Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
27 Cards in this Set
- Front
- Back
|
S/S of increased fluid overload
|
bounding pulse
increasing neck vein distention presence of crackles increasing peripheral edema reduced urine output PULMONARY EDEMA CAN OCCUR VERY QUICKLY AND CAN LEAD TO DEATH |
|
|
drug therapy for removing excess fluid
|
diuretics (loop)
|
|
|
each lb of weight gain equals?
|
500 mL of reatined water
|
|
|
Normal electrolyte values
|
Na+ 136-145
K+ 3.5-5.0 Ca+ 2.25-2.75 Cl- 98-106 Mg+ 1.3-2.1 P 3.0-4.5 |
|
|
HYPONATREMIA
below 136 |
slows excitable membranes
cerebral changes (confusion) deep tendon reflexes diminish leg and arm muscle weakness decreased intestinal motility nausea diarrhea abdominal cramping hypovolemia orthostatic hypotension |
|
|
Nursing interventions for hyponatremia
|
IV saline infusions
hypertonic 2-3% saline osmotic diuretics increased sodium in diet |
|
|
HYPERNATREMIA
above 145 |
excitable tissues (irritability)
agitated--confused--seizures muscle twitching reduced DTR Decreased cardiac contractility increased pulse rate |
|
|
Nursing interventions for hypernatremia
|
HYPOTONIC IV infusions
0.225% ir 0.45% sodium chloride lasix adequate water intake |
|
|
HYPOKALEMIA
below 3.5 |
symptoms appear when loss is extreme
usually caused by use of diuretics or OTC drugs |
|
|
HYPOKALEMIA
below 3.5 |
shallow respirations (assess q2h)
muscle weakness (hyporeflexia) thready weak pulse irregular heartbeat (dysrhythmia) altered mental status lethargic--confused decreased intestinal peristalsis nausea vomiting constipation |
|
|
Nursing interventions for hypokalemia
|
IV supplemental K+
HIGH ALERT WARNING carefully calculate required dilution NEVER give IM or SC STOP IV immediately if infiltration occurs and notify provider diuretics |
|
|
HYPERKALEMIA
above 5.0 |
Cardiovascular most severe and most common cause of death
ectopic beats paresthesia (numbness) in hands--feet--around mouth increased intestinal motility |
|
|
Nursing interventions of hyperkalemia
|
PRIORITY--cardiac complications--fall prevention
K+ excreting diuretics kayexalate IV fluid with glucose and insulin (100mL w/10-20%glucose and 10-20 units regular insulin) Hypertonic in central line cardiac monitoring |
|
|
CALCIUM
PTH |
increases serum calcium by releasing from bone storage
|
|
|
HYPOCALCEMIA
below 9.0 |
Muscle spasms (charley horses)
paresthesias in hands and feet trousseau and Chvostek weak thready pulse increased peristaltic activity cramping--diarrhea osteoporosis |
|
|
Nursing interventions for hypocalcemia
|
calcium replacement w/ vit D
high calcium diet reduce stimulation (limit visiitors) seizure precautions |
|
|
HYPERCALCEMIA
above 10.5 |
increased HR BP
severe muscle weakness decreased DTR decreased peristalsis--constipation |
|
|
Nursing interventions for hypercalcemia
|
IV solutions containing calcium stopped (LR)
fluid volume replacement dialysis for severe drugs: phosphorus-calcitonin-bi-phosphonates--NSAIDS |
|
|
HYPOPHOSPHATEMIA
below 3.0 |
decreased stroke volume and CO--slow peripheral pulses
rhabdomyolysis irritability |
|
|
Nursing interventions for hypophosphatemia
|
drugs to promote phosphorus loss (antacids--osmotic diuretics--calcium supplements)
|
|
|
PHOSPHORUS AND CALCIUM
|
balanced reciprocal relationship.
decreased phosphorus increases calcium levels |
|
|
HYPERPHOSPHATEMIA
above 4.5 |
few direct problems with body function
usually exists with hypocalcemia |
|
|
HYPOMAGNESEMIA
below 1.3 |
increased nerve impulse transmission
hyperactive DTR positive trousseau and Chvostek depression--psychosis--confusion reduced intestinal motility |
|
|
Nursing interventions for hypomangesemia
|
high ceiling loop diuretics are D/C'd.
IV mag sulfate if severe assess DTR qh if receive mag sulfate |
|
|
HYPERMAGNESEMIA
above 2.1 |
bradycardia--peripheral visodilation--hypotension
drowsy--lethargic reduced or absent DTR weak respiratory muscles |
|
|
Nursing interventions for hypermagnesemia
|
D/C all oral and parenteral mag
give IV mag free fluid if no renal failure. loop diuretics |
|
|
CHLORIDE
98--106 |
imbalanced usually occur as a result of other electrolyte imbalances except for vomiting or prolonged gastric suctioning.
imbalanced corrected when other electrolytes are corrected |
