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211 Cards in this Set
- Front
- Back
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Normal 135-145 mEq?
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Sodium (Na+)
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Major extracellular cation with a positive charge?
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Sodium (Na+)
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Fluid Balance
Electrolyte balance Acid-base balance Nerve & Muscular respones? |
Functions of Sodium (Na+)
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Conserves Na+ & Cl- and excretes K+?
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Aldosterone
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Increase water & Na+ (diluted) from increased what?
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Antidiuretic hormone (ADH)
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When this is secreted it causes excretion of Na+?
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Natriuretic peptide (NP)
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Kidneys excrete H2O and reabsorb Na+ when?
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Decreased Na+ inhibits ADH and NP.
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1 tsp salt = 2000 mg
Soy sauce 1 tbsp = 1029 mg 4oz cured pork = 850 mg Cottage cheese 1 oz = 457 mg American cheese 1 oz = 439 mg Mustard 1 tbsp - 188 mg Ketchup 1 tbsp - 156 mg ? |
High Sodium Foods
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Loss of Na by kidneys, GI tract, or skin.
Gain water (increased ADH retains H2O & can dilute Na) Shift of Na into cell if K+ is low. Shift of water from ECF to cell. ? |
Hyponatremia <135mEq
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<135 mEq
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Hyponatremia
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Loss -> vomiting, diarrhea, NG suction, diaphoresis, diuretics, decreased aldosterone, Addison's disease?
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Causes for Hyponatremia
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Poor intake -> NPO, low Na or Na free IV fluids, low oral intake?
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Causes for Hyponatremia
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Psychogenic polydipsia, Frequent NG irrigated with hypotonic fluid?
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Dilutional hyponatremia
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Syndrome of inappropriate antidiuretic hormone where increased ADH retains water and dilutes Na?
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SIADH = too much ADH
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Syndrome of inappropriate antidiuretic hormone (SIADH = too much ADH) where increased ADH retains water and dilutes Na?
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Dilutional hyponatremia
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Fresh water drowning, CHF (NP secreted so Na excreted)?
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Dilutional hyponatremia
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Anorexia, N/V
Abd cramps, diarrhea Dependent edema Headache, Dizzy Postural decreased B/P Disorientation, decreased LOC Muscle weakness |
S&S hyponatremia, low Na
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Wt gain
HTN, rapid HR confused, restless lethargy seizures coma |
S&S hyponatremia, dilutional low Na
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What are the S&S's related to Na+ <125 mEq?
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Nausea, malaise
headache, lethargy, obtundation seizure, coma. |
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What are the S&S's related to Na+ 115-120 mEq?
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Headache, lethargy, obtundation
seizure, coma. |
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What are the S&S's related to Na+ 110-115 mEq?
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Seizure, coma
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CLASH stands for what?
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Reminder for Hyponatremia
C-confusion, coma L-lethargy A-apprehension S-seizures H-headache |
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Reminder for hyponatremia?
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Think Neuro
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I&O's, daily wt, diet, oral sodium replacement, fluid restriction, diuretics, monitor VS's, Neuro assessments, Monitor labs, and seizure precautions?
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Management of hyponatremia
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How many kilograms before edema occurs?
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3 kg
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Administer IV fluids: normal saline, LR or hypertonic solutions (3% or 5%)?
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Hypertonic infusion Tx for hyponatremia
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How do you give a hypertonic solution.
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Slowly because it can cause the brain cells to shrink; leading to seizures and possibly death.
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Do not raise more than 12 mEq/24 hours?
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Hypertonic infusion Tx for hyponatremia
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Poor renal excretion - Renal failure, Steroids, Cushing's disease?
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Hypernatremia >145 mEq/L
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Increased sodium intake -
Oral or intravenously Sodium bicarbonate? |
Causes of hypernatremia > 145 mEq/L
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Water loss -
Diarrhea, dehydration, fever Diabetes Insipidus? |
Hypernatremia >145 mEq/L
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Decreased ADH = increased Na & decreased water?
