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adult health 1 > test 2 > Flashcards

test 2 Flashcards

1
Q

sodium plays a major role in

A

ECF volume and concentration
generating and transmitting nerve impulses
muscle contractility
regulating acid-base balance

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2
Q

what is the brain mostly

A

water

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3
Q

normal sodium range

A

135-145

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4
Q

what causes hypernatremia? MODEL mnemonic

A

M- Medications, meals
O- osmotic diuretics
D- Diabetes insipidus
E- Excessive H20 loss
L- low H2O intake

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5
Q

signs and symptoms of hypernatremia

A

restlessness, seizures, thirst, weakness, increased pulse, postural hypertension

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6
Q

treatment of hypernatremia

A

hypotonic fluids slowly, restrict Na

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7
Q

what is hypernatremia

A

sodium levels >145

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8
Q

hyponatremia causes

A

excess water or Na loss

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9
Q

what is hyponatremia

A

Na >135

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10
Q

hyponatremia signs and symptoms, SALTLOSS mnemonic

A

S- stupor/coma
A- anorexia (nausea and vomiting)
L- legathy
T- tendon reflex decreased
L- limp muscle weakness
O- orthostatic hypotension
S- seizure/headache
S- stomach cramping

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11
Q

hyponatremia treatments

A

restrict fluids if excess water and look diuretics
in extreme cases give 3% Nacl (hypertonic solution)

for Na loss, replace IV fluids, hold diuretics, encourage PO

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12
Q

normal potassium level

A

3.5-5

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13
Q

how much of body’s potassium is inside cell

A

98%

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14
Q

what does Na- K pump do

A

push Na out of the cell and K inside the cell

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15
Q

hyperkalemia causes

A

renal failure, acidosis, burns, K- sparing diuretics, ace inhibitors

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16
Q

hyperkalemia symptoms

A

muscle weakness (first symptom), paralysis, diarrhea, interstitial colic, cardiac arrthymias

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17
Q

hyperkalemia treatments

A

restrict K, kayexalate (pulls potassium into gut, makes poop), IV admin of insulin and dextrose to shift K into cells, dialysis, diuretics

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18
Q

hypokalemia ECG effects

A

slightly prolonged PR Interval
slightly peaked P wave
shallow T wave
Prominent U wave

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19
Q

hyperkalemia ECG effects

A

wide flat P wave
prolonged PR interval
decreased R wave amplitude
widened QRS
depressed ST segment
Tall, peaked T wave

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20
Q

hypokalemia causes. DITCH mnemonic

A

D- drugs like look diuretics, laxatives, glucocorticosteroids
I- inadequate consumption of K
T- too much water intake
C- Cushing syndrome (causes kidney to excrete K)
H- heavy fluid loss

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21
Q

hypokalemia signs and symptoms. 7 Ls

A

Lethargic
Low, shallow respirations- failure
Lethal cardiac dysrhythmias
Lots of urine
Leg cramps
Limp muscles
Low blood pressure

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22
Q

hypokalemia treatment

A

IV supplements, slowly, no more than 20 meq/hr
PO supplements
watch for digoxin toxicity if taking
increase food with K

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23
Q

roles of calcium

A

clotting, muscle contraction, nerve transmission

major cation in bones and teeth

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24
Q

how does body maintain calcium levels

A

through bone deposits or moving it back into system through parathyroid levels and calcitonin

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25
Q

what is needed for calcium to be absorbed thru food

A

vitamin D

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26
Q

normal calcium levels

A

8.5-10.2

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27
Q

hypercalcemia causes

A

hyperparathyroidism, malignancy in body, immobilization

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28
Q

hypercalcemia treatment

A

loop diuretic, isotonic solution, push PO fluids, limit calcium carbonate antacids (tums)

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29
Q

hypercalcemia symptoms

A

painful bones
renal stones
abdominal groans: nausea, vomiting, constipation, indigestion
psychiatric moans- legarthy, fatigue, depression, memory loss

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30
Q

hypocalcemia causes

A

parathyroid removal or injury, acute pancreatitis, alkalosis, laxative abuse, renal failure

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31
Q

hypocalcemia treatment

A

oral calcium chloride, IV calcium admin slowly, oral supplements

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32
Q

hypocalcemia signs and symptoms. CATS mnemoic

A

C- convulsions
A- arrhythmias
T- tetany
S- stridor and spasms

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33
Q

normal magnesium levels

A

1.3-2.1

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34
Q

magnesium functions

A

Bone structure, energy production, DNA/RNA synthesis, blood sugar control, BP regulation, muscle contraction, heart beat, nerve function

