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Unit 3 Flashcards

1
Q

Stroke volume is impacted on which specific 3 things

A

1 myocardial contractility
2 preload
3 SVR-afterload—resistance the ventricles must overcome in order to circulate

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2
Q

What 3 things are comprised in preload, after load, and contractility

A

Preload—venous return, fluid volume, atrial contraction
After load—resistance to ejected blood—systemic vascular resistance, health of vessels, vasoconstriction
Contractility—sympathetic stimulation—NE, parasympathetic stimulation- AcH, drugs—beta blockers calcium channel blocker

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3
Q

Hat is central perfusion

A

Ability of heart and large vessels to deliver oxygenated blood to body organ and tissues
—affected by cardiac output
—both mechanical and electrical components of the pump

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4
Q

What is tissue perfusion

A

Blood that flows through arteries and capillaries into target tissues
—mist have adequate arterial pressure

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5
Q

What are some things that impair central perfusion

A

Occurs due to altered conduction, reduced myocardial contraction, ineffective heart valves, decreased intramuscular volume. Or systemic vascular resistance
Ex: ventricular fibrillation, endocarditis, severe dehydration, hemorrhage

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6
Q

What happens to occur tissue perfusion

A

Arterial blockage
Stroke, myocardial infarction

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7
Q

A nurse is caring for a client with a surgical wound healing by secondary intention. Which finding would indicate proper healing during the granulation phase?
A. Approximation of wound edges.
B. Fibroblast activity with capillary formation.
C. Thick scar tissue forming with irregular borders.
D. Platelet aggregation forming a clot.

A

B

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8
Q

A patient is admitted with erythema, swelling, and warmth around a surgical site. What is the priority nursing intervention?
A. Administer prescribed NSAIDs.
B. Apply a warm compress to reduce swelling.
C. Assess for systemic manifestations of infection.
D. Perform wound care with aseptic technique.

A

C

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9
Q

A nurse is assessing a patient with a pressure ulcer on the sacrum. The ulcer is full-thickness, has slough present, and exposes subcutaneous tissue but no muscle or bone. What stage should the nurse assign?
A. Stage 2
B. Stage 3
C. Stage 4
D. Unstageable

A

B

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10
Q

A nurse is educating a client about the manifestations of localized inflammation. Which of the following signs should the nurse include?
A. Pain
B. Erythema
C. Pallor
D. Loss of function
E. Fever

A

A b d

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11
Q

A nurse is implementing interventions to prevent the development of pressure injuries in an immobile patient. Which actions should the nurse take?
A. Reposition the patient every 2 hours.
B. Place a pillow under the patient’s calves to elevate the heels off the bed.
C. Massage reddened areas to improve circulation.
D. Use a lift sheet when repositioning the patient.
E. Keep the patient’s skin clean and dry.

A

A

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12
Q

Which factors can delay wound healing? (Select all that apply)
A. Smoking
B. Malnutrition
C. Adequate perfusion
D. Diabetes
E. Advanced age

A

A b d e

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13
Q

A nurse is caring for a patient with atopic dermatitis experiencing intense pruritus. What is the priority nursing intervention?
A. Administer prescribed corticosteroids.
B. Teach the patient to avoid environmental triggers.
C. Apply a topical antihistamine.
D. Encourage the patient to wear loose clothing.

A

A

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14
Q

A patient presents with a newly formed wound exhibiting erythema, swelling, and exudate formation. What is the nurse’s priority action?
A. Perform a culture of the wound.
B. Apply a moist wound dressing.
C. Encourage the patient to increase protein intake.
D. Administer prescribed antibiotics.

A

A

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15
Q

A nurse is caring for a bedridden client at high risk for pressure injuries. Which intervention should the nurse prioritize?
A. Monitor the client’s serum albumin levels.
B. Apply a foam dressing to the sacrum.
C. Turn the client every 2 hours.
D. Educate the client about hydration and nutrition.

A

C

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16
Q

Which finding is most indicative of systemic inflammation in a patient with cellulitis?
A. Localized warmth and redness at the site of infection.
B. Elevated WBC count and fever.
C. Clear exudate draining from the affected area.
D. Thick scar tissue forming over the wound.

