Unit 3 study guide Flashcards by Krissa Thrift

signs and symptoms of HYPOnatremia

"Salt loss"
muscle spasam
decreased urine output
weakness shallow respirations
increased bowel motility
decreased DTR
Orthostatic hypotenstion
<135

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Cause of HYPOnatremia

"Salt loss"
NA excretion (renal, ng suction, V/D, diuretics, sweating)
decreased aldosterone
FVD or fluid overload
SIADH
Diabeties insipidus
low intake
<135

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Signs ans symptoms HYPOkalemia

"Slow and low/ A SICK WALT"
Alkalosis
Irritability
Lethargy
Shallow respirations
Decreased breath sounds
increased blood pressure
thready pulse
decreased bowel sounds
constipation
confustion
<3.5

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Signs and symptoms HYPERkalemia

"MURDER"
Muscle spasams/cramps/twitching
Urine loss (decreased urine output)
Respiratory distress
Decreased Cardiac Contractility
EKG Changes
Reflexes, hyperreflexia, areflexia(flaccid)
seizures
weakness
>5.0

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Causes of HYPOkalemia

Drugs
Anorexia
Nitrogen
NPO
Fluid loss
incresed Water intake
cushings disease
increased aldosterone

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Causes of HYPERkalemia

Cellular movement ICF-->ECF
 excess intake
renal failure
addisons (adrenal insufficiency)
Drugs( K-sparing diuretic, ace inhibitors, NSAIDS)

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Signs and Symptoms of HYPOmagnesmia

Trousseaus/Chvosteks response
Tourdes de pointes
tetany
irregular (signifigant changes in) rythms 
seizures
increased deep tendon reflex
increased Blood pressure
low respiration rate
decreased bowel motility

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Causes of low magnesium

limited intake
other electrolyte issues(hypokalemia, hypocalemia)
malabsorption
wasting mg
alcohol
glycemic issues (DKA, Insulin)

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Signs and Symptoms of HYPERnatremia

fever,flushed skin
restlessness
increased fluid retention, edema
dry mouth/skin
agitated
confused
>145

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Causes of HYPERnatremia

"no FRIED food/think dehydrated"
hypercortisolism(cushings)
incR intake (oral/IV)
GI tube w/o adequate water intake
Hypertonic solutions
reduced excretion
Infection, fever, sweating, D
Hyperventilation
hypoaldosteronism
thirst impairment
corticosteroids
loss of fluids
>145

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Signs and symptoms of HYPOcalcemia

"Cramps"
trousseaus/Chvosteks
seizures
arrythmias
increased deep tendon reflex
confusion 
Arrythmias
<8.5

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Causesof HYPOcalemia

Low parathyroid hormone
celiac/chrons
actue pancreatitis
low vitamin D
chronic kidney issues
inadequate intake (alcohol, bulima)
increased Phos.
wound drainage (especially GI)
Meds
decreased mobility

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Signs and Symptoms of HYPERcalcemia

"Body is Weak"
muscle weakness/lethargy
EKG Irregularities
absent or decreased deep tendon response
confusion
abdominal distention r/t contstipation
CA deposits
kidney stone formation

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Causes of HYPERcalcemia

hyper parathyroid Hormone
hyperthyroidism
decreased excretion (renal failure, thiazides)
bone cancer
increased calcium and vitamin D intake
lithium
glucocorticosteroids (supress CA)
Addisons (Adrenal insufficiency)

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Signs and Symptoms HYPERmagnesmia

Muscle weakness which leads to respiratory arrest
EKG irregularities which lead to cardiac arrest
Absent or decreasted deep tendon responses
Nausea and Vomiting
decreased BP

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Causes of HYPERmagnesmia

Mg rich antacids/laxatives (maalox, Mylanta)
Addisons (Adrenal insufficiency)
Golomerular filtration

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Infiltration

Pallor, local swelling at the site, decreased skin temperature around the site, damp dressing, slowed infusion

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Treatment for infiltration

Stop infusion and remove catheter
Elevate extremity
Encourage AROM
Apply cold/warm compress(depending on solution)
Check with PCP if pt still needs IV therapy if so restart infusion proximal to site or in another extremity

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Prevention on infiltration

Secure catheter

Extravasation

Pain, burning, redness, swelling

Treating Extravasation

Stop infusion and notify PCP

Follow facility protocol, which may include infusing an atedote through cath before removal.