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Hypernatremia >145 mEq/L
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Thirst (impaired thirst in elderly)
Edema if hypervolemic Increased temperature, dry & sticky membranes CNS: normovolemic or hypovolemic - agitation, confusion, seizures; hypervolemic - lethargy, stupor, coma. Neuro: mild/early - twitching, irregular contractions; severe/late-muscle weakness, decreased deep tendon reflexes, seizures? |
S&S hypernatremia
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What does SALT stand for?
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Reminder for Hypernatremia
S-seizures, skin flushed A-agitation L-low grade fever T-thirst |
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Think - Neuro?
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Reminder for hypernatremia
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I&O's, daily wt, VS's, Monitor labs
Mild-restrict Na, encourage fluids Severe-Neuro status, seizure precautions Diuretics if hypervolemic Diabetes Inspidus - vasopressin? |
Management of hypernatremia
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How do you give hypotonic IV fluid (1/4 NS, 1/2 NS, D5W) and why?
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You give hypotonic IV fluid slowly to prevent cerebral edema.
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What is the major intracellular cation?
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Potassium (K+)
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What is the normal range for potassium (K+)?
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Normal is 3.5 - 5.0 mEq/L
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When K+ increases causing H+ to enter cells is termed?
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Acidosis
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When K+ decreases causing H+ to leaves cells is termed?
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Alkalosis
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Maintains electrical neutrality and osmolality of cells.
Skeletal & cardiac muscle contraction & electrical conductivity. Affect acid-base balance Maintain protein and glycogen synthesis? |
Functions of Potassium
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Sodium-potassium pump
Kidney function Acid-base (pH effects K+ level)? |
What regulates Potassium (K+)
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80% of what is excreted each day?
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Potassium (K+)
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Through what is potassium excreted, and it also absorbs Na?
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Kidneys
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What is very sensitive to changes in the K+ extracellularly?
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The heart.
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How much of K+ is extracellular?
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About 2%.
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Morton salt substitute - 2400 mg/tsp
Avocado - 1097 mg Raisins - 700 mg Fresh pork - 525 mg Cantaloupe - 494 mg Spinach - 470 mg Banana - 451 mg Veal cutlet - 448 mg |
Potassium rich foods
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<3.5 mEq/L
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Hypokalemia
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This causes reduce excitability of cells and reduces stimuli response of nerves and muscles?
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Hypokalemia <3.5 mEq/L
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Drugs - diuretics, Amphotericin B, aminoglycosides, albuterol
Incresed steroids, Cushing syndrome Diarrhea, vomiting, NG suctioning NPO, poor intake, hyperalimentation Alkalosis Dilutional - water intoxication, IV fluids w/o K+ |
Causes of hypokalemia
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Bradycardia from Digitalis toxicity
EKG changes - U wave, flat T wave Other dysrhythmias, brady and tachy Arrest? |
Hypokalemia cardiac S&S
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Shallow respirations from weak muscles
Flaccid paralysis, hyporeflexia, leg cramps, muscle weakness, paralytic ileus, constipation, lethargy, confusion, hypotension? |
More S&S of hypokalemia.
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What does SUCTION stand for?
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Reminder for hypokalemia
S-Skeletal muscle weakness U-Uwave on EKG C-Constipation (ileus) T-Toxic digitalis I-Irregular weak pulse O-Orthostatic hypotension N-Numbness, Parathesia |
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Think Cardiac is in reference to?
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Hypokalemia
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Management of Hypokalemia
Take with food do not crush or chew dilute elixirs? |
Management of Hypokalemia
Oral KCL |
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Management of Hypokalemia
Give 10 mEq/hour Maximum is 20 mEq/hour (ICU) Never IV push Very irritating to vein (lidocaine)? |
Management of Hypokalemia
IV KCL |
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You would give foods high in K+ when?
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In Management of Hypokalemia
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You would use:
Potassium-sparing diuretics -Spironolactone (Aldactone) -Triamterene (Dyremium) ACE inhibitors and ARBs -Prinivil/lisinopril (ACE) -Diovan/valsartan (ARB)? |
Management of hypokalemia
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I&Os, VS, monitor labs, assess cardiac status?