A

B

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17
Q

A nurse is educating a patient about healing by tertiary intention. Which scenario best demonstrates this process?
A. A clean surgical wound closed immediately with sutures.
B. A wound left open due to infection, then later sutured.
C. A pressure ulcer that closes gradually with granulation tissue.
D. A superficial wound that heals with minimal scarring.

A

B

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18
Q

Which laboratory test result is most relevant for monitoring systemic inflammation in a patient with rheumatoid arthritis?
A. Hemoglobin level.
B. C-reactive protein (CRP).
C. Sodium level.
D. Platelet count.

A

B

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19
Q

Which of the following factors may delay wound healing? (Select all that apply.)
A. Advanced age
B. Diabetes
C. High protein diet
D. Smoking
E. Low hemoglobin levels

A

A b d e

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20
Q

A nurse is caring for a patient with a pressure ulcer exhibiting tunneling and slough. What is the priority nursing action?
A. Measure the depth of the wound and document findings.
B. Debride the wound to remove dead tissue.
C. Administer prescribed antibiotics.
D. Apply a hydrocolloid dressing to the wound.

A

A

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21
Q

A nurse is caring for a patient with localized inflammation after a minor injury. Which is the priority intervention?
A. Administer prescribed NSAIDs.
B. Encourage fluid intake to promote healing.
C. Apply a cold compress to reduce swelling.
D. Perform range of motion exercises to prevent stiffness.

A

C

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22
Q

T/F inflammation does not mean infection

A

T

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23
Q

What are three types of inflammation and give an example of each

A
  1. Acute—paper cut (no scar)
    2 subacute—scab—same as acute but healing weeks to months
    3 chronic — months to years (autoimmune disease)
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24
Q

What are the 4 inflammation responses in order

A

1 histamine and prostaglandins released
2 capillaries dilate clotting begins
3 chemotactic factors attract phagocytic cells
4 phagocytes consume pathogens and cell debris

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25
Q

What stage is capillaries dilate and clotting begins in the inflammation response

A

2

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26
Q

What stage in the inflammation response is when histamine and prostaglandin release

A

1

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27
Q

What stage in the inflammation response is phagocytes consume pathogens and cell debris

A

4

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28
Q

What inflammation response stage is chemotactic factors attract phagocytic cells

A

3

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29
Q

What are the inflammation manifestations of local inflammation
Elevated WBC
Warmth
Swelling
Fever
Malaise
Swelling
Erythema (redness)
Loss of function

A

Erythema
Warmth
Pain
Swelling
Loss of function

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30
Q

T F fever is d/t angiotensin response

A

F
Fever is d/t cytokine response—helpful; tells us the body is attempting to respond

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31
Q

What are the two inflammation. Manifestations

A

Local and systemic

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32
Q

What lab values are correlated to systemic inflammation

A

CBC
WBC—elevated
CRP—elevated and detects systemic inflammation

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33
Q

What does CRP lab value do with inflammation tracking

A

Marker for inflammation in body we want it to trend
But it is not specific

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34
Q

What is RICE with inflammation

A

Rest
Ice
Compress
Elevate

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35
Q

How do you manage inflammation and treat

A

Protein
Fluids
NSAIDS
Antipyretics

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36
Q

What is Allergic Contact Dermatitis

A

Lesasion appears 2-7 days after allergen contract
Red papules and plaques
Purities

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37
Q

How do you treat Allergic Contact Dermatitis

A

Corticosteroids and antihistamines PO and topical

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38
Q

What is Atopic dermatitis

A

Generic chronic relapsing
Environment triggers
Intense pruitis

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39
Q

How do you treat atopic dermatitis

A

Reduce environmental stressors, corticosteroids

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40
Q

What are the wound classifications

A

Surgical vs nonsurgical
Acute vs chronic
Depth of tissue loss
Skin tear

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41
Q

What are the three depths of tissue loss

A

Superficial—epidermis
Partial thickness—extends to dermis
Full thickness—deep layers of tissue destruction

