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fundamentals of nursing > test 4 > Flashcards

test 4 Flashcards

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1
Q

what causes edema

A

too much interstitial fluid

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2
Q

fluid that lives in its own space, inst related to cardiac output

A

transcellular

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3
Q

too much transcellular fluid

A

third spacing

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4
Q

cation electrolytes

A

sodium, potassium, calcium, magnesium

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5
Q

anion electrolytes

A

chloride, bicarbonate, phosphate, sulfate

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6
Q

intracellular electrolytes

A

potassium, magnesium, phosphate

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7
Q

extracellular electrolytes

A

sodium, chloride, bicarbonate

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8
Q

transport that requires energy

A

active

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9
Q

transport that doesn’t require energy

A

passive

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10
Q

osmosis

A

movement of water from low to high concent

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11
Q

concentration of solvent to solute

A

osmolality

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12
Q

serum osmolality

A

comes from blood sample

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13
Q

urine osmolality

A

comes from pee sample

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14
Q

fluid volume deficient

A

less fluid

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15
Q

fluid volume excess

A

more fluid

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16
Q

crystalloids

A

cheap, act quickly in body, very rare to cause reactions in people, tiny particles in fluid so they can cross into or out of vessels easily, so can hydrate or pull fluid

ex: 0.9 NS, lactated ringers, 5% dextrose

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17
Q

colloids

A

large molecules, don’t move quickly, they stay in blood vessels, and don’t cross membranes easily. Very expensive. Patients can have reactions

ex- blood products, dextran, gelatin solutions

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18
Q

diffusion

A

solute moves from high to low to equal concent.

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19
Q

movement of water and smaller products from high to low pressure

A

filtration

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20
Q

what are the 3 major systems involved in fluid regulation

A

endocrine, renal and nervous system

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21
Q

what is thrist triggered by

A

hypothalamus due to changes in plasma osmolality

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22
Q

sensible

A

measurable

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23
Q

insensible

A

not measurable

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24
Q

ADH

A

increase water absorption, decrease urine output
from pit gland, releases when BP drops

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25
Q

renin angiotensin

A

brings BP up when drops, angiotensin 1 turns to 2, clamps vessels holding onto water and sodium

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26
Q

aldosterone

A

increased potassium output, increases sodium absorption

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27
Q

BNP

A

brain natriuretic peptide. hormone is released when there is a lot of stretch in ventricle, opens up vessels and tries to drop BP
Patients with CHF have elevated BNP
the higher the number, the worse

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28
Q

normal soidum level

A

135-145 mEq

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29
Q

what is sodium involved in

A

regulating water balance, controls extracellular fluid volume, stimulates nerve conduction and controls contractility of muscles

can affect mental status

most abundant electrolyte in body

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30
Q

normal potassium levels

A

3.5 to 5.0 mEq/L

a little change outside range can cause issues

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31
Q

what does potassium do

A

helps cells uptake water and nutrients
helps heart contract
helps nerves carry messages
helps digest
balances body fluids

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32
Q

foods high in potassium

A

salmon, sweet potatoes, bananas

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33
Q

normal rage of calcium

A

8.5 to 10.5

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34
Q

what does calcium do

A

involves in muscle contraction, wound healing, nerve impulses, bone structure, cellular metabolism

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35
Q

what controls calcium, and how much calcium lives in bone

A

parathyroid
99%

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36
Q

good sources of calcium

A

dairy, nuts, leafy greens

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37
Q

magnesium normal levels

A

1.5-2.5

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38
Q

what does magnesium do

A

regulate calcium
cleans bowel
relaxes skeletal and smooth muscle
energy production
regulates heart contractility

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39
Q

good souces of magnesium

A

dark chocolate, leafy greens, beans, pumkin seeds

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40
Q

normal chloride levels

A

95 to 105 mEq/L

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41
Q

what does chloride do

A

helps cells take in and out materials
helps muscles contract
helps nerves carry messages
helps with oxygenation of body
helps body digest

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42
Q

what electrolyte works with sodium

A

chloride

if sodium goes up, chloride goes up

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43
Q

normal phosphorus level

A

2.5 to 4.5 mEq/L

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44
Q

what does phosphorus do

A

forms and keeps strong bones and teeth
helps maintain energy levels
forms genetic materials
helps form cell membranes
helps oxygen delivery in body
helps maintain normal acid balance

