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COD Nursing F&E

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Question
Answer
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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