Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
222 exam 3
| Question | Answer |
|---|---|
| The institution of medicine (IOM) reports | To err is human (we make mistakes), crossing the quality chasm-a new health care system for the 21st century |
| The joint commission | national patient safety goals |
| centers for medicare and medicaid services | hospital acquired conditions |
| OSHA | keeps employees safe |
| national voluntary consensus standards for public reporting of patient safety events | framework for publicly reporting patient safety events, indicators, measures abt health care organizations to consumer |
| serious reportable events | HAIs, air embolism, DVT, foreign object left in body, CAUTIs |
| unsafe work environment ex | patient often the source, overcrowded waiting areas, working in isolation from coworkers, high crime areas, mobile workplace, transporting patients, volatile patients |
| nurses role in promoting safety and preventing injury | risk assessment-remove anything off floor, cords, supplies, bed up high. patient education, environmental management |
| QSEN | nurses need knowledge, skills, and attitudes to promote safety. continuous improvement. minimizes risk of harm to patients and providers by system effectiveness and performance |
| QSEN competencies | patient centered care, teamwork, evidence based, quality improvement, safety, informatics |
| how many ppl died annually from preventive measures in the hospital | 98000 |
| basic human needs | oxygen-fire safety, carbon monoxide. nutrition-food safety. temp-hypothermia, heath exhaustion (electrolyte imbalance) |
| individual factors impacting persons safety | internal. physical condition and functioning, impaired mobility, sensory impairment, age, cognitive impairment, developmental level, work, lifestyle, lack of safety awarness |
| environmental factors affecting safety | external. surroundings, conditions of living, work conditions |
| toddlers safety risk | poisoning by ingestion of medication or chemicals, choking, suffocation, electrocution, sharp corners, falls, overheating |
| school aged safety risks | head, neck, and limb injuries rt skating, skateboarding, sledding, bicycle, trampoline, drowing, car accidents |
| teenagers safety risks | motor vehicle rt distracted driving, sti, unplanned pregnancy, depression, self image, violence, alcohol, tobacco |
| adults safety risks | work related injury, overdose of drugs, sti, car accidents |
| older adults safety risks | medication erros rt confusion or sensory deficits |
| safety concerns in home and community settings | food safety, injuries rt motorized and non motorized means of transportations, household equipment safety, poisoning, fired, abuse, suffocation/drowing |
| food safety | keep raw meat, poultry, seafood, and eggs separate and seperate from ready to eat foods. do not thaw on counter, cook food to appropriate temps, store leftovers properly, monitor expiration dates |
| bacteria can multiply rapidly if left at | room temp or in danger zone-40 degrees-140 degrees |
| minimize transportation risk of injury | education programs and safety gear |
| firearms and household equipment safety | firearms-training and permits, locked cabinets, ammo stored separate. household equipment-nonslip shoes, safety gear, store away from children |
| poisioning | intentional or unintentional ingestion, inhalation, injection, or absorption through skin of any substance harmful to body. nurse distinguishes poisoning from other conditions with similar symptoms |
| common toxins | lead, carbon monoxide, plants, medications, household chemicals |
| fire safety | practice escape plan, install alarms, sleep with bedroom door closed. R-rescue a-alarm C-contain E-extinguish |
| electrical hazards | shock can result in no injury, brain injury, or death. sources-overload circuits, appliances near water, use of lights with frayed wires, open outlets |
| abuse | anything offensive, harmful, or injurious to individual. some populations are more vulnerable than others. physical, emotional, sexual,financial |
| suffocation | air no longer reaches the lungs and respiration stops. smothering, drowing, choking |
| take action and evaluate home for safety | teach risks and hazards, remove obstacles in walking path, good lighting, assistive devices within reach, maintain floors, handrails, therapy devices, safe storage of chemicals, carbon monoxide detectors, wath groups, employee assistance programs |