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42
Q

Healing process
What are the phases of primary intention

A

Initial phase—clot formation, platelet matrix forms, WBCs flood the area
Granulation phase—fibroblast migration, collagen secretion, formation of capillaries
Maturation—collagen remodeling, scar strengthens

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43
Q

What are the qualities of secondary intention of healing process
(Trauma.infection after healed the opened and infected)

A

Edges cannot be approximated
Greater inflammation response leads to more debris, cells and exudate
Greater defect and gaping wound edges lead to more granulation tissue and a larger scar

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44
Q

What is tertiary intention healing process mean (delayed primary)

A

Occurs when contaminated wound is left open and sutured closed after infection is controlled
Also occurs when a primary wound becomes infected or opens
Largest and deepest scar

WOUND VAC

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45
Q

T/F dryness is the enemy of wound healing

A

T
Most wound healing is good for skin formation

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46
Q

What does it mean to be an unstageable wound

A

Slough and eschar must be removed to expose the base of the wound for true depth to be determined
Will be stage 3 or 4
If on heals, stable eschar should not be removed

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47
Q

A nurse is assessing a bedridden client and notes an open area on the sacrum with visible subcutaneous fat and slough present around the wound edges. Which stage should the nurse assign to this pressure ulcer

A

C

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48
Q

A nurse is caring for a client with limited mobility. Which of the following actions should the nurse take to help prevent pressure ulcer formation (SATA)
A reposition the client every 4 hours
B place a pillow under the client’s calves to elevate the heels off the bed
C massage any reddened areas to promote circulation
D keep the head of the bed elevated at 30 degrees or lower, if possible
E ensure the client’s skin remains dry and clean

A

B D E

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49
Q

A nurse is providing care to a client with a surgical wound. which of the following findings would indicate that the wound is healing by primary intention
A the wound is open with granulation tissue forming at the base of the
B the wound edges are approximated, with minimal scar formation
C the wound is left open to drain and gradually closes from the edges
D the wound shows thick scar tissue forming with irregular borders

A

B

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50
Q

What are the kidney functions

A

Regulate the volume and composition of the ECF
Excrete waste products
Control blood pressure
Make erythropoietin
Activate vitamin d
Regulate acid-base balance

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51
Q

What are the two types of renal impairment

A

Partial or complete impairment of kidney function that results in the inability to excrete metabolic waste products and water

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52
Q

What are the lab alterations of acute/chronic renal failure

A

BUN and creatinine and K+ increase

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53
Q

what are the staging of CKD

A

Stages 1-5
Gradual, irreversible decline in renal function
Staging determined by GFR

End-stage Renal disease (ESRD) kidneys can no longer function on their own.

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54
Q

What are the major causes and risk factors of CKD

A

Diabetes, hypertension, glomerulonephritis, other urinary disease.

CKD affects all body systems

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55
Q

what are the manifestations of CKD of lab tests

A

Increased BUN and creatine
Lethargy, fatigue, impaired thought process, and headaches
Elevated triglycerides
Increased K and Mg

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56
Q

What are the clinical manifestation of CKD

A

Anemia, risk for bleeding, infections, Dyspnea, GO impacts, neuro impacts, urea crystals on skin —pruritis from calcium -phosphate deposits

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57
Q

Hat are the comorbidities of CKD

A

Cardiovascular disease
Osteoporosis
Hypertension

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58
Q

What does calcium and phosphate in CKD cause

A

Causes CKD mineral and bone disorder (CKD-MBD)

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59
Q

What are the nutrition management of CKD

A

Protein—avoid high protein
Fluids—yesterdays output + 600 ml
Sodium: 2-4 grams/day
Potassium 2-3 grams/day (unless hemodialysis)
Phosphorous restrictions 1G/day in ESRD

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60
Q

What medications treat anemia in CKD

A

Erythropoietin, iron supplements, folic acid

61
Q

Hyperkalemia medication in CKD

A

Kayexalate

62
Q

What medication should treat mineral and bone disease

A
  • vit d, phosphate binders
63
Q

What medication for CKD to treat dyslipidemia

A

Statins

64
Q

What are some implications for treating symptoms of CKD

A

CKD causes the potential from drug toxicity
Drug doses and frequency adjusted based on CKD severity
Toxicity may result as drug levels increase

