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76 Cards in this Set
- Front
- Back
How often do you check IV site
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Every hour
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Signs of Phlebitis
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Red, Warm, Tender to touch, harden by IV site, hard venous cord, induration.
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Signs of infiltration
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cool to touch, firm, leaking from site into tissues
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what is endofiltration
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too much fluid to heart, causes cardian valve to fail, inflamation to valves, failure.
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signs of air embolism
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air into blood, cyonotic, increase BP. Heart sounds like turning sound.
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Treatment for air embolism
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treat patient by putting head down, left side. air stays in rt. atrium.
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Prevention of air embolism
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Make sure lines are secured, change lines every 72 hours, clamp hose if air goes into line, call physician
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Treatment of fluid volume excess
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Slow IV down and contact physician.
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Best temperature for sleep
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68-72 degrees
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what is circadian rhythm
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the 24-hour day, day-night cycle affected by light, temperature, and external factors.
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The stages of sleep
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Wakefulness, NREM Stage 1, NREM Stage 2, NREM stage 3, NREM stage 4, NREM stage 3, NREM Stage 2, REM, NREM stage 2.
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What occurs during REM sleep?
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Dreaming phase, worries, concerns
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Factors creating insomnia
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Pain, anxiety, depression, lung disease, coronary heart disease, nocturia, menopause, restless leg syndrome, surgical removal of ovaries
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What is the criteria for apnea?
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15 seconds of not breathing.
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What is a treatment for snoring?
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Continuous positive airway pressure CPAP.
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What are some herbal remedies that induce restfulness and sleep?
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Valerian root and Kava
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What type of drugs are sleep inducing?
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Hypnotics
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What is an example of a hypnotic drug?
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Benzodiazepines
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How do you stop benzodiazepines?
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Titrate dose down to prevent withdrawal syndrome.
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What is an alternative hypnotic for older adults with insomnia besides benzodiazepines?
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Restoril (temazepam)
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What benzodiazepine has an effect on the elderly of depression, memory loss, confusion, etc.?
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Halcion
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What drug is often used for sedation during CT scans?
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Chlorohydrate
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What medication is given to older adults as a sleep aid?
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Benedryl
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Name two short-term barbiturates
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Nembutal (phenobarbital) and Seconal (secobarbital)
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Name a non-benzodiazepine hypnotic
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Ambien
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When is a antihistamine, sedative-hypnotic contraindicated?
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In acute asthma or lower respiratory tract disease since it thickens secretions.
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What does a hypnotic do?
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Induce sleep
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What does a sedative do
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Reduce anxiety.
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What is the normal level for serum sodium?
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135-145 mEq/L
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Some reasons for Hyponatremia
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Loss of Na in GI Fluids, diuretics, adrenal insuffieincy.
Too much D5W IV, excessive drinking of water, SIADH (excessive ADH is secreted) |
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Characteristics of hyponatremia
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Anorexia, N, V
Lethargy, confusion, muscle cramps, twitching, seizures, coma |
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Treatment of Hyponatrium
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foods with Na+
Hypertonic saline IV Restrict water administer diuretic |
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Reasons for Hypernatremia
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deprivation of water
hypertonic tube feeding excessive salt intake increased water loss |
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To have effective ADH, you need normal
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Potassium
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Characteristics of hypernatremia
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thirst, tongue dry, furrowed, swollen
elevated temperature disorientation, hallucinations, lethargy seizures, coma |
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Treatment for hypernatremia
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offer fluids
give water with tube feedings every 4 hours 100ccs monitor I/O and weight |
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Funcions of potassium
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Chief regulator of cellular enzyme activity and water content
electric impulses in nerve, heart, skeletal intestinal, lung acid-base balance by cellular exchange with H+ |
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Hyperkalemia can lead to
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cardiac arrest.
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Sources of K+
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bananas, peaches, kiwi, figs, dates, apricots, oranges, prunes, melons, raisins, broccoli, potatoes.