| safety concerns in healthcare settings | falls, restraints, medication errors, radiation, procedural errors, chemical exposure, patient inheret accidents |
| SDS | all facilities have them, tell you chemical makeup of what you are exposed to |
| falls | hospitals are not paid for additional costs resulting from falls, perform fall risk assessment, identify patients at risk for falls, ambulation assistance, rooms free of clutter |
| morse falls scale | low risk <25, moderate 25-45, high >45 |
| johns hopkins fall risk assessment tool | low risk 0-5, moderate 6-13, high risk >13 |
| hendrich II fall risk model | high risk >=5 |
| restraints | physical restraints-mechanical or physical device. ex-wrist or ankle restraints, safety jacket, lap belt. chemical restraint-medication administered to patient to control behavior. last resort |
| alternatives to restraints | orient patients and family to environment, companionship and supervision, puzzles, music, hobbies, rooms near nurses station, calm simple sentences, verbal intervention, visual/audit stimuli, remove cues saying to leave room, ambulation scheudle, camo ivs |
| alts to restrains pt 2 | evaluate all medicine and ensure timely pain management, eliminate bothersome treatments, protective devices |
| applying physical restraints | reasoons-medical, behavior/mental issues. immobilize extremity, prevent harmful behavior, treatment without interference |
| evaluating providers orders | renewal, non violent-every 24 hrs. violent adults-4 hrs, children-2 hrs, 9 and under-1 hr. must fot 2 fingers between restraint, remove restraint every 2 hrs for nonviolent. assess every 15 min for violent |
| complications of restraints | compromised circulation, impaired skin, mental status, difficult breathing, pneumonia, constipation, humiliation, strangulation, impaired nutrition, aspiration, fractures, muscle atrophy, death |
| medication errors | errors in interprofessional collaboration/communication, confusion between sound alike spelled drug names, distractions |
| evaluating medication administration | accurate prescription interpretation, accurate dosage calc, approved abbreviations, know pharmacology, patinet identification, how to look up info. never administer medicine u didnt prepare |
| mouth | food mixes with salivary enzymes |
| esophagus | peristalsis moves bolus to stomach |
| stomach | breakdown food, stores swallowed food |
| small intestine | reabsorption |
| large intestine | absorbing remaining water and electrolytes, producing and absorbing vital vitamins like vitamin K and biotin, and forming and storing feces before elimination through the rectum |
| mechanism of normal defecation | contractions beginning from descending colon to anus. as feces reaches rectum, distention causes relaxation of internal spincter. |
| at time of defecation the | external sphincter relaxes, abdominal muscles contract increasing intrarectal pressure |
| if time is not right for defecation | external sphincter will voluntarily contract closing the anus |
| valsalva maneuver | straining, stimulates vagus nerve, causes bradycardia, defecation assisted with a deep breath and tightening muscles. diaphragm moves downward, abdominal muscles contract, danger of stimulating vagus nerve |
| factors affecting bowel elimination | age, diet, position, older adults-gi motility slowed, chewing ability slowed, pregnancy-fetus pushes on colon and fluid can back up into esophogas, activity, habits |
| anesthesia | slows peristalsis |
| bowel medications | laxatives and cathartics(soften stools), antidiarrheal agents(inhibit peristalsis), opiates and anticholinergics-depress peristalsis, constipation, antibiotics-diarrhea, |
| iron | blackening of stool |
| anticoagulants | increases blood in stool |
| surgery in abdominal region | paralytic ileus |
| constipation | infrequent sometimes painful passage of hard stool |
| impaction | hardened feces stuck in rectum |
| flatulence | bloating, distention, and passage of gas |
| hemorrhoids | dilated blood vessels in the lining of anal mucosa, increased venous pressure |
| bowel diversions | wound ostomy and continence nurse, temporary or permanent artificial opening in abdominal wall via a stoma |
| fecal norms | light to dark brown but foods and medication can affect color, aromatic to pungent, soft formed and moist, frequency varies with diet |
