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Nursing 275 > Need-To-Know lab > Flashcards

Need-To-Know lab Flashcards

Important nursing information

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1
Q

Importance of sodium in the body

A

Most abundant cation in extracellular fluid; maintains osmotic pressure of extracellular fluid; regulates renal retention and excretion of water; responsible for stimulation of neuromuscular reactions & maintains SBP

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2
Q

Hyponatremia values

A

serum below 135; critical less than 120

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3
Q

Hyponatremia causes

A

excess sodium loss through N/V/D, skin and kidneys; excess diuretic dosage; liver failure; CHF; increased hypotonic IV fluids

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4
Q

Hyponatremia treatments

A

sodium containing fluids; isotonic ringers; NS 0.9% or 3%

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5
Q

Hyponatremia-Nursing considerations

A

THINK VOLUME..monitor electrolytes, vital signs, neurological responses, mental status, headaches, fluids, I&O overload, weight, cardiac overload (CHF), cramps, weakness, tremors

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6
Q

Hypernatremia values

A

Serum above 145…critical above 160

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7
Q

Hypernatremia causes

A

Dehydration-fluid loss through N/V/D (water loss in excess of salt loss) or excessive sweating; diabetes-DKA; Fever

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8
Q

Hypernatremia treatments

A

Replace fluids (D5W); diuretics-excrete excess volume

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9
Q

Hypernatremia-Nursing considerations

A

THINK VOLUME..monitor electrolytes, vital signs, mental status, weight, I&O, monitor for seizures

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10
Q

Importance of potassium in the body

A

most abundant intracellular cation and is essential for transmission of electrical impulses in cardiac and skeletal muscle; helps maintain acid-base balance and has inverse relationship to metabolic pH..decrease of pH of 0.1 (acidosis) increases K+ by 0.6; 80-90% K+ filtered through the kidneys

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11
Q

Hypokalemia values

A

serum below 3.5…critical below 2.5

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12
Q

Hypokalemia causes

A

inadequate intake of K+; ETOH abuse; CHF/HTN; GI Loss-V&D; Renal loss; Diuretics-loop (Lasix/Bumex)

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13
Q

Hypokalemia treatments

A

Oral or parenteral potassium; diet high in potassium; balanced electrolyte solutions; Pedialyte; Sports drinks

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14
Q

Hypokalemia-Nursing considerations

A

THINK ELECTRICITY..Monitor electrolytes, vital signs (low BP), cardiac responses; irregular heart rate and rhythm for increased ectopy-PVC’s/VT

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15
Q

Hyperkalemia values

A

serum above 5.0…critical above 6

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16
Q

Hyperkalemia causes

A

metabolic acidosis; dehydration; excess potassium intake; potassium sparring diuretics; tissue damage *Burns (K+ goes out of cell); renal failure

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17
Q

Hyperkalemia treatments

A

insulin-Moves K+ into the cell; D50-Prevents hypoglycemia caused by the infusion of insulin; IV calcium gluconate=ER measure to counteract cardiac effects of potassium; Sodium Bicarbonate-treats acidosis caused when K+ moves into the cell and pushes hydrogen ion into the serum

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18
Q

Hyperkalemia-Nursing considerations

A

THINK ELECTRICITY..monitor electrolytes, cardiac responses, musculoskeletal cramps/weakness/parathesias; Peaked T wave/wide QRS; Monitor neurological responses, mental status, headache; Irregular heart rate and rhythm for increased ectopy-PVC’s/VT

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19
Q

Importance of magnesium in the body

A

second most abundant intracellular cation; required for transmission of nerve impulses and muscle relaxation; controls absorption of sodium, potassium, calcium and phosphorus; magnesium, potassium and calcium all go low or high together!

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20
Q

Hypomagnesemia values

A

Serum below 1.8..critical below 1.2

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21
Q

Hypomagnesemia causes

A

chronic alcoholism; GI loss-V&D; impaired absorption; renal disease; pancreatitis

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22
Q

Hypomagnesemia treatments

A

Treat underlying causes; GI loss; Give magnesium replacement

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23
Q

Hypomagnesemia-Nursing considerations

A

THINK NEUROMUSCULAR TRANSMISSION//THINK CARDIAC RESPONSE..Monitor electrolytes and vital signs; tachycardia; increased PVC’s; VTach; Hypertension; Tremors, tetany, paresthesias; Muscle weakness

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24
Q

Hypermagnesemia values

A

serum above 2.6…critical above 6.1

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25
Q

Hypermagnesemia causes

A

dehydration; severe metabolic acidosis; renal failure; tissue trauma

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26
Q

Hypermagnesemia treatments

A

treat underlying cause; renal patients treat with dialysis; monitor cardiac effects of magnesium-increased PVC’s/VT; give calcium gluconate

