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Fundamentals > WEEK 13 > Flashcards

WEEK 13 Flashcards

1
Q

four main electrolytes discussed in class

A

potassium
calcium
magnesium
sodium

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1
Q

electrolytes

A

Minerals in the body that conduct electricity.

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2
Q

electrolyte responsibilities

A

Maintaining the balance of water in the body
Balancing the blood pH (acid–base) level
Moving nutrients into the cells
Moving wastes out of the cells
Maintaining proper function of the body’s muscles, heart, nerves, and brain)

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3
Q

average weight of water in person

A

one-half or two thirds

For males this equates to 60% of weight, for women about 54%, and for babies and young children approximately 70%.

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4
Q

why is it critical to maintain balance of water in the body

A

It is critical to maintain the balance of water in the body to prevent hypovolemia, dehydration, tachycardia, tachypnea, confusion, headache, kidney stones, and numerous other medical complications.

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5
Q

where does water loss in the body primarily occur

A

Water loss in the body primarily occurs through excretion of urine from the kidneys.

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6
Q

what situations can increase water loss

A

Situations such as prolonged vomiting, severe diarrhea, and profuse sweating can greatly increase water loss as well.

When a person is unable to drink enough fluids to compensate for the excess water loss, dehydration or hypovolemia can occur.

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7
Q

hypovolemia

A

Decrease in blood volume due to body fluid or blood loss.

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8
Q

expected range of serum osmolality

A

285-295 mOsm/kg

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9
Q

three main fluid compartments

A

intercellular space- There are three main fluid compartments, with the largest being the intracellular space, which holds 67% of the body’s water.

extracellular space- comprise the interstitial space, which contains 25% of the body’s water

intravascular space- which holds the remaining 8% of body water

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10
Q

thirst response

A

vasopressin is released from the posterior pituitary gland, which is an antidireutic horomone, which tells the kidneys to stop secreting urine and therefore helps the body have more fluid

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11
Q

factors that can contribute to fluid and electrolyte imbalances

A

including dehydration; hypovolemia; overhydration; certain medications; heart, kidney, or liver disorders; and incorrect intravenous fluids or feedings

Conditions such as profuse sweating, vomiting, and diarrhea also result in increased water loss that may disturb fluid and electrolyte balances in the body

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12
Q

expected ranges for postassium

A

3.5-5.1 mEq/L

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13
Q

expected ranges for sodium

A

135-145 mEg/L

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14
Q

calcium expected ranges

A

9-10.5 mg/dL

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15
Q

magnesium expected ranges

A

1.3-2.1 mEq/L

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16
Q

diffusion

A

is the movement of solutes, such as electrolytes, from an area of high concentration (such as within a cell) to an area of low concentration (such as the intravascular area

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17
Q

what is the body’s largest intracellular electrolyte

A

postassium

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18
Q

kidney potassium excretion

A

90%

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19
Q

potassium’s major role

A

Potassium also plays a major role in the conduction of nerve cells within the heart. The body maintains potassium levels within a narrow range. Intake occurs through food, drinks, and supplements.

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20
Q

RDA for daily intake of potassium

A

3,400 mg for adult males and 2,600 mg for adult females.

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21
Q

hypokalemia

A

potassium levels fall below 3.5 mEq/dL

Critical values occur at less than 3 mEq/L for adults and less than 2.5 mEq/L for newborns.

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22
Q

hypokalemia causes

A

Medications
Certain cardiac conditions
Gastrointestinal losses
Metabolic alkalosis
Decreased oral intake of potassium
Excessive alcohol use
Chronic kidney disease
Diabetic ketoacidosis
Excessive sweating
Folic acid deficiency

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23
Q

what is the most common cause of hypokalemia

A

loss of potassium from the kidneys or gastrointestinal tract.

Potassium-wasting diuretics (loop, thiazide, and osmotic) are the medications that most commonly result in hypokalemia through urinary loss.

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24
Q

potassium is what?

A

HIGH ALERT medication

cannot give IV without diluting it or will kill client

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25
Q

hyperkalemia causes

A

over 5 mEq/L but is critical when it reaches 6.1

Renal failure
Dehydration
Diabetes mellitus
Medications
Trauma
Excess intake of potassium
Burns
Transfusions of packed red blood cells
Acidosis
Sepsis

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26
Q

most common cause of hyperkalemia

A

renal failure

treat with hemodialysis some of the time

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27
Q

A nurse is reviewing the medical history of a client who is experiencing hyperkalemia. Which of the following findings put the client at a higher risk for hyperkalemia? (Select all that apply.)

