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372 Cards in this Set
- Front
- Back
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% of RBC's in blood
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Hematocrit
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urine concentration
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Specific Gravity
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4 things considered fluid intake when taking I/O
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anything liquid at room temp
IV's irrigations enemas |
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when measuring I/O, what do you measure as output? (5)
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urine
vomit diarrhea feces drainage from wounds / suction |
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things to consider when taking a pt's daily weight (3)
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same clothes
same scale before breakfast |
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sodium values
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135 - 145
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sodium moves between ISS & IVS by
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diffusion
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sodium moves in/out of cells by
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ATP (sodium-potassium pump)
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osmotic pressure controlled by
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sodium
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colloid osmotic pressure controlled by
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protein
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sodium is regulated by (organ)
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kidneys
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makes the kidneys conserve sodium
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aldosterone
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functions of sodium (3)
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maintains isotonicity & volume of body fluids
controls fluid distribution in body controls osmotic pressure in ECF |
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recommended daily intake of sodium
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2300 mg
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water follows
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sodium
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causes of hyponatremia (5)
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burns
excess salt lost via kidneys diarrhea diuretics fistula drainage |
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abnormal connection between body parts
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fistula
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hyponatremia interventions (3)
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fluid restriction (fluid would dilute sodium even more)
diuretics (to get sodium more concentrated) 3-5% NS IV if below 120 (only do until 120 is reached) |
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in hyponatremia, whats the water going to do?
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because theres not enuf sodium in the IVS to hold it, the water is going to leave the IVS and go into the cells - causing them to swell
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crystalloids
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electrolytes
also called salts |
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colloids (3)
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(non-electrolytes)
protein glucose uria (these all 'suck') |
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potassium levels
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3.5 - 5
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calcium levels
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8.5 - 10.5
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main cation of the ECF
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sodium
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main cation of the ICS
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potassium
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effect the concentration of an electrolyte (2)
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amt of the electrolyte
amt of fluids |
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electrolyte functions (4)
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regulate fluid distribution
transmit nerve impulses blood clotting generates ATP |
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risk for fluid imbalances (3) (not people)
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disease
injury meds that effect fluids |
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works inversly with sodium
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potassium
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regulates ICS water content
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potassium
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controls cellular osmotic pressure
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potassium
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major player in electrical impulse transmission
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potassium
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source of potassium (8)
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salt substitutes
bananas chocolate OJ mac nuts lobster avacodos almonds tuna |
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regulated as a byproduct of sodium
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potassium
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increased K+ will turn on which hormone and why?
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aldosterone
will conserve na and h2o and excrete K (because it works inverse of na) |
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electrolyte that effects the heart
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potassium
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spiromalactone
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potassium sparing diuretic
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s/s of CHF (4)
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sob
crackles edema jvd |
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causes of hypernatremia (5)
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water loss
poor fluid intake (sodium more concentrated) iatogenic (bad f&e mgmt) increase in sodium intake late term abortion |
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in hypernatremia, what will water do?
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leave the cells and go into the IVS to dilute the sodium
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hypernatremia interventions (2)
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give salt free liquids (to dilute na concentration)
D5W IV if over 160 (only until it comes down to 160) |
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hypokalemia
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potassium less than 3.5
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causes of hypokalemia (4)
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fluid loss (diarrhea, vomiting)
suctioning diuretics Diabetic ketoacidosis polyuria cushing syndrome |
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interventions for hypokalemia (2)
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give foods with potassium
IV w/ KCL in it (dependent) |
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hyperkalemia
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potassium over 5.0
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causes of hyperkalemia (4)
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cellular damage (dropped blood sample or blood bag and cells lysed)
massive tissue damage (mi or crush injury) metabolic acidosis (high acid lyses cells) COPD, CRF KCL IV too much / too fast Salt substitutes Iatrogenic (tx enduced) Antacids |
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interventions for hyperkalemia (5)
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dietary counseling and CBIGKD
diuretics kayaxelate (retension enema - lose K, keep Na) insulin and glucose (will carry K+ into cells) calcium glutinate (will carry K+ into cells) |
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with hypokalemia, what will the water do?
