Med Surg 1

Front 1

What is isotonic fluid used for?

Back 1

Treats dehydration, and hypernatremia. (Caution: can cause fluid overload)

Front 2

What are hypotonic fluids used for?

Back 2

Ex: D5w, 0.45 saline. Used to rehydrate cells in burns and diabetic keto acidosis.

(Caution: can cause hypotension)

Front 3

What are hypertonic fluids used for?

Back 3

Ex: colloids, D50, 3 saline

Used to replace electrolytes, treat hypovolemia, hyperkalemia, and edema. (Caution: give slowly! Risk pulmonary edema)

Front 4

Loop diuretics indications and precautions.

Back 4

Works in the loop of henle to excrete more potassium, salt, water, mag, and calcium. Indicated for CHF, renal failure, pulmonary edema, hypertension. Precautions: hyperglycemia, hypokalemia, ototoxicity (give slowly)

Front 5

Indications and precautions for spironolactones

Back 5

Same as lasix except potassium sparing so can cause hyperkalemia.

Front 6

Difference between oncotic/ osmotic vs hydrostatic pressure

Back 6

Oncotic (protein) osmotic (ions) pull Fluid into blood stream while hydrostatic pushes.

Front 7

What system counteracts the RAAS

Back 7

Anp and bnp work to lower blood pressure.

Front 8

What are the signs and symptoms of hypovolemia?

Back 8

Check: Skin tugor, swollen tongue, low weight. High hematocrit = dehydration >54

Symptoms: tachycardia, low bp, cold, diuresis, confusion, clotting, oliguria, tachypnea. JVD, peripheral edema

Front 9

Signs and symptoms of hypervolemia?

Back 9

Pulmonary Edema, low hematocrit, fatigue, cramps, headache, high bp, flushing, dyspnea

Front 10

How do you manage fluid overload?

Back 10

Auscultation of lungs often, weigh daily, dialysis if no urine, digoxin, diuretic if low urine, restrict sodium.

Front 11

What are the s/s of hyponatremia?

Back 11

Serum level under 135. Changes in LOC, weakness, brain edema, seizures, low DTR, anorexia, diarrhea

Front 12

What are the s/s of hyponatremia?

Back 12

Serum level under 135. Changes in LOC, weakness, brain edema, seizures, low DTR, anorexia, diarrhea

Front 13

S/s of hypernatremia?

Back 13

Caused by fevers, high ADH, renal disease, dehydration.

Dehydration, weakness, seizures, confusion, low urine output, edema.

Front 14

Potassium rich foods?

Back 14

Potatoes, spinach, yogurt, fruit, milk, lentil beans, salmon, soy

Front 15

S/s of hypokalemia?

Back 15

Causes? Metabolic alkalosis. Diuretic, water loss, steroids, insulin.

S/s: <3.5, fatigue, low bp, confusion, weakness, arrhythmia, ekg changes (increase T wave, prolonged pr)

Front 16

Potassium supplements and IV use

Back 16

Potassium is always given in an infusion bag. Can cause phlebitis, burning, n/v, GI issues and ecg changes. Do not give with ace inhibitors, or potassium sparing drugs. No kidney problems.

Front 17

Causes, and s/s of hyperkalemia?

Back 17

Causes: metabolic acidosis, spironolactones

S/S: same as low potassium

Front 18

When do you give Kayexilate?

Back 18

For high potassium, it’s a potassium removing resin. It acts in the gut to push K+ into feces, while retaining sodium. Given orally.

Front 19

Calcium rich foods

Back 19

Dairy, almond, kale, broccoli, eggs

Front 20

Relationship between calcium, phosphorus, and vitamin D

Back 20

Vitamin D is needed to absorb calcium. Calcium and phosphorus are inverses.

Front 21

Causes and s/s of hypocalcemia?

Back 21

Causes: vit D deficiency, hypoparathyroidism (calcitonin pushes calcium into bones).

S/S: numbness, tingling, seizure, arrhythmia, trosseaus and chvotskeys, laryngeal strider

Front 22

Hypercalcemia causes and s/s.

Back 22

Causes: immobility (break down of bones), parathyroid rumors, multiple fractures

S/S: bone pain, Polyuria, thirst, loss of memory, constipation, n/v, kidney stones

Front 23

Treatment of hypercalcemia

Back 23

Restrict calcium, loop diuretic, drink, calcitonin, phosphates

Front 24

How does phosphorus effect the body?

Back 24

Normal serum level= 2.5-4.5

S/S: lower peripheral pulses

Front 25

What are good sources of magnesium, and how does it affect the body?

Back 25

Seeds, cashews, almond, spinach

Raises DTR, and effects Bowles

Front 26

Considerations when taking iron supplements...

Back 26

Can stain skin and teeth. Dairy lowers absorption. Can cause GI distress.

Front 27

Normal chloride levels in the body?

Back 27

90-110. It’s a weak base.

Front 28

What causes metabolic acidosis?

Back 28

diarrhea, kidney disease, and liver failure, sepsis, hyperkalemia

Front 29

What causes respiratory acidosis?

Back 29

Drug overdose, hypo ventilations, hypoxia, choking, pneumonia. Too much CO2

Front 30

What are the symptoms of acidosis?

Back 30

Tachycardia, kaussmauls/ tachypnea, low bp, hyperkalemia, weakness, seizures, coma

Front 31

How does the body compensate for respiratory acidosis?

Back 31

Kidneys excrete more hydrogen ions and reabsorption more hco3 to raise pH.

Front 32

How does the body compensate for respiratory acidosis?

Back 32

Kidneys excrete/decrease/eliminate [h+] & increase/retain Na+ & HCO3

Front 33

How does the body compensate for metabolic acidosis?

Back 33

Kaussmaul respiration’s to blow off more CO2 to raise pH. Also, chloride shifts with bicarbonate in the cell.

Front 34

What can cause alkalosis?

Back 34

Hyperventilation, antacids, gastric suctioning, loop diuretics (low pot), vomiting

Front 35

What are the S/S of alkalosis?

Back 35

Weakness, cramps, tetany, bradypnea, seizures, high hr, low bp

Front 36

What can cause alkalosis?

Back 36

Hyperventilation, antacids, gastric suctioning, loop diuretics (low pot), vomiting, addisons

Front 37

Addisons disease

Back 37

Adrenal Fx, too little cortisol, and low adh (low bp) cortisol, hypoglycemia, hyponatremia, dehydration, hyperkalemia/ acidosis, hypermagnesia

Front 38

How many mL in one tsp?

Back 38

5

Front 39

How to do a dosage calculation?

Back 39

What you want x volume/ what you have

Front 40

How to do a dosage calculation?

Back 40

What you want x volume/ what you have

Front 41

How to calculate in flow rates.

Back 41

Manual : V x drip factor (gtt/min)/t (min)

Pump: V/t (hr) = X/t

Front 42

How do the kidneys compensate for alkalosis?

Back 42

Decrease bicarbonate.

Front 43

In case of hyperkalemia what meds?

Back 43

Kayexilate and insulin and d5w

Front 44

Hyperkalemia can cause which acid base imbalance?

Back 44

Metabolic acidosis

Front 45

Too much oxygen leads to?

Back 45

Respiratory alkalosis

Front 46

Acid base keys

Back 46

Hydrogen=acid, bicarbonate =base

Bicarbonate = kidneys =metabolic

CO2= lungs = respiratory

Co2= acid, 02= base