A

use of potassium supplements

kidney failure

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28
Q

sodium

A

body’s most common extracellular electrolyte

regulates normal BP and other stuff

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29
Q

RDA for sodium

A

The RDA for sodium is less than 2,300 mg per day, or approximately 1 teaspoon. Most Americans get more sodium than they actually need

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30
Q

hyponatremia causes

A

less than 136 mEq/L but critical at 120 mEq/L

Medications
Chronic or severe vomiting or diarrhea
Drinking excess amounts of water
Excess alcohol intake
Heart, kidney, and liver problems
Severe burns

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31
Q

most common cause of hypontremia

A

Excess water in the body—rather than a lack of sodium—is the most common cause of hyponatremia, as the presence of too much water dilutes the sodium level

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32
Q

hypernatremia causes

A

greater than 145 mEq/L but critical at 160 mEq/L

Loss of body water
Medications
Gastroenteritis
Vomiting
Prolonged suction
Burns
Excessive sweating
Chronic kidney disease
Diabetes
Impaired thirst response

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33
Q

what is most common cause of hypernatremia

A

loss of body water

Dehydration is diagnosed most often in infants and older adults due to their inability to communicate the thirst response or diminished thirst response (in older adults).

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34
Q

A nurse is caring for a client who has hyponatremia. Which of the following findings or interventions should the nurse expect? (Select all that apply.)

A

Sodium level of 127 mEq/L

Client reporting headache and fatigue

A prescription for a urine sodium test

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35
Q

calcium

A

most abundant mineral in the body and has multiple functions

While calcium is found in the blood and cells, 99% of it is stored in the bones and teeth. Calcium plays a role in the following activities: mineralization of bone, muscle contraction, nerve transmission, clotting of blood, hormone secretion, and normal functioning of the heart.

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36
Q

RDA for vitamin D

A

Absorption of calcium by the intestines depends on an adequate supply of vitamin D. The RDA for vitamin D is 600 international units (IU) for adults and 800 IU for older adults. Excretion of calcium occurs through the kidneys, and is controlled by the action of parathyroid hormone.

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37
Q

hypocalcemia causes

A

below 9 mg/dL and ionized levels are less than 4.5 mg/dL

Medications that decrease the body’s absorption of calcium
Inadequate amount of vitamin D
Hormonal changes (menopause)
Hypoparathyroidism
Renal disease
Multiple blood transfusions
Electrolyte imbalances of magnesium or phosphate
Sepsis
Low albumin levels

38
Q

hypoparathyroidism

A

Body produces low levels of parathyroid hormone (PTH).

causes hypocalcemia

39
Q

hypercalcemia causes

A

greater than 10.5 mg/dL and critical levels at 13 mg/dL

Cancer
Hyperparathyroidism
Vitamin D toxicity
Medications
Renal failure

40
Q

most common cause of hypercalcemia

A

hyperparathyroidism and cancer

Both of these conditions result in excessive calcium being drawn from the bones and into the bloodstream. In hyperparathyroidism, the parathyroid glands secrete excessive amount of the hormone PTH. The elevated PTH levels in the body then lead to increased absorption of calcium by the intestines, increased reabsorption by the kidneys, and increased bone resorption—a process that ultimately leads to excessive levels of calcium in the blood.

41
Q

meds that cause hypocalcemia

A

stimulant laxatives

42
Q

magnesium

A

body’s second most common intracellular electrolyte

As with calcium, much of the body’s store of magnesium, 50% to 60%, is located in the bones. Magnesium’s role in the body is to assist in the regulation of nerve and muscle function, maintain blood pressure and serum glucose levels, support bone and teeth health, and synthesize protein, DNA, and RNA. Intake of magnesium occurs through digestion of whole foods

43
Q

RDA for magnesium

A

The RDA for daily intake of magnesium depends on age and sex. Adult males require 400 to 420 mg/day and adult women need 310 to 320 mg/day.

44
Q

hypomagnesemia causes

A

less than 1.3 mEq/L and critical is 0.5 mEq/L

Medications
Decreased intake
Decreased absorption by the intestines (Crohn’s disease, celiac disease)
Increased excretion by the gastrointestinal tract (diarrhea, pancreatitis)
Increased excretion by the kidneys
Excessive alcohol use
Diabetes mellitus type 2
Undernutrition
Severe burns
Electrolyte imbalances (hypokalemia, hypocalcemia)

45
Q

what is IV magnesium

A

high alert medication

Doses should be double-checked with another nurse and the concentration of the medication should be validated. IV administration of magnesium can cause flushing, sweating, and potentially respiratory depression if the medication is administered too quickly. Decreases in the client’s level of consciousness can occur if the client is also receiving a CNS depressant medication. Monitor urine output in clients who have impaired renal function.