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move from cells into IVS
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most abundant cation in the body
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calcium
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protein bound
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calcium
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a decrease in protein causes a decrease in
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calcium
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calcium functions (4)
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transmission of nerve impulses
blood clotting muscle contraction strong bones and teeth |
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regulates calcium
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thyroid and parathyroid glands
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what hormone moves calcium from the bones and teeth
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parathyroid (PTH)
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what hormone sends calcium to the bones and teeth?
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calcitonin (secreted by thyroid gland)
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disease state indicated by calcium level over 11
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hyperparathyroidism
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hypocalcemia can cause (2)
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tetany
osteomalacia (soft bones) |
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interventions for hypocalcemia (2)
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give calcium carbinate (TUMS)
calcium glutinate IV |
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most common causes of hypercalcemia (2)
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hyperparathyroidism
cancer |
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what does the body do to try to correct hypocalcemia?
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the parathyroid gland excretes parathyroid hormone to take calcium from the bones and teeth
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what does the body do to try to correct hypercalcemia?
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the thyroid gland secretes calcitonin which sends calcium to the bones and teeth
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chronic hypercalcemia can lead to what?
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kidney stones
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interventions for hypercalcemia (4)
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hydrate pt so they pee out calcium
give diuretic give phosphate give calcitonin |
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what hormone sends calcium to the bones and teeth?
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calcitonin (secreted by thyroid gland)
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disease state indicated by calcium level over 11
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hyperparathyroidism
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hypocalcemia can cause (2)
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tetany (involuntary contraction of muscles)
osteomalacia (soft bones) |
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interventions for hypocalcemia (2)
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give calcium carbinate (TUMS)
calcium glutinate IV |
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causes of hypercalcemia (2)
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excess milk
excess antacids |
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most at risk for fluid imbalances (3)
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elderly - low water
obese - low water infants - high water |
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oygen moves into cells by
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diffusion
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hydrostatic pressure
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force of fluid pressing out against the vessel wall
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hormone to conserve fluid
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ADH
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secretes ADH
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pituitary gland
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regulates fluids and electrolytes
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kidneys
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fluid shifts from IVS to ISS and becomes unavailable for use by the body
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third spacing.....
we swell up but still could be dehydrated fluid is not where its supposed to be give protein to fix imbalance |
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earliest symptom of FVD
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thirst
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most at risk for FVD (2)
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infants and elderly
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Hematocrit (increases/decreases) with FVE?
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decreases
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Hematocrit (increases/decreases) with FVD?
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increases
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Specific gravity(increases/decreases) with FVE?
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decreases
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BUN (increases/decreases) with FVD?
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increases
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body temp (increases/decreases) with FVD?
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increases
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with FVD, skin turgor is
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sluggish
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with FVD, mucous membranes are
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dry
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JVD (increases/decreases) with FVD?
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decreases
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with FVD, the pulse feels
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rapid and weak
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urinary output (increases/decreases) with FVD?
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decreases
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weight gain with generalized edema
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anasarca
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with FVE, the pulse feels
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rapid and bounding
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anasarca is a symptom of
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FVE
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edema is a symptom of
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FVE
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rapid weight gain is a symptom of
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FVE
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crackles are a symptom of (2)
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FVE
CHF |
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low pH, high PCO2
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respitory acidosis
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high pH, low PCO2
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respitory alkalosis
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low pH, low HCO3
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metabolic acidosis
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high pH, high HCO3
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metabolic alkalosis
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s/s of CNS depression
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disorientation, confusion, lethargy, malaise
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s/s of CNS stimulation
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numbness, prickling, restless, tingling, tetany
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pH less than 7.35
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acidosis
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pH more than 7.45
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alkalosis
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homeostasis of H+
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acid base balance
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pH reflects
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concentration of H+ ions
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3 ways the body maintains acid base balance
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buffer system (fastest)
respitory system (fast) renal system (slow) |
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co2 concentration is (up/down) when respitory rate is slow?
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up
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co2 concentration is (up/down) when respitory rate is fast?
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down
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BMI formula
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BMI = (Weight in Pounds / (Height in inches) x (Height in inches) ) x 703
or kg / meters x meters |
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waist to hip ratio formula
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waist / hips
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excess weight below waist can cause (2)
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varicose veins
orthopedic problems |
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excess weight around the middle can cause (2)
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type 2 diabetes
heart disease hypertension |
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gluconeogenesis
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making glucose from protein or fat. normally it comes from carbs.