65
Q

What are some nephrotoxic medications

A

NSAIDS, vancomycin, chemo, calcium carbonate, IV contrast

66
Q

Why are some interventions in nursing care in CKD

A

Measure vital sings—daily BPs
Daily weights
Strict intake and output

67
Q

What is the goal of dialysis

A

To correct fluid and electrolyte imbalances and remove waste products
Two methods: hemodialysis or peritoneal dialysis

68
Q

what is the difference between AV fistulas and AV grafts

A

AV fistulas—preferred access, need 3 months to heal before use, assess for thrill and bruit, no BP or lab draws in that arms
AV graft—synthetic graft forms a bridge between vein and artery. Tends to get infected or become throbogenic, infections may require removal

69
Q

What are teh nursing assessments for hemodialysis before treatment, during treatment, after treatment

A

Before treatment—fluid status, condition of vascular access, vital signs, labs
During treatment- two large bore needles in fistula, heparin is added to prevent clotting, during dialysis take vital signs are least every 30-60 minutes
After treatment— fluid status, viral signs, labs (potassium)

70
Q

What are the assessments of clients on peritoneal dialysis

A

Assess fluid status, vital signs, catheter site, labs (weekly)
Monitor inflow and outflow, document intake and output, maintain aseptic dressing changes

71
Q

What are some complications of peritoneal dialysis

A

Exit site infection—redness, tenderness, drainage
Peritonitis—abdominal pain, rebound tenderness, etc.
hernias—due to increased abdominal pressure
Lower back problems—due to increased abdominal pressure
Bleeding—common with initial catheter placement, ongoing is a problem
Pulmonary complications—decreased lung expansion, Atelectasis
Protein loss

72
Q

What are some advantages of hemodialysis

A

Rapid fluid removal
Rapid removal of urea and creatinine
Effect potassium removal
Less protein loss
Lowering triglycerides
Home dialysis possible

73
Q

What are some disadvantages of hemodialysis

A

Vascular access problems
Diet and fluid restrictions
Heparinizations may be necessary
Hypotension during dialysis
Added blood loss that contributes to anemia
Surgery for access

74
Q

Where is a peritoneal dialysis placed

A

Placed surgically through the anterior abdominal wall

75
Q

What are the phases of peritoneal dialysis

A

Inflow0 2 to 3 L over 10minutes
Dwell (equilibrium) 20-30 minute-8 hours
Drain 15-30 minutes

76
Q

What are the two systems of peritoneal dialysis

A

Automated peritoneal dialysis—during sleep
Continuous ambulatory peritoneal dialysis—manual exchange four times a day

77
Q

What do you assess and care for clients on peritoneal dialysis

A

Assess- fluid status, vitals, catheter site, labs (weekly is stable, daily if unstable
Monitor inflow and outflow
Document I/Os

78
Q

What are some advantages for peritoneal dialysis

A

Immediate initiation
Less complicated than hemodialysis
Portable system
Fewer diet restrictions
Short training
Less cardiovascular stress

79
Q

What are some disadvantages for peritoneal dialysis

A

Bacterial or chemical peritonitis
Protein loss into dialysate
Exit site and tunnel infections
Self image problems w catheter placement
Hyperglycemia
Catheter can migrate

80
Q

What are some contraindications for patients with peritoneal dialysis

A

Contraindicated in patient w multiple abdominal surgeries, trauma, unrepaired hernia

81
Q

What are some complications of dialysis overall

A

Hypotension
Muscle cramps
Blood loss
Hepatitis C infection control
Emotional distress

82
Q

What are the three components of perfusion

A

1 pump
2 volume
3 vascular tone

83
Q

What is the cardiac output equation

A

Cardiac output=HRxSV

84
Q

What are the three things that stroke volume is impacted by

A

Myocardial contractility—how hard the myocardium contracts for a given preload
Preload—amount of blood entering the ventricles during diastole
After load—resistance the ventricles must overcome in order to circulate blood

