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25 Cards in this Set

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Name 5 common examples of people at risk for fluid volume deficit
1. vomiting/diarrhea
2. excessive exercise
3. diuretics
4. burn patients
5. polyuria / diabetics
Symptoms of fluid volume deficit
perspiring heavily, breathing rapidly, thrist, weak, dizzy, dried mucous membranes, sunken eys, tachycardia, weak pulse, hypotension, decreased cardiac output, reduced & concentrated urinary output (specific gravity > 1.020, confusion, loss of weight 2 pounds or more, dry tongue
Nursing interventions for fluid volume deficit
*oral fluids
*IV fluids--isotonic NS
*monitor urinary output(should be > 30 mL/h), v/s, daily weight increasing
Symptoms of fluid volume excess
ortopnea (can't breathe lying down), elevated blood pressure, tachycardia w. bounding pulse, peripheral pitting edema, increased weight, acitis (fluid pooling in other places, like abdomen), hematocrit increases
Who is at risk for fluid volume excess
heart or kidney failure, liver failure, too much sodium
Nursing interventions for fluid volume excess
*restrict fluids, NaCl
* monitor v/s, weight, specific gravity
* ice chips, mouth care (chapstick), encourage moderate activity (to move fluid), monitor for signs of pulmonary edema, semi/high fowlers position, may need to insert cath for strict i&o
What are normal serum sodium levels?
135-145 mEq/L
What events could cause hyponatremia (low sodium)
*diuretics
*chemotherapy
*lithium (bipolar treatment)
*blood loss, vomiting, diarrhea
*fistulas or a draining wound
*anorexia
What are the signs and symptoms of hyponatremia?
*sodium levels below 135
*same symptoms of fluid volume deficit
*muscle cramping in lower extremities
*risk of shock
Nursing interventions for hyponatremia
*broth
*NaCl, lactated ringers IV
*monitor vitals
*monitor sodium levels and specific gravity
What could cause Hypernatremia?
*excessive salt intake
*low fluid
*too much IV
*not enough fluid with tubefeed
*renal failure
Signs and symptoms of hypernatremia
*sodium levels over 145
*signs/symptoms like fluid volume excess
*sodium effects brain: convulsions, coma, agitation
Nursing interventions for hypernatremia
*prevention education
*increase fluids slowly (esp w tube feed)
*monitor serum sodium
What is the normal serum calcium level?
9 - 11 mEq/L
What conditions could contribute to hypocalcemia?
*renal failure (kidneys that don't work retain phosphorus--phosphorus and calcium are always in balance--inc phosph = decr calcium)
*any surgery near parathyroid glands
What are the signs / symptoms hypocalcemia
*tetany--irritability of muscles (hand & feet spasms, Trousseaus sign, Chvosteks sign)
*cardiac dysrhythmia
Nursing interventions for hypocalcemia
*nutrients high in calcium
*vitD supplements
*IV Calcium Gluconate or Calcium Chloride
*seizure precautions
Serum calcium is regulated where?
parathyroid glands
Calcium is has a direct inverse relationship with...
phospherous
What are three common occurances that can contribute to hypercalcemia
1)IMMOBILITY: calcium in bone moves to bloodstream when you are not weightbearing
2)overconsumption of calcium
3)excessive loss of phospherous (overactive parathyroid gland)
What are the signs/symptoms of hypercalcemia?
*muscle weakness:constipation, difficulty breathing, heart at risk for arrest
*lethargy
Nursing interventions for hypercalcemia
*give fluids
*calcitonin:tranports calcium to bone
*ambulate if possible
*diuretics
What is creatinine? What are the normal values for creatinine?
* The end product of muscle production (increases when renal function decreases)
* Measure of renal function
* Normal values 0.7 - 1.5 mg/dL
What is hematocrit? What are the normal values for hematocrit?
* % of RBC in whole blood
* increases w/dehydration and polycythemia
* decreases w/ overhydration and anemia
* Normal values 44-52% for men, 39-47% for women
What is polycythemia?
The abnormal increase of RBCs in blood due to excess production by bone marrow