| fecal abnormals | clay-no bile, melena-black tarry from gi bleeding or iron pills, red-lower gi bleeding, anticoagulants, pale and oily-malabsorbption of fat |
| fecal occult blood test | measures microscopic amount of blood in feces, repeat at least 3 times on 3 seperate bowel movements, refrain from eating red meat 3 days before testing, avoid aspirin 7 days before testing. stop vitamin c supplements |
| fecal immunochemical test | no preparation, colon cancer screening, more expensive |
| radiological and diagnostic tests | x rays, barium, swallow, endoscopy, ct scan, mri, ultrasound |
| bowel nursing diagnoses | constipation, bowel incontinence, diarrhea, nausea, distruubed body image, impaired skin integrity |
| bowel diet interventions | encourage intake of high fiber foods, fruits and vegetables, low fat, high in bulk, whole grains |
| fluid intake bowels | 1-2 liters a day, fruit juice provide fluid and bulk, hot fluids increase intestinal motility |
| activity bowel interventions | exercise 3-5 times a week. ROM, bedpans, ambulation asap |
| promoting normal elimination | assist in squatting position, elevated toilet seats, exhale during defecation |
| more bowel medications | short term. osmotic laxatives-pulls fluid into bowel to soften stool. stimulant laxative-local irritation to intestinal mucosa increeases intestinal motility. antidiarrheal-decrease intestinal muscle tone. |
| basic type of stool softener | docusate sodium (colace) |
| enema | promotes defecation, solution instilled into rectum and sigmoid.n types-soapsuds, hypotonic (tap water), isotonic (ns), hypertonic (pulls bowel fluid to interstitial space) oil retention-very concentrated |
| osmolarity | concentration of solution |
| osmotic pressure | pulls from membrane to more concentrated side |
| position for self administering enemas | sims |
| administering bag enemas | prepare solution, clamp tubing, fill bag with 1000 ml, add soap, check temp, purge tubing and clamp. at room temp, left sims position, lubricate tip. container height-12 to 18 inches above butt |
| removing fecal impactions | left side lying position, take slow deep breaths |
| care of hemorrhoids | proper diet, fluids, exercise, sitz bath |
| nasogastric tubes | used for gastric decompression, inserted for ileus, routinely assess nasal passage and surrounding skin, dry oral mucosa |
| procedural errors ex | failing to check identification, incorrect diet, fialure to return bed to lowest position |
| alara | as low as reasonably acceptable (radiation) |
| mrsa | oxacillin, cefoxitin and methiciliin resistant |
| nephrons | remove waste products |
| kidneys | filters waste products |
| ureters | connects kidneys to bladder and keeps urine sterile |
| bladder | reservoir for urine |
| male urethra | 5-6 in |
| female urethra | 1-2in |
| urination | voiding,micturition. urine is expelled from urinary bladder. cerebral cortex, thalamus, hypothalamus, and brainstem |
| factors influencing urination | caffeine, growth, psychological factors, fluid intake, pathological conditions like diabetes, medications, surgeries |
| anesthesia blocks | urinary contractility |
| common dieretic | ferosemis (lasix) |
| alcohol decreases | antidiuretic which makes us urinate more |
| urinary retention | bladder in unable to completely empty. residual urine-urine that stays in bladder after urination |
| UTI | bacteriuria causes dysuria. lower utis-urethritis, cystitis (bladder), prostatitis. upper uti-pyelonephritis-inflammation of pelvis, causes diaphoresis, chills, flank pain, fever |
| urinary incontinence | transient-comes and goes reversible cause functional-loss of continence from outside tract ex-mobility overflow-loss of urine from overdistended bladder stress-loss of urine from cough,sneeze. can result from vaginal delievries |
| urinary incontinence pt2 | urge-loss of urine with strong urgency to over active bladder reflex-predictable times when bladder volume reaches specific volume |
| urinary diversion | continent vs incontinent |
| common urinary complaints | urgency-strong desire to void right away dysuria-painful voiding frequency-more than usual hesitancy-undue delay and difficult voiding polyuria-large amount at once oliguria-small amount of output, less than 500 ml a day |
| common urinary complaints pt 2 | nocturia-excessive urine at night dribbling-leakage of small amount of urine hematuria-blood in urine proteinuria-protein in urine |