85
Q

What affects preload

A

Venous return
Fluid volume
Atrial contraction

86
Q

What affects after load

A

Resistance to ejected blood =systemic vascular resistance
Health of vessels (atherosclerosis)
Vasoconstriction

87
Q

What affects contractility

A

Sympathetic stimulation —norepinephrine
Parasympathetic stimulation —AcH
Drugs -beta blockers, calcium channel blockers

88
Q

What is the difference between central perfusion and tissue perfusion

A

Central—ability of heart and large vessels to deliver oxygenated blood to organs and tissues
(Affected by cardiac output, both mechanical and electrical components)
Tissue—blood that flows through arteries and capillaries into target tissues (must have adequate arterial pressure—product of cardiac output and systemic vascular resistance

89
Q

What types of medication might help perfusion

A

Antiplatelets
Anticoagulant
Vasodilators
Statins
Digoxin
Aspirin
Antidysrhythmics
Ace inhibitors
Dieurtetics
Calcium channel blockers

90
Q

What is virchow triad with venous thrombosis

A

Venous stasis: valve problem or muscle problem
Hypercoaguablility: blood clots more easily
Endothelial damage: direct or indirect; stimulates platelet cascade

91
Q

What are the Clincal manifestations of superficial thrombosis
What are Clincal manifestations for deep VTE

A

Superficial—usually is varicosity, palpable firm chord like veins, area around the vein is itchy, painful, red and warm, edema is rare
Deep VTE—present in deep veins, tenderness, venous distention/congestion, deep in reddish color, edema and “heaviness” in extremities, may have no physical signs

92
Q

What is the difference between thrombu and embolus

A

Thrombus is called an embolus when it becomes mobile.

93
Q

What are serious complications of superficial thrombus

A

VTE=pulmonary embolism (PE), stroke, sudden cardiac death

94
Q

What are preventative interventions of thrombus

A
  1. Early and progressive mobilization
  2. Compression stockings
  3. Sequential compression devices
  4. Prophylactic antiplatelet/blood thinning medications
95
Q

What do you do if there is a known thrombus

A

Extremity assessment, neuro checks, pulmonary assessment

96
Q

What are the interventions of thrombus

A

Administer medications as prescribed
Evaluate lab values
Educate on risks of nicotine, hormone therapy, and inactivity
Educate on s/s of DVTs and further complications

97
Q

What are some considerations of enoxaparin (lovenox)

A

Thrombin inhibitor
Give subq
Use caution in patient with hex heparin-induced thrombocytopenia

98
Q

What is the class and considerations of warfarin

A

Vitamin K antagonist orally
Give at the same time each day

99
Q

What is the class and considerations of apixaban (eliquis) and rocaroxaban (xarelto)

A

Factor Xa inhibitors oral
Good for prevention or treatment of VTEs

100
Q

What is an ischmic stroke

A

Inadequate blood flow
Injury to blood vessel wall and formation of clot or embolic (mobile clot lodges in cerebral artery)

101
Q

What is a hemorrhage stroke

A

Commonly caused by hypertension, vascular malformation, or disrupted coagulation (unable to clot)
Bleeding into brain

102
Q

What are some risk factors for ischemic strokes

A

Perfusion and DVT

103
Q

What does BEFAST mean

A

Balance
Eyes
Face
Arms
Speech
Time (time to call for ambulance)

104
Q

What are some manifestations of right brain damage

A

Paralyzed left side
Left side neglect
Rapid performance, short attention span
Impaired judgement

105
Q

What are some manifestation of left brain damage

A

Paralyzed right side
Impaired speech
Aware of deficits
Impaired comprehension

106
Q

What are some managements of stroke

A

Can they swallow safely
Are they impulsive
Can they reposition themselves
How do they communicate

107
Q

What is the class and considerations of heparin

A

Thrombin inhibitor (indirect)
Give IV for existing blood clots
Give subq for prophylaxis

108
Q

What is the difference between primary hypertension and secondary hypertension

A

Primary—idiopathic, accounts for 90-95% of cases
Risk factors—altered endothelial function, inc SNS activity, inc sodium, obesity, tobacco
Secondary—specific cause (pregnancy, drug, hepatic disease, renal disease) sudden onset treatment is aimed at removing underlying cause

