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40 Cards in this Set
- Front
- Back
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IV fluids give slowly to prevent |
overload, watch with older and younger and heart and kidney problems can cause htn/hypernatermia (isotonic)
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isotonic solutions(goes into vascular space and stays there) uses? |
NS,LR,D5W D51/4 NS lost fluids through n/v burns sweating trauma getting blood |
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hypotonic solutions uses? |
D2.5W,1/2NS,0.33%NS they rehydrate but dont cause HTN patients with HTN renal and heart problems burns hemorrhage also dilution with hypernatermia cell dehydration |
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in hypotonic solution(fluid into vascular space shifting out into cells to replace cellular fluid) watch for |
cellular edema d/t fluid moving out of the cell lead to fluid vol deficit decreased B/P |
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hypertonic solution(packed with particles) draws fluid in vascular space from cells uses? |
D10W,3%NS,5%NS,D5LR,D5 1/2NS,D5NS, TPN,Albumin third spacing edema burns ascites, return fluid vol to vascular space |
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watch for fluid vol excess in which solution |
hypertonic, keep in ccu monitor VSS especially 3%NS or 5%NS |
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Stay where I put it |
Isotonic |
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Go Out of the vessel |
hypOtonic |
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Enter the vessel |
hypErtonic |
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Magnesium and Calcium |
act like sedative mag-1.3-2.1 ca-9.0-10.5 |
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hypermag causes |
renal failure antacids think:muscles first |
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hypermag s/s |
DTR down vasodilate weak flaccid muscles arrhythmias down LOC down pulse down RR flushing warm |
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hypermag tx |
ventilator if RR less than 12 dialysis Antidote: calcium gluconate reverse RR down make up very slow push 1.5-2ml/min, potential arrhythmias |
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hyperCa causes |
too much PTH hyperparathyroidism-pulls ca from the bone thiazides (diuretic retain Ca) immobilization must bear wt to keep Ca in bones will go into blood when on bedrest |
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hyperCa tx |
MOVE! fluids stop kidney stones enema with phos steroids add phos foods to diet must have vit D Calcitonin (Treat Osteoporosis) |
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Ca and phos : |
if one up the other down |
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hypomag causes |
not enough sedation; diarrhea alcoholism not eat drink too much |
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hypomag and hypoCa s/s think muscles first!!! |
rigid tight muscles poss seizure stridor laryngospasm chvosteck's (cheek) troussea's (B/P cuff) arrhythmias increased DTR mind chg Biggest is swallowing |
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hypomag tx |
give mag, chk kidney fxn b/f and during, stop iv if drop in output seizure precautions eat high mag foods |
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high mag foods |
spinach mustard greens summer squash broccoli halibut turnip greens pumpkin seeds peppermint cucumber green beans celery kale sunflower seeds sesame seeds flax seeds |
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if client reports flushing and sweating when iv of mag started? |
STOP INFUSION |
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hypoCa causes |
think not enough sedation hypoparathyroid not enough PTH radical neck thyroidectomy |
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hypoCa tx |
give Vit D phos binding drugs calcium acetate phos decrease makes Ca increase |
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hypernatremia = |
dehydration sodium level 135-145 totally dependent how much water in the body think neuro chgs |
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hypernatremia not enough water too much Na causes |
hyperventilation heat stroke DI vomit/diarrhea |
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hypernatremia s/s |
dry mouth,thirsty-already dehydrated by the time thirst swollen tongue |
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hyperNa tx |
restrict Na dilute client daily wts Na problem is fluid problem I+O labs |
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hypoNa , too much water not enough Na causes |
drinking water for fluid replacement vomiting and sweating replaces water and dilutes blood, pysch polydipsia, D5W iv sugar and water becomes diluted SIADH retaining water |
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hypoNa s/s |
headache seizure coma |
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hypoNa tx |
give Na restrict water give hypertonic saline packed with particles 3% NS or 5% NS acts as sponge in vascular space poss FVE |
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K level 3.5-5.0 excreted by |
kidneys |
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hyperK causes |
kidney trouble spironolactone retain K |
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hyperK s/s |
first muscle twitching and then weakness then flaccid paralysis bradycardia tall peaked t-waves prolonged pr intervals flat absent p waves widened qrs conduction block v-fib |
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hyperK tx |
dialysis kidneys not working calcium gluconate for arrhythmias glucose and insulin kayexalate |
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Na and _______ have inverse relationship |
K |
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hypoK causes |
vomiting ng sxn diuretics not eating |
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hypoK s/s |
muscle cramps weakness u waves pvc v-tach |
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hypoK tx |
give K spironolactone retain K eat K foods take PO K with food causes GI upset |
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always put K on a __________ to administer |
pump NEVER iv push K dilute burns during infusion watch periipheral veins |
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K foods |
spinach fennel kale mustard greens brussel sprouts broccoli eggplant cantalope tomatoes parsley cucumber bell pepper apicots ginger root strawberries avocado banana tuna halibut cauliflower kiwi oranges lima beans poatoes cabbage |