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45
Q

hypovolemia symptoms

A

low fluid volume

poor skin turgor
dry mucous membrane
hypertension
weight loss
tachycardia, tachypnea
oliguria
legarthy

46
Q

hypervolemia

A

increased fluid volume

SOB from pulm congestion
neuro changes from sodium changes
weight gain
presence of S3 heart sound
bounding pulse, hypertension
edema
nausea, anorexia

47
Q

BMP

A

looks at electrolytes, except magnesium, and looks at glucose and kidney function

48
Q

H&H

A

Hematocrit (Osmolarity of blood- amount of blood cells in sample) and hemoglobin (RBC)

IncreaseD levels may be FVD

49
Q

BUN and creatine

A

BUN- blood urea nitrogen
creatinine- protein breakdown.

Increase- more protein breaking down, FVD

50
Q

urine specific group

A

What’s in urine, high number means more particles then fluid= FVD

51
Q

hyponatremia

A

low sodium, fluid excess

drop CVP
headache/seizures,coma
confusion
orthostatic hypertension
abdominal cramps, N/V, anorexia
muscle weakness

52
Q

Hypernatremia

A

low fluids, high sodium

tachycardia
dry mucous membrane
dehydration
low urine
restlessness, irritability
headache/seizures,coma
confusion
orthostatic hypertension
abdominal cramps
muscle weakness

53
Q

hypokalemia

A

low potassium

dysrhythmias
conduction defects
fasciculations and tetany
weakness and paralysis
abdominal distention
polyuria
ileus, N/V

54
Q

hyperkalemia

A

dysrhythmias
conduction disturbances
weakness
paresthesias (tingling)
Paralysis
hyperreflexia
cramping
N/V/D

55
Q

hypercalcemia

A

too much calcium

decreased neuronal excitability- anxiety, depression, cognitive
cardiac arrhythmias
lack of appetite
constipation

56
Q

hypocalcemia

A

not enough calcemia

increased neuronal excitability
seizures
hypocalcemic tetany

57
Q

positive trousseau sign

A

hypocalcemia
when inflating BP cuff, hand will spasm

58
Q

positive chvostek sign

A

shoes hypocalcemia
tapping facial nerve, facial twitch

59
Q

hypomagnesemia

A

low magnesium

confusion
increased deep tendon reflex
seizures
muscle cramps
tremors
insomnia
tachycardia

60
Q

hypermagnesemia

A

flushing
decreased deep tendon reflex
muscle weakness
lethargy
decreased respiration
bradycardia
hypotension

61
Q

hyponatremia intervention

A

fluid restriction

62
Q

resuscitation- IV admin

A

lots of fluid fast

63
Q

routine maintenance- IV admin

A

gentle hydration over a period of time
-for people who are at risk

64
Q

replacement- IV admin

A

if we lost fluid and need it replaced

65
Q

redistribution- IV admin

A

changes where fluid is in body

66
Q

5 Rs iv fluid admin

A

resuscitation
routine maintenance
replacement
redistribution
reassessment

67
Q

isotonic solution

A

flood stays in blood vessels
same as blood serum
ex- LR, NS

68
Q

Hypotonic solution

A

fluid is pushed out of blood vessels into cells, good for if cells are dehydrated, such as from high blood sugar
lower than blood serum
1/2 NS

69
Q

Hypertonic solution

A

fluid is pulled from into cells into blood vessels, good if edema present. but could cause overload. vesicant, can cause damage to tissue
higher than blood serum
D5NS

70
Q

what electrolyte should you monitor reflexes

A

magnesium

71
Q

what electrolyte should you monitor heart rhythm, rate and BP

A

potassium

72
Q

what electrolyte should you monitor with edema

A

sodium

73
Q

When sodium goes up, what electrolyte goes down

A

potassium

74
Q

when calcium goes up, what electrolyte goes down

A

phosphorus

75
Q

when magnesium goes down, what electrolyte goes up

A

phosphorus

76
Q

when calcium goes up, what vitamin also goes up

A

vitamin D

77
Q

When magnesium goes down, what other electrolytes go down

A

calcium and potassium

78
Q

What size needle needed for blood transfusions

A

20 gauge or bigger (bigger is smaller numbers)