109
Q

What are the categories of hypertension, levels

A

Normal <120 and/or <80
Elevated 120-129 and or <80
Hypertension stage 1 130-139 and/or 80-89
Hypertension stage 2 140+ and/or 90+

110
Q

What are some clincial manifestions of hypertension

A

Fatigue, dizziness, palpitations, angina, Dyspnea

111
Q

What are organs are at highest sensitivity to HTN and what do for diagnosis

A

Brain, kidneys, eyes, heart
Extensive HandP
Urinalysis
Blood sugar, cbc, bmp, lipid, ecg

112
Q

What are compactions to the kidneys in hypertension

A

Microalbuminuria
Proteinuria
inc creatine (>=1.5)

113
Q

What are complications of HTN in the brain

A

Stroke and transient ischemic attack

114
Q

What are complications of HTN in the heart

A

CAD, heart failure, left ventricular hypertrophy

115
Q

What are some complications of HTN in the abdomen

A

Aneurysm, aortic dissection

116
Q

T/F is penile erectile dysfunction a complication of hypertension

A

T

117
Q

What is the life’s simple 7 in multidisciplinary care of HTN

A

Stop smoking, get active, control cholesterol, manage blood pressure, eat healthy, lose weight, reduce blood sugar

118
Q

What is the dash diet

A

Low fat, whole grain, fish, poultry, beans, low sodium

119
Q

What do diuretics, ace inhibitors, CCBs and beta blockers do to affect blood pressure

A

Duiretics—affect stroke volume (reduce preload)
—monitor electrolytes
Ace inhibitors—affect cardiac output (reduce preload)
—may not be well tolerated
Beta blockers—decrease HR
CCB—decrease SVE (reduce after load)

120
Q

What is the first line therapy

A

Use non pharmacological and 1 medication
—introduce second medication depending on stage and response

121
Q

What is emergency crisis hypertension

A

SBP >180 and or DBP >120
Emergent when target organ disease exists in
Encephalopathy, brain hemorrhage, MI, HF, acute renal failure, aortic aneurysm, retinopathy

122
Q

What are the management of emergency HTN

A

Hospitalization —IV antihypertensives
Invasive BP monitoring with arterial line
Assess hourly urine output
Slowly lower BP to avoid stroke, renal failure, and HF

123
Q

What are the characteristics of left-sided HF

A

Caused by impaired contractility, valve abnormalities, and hypertension
Systolic failure—it is a failure of left ventricle to empty adequately during systole
EF <45%
Fluid back up into the lungs

124
Q

What are the characteristics of right sided HF

A

Failure of right ventricle
Rest of the body, fluid back up into the venous system
Most common cause left sided HF

125
Q

What are some manifestations in left sided HF

A

Increased HR
Extra heart sounds
Confusion
Cough
Crackles
Pleural effusion
Shallow respirations
Anxiety, depression
Dyspnea
Fatigue
Nocturnal
Orthopnea
Nocturnal Dyspnea

126
Q

What are the manifestations of right sided HF

A

Increase HR
Anasarca
Ascites
Edema,weight gain
Hepatomegaly
JVD, murmurs
Anorexia, G bloating
Anxiety, depression
Fatigue
Nausea, RUQ pain

127
Q

Diuretics remove fluid, what is something we need to do before administering diuretics

A

Know K+ prior to administration

128
Q

What fluid describes fluid inside the cells, has potassium and phosphate , contains higher concentration of proteins

A

Intra cellular fluid
Two third of the body’s water if found in the ICF

129
Q

What is the daily fluid requirement of men and women

A

3.7 men
2.7 women

130
Q

What is the daily fluid output

A

0.5-1.5ml/kg/hr
Normal range 800-2000ml per day

Pediactrics 1-2 ml/kg/hr
Both urinate every 6hrs

131
Q

What conditions where we would see fluid volume deficit

A

Ocurrs with:
1 abnormal body fluid loss
2 inadequate intake
3 shift from plasma to interstitial fluid

Diabetes insipid is, GI losses, hemorrhage, inadequate intake, insensible water loss or perspiration, osmotic diuretics, third space fluid shifts

