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COD N2 Unit I

COD Nursing F&E

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
Created by: jaymee4647