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35
Q

hypomagnesemia causes

A

renal loss, limited magnesium intake, chronic alcohol, high glucose, malabsorption

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36
Q

hypomagnesemia symptoms

A

neuromuscular and CNS irritability, confusion, muscle cramps, tremors, seizures, dysrhythmias

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37
Q

hypomagnesemia treatment

A

Oral and IV supplement. give IV slowly to avoid cardiac/resp arrest

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38
Q

hypermagnesemia symptoms

A

depressed nerve function and skeletal contraction, nausea, vomiting, bradycardia, hypotension, resp depression

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39
Q

hypermagnesemia causes

A

rare, caused by renal failure or excessive intake

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40
Q

hypermagnesemia treatment

A

Oral and IV, hemodialysis, ventilation, monitor cardiac rthyms

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41
Q

normal phosphate levels

A

2.5-4.5. higher in children

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42
Q

hypophosphatemia symptoms

A

rhabdomyolysis (muscles break down and release harmful protein), muscle weakness, ricketts or bone pain, mental confusion, seizures

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43
Q

hyperphosphatemia symptoms

A

associated with low calcium, tetany, seizures, muscle cramp

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44
Q

relationship between phosphate, magnesium and calcium

A

when calcium is low, magnesium and phosphate may be high, and vise versa

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45
Q

why is fluid deficiency more common in elderly

A

higher fat, less fluid

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46
Q

interstitial fluid

A

fluid that surrounds cells not in blood

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47
Q

diffusion

A

high to low

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48
Q

facilitated diffusion

A

use of protein carrier across membrane flowing low to high

ex- glucose requiring insulin

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49
Q

active transport

A

molecules move against gradient using energy

ex- Na-K pump

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50
Q

osmosis

A

water from low to high

ex- IV fluids

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51
Q

second spacing fluid

A

abnormal accumulation of interstitial fluid (edema)

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52
Q

third spacing fluid

A

fluid trapped and cant get back into cell or blood vessel

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53
Q

what causes edema

A

decreased albumin/protein
increased interstitial oncotic pressure to cap walls- burns, inflammation
increased venous hydrostatic pressure inhibits fluid to move back into capillaries (varicose veins)
iv fluids

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54
Q

fluid volume excess symptoms

A

changes in levels of consciousness, headache, seizures, pulmonary congestion, presence of S3, bounding pulse, high blood pressure, anorexia, nausea, edema

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55
Q

FVD symptoms

A

Weak pulse, thirst, postural hypotension, confusion, hypovolemia, tachycardia , dry mucous membrane, poor skin turgor

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56
Q

implementations for fluid volume

A

Daily weight, labs, auscultate heart and lung sounds, patient safety, IV fluids for deficit

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57
Q

isotonic solution

A

expand ECF and don’t move into cell, no net movement of water occurs.
has same osmotic pressure as plasma so ideal for fluid replacement

ex- 0.9 NS, LR, D5W

58
Q

hypotonic solution

A

water moves into cell causing it to swell. not a lot of salt, lowers serum osmolarity.
used for hypernatremia, replacement fluids

ex- 0.45 NaCL, 0.22 NaCl

59
Q

Hypertonic solution

A

more salt, less water. draws fluid out of cell and into blood.
used for hypernatremia and cerebral edema

ex- 3% NaCl, 5% NaCl, D10W, 25% albumin

60
Q

what is important to be monitored in hypertonic fluid or hypotonic fluid

A

change in neuro status due to pulling or overloading sodium

61
Q

colloids

A

large molecules hat pull fluid into blood vessels increasing oncotic pressure. AKA volume expanders

ex- albumin, fresh frozen plasma, blood, dextran

62
Q

what IV fluid can blood only be given with

A

NS

63
Q

important things to remember when doing blood transfusion

A

infuse packed RBC over 2-3 hours to decrease risk of fluid overload
have 2 verifications before beginning
get consent
monitor for reaction

64
Q

what can cause low platelets and WBC

A

chemo

65
Q

Hormone that regulates RBC

A

Erythropoietin

66
Q

why and where is Erythropoietin released

A

released due to low o2
released from adrenal glands

67
Q

Diseases that cause chronic hypoxemia

A

Copd
Emphysema
Chronic bronchitis
CAD

68
Q

Diseases that can affect production of RBC

A
  • Folic acid, b12, folic acid deficiencies
  • Bone marrow cancers
  • Chronic kidney disease (erythropoietin cant be released)
  • HIV/aids
    -inflammation
69
Q

food high in folic acid

A

leafy greens, seafood, fortified cereals

70
Q

foods high in b12

A

leafy green. Red meat, fortified cereals, legumes,diary

71
Q

foods high in iron

A

leafy green, red meat, poultry, seafood, dairy, fortified cereals, dark chocolate