79
Q

how long is a blood cross good for

A

3 days

80
Q

what do u need for blood transusion

A

Type and cross
Need consent- must be from physician, RN can sign as a witness
Explain and educate
Baseline assessment and vitals- especially temp
Physical assessment- cardio and resp
Make sure unit knows you are giving blood- dedicated to that room, other people will need to look after your patients
Have a second IV site available- if something Goes wrong meds cant be given in blood line
2 verifications- verify right patient and right blood, bag and EMAR.
Special tubing needed for blood

81
Q

who can verify blood before tranfusion

A

Can be done with 2 RN, 1 RN 1 LPN, cant be PCT

82
Q

what is the only solution that can be ran with blood

A

normal saline

83
Q

why do we start giving blood slowly

A

incase of a reaction
check vitals within 5-15 mins, look for any skin changes, pallor, SOB ,anything that wasn’t there before

keep in mind reactions could also occur days later

84
Q

what do you do if reaction occurs with blood transfusion

A
  1. stop transfusion
  2. saline flush
  3. notify physician
85
Q

normal hemoglobin level for male

A

14-17 g/dL

86
Q

normal female hemoglobin level

A

12-15 g/dL

87
Q

universal blood donor

A

O-

88
Q

what blood type can receive blood from any donor

A

AB+

89
Q

what do you do with the blood if a reaction occurs during transfusion

A

send it back to lab for future testing

90
Q

perioperative

A

when surgeon and patient decide a surgery is going to happen. Could be months before

91
Q

intraoperative

A

in the OR

92
Q

postoperative

A

when the surgeon no longer thinks patient needs follow up and is no longer in recovery

93
Q

never errors for surgery

A

surgery on wrong patient/part/wrong surgery
foreign body entering
post infection
intraoperative death

94
Q

ablative surgery

A

removing tissue that isn’t doing what its supposed to do. Doesn’t mean its diseased

95
Q

diagnostic surgery

A

scan or blood test that leads us to believe there is a bigger picture, opening and biopsy, ex is a mass

96
Q

palliative surgery

A

for better quality of life, usually related to pain, immobility, etc.
Could be from nerve issues or significant scarring

97
Q

reconstructive/cosmetic surgery

A

could be from major trauma, or issue, or just personal looks

98
Q

transplant surgery

A

taking out something that doesn’t work and replace

99
Q

procurement surgery

A

taking organs/tissue from body to harvest and transplant

RN calls procurement office every time someone dies (unless its a crime) to see if patients are candidates for donation

100
Q

emergent surgery

A

needs to happen then and now, life saving, consent may not be asked

101
Q

urgent surgery

A

surgery that needs to happen within 24 hours, try to get consent but might not be able

102
Q

elective surgery

A

any surgery that isn’t emergent or urgent

could be planned months in advance

103
Q

why does mental status impact surgical risk

A

patient may not be able to understand how to take care of themself after surgery

104
Q

what are some medications that could pose surgical risk

A

Blood thinners, insulin (may not be able to eat and drink for awhile), steroids, BP meds

105
Q

personal/ lifestyle habits that can create surgical risk

A

smoking, alcohol, obesity, underweight (poor wound healing), drug use

106
Q

what does NPO status depend on for surgery

A

the type of surgery being preformed

107
Q

surgical physical preparation (what we do for patients before they go to OR)

A

NPO
skin prep
Bladder and bowel
removing personal items
prosthetic management
anti embolism stockings

108
Q

circulating nurse

A

OR nurse that does non sterile things, such as monitors and documents

109
Q

scrub nurse

A

OR nurse that sterilizes and can assist with procedures

110
Q

POST OP care

A

Vital signs, airway, level of consciousness, positioning, wounds/dressings, IV, comfort

111
Q

on the unit care

A

get SBAR from post op nurse
manage diet, activity, SCDs, ambulation, signs/symptoms, follow up care that is needed
monitor vitals frequently

112
Q

what can anesthesia cause

A

abdominal distention
constipation/ileus
urinary retention

should be back to normal within hours

fundamentals of nursing (4 decks)

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