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In Management of hypokalemia
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Management of hypokalemia
Prininvil? |
Management of Hypokalemia
lisinopril (ACE) |
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Management of Hypokalemia
Diovan? |
Management of Hypokalemia
valsartan (ARB) |
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Management of Hypokalemia
Spironolactone? |
Management of Hypokalemia
Aldactone |
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Management of Hypokalemia
Triamterene? |
Management of Hypokalemia
Dyremium |
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Ace inhibitors & ARBs
Excess K+ intake like salt substitutes, KCL oral or IV, blood transfusion. Decreased excretion of K+ through Addison's disease, Renal failure, or potassium-sparing diuretics. Excess K+ due to tissue damage and acidosis. ? |
Causes of hyperkalemia >5.0 mEq/L
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Hemolysis
Blood draw is coagulated Blood pressure cuff Blood drawn above IV line with K+ ? |
Causes of Pseudo-hyperkalemia
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Braycardia
Ventricular dysrhythmias Hypotension Cardiac arrest EKG changes: Tall peaked T wave ? |
Cardiac S&S of hyperkalemia
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GI: hyper bowel sounds, diarrhea
Neuro: early/mid - muscle twithes, cramps, paresthesia late/severe - weakness, flaccid arms & legs, confusion Repiratory: late respiratory failure. ? |
S&S of hyperkalemia
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Reminders for hyperkalemia
What does HELPER stand for? |
Reminders for hyperkalemia
H-hypotension E-EKG changes L-loose stools P-peaked T wave E-end result of acidosis R-renal failure |
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Think cardiac
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Reminder for hyperkalemia
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Diuretics
Sodium polystyrene sulfonate (Kayexalate) with sorbitol 50% dextrose and insulin Sodium bicarbonate Calcium gluconate Albuterol |
Management of hyperkalemia
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What is the name for sodium polystyre sulfonate with sorbitol?
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Kayexalate
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Have low K+ in diet and IV fluids
Monitor I&Os, VSs and labs Monitor heart Dialysis and Patient teaching ? |
Management for hyperkalemia
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Deficient fluid volume. Deficient knowledge Excess fluid volume. Diarrhea. Impaired gas exchange. Imbalance nutrition: less or more than body requirement. Nausea. Pain. Risk for activity intolerance. Risk for infection. Risk for injury.
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Nursing diagnosis statements for hypo/hypernatremia and hypo/hyperkalemia.
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Definition - Introduction of a substance, especially nutritive material into the body by means other than the intestinal tract.
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Definition of IV Fluids
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Achieve normal fluid and electolyte balance
Achieve optimal nutrition status Maintain hemostasis through blood and blood component administration Provide a medium for administering medications and nutritional support? |
Goals of IV Fluids
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What percentage of an adult's body weight is water?
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About 60%.
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What are things that cause variation in adults percentage of water in their bodies?
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Age, Gender, and percentage of body fat.
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How much body weight is in the intracellular compartment (inside the cell)?
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40%
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Where does balance of fluids occur in the body?
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In the extracellular fluid.
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How does fluid balance happen in the extracellular fluid?
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By osmosis.
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Intravascular fluid is where?
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In the blood vessels.
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Interstitial fluid is where?
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Between the blood vessels and cells.
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Transcellular fluid is where?
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Cerebrospinal, pleural, peritoneal, and synovial fluids.
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Solutions used for IV therapy
This type of fluid has osmolarity about equal to that of serum. Becuase it stays in the intravascular space, it expands the intravasular space, it expands the intravascular compartment. (no change in the cell)? |
Solutions used for IV therapy
Isotonic Fluid |
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Solutions used for IV therapy
This type of fluid has osmolarity lower than that of serum. It shifts out of the intravascular compartment, hydrating cells and the interstitial compartments. (could cause cells to swell or burst)? |
Solutions used for IV therapy
Hypotonic Fluid |
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Solutions used for IV therapy
This type of fluid has an osmolarity higher than that of serum. It draws fluid into the intravascular compartment from the cells and the interstitial compartments. (could cause cells to shrink)? |
Solutions used for IV therapy
Hypertonic Fluid |
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Solutions used for IV therapy
0.9% sodium chloride Lactate ringers D5W - (acts as hypotonic in the body) Given to provide free H2O to all body compartments. These IV fluids are used to replace extracellular fluid losses and to expand vascular volume quickly? |
Solutions used for IV therapy
Isotonic Solutions |
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Solutions used for IV therapy
0.45% sodium chloride (1/2NS) 0.25% sodium chloride (1/4NS) D5 1/2 NS, D5NS, D51/4NS (maintenance fluids) These solutions are used to prevent and treat cellular dehydration by providing free water to the cells. These solutions are contraindicated in acute brain injury - may cause cerebral edema? |
Solutions used for IV therapy
Hypotonic Solutions |
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Isotonic, Hypotonic, Hypertonic, Crystalloid or Colloid?
