F&e Test 5

Front 1

Trousseau's Sign

Back 1

blood pressure placed on arm, hand and finger spasms

Front 2

Chevostek's Sign

Back 2

hyper activity of facial nerve when cheek is tapped

Front 3

Nursing Dx for
hypomagnesemia

Back 3

risk for injury/falls d/t Decr. DTR's and muscle weakness
risk for injury (aspiration d/t dysphagia
knowledge deficit d/t diet
decreased cardiac output d/t dysrhythmias

Front 4

Nursing management of
hypomagnesemia

Back 4

ensure safety (assess DTRs)
teach about diet, meds, alchohol

Front 5

magnesium has inverse relationship with ______

Back 5

calcium
(monitor for hypocalcemia in hypermagnesemia and vice versa)

Front 6

serum level of _____ is hypermagnesmia

Back 6

2.5 mg.dL
(rare)

Front 7

causes of hypermagnesemia

Back 7

kidney failure
DKA
excessive admin of Mag.

Front 8

manifstations of hypermagnesemia

Back 8

flushing, low BP, nausea, vomiting
HYPOactive DTRs
drowsiness & depressed respirations
ECG changes & dysrhythmias
too much MOM or TPN

Front 9

nursing Dx for
hypermagnesemia

Back 9

risk for injury r/t falls, decr. BP, decr, DTRs, aspiration
knowledge deficit r/t diet, meds
decreased cardiac output r/t dysrhythmias
alterations in mood r/t drowsiness

Front 10

medical Tx of
hypermagnesemia

Back 10

IV calcium gluconate (inverse relationship)
Loop Diuretics
IV of NS or Lactated Ringers (isotonic)
hemodialysis

Front 11

nursing management of
hypermagnesemia

Back 11

avoid administration of magnesium
teach about OTC sources of mag, dietary sources

Front 12

value of below normal serum potassium

Back 12

<3.5 mg/dL
hypokalemia can occur with "normal" potassium levels in pts. in alkalosis (ABG pH <7.45)

Front 13

potassium is the chief regulator of _____ _____

Back 13

enzyme activity

Front 14

causes of hypokalemia

Back 14

GI losses
meds (loop diuretics, digoxin, steroids, Gentamycin, theophylline)
skin losses (diaphoresis, wounds)
alterations in acid/base balance
poor dietary intake

Front 15

dietary K+ sources

Back 15

(ABC) apricots, bananas, canteloupe
(ABC) asparagus, broccoli, cauliflower
also: citrus and tomato

Front 16

inverse relationship with potassium?

Back 16

sodium

Front 17

manifestations of
hypokalemia

Back 17

fatigue, anorexia, nausea, vomiting, NG tube suction, constipation, distention, pt. on Lasix, glucose intolerance
weakness, heart flutters, dysrhythmias, muscle weakness, decrease GI motility, decreased DTRs

Front 18

pts. with ____ ____ are often on low K+ diet

Back 18

kidney failure

Front 19

medical management of
hypokalemia

Back 19

increase dietary K+
PO K+ replacement
IV K+ replacement for sever cases

Front 20

IV admin of K+

Back 20

never IV push!!
very caustic, must be administered slowly (dysrhythmias)

Front 21

nursing Dx for
hypokalemia

Back 21

decreased cardiac output r/t dysrythmias
ineffective breathing pattern r/t weakness
constipation r/t decr. H2O in colon, immobility
risk for injury (fall) r/t activity intolerance, weakness fatigue

Front 22

nursing management for
hypokalemia

Back 22

ABGs
severe hypokalemia is LIFE THREATENING
monitor ECG for dysrhythmias
teach about dietary sources of K+
amin. rider of K+

Front 23

what blood level of potassium is considered
hyperkalemia?

Back 23

5.3 mEq/L

Front 24

causes of hyperkalemia

Back 24

excess dietary intake of K+
K+ sparing diuretics (Aldactone)
blood products (old)
ACE inhibitors
Beta-adrenergic blockers
NSAIDS
Heparin
Bactrim
impaired renal Fx
tissue trauma in which K+ lost from cells

Front 25

how fast should K+ be administered IV?

Back 25

about 10mEq/hr.
very slowly

Front 26

manifestations of
hyperkalemia

Back 26

life-threatening (mostly ventricular) dysrhythmias could lead to cardiac arrest
slow, weak pule and hypotension
muscle weakness (could involve resp impairment)
restlessness, irritability
GI spasms, n/v/d, hyperactive bowels

Front 27

medical management of
hyperkalemia

Back 27

monitor ECG
administer cation exchange resin Kayexalate ( usually rect, also IV or PO)
give Lasix (K+ wasting!)
IV sodium bicarb (inverse!)
IV calcuim gluconate
D10W (hypertonic) and R insulin IV (to move K+ into cells)
limit dietary K+
dialysis

Front 28

nursing Dx for
hyperkalemia

Back 28

decreased cardiac output r/t dysrhythmias
knowledge deficit r/t diet
risk for injury r/t muscle weakness
MONITOR for hypokalemia!

Front 29

nursing management for
hyperkalemia

Back 29

stop IV K+ or withhold PO K+
monitor medication effects (monitor for hypokalemia)
teach dietary K+ restrictions
increase K+ excretion (Lasix, Kayexcelate)
promote mvt. of K+ from ECF to ICF (dextrose and insulin as ordered)

Front 30

how does nurse know Kayexcelate or Lasix is working to decrese hpyerkalemia?

Back 30

more normal ECG, decreased PVCs
normalizing pulse rate

Front 31

_____ or ____may result in a falsely high K+ level

Back 31

hemolysis of specimen
or blood drawn above IV site

Front 32

salt substitutes contain ___

Back 32

potassium

Front 33

renal dysfunction patients should not use _________ diuretics which may cause _____

Back 33

K+ sparing
hyperkalemia

Front 34

serum level less than ____ is considerd hypomagnesemia

Back 34

1.5 mg/dL

Front 35

causes of
hypomagnesemia

Back 35

malnutrition (especially alcoholism)
GI losses (NG tube, vomit, diarrhea)
parenteral feedings deficient in magnesium
meds. (loop diuretics)
severe burns & wound debridement

Front 36

manifestations of
hypomagnesemia

Back 36

hyperactive DTRs, muscle spasms, tremors (especially ETOH pts)
ECG changes & dysrhythmias
alterations in mood (combative, irritable)
positive Trousseau's and Chvostek's

Front 37

if someone has hypercalcemia they may also have _____ (inverse relationship)

Back 37

hypomagnesemia

Front 38

dietary sources of magnesium

Back 38

nuts, cereal grains, dk. green leafys, seafood