72
Q

hemoglobin level

A

11-17

73
Q

hematocrit level

A

35-48%

74
Q

RBC level

A

4-6

75
Q

what does bone marrow make

A

PLT, WBC, RBC

76
Q

how long does RBC live

A

120 days

77
Q

Anemia

A

deficiency in number of circulating RBC
many causes:
overproduction of normal or defective cells
decreased erythrocyte production
blood loss
increased erythrocyte destruction

78
Q

Polycythemia

A

increase in number of RBC
unknown etiology

79
Q

decreased erythrocyte production anemia

A

iron deficiency
thalassemia
megaloblastic (folic acid, b12)

80
Q

increased erythocyte destruction anemia

A

sickle cell

81
Q

overproduction of normal or defective cells anemias

A

polycythemia
blood cancers

82
Q

common symptoms of anemia

A

Fatigue, cold, dizziness, orthostatic hypertension, pale, dark urine and little output (kidneys aren’t working as well due to lack of o2), difficulty exercising due to lack of energy and labored breathing, palpitation, weakness, constipation, diaphoresis

83
Q

what organ diseases can affect RBC

A

liver, kidney

84
Q

why is jaundice possible in anemia

A

liver may not be able to excrete bilirubin so builds up

85
Q

anemia diagnostics

A

total erythrocyte count
hgb/hct
iron/b12/folic acid level
elevated pulse
low o2 saturation

86
Q

iron deficiency anemia diagnosis

A

low ferritin level
microcytic cell

-decreased RBC prod

87
Q

thalassemia

A

insufficient production of hemoglobin
- genetic_ autosomal recessive
only cure is Hemptopatic stem cell trans… lots of risks

decreased RBC production

88
Q

causes of b12 (pernicious) anemia

A

decreased intake/decreased absorption
intrinsic factor no longer secreted
autoimmune
crohns, bowel resection, gastrectomy

-decreases RBC prod

89
Q

causes of folic acid anemia

A

inadequate intake of folic acid

  • decreases RBC prod
90
Q

interventions for anemia

A

advice rest periods, assess for falls and safety, prevent skin breakdown (lack of o2), assess dietary needs, monitor labs, oxygen, oral hygeine

91
Q

adding iron

A

iv route- preferred
oral (between meds not during)

iron causes constipation

92
Q

B12 supplements

A

oral
IM
nasal

93
Q

folic acid supplement

A

oral

94
Q

job of spleen

A

stores RBC

95
Q

sickle cell

A

thick, hard irregular shaped RBC that does not carry oxygen and can occlude blood vessel

inherited autosomal recessive disorder

96
Q

managing SCD to prevent

A

good hydration, nutrition, stress prevention, and preventing illness

97
Q

how to diagnose SCD

A

peripheral blood smear

98
Q

complications of SCD

A

HF (damage)
pulm infarction (blocked artery)
retinal damage (small vessels- eye issues)
stoke
renal damage
leg ulcers
osteoporosis (bone not getting oxygen)
pneumonia (fluid may not be able to move in and out of cell)
shock

99
Q

interventions for SCD

A

o2
fluids
blood transfusions
pain management
prevention**
hydroxyurea- drug that helps but suppresses RBC and PLT

100
Q

UTERINE PROLAPSE

A

uterus into vaginal canal

symptoms vary, but feeling something is “coming down”, backache, stress incontinence

treated by pelvic muscle strengthening exercises, pessary, surgery

101
Q

cystocele

A

protrusion of bladder through vaginal wall

symptoms- issues voiding, stress incontinence, inability to empty bladder, causing UTIs

diagnosed by cystourethrogram- injecting dye, taking x-ray

treated by pelvic floor therapy, surgery

102
Q

rectocele

A

protrusion of rectum through vaginal wall

symptoms- rectal pressure, hemorrhoids

diagnosed by pelvic exam

treated by pelvic floor therapy, pessary, surgery

103
Q

fistula

A

abnormal connection between organs

most common between rectum and vagina
due to complications from childbirth, or long labor

can close on own or surgery may be needed

104
Q

menopause

A

cessation of menses with decline in ovarian function, diagnosed by 12 months no period, or can check estrogen levels