0.9% sodium chloride? |
Isotonic
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Isotonic, Hypotonic, Hypertonic, Crystalloid or Colloid?
Lactate ringers? |
Isotonic
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Isotonic, Hypotonic, Hypertonic, Crystalloid or Colloid?
D5W? |
Isotonic
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Isotonic, Hypotonic, Hypertonic, Crystalloid or Colloid?
0.45% sodium chloride (1/2 NS)? |
Hypotonic
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Isotonic, Hypotonic, Hypertonic, Crystalloid or Colloid?
0.25% sodium chloride (1/4 NS)? |
Hypotonic
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Isotonic, Hypotonic, Hypertonic, Crystalloid or Colloid?
D5 1/2 NS? |
Hypotonic
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Isotonic, Hypotonic, Hypertonic, Crystalloid or Colloid?
D5NS? |
Hypotonic
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Isotonic, Hypotonic, Hypertonic, Crystalloid or Colloid?
D5 1/4 NS? |
Hypotonic
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Isotonic, Hypotonic, Hypertonic, Crystalloid or Colloid?
Albumin? |
Colloid
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Isotonic, Hypotonic, Hypertonic, Crystalloid or Colloid?
Dextran? |
Colloid
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Isotonic, Hypotonic, Hypertonic, Crystalloid or Colloid?
Hetastarch? |
Colloid
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Definition
A large solute particle, such as a protein that normally does not pass through cell and capillary? |
Colloid
Volume expanders |
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Colloids
Provides 80% of plasma colloid osmotic pressure? |
Colloids
Albumin |
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Colloids
Prepared from donor plasma but heat treated to prevent risk of hepatitis or HIV? |
Colloids
Albumin |
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Colloids
Use as a plasma volume expander especially if someone has edema and Hypovolemia? |
Colloids
Albumin |
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Colloids
Used a lot in volume depletion due to third spacing? |
Colloids
Albumin |
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Colloids
Will not correct nutritional deficits? |
Colloids
Albumin |
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Colloids
Comes in bottles usually given 2-3 times a day? |
Colloids
Albumin |
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Colloids
Watch for fluid overload? |
Colloids
Albumin |
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Colloids
5% solution in 500ml? |
Colloids
Albumin |
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Colloids
Polysaccharides useful with shock patients, helps with microvascular circulation? |
Colloids
Dextran |
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Colloids
Can cause anaphylactic reactions? |
Colloids
Dextran |
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Colloids
Interferes with blood cross-matching? |
Colloids
Dextran |
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Colloids
May increase risk for bleeding? |
Colloids
Dextran |
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Colloids
Like hetastarch, not a blood substitue? |
Colloids
Dextran |
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Colloids
Used as a volume expander in hemorrhage, shock trauma and burns? |
Colloids
Hetastarch |
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Colloids
Less expensive than albumin? |
Colloids
Hetastarch |
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Colloids
Raises serum amylase? |
Colloids
Hetastarch |
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Types of Intravenous access
Most common 3/4 to 1 inch in length in the superficial veins of the hands and arms? |
Types of Intravenous access
Peripheral |
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Types of Intravenous access
Short-term use must be changed every 3-4 days? |
Types of Intravenous access
Peripheral |
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Types of Intravenous access
Depends on the size of the vein and the type of solution subject to phlebitis? |
Types of Intravenous access
Peripheral |
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Types of Intravenous access
If no fluids are infusing, can be maintained by TID saline flushes? |
Types of Intravenous access
Peripheral |
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Isotonic, Hypotonic, Hypertonic, Crystalloid, or Colloid?
