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concepts cp 29/38
| Acidosis | too much acid in the blood (ph below 7.35) |
| alkalosis | too much base (alkaline) in the blood (ph above 7.45), projective vomiting |
| Antidiuretic hormone( ADH) | tell kidneys to save water |
| aldosterone | saves sodium and water, gets rid of potassium |
| Electrolyte | minerals like sodium and potassium that help muscles, heart and brain work |
| osmosis | water moves were theirs more stuff(solute) |
| diffusion | solute move from high to low concentration |
| buffer | keep PH steady, not too acidic or alkaline |
| water essential- WATER | 50-70% of body weight is water |
| water essential- INFANTS | 65-80% |
| water essential- ADULT MALES | 60-65% |
| water essential- OLDER ADULTS | 50-55% |
| where is water? | ICF(Intracellular fluid): inside cells (2/3 of body water) ECF(Extracellular fluid) outside cells (1/3 body water) Interstitial: between cells Intravascular: blood/plasma |
| * Where sodium goes, water follows | |
| Thiozide diuretic | Potassium |
| Lasix | muscle spasm |
| *STUDY DROP FACTOR FOR DOSAGE QUESTIONS | |
| * IF YOU ARE WORKING AS A NURSE THE PT WITH CHF AND STRIDOR ARE YOUR FIRST PRIORTY | |
| A pt with vomit and diarrhea | give 0.9% Na chloride |
| water role | regulate temp. transport nutrients and waste protects brain/ spinal cord (via CSF) Lubricates joints and GI tract |
| thirst | primary intake regulator (controlled by hypothalamus) |
| ADH | save water (less pee) only work on kidney to decrease urine production |
| Aldosterone | saves salt and water, get rid of potassium decrease urine production and increase body fluid level |
| ANF | gets rid of salt and water(lower bp) causes kidney to excrete more urine |
| dehydration | alterations in body Temps sweating/ hard breathing cause fluid loss |
| Hypovolemia | High specific gravity High Bun High hematicrit |
| nursing actions: dehydration/ hypovolemia | Monitor I&O Give fluids (oral or IV) Monitor BP/HR Mouth care watch for <30 mL/hr urine (may mean kidney failure) |
| fluid volume deficit: Dehydration/ Hypovolemia | cause: diarrhea, vomiting, bleeding, diuretics s/s: dry skin/mouth, low BP, fast HR, sunken eyes, dizziness, poor skin turgor |
| Fluid volume excess: HYPERVOLEMIA | cause: too much salt or IV fluids, kidney/heart/liver failure S/S: Swelling (edema) , shortness of breath, crackles, high BP, Weight gain |
| nursing action: HYPERVOLEMIA | I&O Give diuretic Daily weight Low sodium diet watch lung sounds and O2 levels Monitor edema |
| Hypervolemia patient teaching | |
| NA+ (sodium) | range: 135-145 control water balance, nerves/ muscle |
| K+ (potassium) | 3.5-5.3 heart rhythm muscle function monitor muscle weakness make sure pt on cardiac monitor DONT PUSH IV |
| CL-(Chloride) | 97-107 balance sodium help acid/ base may cause seizure / coma tetany |
| Ca2+ (calcium) | 8.2-10.2 bones muscles and heart contractions NAUSEA CONSTIPATION |
| Mg2+ (magnesium) | 1.6-2.2 never/muscle function BP control RESPIRATORY DEPRESSION WEAKNESS |
| Pos (phosphorus) | 2.5-4.5 energy bone muscle/nerve work |
| TOTAL CALCIUM | 17.5 is not normal |
| potassium is critical | too high or too low= risk for deadly heart rythm |
| HYPOCALCIUMIA | cevostek trousseau sigh |
| PH range | 7.35 acidosis 7.45 alkalosis |
| normal blood PH | 7.35-7.45 |
| Respiratory acidosis | slow breathing |
| Respiratory alkalosis | fast breating |
| metabolic acidosis | acid buildup or base loss |
| metabolic alkalosis | base buildup or acid loss |
| Fluid overload | renal failure |
| fluid & electrolyte maintenance | for NPO patients or those unable to ingest fluids orally(nausea, dysphagia) Prevents dehydration, maintain cellular function, and prevent death |
| Fluid & electrolytes replacement | replaces losses from vomiting, diarrhea, GI, suctioning,fever, trauma, hemorrage prevent hypovolemia and shock must be tailored to lab value (NA+,K+,CL-,HCO3-) |
| Medication administration | direct, rapid route with high bioavailability can be continuous, intermittent, or IV push |
| what fluid given to person dehydrated | normal saline |
| Isotonic | 0.9% NS OR NS,LR,D5W hydration, volume replacement, blood product |
| hypotonic | fluid in cell, 1/2 NS, 1/3NS same as 0.45% hypertonic dehydration, gastric suctioning, H20 replacement avoid hypotension, burns, head trauma (risk of cerebral edema) |
| Hypertonic | fluid out of cells, D5NS, D10W, 3% NaCL hyponatremia, fluid resuscitation, LOST OF BLOOD Admin slowly: monitor for fluid overload & cell dehydration |
| * If pt having blood transfusion reaction you do not hang anoter blood product | |
| Hypothyroid | hypocalcium |
| low calcium | caused by hypothyroidism |
| component of Iv fluids | water- base solvent electrolytes- maintain homeostasis glucose- energy source vitamin/amino acid - metabolic function |
| thromboitis | inflammation of vein & thrombus flabitise |
| Signs and symptoms | dyphnea cynosis tachycardia |
| winged butterfly | aka scapped vein needle short term, blood draw, infants, short infuse time |
| blood transfusion | 16-18G |
| when giving blood tranfusion | collect before,during, after verfy identity & blood capatibility prime tube with NS(0.9) always remain with pt 15 min |
| Basal metabolic panel | Na+, k, hco3, Bun, cr, BS |
| infiltration | swollen, cool to touch redness, pain,warmth,streak action: discontinue IV apply warm compress |
| Sepsis | if patient having fever, hypotension & chill |
| * air embolism if iv not primed | |
| * with any complications STOP transfusion | |
| change tubing | anytime contaminated facility policy |
Created by:
indiallano91