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41 Cards in this Set

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What are the major Functions of Calcium?
Transmission of nerve impulses
Cardiac contractions
Blood clotting
Formation of bones and teeth
Muscle contraction
Most common hypotonic crystalloids?
½ NS 154
D5W 253
Most common isotonic crystalloids?
LR 273 mOsm/L (normal in humans is 285-295)
NS 308
Most common hypertonic crystalloids?
D5 ½ NS 432
D5LR 525
D5NS 586
NS 3% 1026 (hypovolemic resuscitation/hyponatremia)
Calcium production requires?
Vitamin D
Parathyroid Hormone (PTH)
Calcitonin (from thyroid gland)
Estimated blood volume for adult male?
Men 75 ml/kg
Estimated blood volume for adult male/female?
Adults: Men 75 ml/kg
Women 67 ml/kg
Estimated blood volume for infants?
Infants: 80 ml/kg
ABL (Allowable blood loss)?
80 kg male = 80kg x 75ml/kg = 6,000ml
EBV x (starting hct – target hct)/starting hct =
(6,000 x (39 – 25)/39=2,153 ml
ABL (allowable blood loss) = 2,153ml
Maintenance fluids for
Peds?
Adults?
Pediatrics
1st 10 kg: 4ml/kg/hr……….8 kg = 32 ml/hr
10-20 kg: add 2ml/kg/hr……13 kg = 46 ml/hr
Each kg >20: add 1ml/kg/hr…..27 kg = 67 ml/hr
Adults
1.5 x weight in kg….80 kg = 120 ml/hr
Above formula = 40 + 20 + 60 = 120 ml/hr
Estimated blood volume for neonates? Premie and Full term
Neonates
Premature: 95 ml/kg
Full-term: 85 ml/kg
Total Body Fluid (% of body weight)
Newborn: 70-80%
1 year: 64%
12-39: Men 60% Women 52%
40-60: Men 55% Women 47%
61+: Men 52% Women 46%
Total body Water:
ICF: 2/3 of total body volume, K+, Phosphate, Mag.
ECF: 1/3 of total body volume, Na++, Cl-
IVF: intravascular fluid, 42%
ISF: interstitial fluid, plasma,interstitial,lymph
Cations
Na+, K+, Ca++, Mg+
Anions
HCO3, Cl-, PO2-
1 L water =
2.2 lb or 1 kg
Main ICF electrolyte
K+
Main ECF electrolyte
Na++
Diffusion
High concentration to low
Osmosis
A solvent (water) passes through a semipermeable membrane that separates two different concentrations. Influenced by osmotic pressure
Osmotic pressure
The force of a solvent as it passes through a semipermeable membrane
Osmolarity
The concentration of osmotically active particles in a solution.
Regulation of Water Balance
Anti-Diuretic Hormone (ADH) from Hypothalamus and Posterior Pituitary
Adrenal Gland (glucocorticoids and mineralcorticoids)
Kidneys (urine volume)
Cardiac (vasoconstricition excretion of urine)
Gastro Intestinal Intake 2-3 L/24 hours
Insensible loss: 900 ml via lungs and skin
Sodium (Na+) NL
135-145 mEq/L
Major functions of Na+
Water balance
Transmission of nerve impulses (deficits = neurological change)
Na+ absorbed from food and eliminated via urine, sweat and feces
Na+ >145 mEq/L Causes
Water loss or sodium gains
Elderly patients
Na+ intake more than water intake
Diabetes Insipidus
Na+ >145 mEq/L Manifestations
Thirst, dry tongue
Restlessness
Weight changes
Na+ >145 mEq/L Treatment
Dilute Na+ and promote excretion, D5W & diuretics
Na+ < 135 mEq/L Causes
Water gain or sodium loss
GI loss (diarrhea, vomiting, NG suctioning)
Urine/Renal disease
Psychiatric (excessive H20 intake)
CHF
Na+ < 135 mEq/L Manifestations
Water excess rapid weight gain
Na+ loss  neuro symptoms (irritability)
Na+ < 135 mEq/L Treatment
water excess restrict fluids, hypertonic saline (3% NS)
sodium lossoral or iv sodium
Manifestations of vital signs for fluid excess
BP: elevated
Pulse: bounding and rapid
Respirations: increased
CVP: elevated
Lung sounds: moist, crackles, shortness of breath
Manifestations of vital signs for fluid deficit
BP: normal (compensatory mechanisms)
Orthostatic hypotension
Pulse: thready with severe hypotension
CVP: reduced
Respirations: increasesd (hypoxia)
Severe deficit: shock
Potassium (K+) NL
3.5-5.5 mEq/L
Potassium (K+)
Maintained by sodium-potassium pump in cells
K+ changes  altered excitability of muscles, neurons, pancreatic cells (release insulin)
Eliminated by kidneys (renal problems)
Hyperkalemia
Cause K+ to move from ECF  ICF: Insulin
Cause K+ to move from ICF  ECF: acidosis, trauma to cells and exercise
K+ >5.5 mEq/L Causes
Excess or rapid delivery of K+
Excessive use of salt substitutes with K+
Renal failure
Uncontrolled diabetes
Massive cell destruction
Transfusion of old blood
K+ >5.5 mEq/L treatment
Eliminate K+ (oral & parenteral)
Diuretics - lasix
Dialysis
Kayexalate
Increase fluids
IV Insulin
Cardiac monitor
K+ <3.5 mEq/L Causes
Shift from ECFICF
Abnormal loss (NG, diarrhea, vomiting)
Elevated aldosterone (diuresis)
Metabolic alkalosis
K+ <3.5 mEq/L Manifestations
Fatigue, muscle weakness (leg), weak, irregular pulse, arrhythmias
K+ <3.5 mEq/L treatment
Give Potassium Chloride (KCl)
30cc/hr urine output (minimum)
NEVER PUSH---dilute and do not give more than 20 mEq/hour IV
Prevent persons on diuretics from eathing foods high in K+
Major Functions fo Calcium
Transmission of nerve impulses
Cardiac contractions
Blood clotting
Formation of bones and teeth
Muscle contraction
Calcium Requires
Vitamin D
Parathyroid Hormone (PTH)
Calcitonin (from thyroid gland)