132
Q

What manifestation would we see with fluid volume deficit

A

Cap refill, confusion, restlessness, lethargy
Cold clammy skin, postural hypotension, increase pulse, seizures, coma, thirst, dry mucus membranes, urine concentration, weight loss

133
Q

What are some implementations of fluid volume deficit

A

Record I and Os
Monitor vital signs
Oral rehydration in mild cases
Moderate-severe rehydration
Fall precautions
Provide prescribed diet
Frequent oral cares

134
Q

What are some causes of fluid volume excess

A

Long-term corticosteroid use
Cushing syndrome
HF
Primary Polydipsia
Renal failure

135
Q

What will we see with fluid volume excess

A

Bounding pulse, inc HR, confusion, headache, lethargy, Dyspnea, crackles, pulmonary edema
Edema, JVD, muscle spasms, polyuria, extra heart sounds, weight gain

136
Q

What are some implementations of fluid volume excess

A

Daily weights, record I and Os, monitor vital sings, administer diuretics, sodium fluid restrictions, implement fall precautions, skin care-frequent position changes, elevate edematous extremities

137
Q

What takes priority in FVE

A

Cardiovascular checks take priority

138
Q

What are plasma electrolytes

A

Sodium H, K l, Ca l, Mg l
Cl h,

139
Q

What are intracellular electrolytes

A

K h, Na l, Mg l

140
Q

Normal range of Na and what are the functions of Na

A

136-145
1 maintain water volume in ECF
2 electrical transmission of nerve impulses
3 maintaining acid-base balance of blood
4 regulate relationship of Na and K placement

141
Q

Normal potassium range and what are the functions

A

3.5-5
1 nerve impulse conduction
2 cardiac electrical activity regulation
3 skeletal and smooth muscle contraction
4 regulate acid-base balance

142
Q

What are manifestations and interventions of hyperkalemia

A

Bilateral muscle weakness (begins in quads)
Abdominal distention
Decreased bowel sounds
Constipation
Dysrhythmias
ECG abnormalities (U waves flattened, inverted T waves, ST depression)
Treat with PO or IV KCl
Increase K foods, treat underlying cause

143
Q

What are the manifestations of hyperkalemia

A

Bilateral muscle weakness
Abdominal cramps
Diarrhea
Dysrhythmias
Cardiac arrest if severe
ECG abnormalities (peaked T waves, widened QRS

Stop Po and IV k intake
Increase potassium excretion (loop/thaizide diuretic)
Administer insulin, dextrose, albuterol
Treat underlying cause

144
Q

What is the normal value of calcium and what are the functions

A

8.2-10.2
Need vit d, magnesium, phosphorus, and vitamin K are needed for absorption
1. Build strong bones and teeth
2 facilitates blood clotting
3 essential for nerve impulse transmission
4 activation of certain enzymes

145
Q

What are the manifestations and interventions of hypocalcemia

A

Numbness, finger/toe tingling
Positive Chvostek sign
Hyperactive reflexes
Muscle twitch/cramping
Carpal and pedal spasms
Positive trousseaus sign
Seizures
Laryngospasm
Dysrhythmias

Treat w PO and IV mediations
Gluconate+vit d to aid in oral absorption
Adjust diuretics from loop to thiazide

146
Q

What are the manifestations and interventions of hypercalcemia

A

Anorexia, nausea, vomitting,
Constipation, fatigue, diminished reflexes
Lethargy, LOC, confusion, personality change

Treat with PO or IV calcitonin, biphosphonates, prednisone)
Restrict calcium intake
Increase weight bearing activity, maintain hydration

147
Q

What is the normal value of magnesium and the functions

A

1.3 to 2.1

1 needed for normal function in muscles, nerves, and cardiac conduction
2 supports immunity
3 assist in blood clotting
4 required for calcium and vitamin d absorption

148
Q

What does the numonic mean create bind at the ren fair

A

BUN and creating values most affect renal failure

149
Q

What does the numonic bro please, what the cost for the VR

A

Blood pressure=cardiac output x systemic vascular resistance

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