random 3 (hurst) Flashcards
adosterone found? does what?
in adrenal gland (steroid, mineralcorticoid)
when blood vol gets low, aldosterone is secreted and and kidneys retain Na and water
cushings too much
addisions too little
ANP found? what does it do?
artial natretic peptide
artium of heart
when volume increases, atrium stretches and releases ANP which causes kidneys to excrete Na and water
ADH found? does what?
what causes?
what is the drug name?
Antidiuretic hormone in pituitary
ADH = H2O
makes you retain water
< often cause of head trauma or sinus injury.
< increased ICP can = ADH prob
< vasopressin
ADH problems:
Too much
< causes water retention. FVE
< SIADH–> often caused by lung tumor!
< too many letters = too much water
< urine concentrated bc not peeing. makes Na and USG increase
< blood is dilute bc too much fluid. Hct is decreased
ADH too little
< causes diurese. lose water.
< DI. think shock!!!
< urine is dilute and blood is concentrated.
< Na and urine specifc grav goes down
< Hct goes up
< use vasopressin
normal CVP
2-6 mmHg
5-10 cm H2O
bed rest…
induces diueses by increasing ANP and decreasing production of ADH
renal failure think…
shock first!!!!
isotonic
NS, D5W, RL, D5 1/2NS
do not use on PT HTN or renal failure
can cause HTN, FVE or hyperNa
Hypotonic
D2.5W,
1/2 NS
.33% NS
< rehydrates but doesnt stay in vas space
< use if HTN, renal, or cardic disease
< water moves out of vas space and into cells
hypertonic
all others and TPN
Use for 3rd spacing and hypoNa (edema, burns, ascites)
returns fluid to vascular space.
Mg
< does the opp of prefix.
< sedative
< 1.3- 2.1
PTH pulls Ca from
bones to blood
Calcitonin pulls CA from
blood to bones
sodium polyesterene sulfonate
Kayexalate
for hyperkalemia
give enema or PO. will exchange K+ ions for Na ions in the GI tract. will have Na prob then but you can treat with fluids then.
takes a bit longer than Glucose and insulin. Insulin pushes glucose and K+ back into cells and out of blood
if giving potassium… causes?
must have?
never?
causes GI upset and burns veins
must have good urine output. make sure to watch otherwise they will retain K+
never push IV K+
restless and tachycardia think?
hypoxic first!
systolic < 90 =
inadequate perfusion to vital organs
what do you use to determine PTs fluid vol is adequate?
IV fluids to maintain OP?
urine output
> 0.5mls/kg/hr
what immunizations would you give after a burn?
- tetanus toxoid - active immunity.
> takes 2-4 weeks to develop own immunity - immune globulin- passive immunity.
> immediate protection
> inject antibodies until body has time to make own.
what is released into blood from muscles post burn
myoglobin fro damaged muscles. Makes the urine red/brown and can clog the kidneys.
Call MRP
what might be ordered to flush out the kidneys?
mannitol- flushes out debri
how long after burn will PT start to diurese?
24 hrs when fluid return to vascular space.
need to watch for FVE then
what happens to the K+ in burn victim?
it increased d/t cellular lysis.