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25
Q

What is DIffusion?

A

MOVEMENT OF SOLUTES from area of higher concentration to lower concentration

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26
Q

What is active transport?

A

physiologic pump that moves fluid from area of lower concentration to higher concentration
This is movement against the concentration gradient!

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27
Q

What is hypovolemia?

A

fluid volume deficit

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28
Q

What is hypervolemia?

A

fluid volume excess

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29
Q

Manifestations of hypovolemia? (7)

A

rapid weight loss, decreased skin turgor, oliguria, concentrated urine, rapid weak pulse, increased temp, thirst

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30
Q

Manifestations of hypervolemia? (8)

A

edema, distended neck veins, abnormal lung sounds, tachycardia, increased BP, SOB, increased urine output, increased weight

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31
Q

What is chloride for?

A

peak muscle function

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32
Q

What is potassium for? (3)

A

muscle contraction, nerve transmission, glycogen formation

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33
Q

What is sodium for?

A

nerve transmission

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34
Q

What is magnesium for? (2)

A

ATP (energy), production

35
Q

What is calcium for? (3)

A

bone health, nerve transmission, muscle contraction

36
Q

Causes of hyponatremia? (6)

A

adrenal insufficiency, water intoxication, losses by vomiting, diarrhea, sweating, diuretics

37
Q

Manifestations of hyponatremia? (6)

A

poor skin turgor, dry mucosa, HA, decreased salivation, decreased BP, nausea

38
Q

Causes of hypernatremia? (5)

A

excess water loss, excess sodium administration, diabetes insipidus, heat stroke, hypertonic IV solutions

39
Q

Manifestations of hypernatremia? (5)

A

thirst, elevated temp, dry swollen tongue, neurologic symptoms, weakness

40
Q

Causes of hypokalemia? (5)

A

GI losses, medications, alterations of acid base balance, hyperaldosterism, poor dietary intake

41
Q

Manifestations of hypokalemia? (8)

A

fatigue, anorexia, NV, dysrhythmias, muscle weakness/cramps,paresthesias, decreased bowel motility, dysrythmias

42
Q

Causes of hyperkalemia? (5)

A

usually treatment related, impaired renal function, hypoaldosteronism, tissue trauma, acidosis

43
Q

Manifestations of hyperkalemia? (5)

A

cardiac changes and dysrhythmias, muscle weakness, paresthesias, anxiety, GI problems

44
Q

Use of two main medications in hyperkalemia?

A

Kayexalate, beta-2 agonists

45
Q

Causes of hypocalcemia? (7)

A

hypoparathyroidism, malabsorption, pancreatitis, alkalosis, massive transfusion of citrated blood, renal failure, medications

46
Q

Manifestations of hypocalcemia? (8)

A

tetany, circumoral numbness, paresthesias, hyperactive DTRs, Trousseau’s sign, Chovstek’s sign, seizures, anxiety

47
Q

What is the Trousseau’s sign?

A

put on BP cuff, pump up cuff, hand bends at wrist and finger distort, hand crumples-indicated hypocalcemia

48
Q

What is Chovstek’s sign?

A

muscle twitching when facial nerve is tapped-indicates hypocalcemia

49
Q

What vitamins are given to hypocalemic patient?

A

Vitamin D and calcium

50
Q

Causes of hypercalcemia? (5)

A

malignancy and hyperparathyroidism, anorexia, N/V, constipation

51
Q

Manifestations of hypercalcemia? (4)

A

muscle weakness, lack of coordination, bone pain, GI upset

52
Q

Medications for Hypercalcemia? (4)

A

furosemide, phosphates, calcitonin, biphosphonates

53
Q

Causes of hypomagnesemia? (7)

A

alcoholism, GI losses, diet deficiency, medications, sepsis, burns, hypothermia

54
Q

Manifestations of hypomagnesemia? (5)

A

neuromuscular irritability, muscle weakness, tremors, dysrhythmias, alterations in mood or LOC

55
Q

When giving oral meds to hypomagnesemiac patient, assess what first?