105
Q

induced menopuase

A

taking out uterus and ovaries

106
Q

what does menopause put women at risk for

A

CAD
osteoporosis
fat redistribution
weight gain
joint and muscle pain
hair thinning
atrophy of genitalia and breast tissue
memory loss
frequent urination
hot flashes, night sweats

107
Q

management for menopause

A

prevent further bone loss- vitamin D, calcium (1500 mg/day)
bisphosphonates for bone loss
exercise
diet
HRT therapy
emotional support

108
Q

what is high BP a sign of

A

heart and blood vessels are being overworked

109
Q

if heart builds up to much muscle what can happen

A

less room to hold blood or heart enlargement

110
Q

if untreated, hypertension can lead to

A

atherosclerosis, CHF, blindness, kidney failure, stroke, heart attack, erectile dysfunction, aneurysms, enlarged heart

111
Q

systolic BP

A

pressure from contracted beat

112
Q

diastolic BP

A

pressure when heart is relaxed

113
Q

s1 sound

A

mitral and tricuspid closing

114
Q

s2

A

pulmonic and aortic valve closing

115
Q

preload

A

amount of blood left in ventricle after diastole (relaxed)… trying to get out

116
Q

med that decreased preload

A

diuretic

117
Q

what causes a increase in preload

A

Hypervolemia
regurgitation of cardiac valves
heart failure

118
Q

afterload

A

resistance left ventricle must overcome to circulate blood
-ventricle is trying to push blood out
the more afterload, the more cardio workload

119
Q

what causes afterload

A

hypertension
vasoconstriction

120
Q

normal BP

A

<120 over <80

121
Q

elevated BP

A

120-129 over <80

keep in mind if diastolic above 80 then its stage 1

122
Q

stage 1 hypertension

A

130-139 diastolic
or 80-89 systolic

123
Q

stage 2 hypertension

A

> 140 sysolic
or >90 diastolic

124
Q

patient position for bp

A

make sure legs aren’t crossed, arms at heart length

125
Q

race most at risk for htn

A

blacks

126
Q

what gender is more likely to get htn at a younger age

A

men

127
Q

woman and htn

A

higher rate after age 64 with poorer control
increased with risk of birth control pills

128
Q

cardiac output

A

HR and contractility
renal fluid volume control (renin-angiotensin)

129
Q

systemic vascular resistance

A

Sympathetic NS (alpha vasoconstrict, beta vasodilate)
neurohormonal (vasoconstrict- NE, angiotensin)
local regulators

130
Q

primary htn

A

no identifiable cause

Risk factors- obesity, family history, lack of exercise, smoking, diabetes, stress, alcohol, ethnicity, socio economic, age

131
Q

secondary htn

A

caused by cirrhosis, sleep apnea, renal disease, pregnancy, drugs, neuro causes

132
Q

diagnostics for htn

A

history and physical
eye exam
Blood test- cbc, lipid panel, UA
ECG
*bring BP diary to dr
echocardiogram

133
Q

preventning HTN

A

DASH diet - low Na, fat, increase veggies and fruits
exercise- aerobic and muscle strength
manage stress
stop smoking
limit alc

134
Q

how many drinks can genders have a day

A

men- 1-2
woman- 1 or less

135
Q

ACE inhibitors for htn

A

prevent conversion of angiotensin 1 to angiotensin 2: reduces vasoconstriction, salt and water retention
*doesnt effect heart rate
- these drugs end in -pril
side effect- cough

136
Q

ARBS for htn

A

angiotensin receptor blocker, prevents angiotensin II from binding to receptor
*does not affect heart rate
ends in -statin

137
Q

thiazide diuretic for htn

A

promote Na and water excretion, decrease plasma volume and SVR
- typically first drug given
- ends in -zide
K+ wasting drug

138
Q

calcium channel blocker (CCB) for htn

A

increases Na excretion, prevents artery constriction
ends in -pine
peripheral edema common side effect

139
Q

common side effects for all htn drugs

A

orthostatic hypotension, hypotension

140
Q

common OTC drugs that cause htn

A

sudafed, ibuprofen

talk to pharmacist before buying otc drugs

141
Q

why do elders get HTN

A

Loose elasticity in cardiovascular, change in lifestyle, organs wearing out
- at risk for orthostatic hypo— fall risk

bp goal for above 60 is 150/90

adult health 1 (5 decks)

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