46
Q

hypermagnesemia causes

A

greater than 2.1 mEq/L

Kidney disease (acute and chronic)
Excessive intake
Medications
Trauma
Acidotic states
Hypothyroidism
Chronic alcohol use disorder

47
Q

most common cause of hypermagnesemia

A

acute or chronic kidney disease, as the impaired kidneys fail to excrete enough magnesium through the urine.

48
Q

hypermagnesemia levels greater than 12 mg/dL cause?

A

severe reactions such as muscle flaccid paralysis, decreased respiratory rate, hypotension, bradycardia, and dysrhythmias. If the imbalance is not corrected, seizures, coma, cardiac arrest, and death can occur.

49
Q

what are three distinct imbalances that can threaten homeostasis

A

dehydration, hypovolemia, and hypervolemia.

50
Q

hypervolemia

A

Fluid overload, the body has too much water.

51
Q

what happens in dehydration with urine

A

the urine gravity will be high if you are dehydrated

52
Q

hypovolemia causes

A

Blood loss
Gastrointestinal losses
Severe burns
Third spacing
Excessive sweating
Fever
Medications
Trauma

53
Q

hypovolemic shock

A

If the circulating volume lost becomes greater than 20% of the total volume, hypovolemic shock can occur.

If not reversed, this lack of perfusion to the vital organs can lead to multiple organ failure, in which the lungs, kidney, brain, and heart experience tissue death.

54
Q

reasons why older clients are at most risk for dehydration

A

Diminished thirst response
Decline in total body fluid
Decreased kidney function
Underlying health conditions
Medications

55
Q

IV access: what should tourniquet be applied at above the site of access

A

The tourniquet should be applied 5 to 10 cm above the selected site.

The nurse should assess the client’s pulse distal to the tourniquet to confirm that the tourniquet is not applied too tightly.

56
Q

types of solutions to treat fluid imbalances

A

crystalloid solutions and colloidal solutions.

57
Q

colloidal solutions

A

treat fluid imbalances

Intravenous solutions that contain large molecules unable to pass through capillary membranes.

58
Q

crystalloid solutions

A

treat fluid imbalances

Crystalloids are fluids that contain solutes such as electrolytes or dextrose. These solutes readily dissolve in a solvent such as water and can diffuse through cell membranes.

59
Q

what are crystalloid solutions classified

A

based on their osmolality

hypotonic- A solution that has fewer solutes than cell components and results in fluid moving into the cell.

isotonic- A solution that has the same number of solutes than cell components and results in NO fluid movement into or our of the cell.

hypertonic-A solution that has more solutes than are present within the cell and results in fluid movement out of the cell.

60
Q

hypotonic crystalloid IV solution

A

less than 250 mOsm/L

Extracellular fluid has fewer solutes than fluid in cells
Water moves from extracellular space into cells

Treats hypernatremia and diabetic ketoacidosis.

Monitor for hypotension.

Contraindicated in clients with burns, liver disease, increased intracranial pressure, and trauma.

61
Q

example of hypotonic crystalloid IV solution

A

0.45% Sodium chloride (0.45% NaCl)

62
Q

hypertonic crystalloid IV solution

A

greater than 375 mOsm/L

Extracellular fluid has more solutes than within the cells
Water leaves the cells and interstitial fluid moves into the plasma

63
Q

examples of hypertonic crystalloid IV solutions

A

3% Sodium chloride

Dextrose 5% in 0.45% sodium chloride solution (D51/2NS)

Dextrose 5% in 0.9% sodium chloride solution (D5NS)

Dextrose 5% in lactated Ringer’s solution (D5LR)

Dextrose 10% in water (D10W)

Hypertonic solutions may be contraindicated in cases of cardiac or renal disease.

64
Q

isotonic crystalloid IV solution

A

250-375 mOsm/L

No movement of water between extracellular and intracellular fluids, as osmolarity is the same
Causes expansion of the extracellular fluid

65
Q

examples of isotonic crystalloid IV solution

A

0.9% Sodium chloride solution (NaCl)

most commonly used IV fluid

66
Q

whole blood

A

Combination of red cells, white cells, and platelets in blood plasma.

this is what you usually donate when just donating blood at a blood drive i.e.