| kidney urine production rate | 30 ccs of urine an our |
| physical assessment | skin and mucosa, kidneys, bladder, perineal skin, urethral meatus |
| characteristics of urine color | normal color-pale straw to amber, depends on hydration. abnormal color-hematuria, dark amber (bilirubin, volume depletion), blue green color (medications, amitriptyline) |
| orange red urine | pyridium-phenazopyidine |
| urine clarity | normal-transparent abnormal-sediment, cloudy, mucous shreds |
| odor urine | ammonia |
| volume of urine | normal-30cc/hr. bladder capacity-300-600 cc, only 10 ml left in bladder, 1200-1500 ml in 24 hrs. abnormal-absense in 3-6 hrs, frequent voids of 50-100ml, less than 30ml an hour |
| normal urine production | 1-2 liters. Day, 95% water 5% solutes |
| intake urine | oral liquids, semiliquids, enteral feedings, blood, iv fluid |
| output urine | any measurable fluid that leaves the body |
| 1 oz | 30mL |
| measuring urine volume | output, collection device, accuracy, every 8 hrs, monitored electronic record |
| lab and diagnostic testing urine | specimen collection-bacteria, chemicals, obtained in sterile manner, delivered immediately to lab, refrigerate if delivery beyond 30 minutes, date time and sign at bed table |
| urinalysis | collected in urethral catheter or by patient in appropriate clean container, need sterile cup. 24 hr urine collection. indicate start time on container, keep on ice, least 10 cc for sample |
| post void residual | less than 50 mL, greater than 200mL is inadequate (retaining urine), greater than 300mL requires catheterization |
| urine nursing diagnosis | impaired urinary elimination, urinary retention, risk for infection, urinary incontinence |
| general urination interventions | support usual pattern, assure privacy, assist to assume usual voiding position, restrict fluids in renal disease, bathrooms unlocked |
| managing urinary incontinence | bladder retraining, toileting schedules, encourage to empty bladder, kegel exercises-isometric. tightening/release muscles on pelvic floor |
| women infection preventions | front to back, void after intercourse, avoid bubble bath, avoid tub baths, 8 glasses of water a day |
| older adult urine interventions | ensure easy access and assist in bathroom, discourage fluid at bedtime, provide night light |
| catherization indication of use | immediate relief of bladder distenton, incompetent bladder, residual urine assesment, irrigating bladder, instilling medicaiton |
| catherization | md order, infection and trauma, bardex, foley, coude, straight, latex |
| intermittent catheterization | in and out or straight. spinal cord injury/neurologic condition, no balloons, regular intervals |
| if allergic to iodine u cant use | betadine |
| general rules for catheters | md order, sterile asepsis, closed system, bag below bladder, bag emptied every 8 hrs, when half full, hang bags on frame, close spigot after draining, check kinks, perineal care |
| irrigating catheter | triple lumen catheter with continuous irrigation prefered after surgical procedure. flush tube wt solution, instill medication.huge 3L bag of fluid going intocatheter |
| leg bag | used during day, educate, use for a long period of time, ex-prostate removed |
| removing catheter | wash hands, gloves, deflate balloon wt 10 ml syringe, deep breaths |
| alternatives to catheters | condom catheter/purewick, ureterostomy, suprapubic catheter |
| nociception | pain is conducted from the skin to the central nervous system. begins with conversion of noxious stimuli (injury). distributed throughout the body in joints, muscles, skin, and viscera. highest density-skin lower density-joints/tissues, lowest den-organs |
| transduction | thermal, chemical, and mechanical stimulus. converts energy produced to an electrical impulse |
| transmission | transfers pain info from periphreal to cns |
| perception | message moves up nervous system to brain |
| modulation | when you perceive a message, brain releases inhibitory neurotransmitters |
| reflex arc | message goes to muscle fiber first |
| acute pain | transient, short duration, fast onset, identifiable cause, diminishes as injury heals |
| chronic pain | persistent pain, long duration, intermittent, does not always have cause, can lead to disability |
| functions of pain | protection, warning, response to injury |