Includes solutions containing more than 10% dextrose, 5% protein, and high electrolyte concentrations? |
Isotonic, Hypotonic, Hypertonic, Crystalloid, or Colloid?
Hypertonic |
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Isotonic, Hypotonic, Hypertonic, Crystalloid, or Colloid?
This Hypertonic solution draws fluid from the cells. It is used to maintain blood sugar in severely hypoglycemic pts. Also used to wean pts off of TPN? |
Isotonic, Hypotonic, Hypertonic, Crystalloid, or Colloid?
D10 |
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Isotonic, Hypotonic, Hypertonic, Crystalloid, or Colloid?
D10? |
Isotonic, Hypotonic, Hypertonic, Crystalloid, or Colloid?
Hypertonic |
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Isotonic, Hypotonic, Hypertonic, Crystalloid, or Colloid?
Diffuse through the capillary wall and become distributed through the extracellular fluid of which 25% is the vascular system? |
Isotonic, Hypotonic, Hypertonic, Crystalloid, or Colloid?
Crystalloids |
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Isotonic, Hypotonic, Hypertonic, Crystalloid, or Colloid?
Solutions with protein or starch molecules that remain distributed in the ECF and do not form a true solution? |
Isotonic, Hypotonic, Hypertonic, Crystalloid, or Colloid?
Colloids |
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Isotonic, Hypotonic, Hypertonic, Crystalloid, or Colloid?
Increase osmotic pressure within the plasma space and cause fluid to move into the intravascular space? |
Isotonic, Hypotonic, Hypertonic, Crystalloid, or Colloid?
Colloids |
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Isotonic, Hypotonic, Hypertonic, Crystalloid, or Colloid?
In patients with normal capillaries, will remain in the vascular space for several days? |
Isotonic, Hypotonic, Hypertonic, Crystalloid, or Colloid?
Colloids |
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Isotonic, Hypotonic, Hypertonic, Crystalloid, or Colloid?
Sodium chloride is the most commonly used? |
Isotonic, Hypotonic, Hypertonic, Crystalloid, or Colloid?
Crystalloid |
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Isotonic, Hypotonic, Hypertonic, Crystalloid, or Colloid?
Think Clear? |
Isotonic, Hypotonic, Hypertonic, Crystalloid, or Colloid?
Crystalloid |
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Isotonic, Hypotonic, Hypertonic, Crystalloid, or Colloid?
A substance that in solution can pass through a semipermeable membrane and be crystallized? |
Isotonic, Hypotonic, Hypertonic, Crystalloid, or Colloid?
Crystalloid |
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Problems with peripheral IV's
Fluid is leaking out of the vein? |
Problems with peripheral IV's
Infiltration |
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Problems with peripheral IV's
May decrease the incidence with proper stabilization of IV sites? |
Problems with peripheral IV's
Infiltration |
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Problems with peripheral IV's
Swelling, tightness, leaking at the site, coolness at the site and pain? |
Problems with peripheral IV's
Infiltration |
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Problems with peripheral IV's
Compare side to side? |
Problems with peripheral IV's
Infiltration |
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Problems with peripheral IV's
Rule out other causes of edema? |
Problems with peripheral IV's
Infiltration |
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Problems with peripheral IV's
Flush line and check for blood flow but can be falsely negative or positive? |
Problems with peripheral IV's
Infiltration |
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Problems with peripheral IV's
Be especially careful if infusing vesicant medications, those that can cause tissue ulceration or necrosis or compartment syndrome (med surge examples: doxycycline, nafcillin, piperacillin, zosyn, vancomycin, kcl? |
Problems with peripheral IV's
Infiltration |
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Problems with peripheral IV's
Elevate?, remove catheter, use heat to decrease contact of medication with subcutaneous tissue, watch site, check with institution on use of antidotes? |
Problems with peripheral IV's
Treatment of Infiltration |
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Problems with peripheral IV's
Result of irritation of the vein? |
Problems with peripheral IV's
Phlebitis |
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Problems with peripheral IV's
Complicated by small veins, unstable IV's and irritatin solutions and medications? |
Problems with peripheral IV's
Phlebitis |
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Problems with peripheral IV's
Redness, warmth, and pain may be prevented by diluting or running infusions slower, changing IV sites every 3-4 days? |
Problems with peripheral IV's
Phlebitis |
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Problems with peripheral IV's
Using CVAD for long term use of known irritatin solutions? |
Problems with peripheral IV's
Phlebitis |
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Problems with peripheral IV's
Treatment, remove IV and apply heat, watch for signs of infection, especially in immunocompromised patients? |
Problems with peripheral IV's
Phlebitis |
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Useful for isotonic fluids and medications. Not for TPN and is not a cental line. Care is similar to PICC lines?
