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NUR 112
F&E lecture notes
| Question | Answer |
|---|---|
| Early sign on fluid volume deficit | thirst |
| VS during fluid volume deficit | high temperature, tachypnea, hypotension, tachycardic (weak and rapid) |
| s/s of fluid volume deficit | weight loss, tenting skin, anxiety, exhaustion, HA, lethargy, confusion, disorientation, decreased urine output |
| causes of fluid volume deficit | Burns, vomiting, diarrhea, GI suctioning, decreased PO intake, or increased intake of coffee/ alcohol, hemorrhage, diuretics, hyperglycemia, hypoaldosteronism |
| difference between fluid volume deficit and dehydration | no sodium loss with dehydration |
| how to fix dehydration | PO intake of water |
| what type of fluid to administer for fluid volume deficit | lR of 0.9% NS |
| VS in fluid volume overload | normothermic, bounding pulse; muffled heart sounds, hypertensive, increase RR, SOB, dyspnea |
| s/s of fluid volume overload | weight gain, peripheral edema, JVD present, apprehension, diluted urine |
| what is ascites | increase of fluid in the intestinal compartments |
| how can renal failure cause fluid volume overload | fluid retention due to decline in production of urine |
| causes of fluid volume overload | CHF, renal failure, cirrhosis of liver, excess ingestion of sodium, excessive or too rapid IV fluid infusion |
| specific NI for | admin diuretics, restrict fluids, assess breath sounds and breathing pattern, semi-fowlers for dyspnea, skin care |
| sodium normal levels | 135-145 |
| causes of hypernatremia | impaired thirst mechanism, profuse sweating, diarrhea, diabetes insipidus, cushings syndrome, inappropriate use of oral electrolytes |
| s/s of hypernatremia | observe for HA, N/V, increased BP, confusion |
| management of hypernatremia | fluid replacement at a moderate rate |
| causes of hyponatremia | diuretic use, renal disease/ adrenal insufficiency, Vomitting, diarrhea, excessive GI suctioning, burns, HF, hypotonic IV fluid replacement |
| manifestations of hyponatremia | edema, muscle cramps, abd cramps, weak/fatigue, anorexia, N/V |
| when Na is less than 120 what can happen | convulsions, coma, death |
| when Na is more than 160 what can happen | seizures |
| management of hyponatremia | safety promotion, sodium containing fluids, sodium containing foods |
| is sodium extracellular or intracellular | extracellular |
| is potassium extracellular or intracellular | intracellular |
| normal potassium | 3.5-5 |
| hyperkalemia causes | renal failure, pot-sparing diuretic use, excessive K+ intake, adrenal insufficiency, acidosis, burns/ tissue trauma, starvation |
| hyperkalemia cardiac manifestations | Tall, peaked T waves, widened QRS -dysrhythmias -cardiac arrest |
| hyperkalemia other manifestations | N/V, abd cramping, diarrhea, paresthesia |
| management of hyperkalemia | admin of calcium gluconate, insulin and glucose, polystyrene sulfonate -- diuretics if renal excretion is normal |
| causes of hypokalemia | loop/thiazide diuretics, corticosteroid use, some antibiotics, severe vomiting, GI suctioning, alkalosis, long term IV fluid use without addition of K+ |
| hypokalemia cardiac manifestations | dysrhythmias, flat or inverted T-waves |
| other hypokalemia manifestations | anorexia, decreased bowel sounds, ileus, muscle cramps, suppressed insulin secretion, increased risk for digoxin toxicity |
| management of hypokalemia | replacement of potassium salts |
| chloride normal levels | 95-105 |
| chloride extra or intracellular | extracellular |
| causes of hyperchloremia | diarrhea, renal failure, overactive parathyroid glands, use of carbonic anhydrase inhibitors, metabolic acidosis, respiratory alkalosis |
| hyperchloremia manifestations | kussmaul respirations, weakness, increased thirst |
| management of hyperchloremia | diuretics, IV fluids, Tx of underlying cause, dialysis |
| hypochloremia causes | loss of body fluid, V/D |
| manifestations of hypochloremia | paresthesia of face/ extremities, muscle spasms/ tetany |
| management of hypochloremia | increase salt in diet, adding chloride to IV fluids, TX of underlying cause |
| calcium normal levels | 9-11 |
| calcium uses | Bones, Blood clotting, Beats (muscle contraction) |
| what controls calcium levels | vitamin D, calcitonin, parathyroid hormone |
| causes of hypercalcemia | Hyperparathyroidism Bone malignancy Drug toxicity |
| manifestations of hypercalcemia | Fatigue, weakness Decreased deep tendon reflexes Headache, impaired cognition Anorexia, nausea, vomiting, constipation Lethargy Polyuria Renal calculi Cardiac dysrhythmias Conjunctival calcifications |
| management of hypercalcemia | Partial parathyroidectomy Discontinuation of thiazide diuretics Vitamin and mineral supplements Low-calcium diet |
| causes of hypocalcemia | Transfusion of large volume of citrated blood Decreased parathyroid hormone Elevated serum phosphorus Decreased magnesium levels Hypoalbuminemia Alkalosis |
| manifestations of hypocalcemia | Bradycardia and hypotension Numbness, tingling of fingers Hyperactive reflexes, muscle cramps Laryngeal spasms Tetany Confusion, possible seizures Pathologic fractures Trousseau sign, Chvostek sign |
| management of hypocalcemia | Severe symptoms managed with IV replacement of calcium at moderate rate, 60 mg elemental calcium per minute |
| magnesium levels | 1.5-3.0 |
| causes of hypermagnesmia | Bowel disorders Overuse of magnesium-containing antacids Renal insufficiency |
| manifestations of hypermagnesemia | Flaccid muscle tone Decreased response in deep tendon reflexes |
| management of hypermagnesemia | Discontinue any intervention containing magnesium Hemodialysis at very high magnesium levels |
| causes of hypomagnesemia | Malabsorption Renal wasting Poor dietary intake Side effects of medication |
| manifestations of hypomagnesemia | can lead to neurologic, cardiac complications, Muscle cramps, Tremors |
| management of hypomagnesemia | Magnesium salts when symptomatic or persistent |
| causes of hypophosphatemiac | Alcoholism Excessive antacid intake Low vitamin D intake Certain medications Hyperparathyroidism |
| what to know about hyperphosphatemia | Rare Asymptomatic Related to excessive intake |
Created by:
ginnyfoscue
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