| gate control theory | regulates or blocks pain impulses, pain impulses pass through when a gate is open and are blocked when a gate is closed |
| sympathetic stimulation | dilation of bronchial tubes and increased respiratory rate, increase heart rate, vasoconstriction, increase glucose and cortisol, diaphoresis, pupils dilate, increase muscle tension, decrease gi mobility. low to moderate pain |
| parasympathetic stimulation | pallor, nausea, decrease hr and bp, irregular breathing, severe pain |
| behavioral responses to pain | vocalizations, facial expressions, body movement, social interactions |
| neuropathic pain | episodic/continous pain that results from a nerve injury and persists without painful stimuli ex-tumor, infection, toxicity from chemo |
| cancer pain | stems from cancer/treatment. acute or chronic |
| idiopathic pain | chroonic pain in the absense of physical or psychological issue, excessive for condition. ex-migraines, fibromyalgia, depression/anxiety |
| noncancer pain | acute pain that proceeds to chronic pain and may be prolongrf and life threatening. ex-whiplash, sickle cell, low back pain |
| visceral pain | nociceptive or physiologic pain source-organs |
| radiating pain | pain that extends to other areas. source-gi reflux, extending too thorax |
| somatic pain | nociceptive or physiologic pain. source-bone, skiin, joint, muscle |
| phantom pain | neuropathic or pathologic pain from loss of a body part |
| psychogenic pain | perceived pain without a physical cause source-headache, backache |
| breakthrough pain | spike in pain when chronic pain already exist. source-surgery, injury source-surgery injury |
| factors influencing pain | age, fatigue, gender, neurological factors, attention, previous experience, family/support, loss of independence, being a burden, cultural factors, meaning of pain, anxiety, depression, cope |
| inadequate pain management may lead to | impaired recovery, prolonged hospitalization, adls impacted, insufficient sleep, increase costs, loss of employment |
| pain cues | patients expression of pain,always ask, recognize nonverbal expressions |
| characteristics of pain | P-precipitating factors Q-quality R-relief measures, region/location S-severity T-timing U-understanding effect of pain |
| socrates pain assesment | S-site O-onset C-character (quality of pain)R-radiation A-assosiations T-time E-exacerbating/relieving factors S-severity |
| concomitant symptoms | occur with pain and usually increases pain intensity |
| prioritize | urgency, likelihood, risk |
| SMART planning goals | S-specific M-measurable A-attainable R-realistic T-timely |
| pharmacologic pain measure | using medications such as opioids, non-steroidal anti-inflammatory drugs (NSAIDs), anticonvulsants, and antidepressants to reduce pain |
| non pharmacological pain measure | non-drug methods for managing pain, including physical treatments like heat, ice, massage, physical therapy, and exercise, as well as mind-body practices such as meditation, yoga, and cognitive-behavioral therapy. a distraction |
| complementary therapies | herbal remedies, yoga, biofeedback, meditation, hypnosis, acupuncture |
| TJC standards | collaborative, non pharmacological modalities, non opioid pain management |
| chronic pain therapies | spinal cord stimulation, TENS, heat/cold therapy |
| multimodal analgesia | use of one or more than one means for controlling pain. fewer side effects, more effective, low dose of each medicine |
| non opioid analgesics tylenol | mild to moderate pain, acetaminophen, combined with opioids, adults shoudlnt exceed 4 grams. long term use can resul tin hepatotoxicity, leukopenia, renal failure |
| non opioid analgesics NSAIDS | ibuprofen, nacopren, ketorolac, mild to moderate pain, treating acute bone and inflammatory pain. side effects-gi bleed, cardiac complications, renal failure |
| opioid analgesics | hydrocodone, oxycodone, morphone, fentanyl. moderate to severe pain. check vital signs before administering |
| patient controlled analgesia | electronically controlled infusion pump, usually opioids |
| good samaritan laws | encourage nurses to assist in emergency situations, limit liability and offer legal immunity, allows nurses to treat minors in an emergency without parental consent |