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27
Q

Hypermagnesemia-Nursing considerations

A

THINK NEUROMUSCULAR TRANSMISSION//THINK CARDIAC RESPONSE…monitor electrolytes/VS; bradycardia; hypotension; muscle weakness

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28
Q

Importance of calcium in the body

A

Most abundant cation in body and necessary for almost all vital processes; half of total body calcium circulates as free ions that participate in coagulation, neuromuscular conduction, intracellular regulation, control of skeletal and cardiac muscle contractility; 98-99% calcium reserves stored in teeth and skeleton

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29
Q

Hypocalcemia values

A

serum below 8.5..critical below 7

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30
Q

Hypocalcemia causes

A

ETOH abuse; pancreatitis; chronic renal failure-inadequate intake; decreased Vitamin D (sunshine); lack of weight bearing; loop diuretics; hypomagnesemia

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31
Q

Hypocalcemia treatments

A

Oral calcium carbonate/gluconate; calcium chloride (more irritating to the vein); watch for extravastation into subcutaneous tissue

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32
Q

Hypocalcemia-Nursing considerations

A

THINK MUSCLE RESPONSE…monitor vital signs/electrolytes; cardiac output decreases; hypotension; dysrhythmias; monitor neuromuscular responses-seizures, tetany, paresthesias, muscle spasms

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33
Q

Hypercalcemia values

A

serum above 10.5..critical above 12

34
Q

Hypercalcemia causes

A

Prolonged immobilization; dehydration; cancer; excess antacid intake

35
Q

Hypercalcemia treatments

A

Eliminate calcium through kidneys through IV fluids; Loop diuretic to promote elimination of calcium

36
Q

Hypercalcemia-Nursing considerations

A

THINK MUSCLE RESPONSE…monitor electrolytes; monitor VS-hypertension; Monitor GI: N/V, anorexia; Dysrhythmias

37
Q

Creatinine patho

A

End product of creatine metabolism which is performed in skeletal muscle; Small amount of creatine is converted to creatinine which is then secreted by the kidneys; Amount of creatinine generated proportional to mass of skeletal muscle

38
Q

Creatinine values

A

0.5-1.3; Gold standard for kidney function because creatinine is produced in consistent quantity and rate of clearance reflects glomerular filtration

39
Q

Decrease in creatinine caused by

A

decreased skeletal muscle; inadequate protein intake

40
Q

Increase in creatinine caused by

A

CHF; dehydration; Acute/Chronic renal failure; Shock

41
Q

Creatinine treatments

A

Correct underlying problems; fluid resuscitation to keep SBP > 90; Dialysis

42
Q

Creatinine-Nursing Considerations

A

THINK FLUID BALANCE…Assess I&O closely; Fluid restriction; Assess for signs of fluid retention/edema

43
Q

BUN patho

A

urea represents end product of protein metabolism performed in the liver; urea diffuses freely in intra/extracellular fluid and then excreted by kidneys; BUN reflects balance between production and excretion of urea; Ratio to creatinine is 15-24:1; Is indirect measurement of renal function but does not reflect glomerular filtration

44
Q

BUN values

A

10-20…critical >100

45
Q

BUN decrease causes

A

poor protein intake/malnutrition; liver disease; malabsorption syndromes

46
Q

BUN increase causes

A

acute renal failure; CHF; hypovolemia-dehydration; pyelonephritis; hyperalimentation/TPN

47
Q

BUN treatments

A

fluid resuscitation-HIGH; dialysis-HIGH; improve nutritional intake/Failure to thrive-LOW

48
Q

BUN-Nursing considerations

A

THINK FLUID BALANCE…assess I&O closely; fluid restriction; assess for signs of fluid retention/edema; assess for agitation, confusion, fatigue; N&V (HIGH); Assess liver profile labs for correlating liver damage

49
Q

Hemoglobin patho

A

Primary protein of erythrocytes that is composed of heme (iron) and globin (protein); carries oxygen to cells and carbon dioxide back to lungs; parallels hematocrit which is the % of RBC in proportion to total plasma volume; GOLD standard for evaluating blood/RBC adequacy (anemia, blood loss)

50
Q

Hemoglobin values

A

Adult: 13-17…critical below 6 or above 18

51
Q

Mild Anemia value/symptoms

A

10-12; asymptomatic

52
Q

Moderate Anemia value/symptoms

A

6-10; weakness, fatigue, palpitations, SOB, decreased tol to activity (orthostatic hypotension)

53
Q

Severe Anemia value/symptoms

A

below 6; Hypoxia, confusion, SOB, skin pallor MM/nail-beds, dizziness, weakness, tachycardia

54
Q

Hemoglobin testing purpose

A

detect blood loss; anemia and response to treatment; detect any possible blood disorder

