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COD N2 Unit I
COD Nursing F&E
| Question | Answer |
|---|---|
| What is IV Therapy? | administering a solution intravenously (into a vein) |
| What can be given IV? | Fluids, Electrolytes, Blood and blood products, Some medications, Nutrition, Vitamins,Crystalloids, Colloids, Blood and blood products, Pharmaceutical plasma expanders |
| What wont N002 COD Student be giving this semester? | TPN, Blood |
| What kind of fluid accounts for intake? | Oral liquids, Water in food, Water from metabolism |
| What kind of fluids make up the output? | urine, stool, skin, lungs,Insensible losses |
| What is serum osmolality? | osmolality is a measure of the solute concentration of blood |
| What is the Normal Range for Na+? | 136-145 mEq/L |
| What is Hyponatremia | Na+ below 136 mEq/L, is the reach 115 mEq/L or below can cause seizure and coma, even death |
| (on average)An 80 yr old male will be ___% of body will be water? | 50% |
| What is intracellular Fluid (ICF) | it is the fluid inside each cell of the body |
| what % of the body is intracellular fluid | 2/3 |
| What is extracellular fluid (ECF) | it accounts for approx. 1/3 of the body's fluid, it includes the fluid in the bloodstream.. Intravascular fluid (excluding the fluid within the cells inside the bloodstream), Interstitial fluid |
| Should fluid intake = output | yes |
| Can all out put be measurable? | No, insensable loss is know but difficult to measure |
| What is Active Transport? | Active transport is the movements of solutes across cell membranes from a less concentrated solution to a more concentrated one |
| What is Osmolality? | The number of solutes per Kilogram of fluid |
| what is Osmolarity? | The number of solutes per Liter of fluid |
| What is a Hypertonic solution? | A solution that has higher osmotic pressure (or has more solutes) than the extracellular fluid therefore will move water from the cells into the vessels |
| What is the normal range for K+? | between 3.5 and 5.5 mEq/L |
| SS of Hypokalemia? | potassium lower than normal range, poor muscle contraction, weak muscle tone, hyporeflexia, paralysis, GI motility with anorexia, nausea, vomiting, ileus with decreased bowel sounds |
| What Cardiac EKG changes could you see from someone with hypokalemia? | Flatened T wave |
| What would you look at if your patient has a history of A-fib and you suspect hypokalemia? | risk for digitalis toxicity, get a digoxin level |
| SS of FVD? | decreased B.P., Increased Pulse, Cool Extremities, Decreased Renal Function |
| What are common causes of dehydration? | You don't drink enough because you're sick or busy, or because you lack access to safe drinking water when you're traveling, hiking or camping. Illness: Diarrhea, vomiting,fever,Excessive,sweating,Increased urination (esp. when taking diuretics, antihis |
| what is the meaning of drip rate / drop | gtt/min |
| what is a secondary set? | when more than 1 solution needs to be infused at the same time, a secondary set (tandem or piggyback) is used |
| Extravasation | is the unintended administration of vesicant (drug capable of causing tissue necrosis) drugs or fluids into the subcutaneous tissue |
| Infiltration | the unintended administration of nonvesicant drug or fluid into the subcutaneous tissue |
| Nursing intervention for Phlebitis | DC the IV and remove needle, Apply warm compress, Start new IV, Select large vein when administering irritating agents, anchor cannula to prevent movement of the vein. |
| vesicant | highly caustic medications some examples: Dopamine, Dextrose solutions >10% |
| S/S of Hypernatremia | Decreased extracellular volume, dry mucus membranes, postural HTN, confusion, lethargy, seizures, coma |
| What is Hypocalcemia and what are the complications | Ca++ lower than 8.5 mEq/L ..S/S spontaneous and constant contractions of the muscle cells, cramping & Diarrhea, disrhythmias, seizures |
| 2 Nursing Diagnoses for Hypocalcemia | Decreased Cardiac output, ineffective breathing R/T resp. tetany |
| Cations | positive charged ions EX: Calcium, sodium, magnesium |