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Problems with peripheral IV's
Midline catheters/Midclavicular |
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No matter how they are placed the key is where the tip of the catheter is, it should be in the superior vena cava?
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Central Venous Catheters
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Can give hypertonic solutions because the volume of blood flow will rapidly dilute the solution?
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Central Venous Catheters
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Can have one to four lumens?
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Central Venous Catheters
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Will need to do a chest x-ray after insertion to confirm placement and be sure the lung has not been puncture, x-ray should tell you where the catheter tip is, not that it is just OK to use?
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Central Venous Catheters
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Assess patients carefully for any pain or SOB?
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Central Venous Catheters
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Need to be capped and possibly clamped if open to the air, patient could suffer a fatal air embolus?
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Central Venous Catheters
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Catheter tip should not be in the right atrium can cause cardiac problems?
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Central Venous Catheters
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Inserted in radiology through the antecubital area and advanced into the SVC?
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PICC - Peripherally Inserted Central Catheters
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Position must be confirmed by x-ray, should measure the external part and document length so catheter movement can be determined?
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PICC - Peripherally Inserted Central Catheters
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Can be used for hypertonic solutions such as TPN or vancomycin?
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PICC - Peripherally Inserted Central Catheters
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Made of a soft pliable material?
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PICC - Peripherally Inserted Central Catheters
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Dressing change after 24 hours then weekly, remember dressing helps secure it in place so consult policies for specifics?
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PICC - Peripherally Inserted Central Catheters
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If drawing blood use syringes not vacuum tubes, MUST USE 10-12 CC SYRINGES AT ALL TIMES?
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PICC - Peripherally Inserted Central Catheters
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Can remain in place for up to a year, can be repaired, change end caps weekly, and always check for blood return?
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PICC - Peripherally Inserted Central Catheters
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Always obtain order prior to using after insertion?
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PICC - Peripherally Inserted Central Catheters
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CVAD that stay awhile?
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Tunneled catheters-Hickman-Groshong-Broviac-Holm-Leonard
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Inserted in surgery, tunneled under the skin usually in the chest?
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Tunneled catheters-Hickman-Groshong-Broviac-Holm-Leonard
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Made of durable medical grade silicone, has a cuff in the subcutaneous tissue that helps secure it and decreases the risk of infection?
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Tunneled catheters-Hickman-Groshong-Broviac-Holm-Leonard
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Catheter should exit the tunnel at nipple level?
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Tunneled catheters-Hickman-Groshong-Broviac-Holm-Leonard
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Has a one way valve that restrict backflow of blood so this eliminates the need for heparin flushes?
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Groshong
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Catheters need to be flushed after use and at least weekly?
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Tunneled catheters-Hickman-Groshong-Broviac-Holm-Leonard
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Used a lot for chemotherapy?
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Tunneled catheters-Hickman-Groshong-Broviac-Holm-Leonard
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Dressing changes the first 10 days per hospital routine after scar tissue grows onto cuff anchoring it and preventing microorganisms from migrating up the tunnel, no dressing is needed unless patient is immunocompromised?
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Tunneled catheters-Hickman-Groshong-Broviac-Holm-Leonard
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Can stay in place indefinitely, will probably need surgical removal?
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Tunneled catheters-Hickman-Groshong-Broviac-Holm-Leonard
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Use SASH method, flush daily with heparin, unless a groshong, then once a week with saline, change end cap weekly?
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Tunneled catheters-Hickman-Broviac-Holm-Leonard
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May use vacuum to draw blood?
