COD Nursing F&E
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What is IV Therapy? | administering a solution intravenously (into a vein)
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What can be given IV? | Fluids, Electrolytes, Blood and blood products, Some medications, Nutrition, Vitamins,Crystalloids, Colloids, Blood and blood products, Pharmaceutical plasma expanders
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What wont N002 COD Student be giving this semester? | TPN, Blood
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What kind of fluid accounts for intake? | Oral liquids, Water in food, Water from metabolism
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What kind of fluids make up the output? | urine, stool, skin, lungs,Insensible losses
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What is serum osmolality? | osmolality is a measure of the solute concentration of blood
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What is the Normal Range for Na+? | 136-145 mEq/L
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What is Hyponatremia | Na+ below 136 mEq/L, is the reach 115 mEq/L or below can cause seizure and coma, even death
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(on average)An 80 yr old male will be ___% of body will be water? | 50%
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What is intracellular Fluid (ICF) | it is the fluid inside each cell of the body
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what % of the body is intracellular fluid | 2/3
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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
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Should fluid intake = output | yes
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Can all out put be measurable? | No, insensable loss is know but difficult to measure
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What is Active Transport? | Active transport is the movements of solutes across cell membranes from a less concentrated solution to a more concentrated one
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What is Osmolality? | The number of solutes per Kilogram of fluid
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what is Osmolarity? | The number of solutes per Liter of fluid
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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
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What is the normal range for K+? | between 3.5 and 5.5 mEq/L
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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
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What Cardiac EKG changes could you see from someone with hypokalemia? | Flatened T wave
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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
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SS of FVD? | decreased B.P., Increased Pulse, Cool Extremities, Decreased Renal Function
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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
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what is the meaning of drip rate / drop | gtt/min
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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
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Extravasation | is the unintended administration of vesicant (drug capable of causing tissue necrosis) drugs or fluids into the subcutaneous tissue
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Infiltration | the unintended administration of nonvesicant drug or fluid into the subcutaneous tissue
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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.
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vesicant | highly caustic medications some examples: Dopamine, Dextrose solutions >10%
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S/S of Hypernatremia | Decreased extracellular volume, dry mucus membranes, postural HTN, confusion, lethargy, seizures, coma
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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
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2 Nursing Diagnoses for Hypocalcemia | Decreased Cardiac output, ineffective breathing R/T resp. tetany
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Cations | positive charged ions EX: Calcium, sodium, magnesium
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Anions | negatively charged ions
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Oncotic pressure | is a special type of osmotic pressure that is due to the presence of proteins
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orthopnea | The inability to breathe easily unless one is sitting up straight or standing erect.
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Hypovolemia S/S | Slow fluid loss may show little or no S/S. Rapid loss: low BP, increased HR,
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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.
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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
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Hyponatremia and Hypernatremia both cause: | seizures
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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
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Labs for Hypernatremia | Serum Na+ will be greater than 145mEq/L, Hct & Hgb may be elevated if extracellular dehydration is present
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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)
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Causes of Hyppokalemia | Diuretics, Excessive aldosterone release (as occurs with heart failure), Diarrhea, vomiting, drainage from wounds, NG suction, Limited food intake
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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
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Hyperkalemia Tx, in severe cases | Hemodialysis
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What is Intracellualr fluid (ICF) | it is the fluid inside each cell in the body
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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
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The average human body is what % water? | 60%
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what are 2 types of primary fluid imbalances | FVD & FVE
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Isotonic IV solutions | LR, NS, 5% dextrose in sterile water
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Hypotonic IV solutions | 0.45% NS, 0.25% NS
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accumulation of fluid in the insterstitial space will lead to________ | edema
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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
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this IV complication that presents as cool, pale swollen IV Site | infiltration
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this IV complication presents as SOB, wheezing | fluid overload
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This hypertonic saline solution used only in extream cases of hyponatremia | 3% NS
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This way of K+ administration is NOT allowd and cause death | IVP
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formula for IV Administration without a pump | V/T x C
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normal K+ levels | 3.5-5.5 mEq/L
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Kayexalate, sodium polysterine | is used for Hyperkalemia
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leg cramps are a sign of | hypokalemia
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3 things to check before giveing lasix | K+, BP, renal function
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3 ways Hyperkalemia is treated | Kayexalate, diuretics, albuterol, Ca+, dialsys, sodium bicarb
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priority nursing diagnosis for a pt with hyponatremia | risk for injury rt poss. seizures
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IV solution has shown to reduce hyponatremia in a hospital setting | NS
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This is a common hypontonic IV soulution of Sodium Chloride | 1/2 NS
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HTN Medications can put pt's at risk for hypekalemia | Ace Inhibitors ie: Altace, lisinopril, enalapril, ramparil, Zestril
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Causes GI Upset | PO K+
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1Kg = | 2.2lbs
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these part of the CBC become elevated if the pt is dehydrated | hgb & hct
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These diagnostic urine values become elevated during FVD | urine specific gravity & osmoality
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what does TKO & KVO | To Keep Open / Keep Vein Open
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What is the FIRST sign of Fluid Overload? | Shortness of Breath / dyspena / SOB
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