Catheter Embolus

Missing cath tip after removal

Severe pain at the site with migration, no symptoms if no migrations.

Phlebitis

Edema, burning, throbbing, or pain at the site; increased skin temp; erythema; red line up the arm with a palpable band at the vein site; slowed infusion

Treatment of Phlebitis

Discontinue and remove cath
Elevate extremity
Apply cold compress to minimize blood flow
Apply warm compress to increase circulation
Check with PCP if pt still needs infusion if so continue proximal to the site or another extremity
Obtain specimen for culture at the site and prepare the cath for culture if drainage is presence.

Prevention of phlebitis

``` Rotate site every 72 hours (or sooner depending on facility policy) Asses IV site using phlebitis scale Avoid lower extremities Use hand hygiene Use surgical aseptic technique ```

How Albuterol/ levalbuterol is given

Beta2-adrenal agonists(prototype med) Can be inhaled, but makes it short acting Can be OP which makes it long acting.

Therapeutic uses of Albuterol/levalbuterol

Prevention of exercise induced asthmatic episodes When inhaled, it is used for the prevention of asthma Treatment of bronchospasm Long term control of asthma

Complications with Albuterol/levalbuterol

OP can cause tachycardia and angina b/c of activation of alpha1 receptors in heart. Tremors, caused by the activation of beta2 receptors in skeletal muscles. Palpitations

Theophylline

OP is used for long term control of chronic asthma or COPD. Is a bronchodilator. Mild toxicity can include GI distress and restlessness. More severe reactions include dysrhythmias and seizures. Avoid caffeine. Xanthines Reduce or eliminate caffeine intake

When taking theophylline with phenobarbital, phenytoin, or rifampin one should

Increase theophylline levels because these medications decrease the therapeutic effects.

When taking theophylline with ciprofloxacin, cimetidine, or other fluoroquinolone antibiotics one should

Decrease theophylline levels because these medications increase the effects of these medications.

Lasix

Loop diuretic. Takes out fluid, electrolytes, everything. Take in morning. Can lower BP

Thiazide

Widens circumference of blood vessels. Used for high BP Takes Sodium and Potassium out

Triamtcrene

Congestive heart failure Restrict salt Used for high BP No canned soup, processed meat, or cheese

Decongestants

Slows formation od mucus but can increase BP. Reduces Edema Not for seizure pt’s

Antihistamines

Reduce swelling | S/E: dry mouth, urinary retention

Corticosteroids

Reduce inflammation

Expectorants

Robitussin | Lubricate airways and help cough better

Antitussive

Benadryl | Helps suppress cough

Mucolytic

Mucomyst | Reduces stickiness of mucus

Beta-adrenergics

Proventil Used as rescue inhaler Avoid caffeine

Anticholinergics

Atrovent Urinary retention Rinse mouth out after using

people more at risk for FVE

Pt with Heart disease, kidney dysfunction, or diabetes with peripheral vascular disease.

How to treat FVE

``` Limit water and sodium intake Administer diuretics (loop diuretics, thiazide diuretics, Potassium sparking) Low sodium diet ```

Nasal cannula

Rubbing with two small prongs inserted into the nares | Delivers FiO2 of 24% to 44% at a flow rate of 1 to 6 L/min

Simple face mask

Covers nose and mouth Delivers FiO2 of 40%-60% flow rate of 5 to 8L/min Since flow rate is less than 5 L/min can result in rebreathing of CO2

Partial rebreather

Covers the pt nose and mouth Delivers FiO2 of 24% to 44% at a flow rate of 1-6 L/min The mask as a reservoir bag attached with no valve which allows the client to rebreathe 1/3 of the exhaled air with room air Complete deflation of the reservoir bag during inspiration causes build up of CO2