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76 Cards in this Set

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