| consent | when is it necessary?-on admission to the hospital or health care agency, invasive procedures, participate in research studies. considerations-communication issues, cultural issues, unconscious patients |
| standards for determination of death | cardiopulmonary and brain death |
| privacy | health insurance portability and accountability act |
| mandatory things to report | abuse, rape, gunshot wound, attempted suicide, communicable disease, unsafe professionals |
| patient protection and affordable care act | consumer rights and protection, affordable health care, increase access to care, quality of care meets needs of patient |
| emergency medical treatment and active labor act | prohibits transfer of patients from private to public hospitals without appropriate screening and stabalization |
| health information act | nurses must ensure phi is protected |
| americans with disability act | protects rights of people with physical or mental disabilities |
| mental health parity and addiction equity act | requires health insurance companies to provide coverage for mental health and subatnce use treatment |
| code of ethics key principles | advocacy, responsibility, accountability, confidentiality |
| to resolve ethical problems one must | distinguish value, fact, and opinion |
| deontology | whats right/wrong, being truthful |
| utilitarism | greatest good for greatest number of people |
| types of ethical problems | ethical dillema, moral distress |
| osmolarity | concentration. number of particles per kg of h2O reported in mOsm/kg. Na greatest determinant. contributors-potassium, glucose, urea. normal-275-295 millimoles |
| composition | electrolyte concentration |
| water | cell function and metabolism, transporter of nutrients/waste product, lubricant, shock absorber, regulates temp |
| extracellular compartment | intersitial-speace between cells,removes waste. intravascular-inside blood vessels. transcellular-fluid in other areas. |
| intracellular compartment | inside of cells |
| transcellular compartment | synovial, pleural, peritoneal, cebrospinal |
| what is dissolved in water | O2 from lungs, dissolved nutrients from GI tract, excretory products like Co2 and urine, ions, glucose, urea |
| insensible loss | breathing |
| Na+ | chief cation of ECF. 135-145 mEq/L |
| K+ | cation in ICF. 3.5-5 mEq/L |
| plasma | dissolved blood cells,watery |
| osmosis | movement of water across semipermeable membrane from high concentration to low |
| diffusion | movement of solutes from higher to lower concentration |
| filtration | net effect of several forces moving fluid across a membrane. fluids move in and out of capillaries between vascular and interstitial spaces. force pushingh2O and dissolved substances, hydrostatic pressure |
| active transport | movement across cell membrane from low to high concentration. |
| elevated glucose | increase osmolarity, hyperosmolar state |
| isotonic | equal oncotic pressure, expands circulating blood volume |
| hypotonic | lower than bloods oncotic pressure |
| hypertonic | higher oncotic pressure |
| isotonic: | D5W, .9% NACL, LR. whats ib bag is isotonic, but when it goes to the body its hypotonic |
| hypotonic 1/4.... | NS or .45NS, tap water |
| hypertonic NS | 3%NS, D10!,D5NS |
| colloid blood products | whole blood, rbc, alubumin, platlets, plasma |
| regulation of body fluids | thirst mechanism-increase osmolarity, hypothalamus stimulates, ADH-decrease urine production, reabsorbs water. renin angiotensin-retention of Na and H2O and vasoconstriction, ANP-vasodialation, Na and water secreted,heart response to too much blood volume |
| fluid intake | average healthy adult-2200-2700 cc/day. oral, ice, liquids at room temp, tube feeding, IVs |
| output | 2200-2700 cc/day, skin and lungs-insensible loss, feces, urine, vomit, wound and nasogastric drainage |
| 30cc | 1 oz |
| extracellular fluid volume deficit | hypovolemia, isontonic loss |
| extracellular fluid volume excess | hypervolemia, isotonic gain |
| dehydration | hyper osmolar |
| overhydration | hypo osmolar imbalance |
| fluid volume deficit | manifestations-weak, thirsty, dry mucous membrane, weak pulse, low bp, decrease skin turgor, weight loss etiology-decrease intake, GI loss, diuretic, blood loss, sweating risk factors-vomit, diarhea, hemmorage, liver failure |
| common dieruetic | ferosimide |
| third spacing | fluid shifts from intravascular to interstitial space, edema, fluid in pertioneal cavity |
