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25 Cards in this Set
- Front
- Back
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Name 5 common examples of people at risk for fluid volume deficit
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1. vomiting/diarrhea
2. excessive exercise 3. diuretics 4. burn patients 5. polyuria / diabetics |
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Symptoms of fluid volume deficit
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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
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Nursing interventions for fluid volume deficit
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*oral fluids
*IV fluids--isotonic NS *monitor urinary output(should be > 30 mL/h), v/s, daily weight increasing |
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Symptoms of fluid volume excess
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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
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Who is at risk for fluid volume excess
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heart or kidney failure, liver failure, too much sodium
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Nursing interventions for fluid volume excess
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*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 |
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What are normal serum sodium levels?
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135-145 mEq/L
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What events could cause hyponatremia (low sodium)
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*diuretics
*chemotherapy *lithium (bipolar treatment) *blood loss, vomiting, diarrhea *fistulas or a draining wound *anorexia |
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What are the signs and symptoms of hyponatremia?
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*sodium levels below 135
*same symptoms of fluid volume deficit *muscle cramping in lower extremities *risk of shock |
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Nursing interventions for hyponatremia
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*broth
*NaCl, lactated ringers IV *monitor vitals *monitor sodium levels and specific gravity |
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What could cause Hypernatremia?
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*excessive salt intake
*low fluid *too much IV *not enough fluid with tubefeed *renal failure |
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Signs and symptoms of hypernatremia
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*sodium levels over 145
*signs/symptoms like fluid volume excess *sodium effects brain: convulsions, coma, agitation |
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Nursing interventions for hypernatremia
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*prevention education
*increase fluids slowly (esp w tube feed) *monitor serum sodium |
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What is the normal serum calcium level?
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9 - 11 mEq/L
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What conditions could contribute to hypocalcemia?
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*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 |
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What are the signs / symptoms hypocalcemia
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*tetany--irritability of muscles (hand & feet spasms, Trousseaus sign, Chvosteks sign)
*cardiac dysrhythmia |
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Nursing interventions for hypocalcemia
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*nutrients high in calcium
*vitD supplements *IV Calcium Gluconate or Calcium Chloride *seizure precautions |
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Serum calcium is regulated where?
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parathyroid glands
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Calcium is has a direct inverse relationship with...
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phospherous
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What are three common occurances that can contribute to hypercalcemia
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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) |
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What are the signs/symptoms of hypercalcemia?
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*muscle weakness:constipation, difficulty breathing, heart at risk for arrest
*lethargy |
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Nursing interventions for hypercalcemia
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*give fluids
*calcitonin:tranports calcium to bone *ambulate if possible *diuretics |
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What is creatinine? What are the normal values for creatinine?
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* The end product of muscle production (increases when renal function decreases)
* Measure of renal function * Normal values 0.7 - 1.5 mg/dL |
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What is hematocrit? What are the normal values for hematocrit?
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* % 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 |
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What is polycythemia?
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The abnormal increase of RBCs in blood due to excess production by bone marrow
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