A

swallowing ability, dysphasia is common in hypomag patients

56
Q

Causes of hypermagnesemia? (3)

A

renal failure, diabetic ketoacidosis, excessive admin of magnesium

57
Q

manifestations of hypermagnesemia? (7)

A

flushing, lowered BP, N/V, hypoactive reflexes, drowsiness, muscle weakness, dysrhythmias

58
Q

causes of hypophosphatemia? (10)

A

alcoholism, pain, heat stroke, refeeding starved patient, hyperventilation, respiratory alkalosis, major burns, low mag, low potassium, use of diuretics

59
Q

manifestations of hypophosphatemia? (6)

A

neurologic symptoms, confusion, muscle weakness, tissue hypoxia, muscle and bone pain, increased risk of infection

60
Q

causes of hyperphosphatemia? (4)

A

renal failure, excess phosphorus, excessive Vit D, chemo

61
Q

manifestations of hyperphosphatemia?

A

few symptoms, associated with hypocalcemia

62
Q

causes of hypochloremia? (6)

A

addison’s disease, GI losses, excessive sweating, fever, burns, meds

63
Q

manifestations of hypochloremia? (6)

A

agitation, irritability, weakness, hyperexcitability in muscles, seizures, coma

64
Q

causes of hyperchloremia? (7)

A

excess chloride infusions, head injury, hypernatremia, dehydration, respiratory alkalosis, metabolic acidosis, medications

65
Q

manifestations of hyperchloremia? (5)

A

tachypnea, lethargy, weakness, rapid deep respirations, hypertension

66
Q

In metabolic acidosis, pH is _______ and bicarbonate is ________.

A

low, low

67
Q

Metabolic acidosis is most commonly due to ?

A

renal failure

68
Q

manifestations of metabolic acidosis? ()

A

HA, confusion, drowsiness, increased respirations, shock, dysrhythmias

69
Q

Monitor which two electrolyte levels during metabolic acidosis?

A

calcium and potassium

70
Q

In metabolic alkalosis, pH is ______ and bicarbonate is _____.

A

high, high

71
Q

Metabolic alkalosis is most commonly due to what?

A

vomiting, gastric suction, pyloric stenosis

72
Q

Manifestations of metabolic alkalosis? (2)

A

respiratory depression, tachycardia

73
Q

In respiratory acidosis, pH is ____ and CO2 is _____.

A

low, high

74
Q

Respiratory acidosis is always due to what?

A

respiratory problem with inadequate excretion of CO2

75
Q

Manifestations of resp acidosis? (7)

A

asymptomatic ususally; later: increased pulse, BP, and respirations; mental changes, feeling of fullness in head; leads to shock and cardiac arrest

76
Q

In respiratory alkalosis, pH is ______ and CO2 is ______.

A

high, low

77
Q

respiratory alkalosis is always due to what?

A

hyperventilationl leading to hypoxia

78
Q

manifestations of resp alk? (4)

A

lightheadedness, inability to concentrate, numbness, tingling

79
Q

Foods high in phosphate? (6)

A

milk, organ meats, nuts, fish, poultry, whole grains

80
Q

Respiratory acidosis occurs in emergency situations such as…? (9)

A

acute pulmonary edema, aspiration of foreign objects, atelectasis, pneumothorax, overdose of sedatives, sleep apnea, administration of oxygen to a patient with chronic hypercapnea (excessive CO2 in the blood), severe pneumonia, acute respiratory distress syndrome

81
Q

Normal BUN levels?`

A

7-20 mg/dL

82
Q

Normal creatinine levels?

A

0.7 to 1.4 mg/dL

83
Q

What is a hypotonic solution?

A

Water moves into cell to balance out solute concentration. Cell expands and eventually explodes.

84
Q

What is a hypertonic solution?

A

Water moves out of cell to balance out solute concentration. Cell shrinks and eventually shrivels to nothing.

Med Surg (1 decks)

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