| fluid volume excess | risk-poor diet, not taking medicine etiology-excessive intale, heart, liver, kidney failure manifestations-sudden weight gain, edema, full neck veins |
| edema | interstitial-excess fluid in interstitial spaces pitting-depression in edematous area. dependent-fluid settles by gravity refractort-resistant by not responding to typical treatment anasarca-full body edema, brawny-can not be displaces, taunt shiny skin |
| etiology dehydration | poor intake, diabetes insipidus (ADH definciency). hyperosmolar condition, cell will go into extracellular space |
| overhydration etiology | excesisce ADh, forced H2O intale, excessive hypotonic IV solution cerebral edema-trauma. may appear on labs as hyponatremia, long term steroid use |
| calcium | neuromuscular function, we absorb less as we age. 8.5-10.5mg/dl |
| chloride | major anion in Ecf. 95-108 mEq/L |
| phosphate | anion in ICF. 2.5 to 4.5 mg/dL |
| magnesium | metabolism, ATP, second most abundant cation in ICF, 1.5-2.5 mg/dL. important for cardiac function. used in labor and delivery thru iv if preterm deleivery happens. settles irritable msucles |
| hyponatremia | results from loss of excessive water. causes headache, confusion, irritability, weakness |
| hypernatremia | inadequate water, high sodium foods. causes hyperosmolarity and cellular dehydration |
| hypokalemia | leads to muscle cramping and irritablity. increase loss via kidneys or gi tract. shifts from ecf to icf. treat-iv fluid, diet, never iv push |
| hyperkalemia | cause-kidney failure. shift from icf to ecf. treat-diuretic, kay exultate enema, insulin, P50 |
| hypocalcemia | muscle cramps, paresthesia, tingling, numbness, spasms. risk-pth removed, pancreatitis, alcoholism. chvostek-facial nerve twitches when touched |
| hypercalcemia | prolonged immobility, shift from bone to ecf. malignancy, hyperparathyroidism |
| hypermagnesemia | increase intake of products with magnesium, excess iv fluid mg. decrease muscle excitability. antacids/laxatives cause factor. lethargy |
| hypomagnemesia | prolonged fasting or starvation. increase muscle excitability. alcoholism, diuretics can be causes and fluid loss of gi tract |
| lab tests ex | CBC, basic or complete metabolic panel-BUN, electrolytes, creatinine(most specific), tests kidney function/electrolytes, urinalysis |
| implementation | health promotion-fluid replacement education, teach abt risk factors/signs of imbalances acute care-enternal replacement of fluids, restriction of fluids, parenteral nutrition(cant use gi system at all), crystalloids(IV fluid), colloids |
| IV therapy | multivitamins make iv fluid yellow. iv allows direct access to vascular syste. goal is to prevent or correct fluid imbalances. |
| vascular access devices | short term-periphreal catheters. long term-central lines, peripherally inserted central catheters and ports |
| complications of iv therapy | overload of iv solution. infiltration-iv fluid leaks into SC tissue. extravasation-medication cause tissue damage and pumped into interstitial space. phlebitis-inflamed vein. infection at drainage site. air embolism, bleeding at site |
| what. to assess for ABG | need for O2, ph, CO2 and HCo3, compensation |
| normal ph | 7.35-7.45 |
| normal CO2 | 35-45 mmHg |
| normal HCO3 (bicarbonate) | 22-26 mEq/L |
| normal pO2 | 80-100 mmHg |
| normal SaO2 | > or equal 95% |
| respiartory OPPOSITE | high CO2=low pH low CO2=high pH |
| metabolic EQUAL | high HCO3=high ph low HCO3=low pH |
| respiratory acidosis | pH:below 7.35 paCO2-above 45 paO2-below 80 HCO3 normal if uncompensated, above 26 if compensated |
| respiratory alkalosis | ph-above 7.45 paCO2-below 35 paO2 normal HCo3 normal if uncompensated below 22 if compensated |
| metaboic acidosis | ph-below 7.35 paCO2-normal of uncompensated below 35 if compensated paO2-normal or increased HCO3-below 22 |
| metabolic alkalosis | ph-above 7.45 paCO2-normal if uncompensated, above 45 if compensated paO2-normal or increased HCO3 above 26 |
| rspiratory acidosis cause | COPD, airway obstruction, chest trauma |
| respiratory alkalosis cause | fever, anxiety, pain |
| metabolic acidosis cause | renal failure, shock, starvation |
| metabolic alkalosis cause | decrease gastric secretions, vomiting |
| normal paO2 | 80-100mmHG |
| constitutional law | federal and state constitutions |
| statutory law | derived from statues [assed by us congress. laws are civil/criminal |
Created by:
cwehner125