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Tunneled catheters-Hickman-Groshong-Broviac-Holm-Leonard
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Long term CVAD, under the skin consists of a reservoir, silicone catheter, and a central septum?
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Implanted ports
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Must be surgically inserted, some must be accessed by special needles inserted through the skin?
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Implanted ports
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Flush monthly with heparin when not in use, may draw blood, special training to access and care for?
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Implanted ports
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Education of patient before and after catheter insertion.
Confirmation of catheter tip. Assessment of patient and equipment, insertion site, dressing, extremity, rate of infusion, type of fluid, tubing date. Dressing changes. ? |
Nursing Responsibilities for pts with catheters
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Changing tubing and needle connectors per routine.
Controlling infusion pressure. Flushing the catheter. Obtaining blood samples. Removing the catheter. ? |
Nursing Responsibilities for pts with catheters
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Can provide all the nutritional needs of patients.
Given via a central venous catheter, which has the tip in a large vein, preferably the vena cava, where the blood flow is rapid and the hypertonic solution can be rapidly diluted without causing irritation to the vessel? |
Total Parenteral Nutrition
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Standard solutions or can be mixed to patient needs, most contain 25% glucose, 4.25% amino acids, electrolytes and vitamins as needed and many are mixed with lipid to form a three in one solution, can add regular insulin, pepcid and heparin if needed?
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Total Parenteral Nutrition
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Preparation and delivery of nutients intravenously and monitoring of patient responsiveness?
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Definition of Total Parenteral Nutrition (TPN)
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Via an IV pump at all times and is usually titrated up to the desired rate and then that rate is maintained?
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TPN Administration
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Use a filter with the tubing and change tubing every 24 hours, some hospitals have a 24 hour bag to cut down on tubing manipulations?
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TPN Administration
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Should not piggyback or give anything into the line, use another port or start a new IV?
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TPN Administration
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If it is unavailable, hang D10W until bag arrives, some home patients may only recieve it for part of the day?
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TPN
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These are isotonic so can be given peripherally or mixed in TPN or given separately via the central line?
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Lipids
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Available in 10% 1 calorie per cc and 20% 2 calories per cc which can enable someone to get more calories in less fluid volume which can be helpful for patients with fluid restrictions?
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Lipids
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Some find less complications with three in one solutions?
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Lipids
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Complications of TPN
Monitor blood sugars q 6 hours and give insulin if needed? |
Complications of TPN
Hyperglycemia |
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Complications of TPN
Monitor temp and WBC count, aseptic techniques? |
Complications of TPN
Infection |
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Complications of TPN
Careful assessment is needed because TPN can cause FVD or FVE, also known as a? |
Complications of TPN
Fluid Imbalance |
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Complications of TPN
Monitor fluids for? |
Complications of TPN
Electorlyte imbalance |
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Complications of TPN
Wean off and assess? |
Complications of TPN
Hypoglycemia |
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Processed foods contain a significant amount of this?
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Salt
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An imbalance in this is seen with a Ca imbalance?
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Phosphorus
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Hypermagnesium can cause this?
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Vasodilation
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This medication decreases PO4 by binding to it?
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Phoslo
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Thirst is a S&S of this?
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Hypernatremia
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Mild hyponatremia can be treated by a fluid?
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Restriction
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Good source of calcium?
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Dairy
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Do not give digoxin with this electrolyte problem?
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Hypokalemia
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Good source of magnesium?
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Chocolate
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This is never give IV push?
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KCl
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Facial twitching sign?
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Chvosteks
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Pulls calcium from the bone to increase serum Ca?
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Pth
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This sign is a spasmotic plantar flexion of the hand?
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Trousseau
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Too much of this hormone causes dilutional hyponatremia?
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ADH
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This acid base disorder is seen in hyperkalemia?
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Acidosis
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Thiazide diuretics can cause this lyte abnormality?
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Hypercalcemia
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Primary cause of hypomanesium in the U.S.?
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Alcoholism
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A high concentration of this causes increased neurological symptoms?
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Sodium
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This is given for hyperkalemia?
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Kayexalate
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IV solutions used to treat severe hyponatremia?
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Hypertonic
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