| Anions | negatively charged ions |
| Oncotic pressure | is a special type of osmotic pressure that is due to the presence of proteins |
| orthopnea | The inability to breathe easily unless one is sitting up straight or standing erect. |
| Hypovolemia S/S | Slow fluid loss may show little or no S/S. Rapid loss: low BP, increased HR, |
| Fluid Overload interventions | weight gain over 5%, check for fluid intake greater than output, JVD, mental confusion, moist crakles (rales) in lungs; dyspnea, shortness of breath. |
| Hyponatremia Tx: | Hypotonic IV stopped, restrict fluids per MD order, loop diuretics, Severe cases may be treated with hypertonic saline (3%) Treat Slowly- too fast can cause brain dammage; demyelination... pad the bed in case of seizure |
| Hyponatremia and Hypernatremia both cause: | seizures |
| hypernatremia | greater than 145 mEq/L, renal failure, corticosteroids, cushings syndrome, Hyperaldosteronism, increased water loss, decreased water intake, increase Na+ injestion, Excessive ADH (causes retention of water |
| Labs for Hypernatremia | Serum Na+ will be greater than 145mEq/L, Hct & Hgb may be elevated if extracellular dehydration is present |
| Labs for Hypokalemia | Serum potassium lower than 3.5mEq/L, Below 3.0mEq/L should have ECG taken plus placed on continuous cardiac monitoring,(monitor for flattened T waves) |
| Causes of Hyppokalemia | Diuretics, Excessive aldosterone release (as occurs with heart failure), Diarrhea, vomiting, drainage from wounds, NG suction, Limited food intake |
| What should you do with someone with elevated K+? | Kayexalate, IV Calcium, Insulin (must be given with glucose) Loop diaretic (only with good renal function) albuterol |
| Hyperkalemia Tx, in severe cases | Hemodialysis |
| What is Intracellualr fluid (ICF) | it is the fluid inside each cell in the body |
| what is 3rd spacing? | is the physiological concept where body fluids accumulate in the third space.With pancreatitis or ileus, fluids may "leak out" into the peritoneal cavity |
| The average human body is what % water? | 60% |
| what are 2 types of primary fluid imbalances | FVD & FVE |
| Isotonic IV solutions | LR, NS, 5% dextrose in sterile water |
| Hypotonic IV solutions | 0.45% NS, 0.25% NS |
| accumulation of fluid in the insterstitial space will lead to________ | edema |
| what are you going to do if your patients BP is elevated | retake on the other arm, check what patients baseline is, check to see if pt has hx of HTN (is medication due) is there a standing order for pt |
| this IV complication that presents as cool, pale swollen IV Site | infiltration |
| this IV complication presents as SOB, wheezing | fluid overload |
| This hypertonic saline solution used only in extream cases of hyponatremia | 3% NS |
| This way of K+ administration is NOT allowd and cause death | IVP |
| formula for IV Administration without a pump | V/T x C |
| normal K+ levels | 3.5-5.5 mEq/L |
| Kayexalate, sodium polysterine | is used for Hyperkalemia |
| leg cramps are a sign of | hypokalemia |
| 3 things to check before giveing lasix | K+, BP, renal function |
| 3 ways Hyperkalemia is treated | Kayexalate, diuretics, albuterol, Ca+, dialsys, sodium bicarb |
| priority nursing diagnosis for a pt with hyponatremia | risk for injury rt poss. seizures |
| IV solution has shown to reduce hyponatremia in a hospital setting | NS |
| This is a common hypontonic IV soulution of Sodium Chloride | 1/2 NS |
| HTN Medications can put pt's at risk for hypekalemia | Ace Inhibitors ie: Altace, lisinopril, enalapril, ramparil, Zestril |
| Causes GI Upset | PO K+ |
| 1Kg = | 2.2lbs |
| these part of the CBC become elevated if the pt is dehydrated | hgb & hct |
| These diagnostic urine values become elevated during FVD | urine specific gravity & osmoality |
| what does TKO & KVO | To Keep Open / Keep Vein Open |
| What is the FIRST sign of Fluid Overload? | Shortness of Breath / dyspena / SOB |
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jaymee4647
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