67
Q

shelf life of whole blood

A

Whole blood has a shelf life of 21 to 35 days and is rarely used outside of severe traumatic injury

68
Q

two components whole blood is divided into

A

cells and a liquid called plasma

The cellular portion of blood contains red cells, white cells, and platelets and accounts for approximately 40% of the blood volume. The plasma makes up the remaining 60% of the volume.

69
Q

thrombocytes

A

Also known as platelets; responsible for blood clotting.

70
Q

RBCs

A

Red blood cells (RBCs), or erythrocytes, account for 45% of the cellular portion of whole blood.

There are about 1 billion red blood cells in two to three drops of blood

71
Q

plasma

A

Plasma, the liquid portion of blood, constitutes about 55% of whole blood. It consists mostly of water.

In addition to transporting the cells, plasma helps maintain blood pressure and volume.

72
Q

four basic blood types

A

A, B, AB, O

73
Q

antigens

A

The various blood types are identified by the presence or absence of antigens, which can cause an immune response if they are unfamiliar to the body. Since a mismatch of antigens can trigger a patient’s immune system to attack transfused blood, safe blood transfusions depend on careful blood typing and cross-matching.

74
Q

Rh factor

A

Protein of the blood type represented as (+) if present and (-) if absent.

75
Q

Blood Types: Universal Donor and Recipient

A

Universal donor blood type: O–

Universal recipient blood type: AB+

76
Q

most common acute transfusion reactions

A

include acute hemolytic reactions, which occur when the blood transfused is not compatible with the blood of the client; febrile non-hemolytic transfusion reactions; allergic reactions, which can range from mild to anaphylactic; transfusion-related acute lung injury (TRALI), which results in edema of the lung tissues and airways; and transfusion-associated circulatory overload (TACO), which is often the result of too-rapid administration of blood products.

77
Q

pH scale

A

0 is strongly acidic
7 is considered neutral
14 strongly aklaline

78
Q

expected reference range for the pH of human blood

A

7.35-7.45

death occuring at less than 6.9 or greater than 7.8

79
Q

acid-base balance

A

The homeostasis of acidic and basic (alkaline) compounds in the blood to maintain a blood pH of between 7.35 and 7.45.

80
Q

acidosis

A

Levels of acid in the blood are too high, a pH of less than 7.35.

81
Q

alkalosis

A

The blood is too alkaline, a pH of greater than 7.45.

82
Q

metabolic acidosis

A

When the blood in the body is too acidic, with an HCO3- less than 21 and a pH less than 7.35.

83
Q

metabolic alkalosis

A

Blood in the body is too alkaline, with an HCO3- greater than 28 and a pH greater than 7.45

84
Q

respiratory acidosis

A

A buildup of carbon dioxide in the lungs and the body fluids, which results in a PaCO2 greater than 45 and a pH less than 7.35.

85
Q

respiratory alkalosis

A

Low carbon dioxide levels in the body, with a PaCO2 less than 35 and a pH greater than 7.45.

86
Q

what can cause respiratory alkalosis

A

hyperventilation, such as pain, anxiety, severe stress, pregnancy, sepsis, infection, trauma or fever

87
Q

nonspecific immunity

A

Nonspecific immunity refers to neutrophils and macrophages and their work as phagocytes.

Phagocytes eat and destroy microorganisms, thereby helping to protect the body from harm.
Both neutrophils and macrophages are released during the inflammatory response

88
Q

specific immunity

A

Specific immunity refers to the work of antibodies (also called immunoglobulins) and lymphocytes. Antibodies bind to infectious agents and call to the white blood cells and complement to destroy them.

89
Q

stages of infection

A

Incubation: An infection enters host and begins to multiply.
Prodromal: The client begins having symptoms.
Acute illness: Manifestations of the specific infectious disease process are obvious and may become severe.
Decline: Manifestations begin to wane as the degree of infectious disease decreases.
Convalescence: The client returns to a normal or a “new normal” state of health.

90
Q

pathogens

A

bacteria-most common type (staph, E-coli)
viruses-use host to reproduce (HIV, hep, herpes zoster)
fungi-molds and yeasts (candida albicans)
prions-protein particles that can cause infection (jakob disease)
parasites- organisms that live on and often cause harm to host

91
Q

types of parasites

A

protoza (malaria)

helminths (worms)

flukes (schistosomes)

arthropods (lice, mites, ticks)

92
Q

general expected findings for infection

A

chills
sore throat
fatigue, malaise
nausea and vomiting

93
Q

sepsis

A

A systemic inflammatory response syndrome resulting from the body’s response to a serious infection, usually bacterial (peritonitis, meningitis, pneumonia, wound infections, urinary tract infections)

can lead to organ failure

Fundamentals (20 decks)

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