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FLUID EXCESS
Human Needs- Test 1
| Term | Description |
|---|---|
| Hypervolemia | overhydration- ** Pay close attn. to K+ levels: incr. urine volume |
| Hypervolemia Treatment: | diuretics: ** Na+ restricted diet and 1000 cc/day incl meals ( fluid restriction) |
| Na+ functions: | major extracellular cation, maintains osmotic pressure, maintains acid/base balance, chem. reactions such as sodium/potassium pump, muscles, nerves, heart |
| Loss of Na+ ( Hyponatremia) | excessive intake or retention of water, (diarrhea) |
| Shock patients | ***IV access*** |
| Hyponatremia | main cause*** NG tube |
| Hyponatremia causes | too many tap water enemas, too much dextrose in water, cirrhosis, malnutrition, concerts ( heat) |
| Hyponatremia Symptoms | cold clammy skin, confusion, dizziness, oliguria ( less than 30cc/hr) |
| Serum Sodium | 135 - 145 |
| Hyponatremia TREATMENT | restrict water in dilutional, IV sodium fluids |
| Hypernatremia | excessive Na+, caused from drinking excess salty fluids, salt water drowning, loss of H20, fever, |
| Symptoms of Hypernatremia | compain of thirst, dry tongue, flushed skin, fever |
| TREATMENT of Hypernatremia | restriction of sodium, admin of H20, diuretics |
| K+ | 3.5- 5.5 (HEART) *** It has to be diluted if given IV and not PUSH!!!**** |
| K+ functions | nece. for cell growth, aids in acid/base balance |
| K+ moves: | outside the cell durin acidosis and inside cell during alkalosis |
| Hypokalemia | diarrhea, vomitting, Gastric suction, lasix ( loss of potassium) |
| Hypokalemia Symptoms | cramps in leg (charlie horse), constipation, decr. resp. serum K+ <3.5, polyuria |
| K+ EKG:Normal: | u wave shallow |
| K+EKG: Abnormal | Hypokalemia ( prominant U WaVE) |
| Hypokalemia TREATMENT | Easier to Treat::***Oral or IV K+: IV: is discomforting to patient ( MUST BE DILUTED)and over a time frame, encouraged to eat foods high in K+ |
| Hyperkalemia Causes | kidney failure, acidosis |
| Sympt. of Hyperkalemia | cardiac arrhythmias |
| EKG K+ Hyperkalemia | high peaked T wave |
| hyperkalemia TREATMENT | Kayexalate, orally or retention enema, sodium bicarb. |
| Calcium | decr. excitable membranes, promotes coaggulation of blood, builds strong bones and teeth |
| Ca+ relationship | when K+incr. Phosphorous decr. ( drinking cokes) |
| Hypocalcemia | Alkalosis, Vit. D deficit |
| Hypocalcemia Symptoms | hyperactive reflexes, high pitched sound in resp. "crowing sound" ( laryngeal stridor) |
| Chvosteks sign | contraction of facial muscle |
| Trosseaus sign | bp cuff- have carpral spasm |
| Hypocalcemia symp | numbness/ tingling in fingers/ mouth, hyperactive bowel sounds, osteoperosis, Ca+ < 4.5 |
| Ca+ levels | 4.5- 5.5 |
| Phosphate | admin. phosphate is dangerous! rickets, irritability, coma, chemotherapy causes it. |
| Phosphate TREATMENT | aluminum hydroxide |
| Magnesium- hypo | alcholism, met. acid., tetany, ataxia, IV magnesium sulfate |
| Hyper magnesium | renal failure, bradycardia, resp. depression, dialysis- TREATMENT: avoid Mg. substances |
| Blood Transfusion | run normal saline- piggy back |
| Normal SaIine | isotonic sol.- ** CANT give pure H2O |
| Hypertonic Sol. | useful in treatment of hypovolemia and hyponatremia |
| Anaphylactic Shock TREATMENT | Epinephrine, Benadryl, O2 |
Created by:
baylorchic
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