Week 1: Fluids and Electrolytes Flashcards
Drug>
Chemicals introduced into the body to cause some sort of change.
Pharmacology
the study of the biological effects of chemicals
Chemical name
molecular structure
Generic name
shortened name based on the chemical name
Trade name
name which drug is sold by individual companies
Commonwealth legislation
therapeutic goods act (89), therapeutic goods regulation (90), national health act (53), narcotic drugs act 61)
State legislation
therapeutic good act (94), drugs poisons & controlled substances act/”” regulation (81/06)
Schedule 2
pharmacy only
Schedule 3
pharmacist
Schedule 4
prescription
Schedule 8
controlled drugs
Schedule 11
drugs of dependence
Absorption
drug moves from site of admission to blood stream to get to target site
Distribution
once in the blood stream, it can be distributed to various sites
Biotransformation (metabolism)
chemical alteration of the drug to water soluble metabolite
Factors affecting drug metabolism >
> genetic, environment, disease status, ageing process
Hepatic first pass
go through portal system and liver before entering systemic circulation
Plasma half life
time taken for the plasma concentration of a drug to fall by 50%
Factors contributing to ADR’s
Age, gender, dose, polypharmacy, history, genetics
Factors that influence medication across the lifespan
pregnancy, lactation, paedicatric, geriatric
Fluid body compartments
intracellular (2/3 TBW), Extracellular (1/3TBW) [interstitial, intravascular]
Crystalliods
body fluid composition & moves quickly between compartments
Colloids
contain undissolved solutes which are too large to pass through capillary wall, stays longer intravascular & draws fluid from interstitial ^ BP longer
Isotonic IV fluids
0.9% NaCl normal saline; fluid. Hartmanns solution; electrolytes. 5% dextrose in water; fluid and energy
Hypotonic IV solutions
4% dextrose; fluids and electrolytes. 0.18% NaCl (4% and 1/5) :fluids and electrolytes
Hypertonic IV solutions
5% dextrose in 0.9% normal saline; energy and electrolytes. 10% dextrose, energy and fluids
Osmosis
movement of fluid from ^ H20 concentration to low concentration across semi permeable membrane
Hydrostatic pressure (out)
movement of fluid and solute through the capillary wall into interstitial space
Oncotic pressure (in)
created by proteins which draw fluid into the intravascular space
Mechanisms for regulating body fluid
thirst, kidneys, hormones (ADH, Renin), GI tract regulation, insensible lose
Hypovolemia
abnormal loss of fluid, inadequate intake fluid shifting
Hypervolamia
excess intake of fluids, retention, fluid shifts
Dehydration
fluid deficit with no electrolyte imbalance
Normal pH of the body
7.45 alkalotic
Pre-operative education
tests, physical prep, recovery room, what to expect, post op pain & management, deep breathing exercises, active and passive limb movements
Physical prep for a patient for theatre
fasting, elimination, medications (check continuation), premedication (IM, IV, Oral, sedations, analgesic, antiemetic, hygiene (hair, nails, jewellery, makeup, nailpolish, shower)
Physical prep for return from theatre
bed, vitals equipment, o2 & suction, hygiene equipment, special equipment
Elements of handover from PACU nurse to ward nurse
procedure, difficulties/problems, post op orders, medications, iv fluids, wound details, elimination details, drain tubes
Assessment and care interventions of a patient on return to the ward from recovery
vitals, level of consciousness, skin color and temp, iv fluids & cannula site, wound site and dressing, drains and tubes, pain and discomfort, nausea/vomiting, position, hygiene, comfort
Identify general post-op complications
haemorrhage, infection, thrombosis, pneumonia
Physical response to pain
tachycardia, hypertension, elevated pitch, muscle tension, dilated pupils
Who analgesic ladder
a strategy for managing pain in a range of situations; by the ladder, clock, mouth, for the individual with attention to detail
Acute pain
sudden and short
Chronic pain
persistent and long term
Chain of infection
infectious agent>reservoir>portal of exit>mode of transportation>portal of entry>host>
The immune response
a collective and coordinated defense mechanism of the cells and molecules of the immune system
Innate immunity (defense mechanism)
early response, natural immunity
Adaptive immunity (defense mechanism)
> late response, acquired immunity
Inflammatory response
vasodilation ^ blood flow to damaged area > ^ vascular permeability & plasma into damaged area > WBC into damaged area for repair
Acute inflammatory response
isolated damaged area and mobilizes immune cells and promotes healing
Chronic inflammatory response
stimulates destruction and healing of the tissue involved in the inflammatory response
Process of tissue repair and wound healing
> imflammation, 2-5 days > reconstruction, 3-24 days, granulation, contraction and epitheliazation > remodeling, 3 weeks – 2 years
2 reasons for IV infusions
rehydration, nil oral patients
Veins used for IV insertion
cephalic and basalic veins in the forearm and the veins of the dorsum of the hand
Equipment needed for IV infusion
order sheet, solution, giving set, stand, alcowipes, IV cannula, tape and dressing materials, gloves, watch, FBC
Post op complication for emergency appendicectomy
hemorrhage, infection, bowel obstruction, DVT, pulmonary embolism, constipation