55
Q

Decrease in hemoglobin caused by

A

anemia; cancer; fluid retention/overload; hemorrhage

56
Q

Increase in hemoglobin caused by

A

COPD; CHF; Dehydration; Polycythemia

57
Q

Hemoglobin treatments

A

correct underlying problem; blood transfusions if symptomatic

58
Q

Hemoglobin-Nursing considerations

A

THINK BLOOD LOSS/ANEMIA…identify early signs of blood loss: tachycardia, then hypotension; Transfuse as needed-assess closely in first 30 minutes for transfusion reactions; Assess for signs of tissue hypoxia

59
Q

White Blood Cell Count (WBC) patho

A

WBC represent primary defense against invading infection; this is a total count of all 5 leukocytes: neutrophils, basophils, monocytes, lymphocytes, eosinophils; Indicates overall degree of body’s response to pathology, but must be evaluated and correlated through differential count; physiologic stress or steroids will increase WBC

60
Q

WBC values

A

4,500-11,000…critical below 2,500 or above 15,000

61
Q

Decrease in WBC caused by

A

ETOH abuse; anemia; bone marrow depression; viral infections

62
Q

Increase in WBC caused by

A

infection; anemia; inflammatory disorders; steroid use (acute or chronic)

63
Q

WBC treatments

A

identify infectious process; confirm bone marrow depression in chemo/radiation therapy

64
Q

WBC-Nursing considerations

A

THINK INFECTION…low or elevated WBC can represent sepsis; assess closely for hypotension with known infection (septic shock); assess closely for any change in temperature trend–hypothermia or febrile can both represent sepsis especially in elderly

65
Q

Neutrophils patho

A

most predominant differential WBC–comprise 50-70% of all WBC’s; First line of defense against bacterial infection through phagocytosis (think pacman); BANDS–if present on differential–correlate with overwhelming sepsis. Immature neutrophils body is kicking into circulation before they are ready because of the severity of infection/sepsis.

66
Q

Neutrophils values

A

50-70% of differential…critical or clinical concern over 80%

67
Q

Increase in neutrophils caused by

A

infection; acute hemorrhage; physical stress; tissue necrosis/injury

68
Q

Decrease in neutrophils caused by

A

Bone marrow depression (chemo/radiation therapy); Viral infection (due to increased lymphocytes)

69
Q

Neutrophils treatments

A

Identify infectious process; Confirm bone marrow depression in chemo/radiation therapy

70
Q

Neutrophils-Nursing considerations

A

THINK INFECTION…low or elevated WBC can represent sepsis; assess closely for hypotension with known infection (septic shock); assess closely for any change in temperature trend–hypothermia or febrile can both represent sepsis especially in elderly

71
Q

Troponin patho

A

Contractile protein found in cardiac muscle that will be released into systemic circulation with cardiac ischemia or acute MI; Levels will rise 2-6 hours after injury-peak 16-24 hours and then remain elevated for several days; if acute onset CP to r/o MI they will be done every 6 hours x3 to determine pattern of abnormal elevation

72
Q

Troponin values

A

<0.05 this may be depending on each hospital lab; if elevated this establishes diagnosis of acute MI; if positive MI, the degree of elevation provides general barometer of degree of heart muscle damage

73
Q

Troponin increase is caused by

A

Acute MI; Unstable angina; Minor myocardial damage after CABG or PTCA/stent placement

74
Q

Troponin treatments

A

Standards of cardiac care include continuous telemetry, b-blockers to decrease cardiac workload, heparin or nitroglycerin gtts; definitive treatment of MI includes PTCA/stent or CABG

75
Q

Troponin-Nursing considerations

A

THINK CARDIAC–MI…assess closely for recurrent or new onset of chest pain; assess cardiac rhythm for any changes such as PVC’s, VT or atrial fibrillation; assess HR and SBP carefully to promote decreased cardiac workload (maintain heart rate <80 and SBP <140); assess tolerance to activity closely

76
Q

Brain Natriuretic Peptide (BNP) patho

A

hormone that is stored in the ventricle of the heart; when left ventricle is distended and stretched due to CHF exacerbation, BNP is released into circulation; inhibits the release of renin by kidneys which promotes water and sodium loss as well as increases in glomerular filtration rate (Body’s own ACE inhibitor)

77
Q

BNP values

A

Normal: <100; 100-500 abnormal but not critical for ventricular strain (mild); above 500 critical for positive correlation of CHF exacerbation

78
Q

BNP causes

A

CHF exacerbation; ventricular hypertrophy (cardiomyopathy); severe hypertension

79
Q

BNP treatments

A

Aggressive diuresis for fluid overload; may be on NTG gtts or PO Nitrates to decrease preload which decreases workload of heart

80
Q

BNP-Nursing considerations

A

THINK CARDIAC–CHF…assess respiratory status for tachypnea and breath sounds closely for basilar or scattered crackles; assess HR and SBP carefully to promote decreased cardiac workload (HR <80, SBP <140); assess tolerance to activity closely; assess I&O closely; Assess K+ closely with loop diuretics

Nursing 275 (3 decks)

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