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Losses of K+
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Excreted by kidneys
GI secretions, perspiration, saliva. |
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What hormone prompts excretion of K+ in urine
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aldosterone
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Reasons for hypokalemia
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diarrhea, V, gastric suction
poor intake, anorexia, alcoholism diuretics (lasix) steroids penicillin |
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Characteristics of hypokalemia
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fatigue, muscle weakness (heart), decreased bowel motility, N, V, anorexia, cardiac arrhythmias, postural hypotension, parasthesias (tingling), polyuria
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Treatment for hypokalemia
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eat foods high in K+
Administer K+ supplements (give with food - hard on stomach) Administer K+ in IV - too much cardiac arrest! |
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Reasons for hyperkalemia
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renal failure
high K+ intake tissue trauma |
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Characteristics for hyperkalemia
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muscle weakness, flaccid muscle paralysis, nausea, cardiac arrhythmias, bradycardia, paresthesias, decrease in urine output
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Treatment for hyperkalemia
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Avoid salt substitutes
decrease intake of coffee, cocoa, tea, dried fruits Kay-exelate promotes excretion through bowels |
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Treatment for hyperkalemia
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insulin added to glucose IVF
Bicarbonate to drive K+ into cell Dialysis Calcium gluconate |
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Normal level of serum chloride
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95-105 mEq/L
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Functions of chloride
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Maintains osmotic blood pressure
buffers oxygen & CO2 exchange in RBCs Found in gastric juices |
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Reasons for Chloride deficit
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V, D
Use of diuretics excessive sweating low sodium diet too much IV dextrose |
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Characteristics of chloride deficit
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hyperexcitability of muscles, tetany, termors, twitching, slow, shallow breathing, BP decrease & dehydration
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Treatment of chloride deficit
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correct K+ deficit along with Cl- deficit
administer normal saline IV accurately record gastric fluids lost in emesis, suction. |
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Characteristics of chloride excess
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weakness, lethargy, coma, deep, rapid breathing to blow off carbon dioxide to reduce acid load.
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Functions of calcium
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nerve impulse transmission
blood clotting muscle contraction, cardiac function bones, teeth, cell membranes |
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sources of ca+
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cheese, milk, greens, broccoli, salmon, dried beans, vitamin D promotes calcium absorption
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loss of calcium
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excreted in urine, feces, bile, digestive secretions, sweat
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Regulation of Calcium
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parathyroid hormone
calcitonin vitamin D High phosphate lowers Ca+ |
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Reasons for Hypocalcemia
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removal of parathyroid gland
vitamin D deficiency administration of citrated blood low albumin levels increased Mg impairs PTH release increaased phosphate lower Ca+ |
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characteristics for hypocalcemia
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numbness, tingling, muscle cramps in extremeties, confusion, irritability, chvostek's and Trousseau's
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Treatment for Hypocalcemia
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seizure precautions, safety precautions, administer calcium, Ca+ gluconate IV
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Reasons for hypercalcemia
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overuse of calcium antiacids
prolonged immobilization large doses of vitamin D |
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characteristics for hypercalcemia
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decreased neuromuscular excitability, weakness, lethargy, decreased memory span, decreased attention span, confusion, polyuria, cardiac arrest
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Treatment for hypercalcemia
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IV furosemide (excretion of Ca+)
dialysis for crisis promote movement of calcium into bone |
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Treatment for Hypercalcemia
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eliminate drugs causing Ca+ increase
increase fluids to prevent stones avoid high calcium foods ambulate to keep calcium in bones handle client gently to prevent fractures |
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Where is magnesium found
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Intracellular in heart, bone, nerve, muscle
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Functions of Mg+
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regulates neuromuscular activity for skeletal and heart
maintains levels of K+ in cells Needed for protein synthesis, DNA, RNA |
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Sources of Mg+
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green vegetables, nuts, legumes, whole seeds, grains, bananas, chocolate, grapefruit
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Regulation of Mg+
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Absorbed by intestines & excreted by kidneys
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Normal level of Mg+
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1.3 - 2.1 mEq/L
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Reasons for Mg deficit
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Intestinal malabsorption, diarrhea, NG suction, diabetic ketoacidosis, excessive doses of vitamin D or calcium supplements, diuretics
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Characteristics of Mg deficit
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Neuromuscular irritability, tetany, Chvostek's & Trousseau's signs, (similar to hypocalcemia)
Tachyarrythmias, increased sensitivity to digitalis toxicity |
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Characteristics for Mg+ deficit
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mental changes, disorientation, mood changes, intense confusion, hallucinations
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Treatment for Mg+ deficit
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Seizure and safety precautions
monitor airway aspiration precautions increase Mg+ rich foods Mg sulfate IV |
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Reasons for Excess Mg+
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Renal failure
Adrenal insufficiency Excessive magnesium administration from laxatives and antiacids |
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Characteristics for Mg+ excess
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flushing, skin warmth, depressed respirations, drowsiness, hypoactive reflexes, cardiac abnormalities, weak or absent cry in newborn
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