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only essential fatty acid
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linoleic acid
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fat soluable vitamins and where are they stored
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A,D,E,K, stored in liver and fatty tissue
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alcoholics are usually deficient in
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thiamin
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prealbumin (2)
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indiucates recent nutrition problem
short half life |
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protein calorie malnutrition
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serum albumin <2.9
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BUN / Creatinine measures
|
kidney function
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Transferrin
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binds and carries iron
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low serum albumin indicates
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long term malnutrition
has long half life |
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how to measure a feeding tube
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nose to ear to xiphoid process
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2 uses for salem sump tube
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feeding or suctioning
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risk w/ using salem sump tube
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can stick to stomach wall. needs to have the blue end with the air vents
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diet for pulmonary pt's is missing what and why
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carbs because a byproduct of carbs is CO2
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liver diet is missing what
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amino acids
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checking placement of feeding tube (3)
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see if they can talk
put end in h2o, should be no bubbles 30 ml air first then aspirate and check pH < 4 |
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< 100 ml of stomach fluid aspirated. what to do
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put back in
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> 100 ml of stomach fluid aspirated can indicate what
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delayed GI emptying. dont put it back, tell dr.
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how to / how often to flush feeding tube
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30 ml h20 q 4 hr
good mouth care |
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how long, how often for intermittent bolus feeding
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takes a few mins, do 4-6x/day
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how long, how often for intermittent gravity drip feeding
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takes 30 mins, do 4-6x/day
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what to do during continuous feeding?
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check for residual every 4 hrs and give pt 30 ml water. this runs from 16 to 24 hrs.
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what to do after administering tube feeding
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flush w/ 30 ml h2o
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TPN is given where?
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central line
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PPN is given where?
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peripheral vein
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TPN - which lumen for meals?
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middle
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what to do / how often with TPN
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check glucose levels every 6 hrs
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when to use PPN / TPN feedings
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when GI doesnt work at all
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how to stop TPN feeding
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gradually over 2 - 3 days because glucose will fall when stopped
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mineral oil laxitives should be avoided when
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around food time
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wernickes disease
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thiamin deficiency (usually w/ alcohol abuse)
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kwashiorhor
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protein calorie malnutrition
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lab tests for nutrition status (4)
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h&h
prealbumin albumin transferrin |
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what will h and h show in nutrition status (4)
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iron deficiency
anemia over or under hydration polycythemia (too many rbcs) |
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what will albumin tell in nutrition status
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how long persons been having problem
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what will be different in a renal diet?
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low protein
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increases BMR (5)
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growth
FEVER infection tension extreme environmental temps |
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decreases BMR (3)
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age
prolonged fasting sleep |
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main source of energy
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carbs
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uses of protein (3)
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tissue growth
fluid bal (albumin draws fluid) energy source |
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position of salem sump air vent
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above pt stomach
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transamination
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conversion to another amino acid
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deamination
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using protein for energy during starvation
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protein difficiency can cause (4)
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stunted growth
delayed wound healing edema (hydrostatic pressure is lower so fluid is pushed into tissues) blood osmolarity is hypotonic |
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negative nitrogen balance
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starving
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nuetral nitrogen balance
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anabolism and catabolism are equal
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hyperlipidemia
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high cholesterol
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elevate blood sugars
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steroids
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rickets
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abnormal bones
vit D deficient |
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pallegra
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vit b deficiency
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vit b12 deficiency can cause
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pernisious anemia (body cant make rbc's)
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Protein-energy malnutrition
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inadequate protein intake.
Kwashiorkor (protein malnutrition predominant) Marasmus (deficiency in both calorie and protein nutrition) |
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diet for trauma pt
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high in protein and cals
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start low and go slow
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TPN
|
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TPN solution sould not hang longer than
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24 hrs
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TPN is (hyper/hypo)tonic?
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hypertonic
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TPN solution appearance
|
clear or pale yellow and no oily layer
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Lipid emulsions assist with
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wound healing
|
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dont use Lipid emulsions if
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pancreatitis or coagulation problems
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hypercapnia
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increased co2 in arterial bllod
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hypoxemia
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decreased o2 in arterial blood
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decreased o2 in the body tissues from prolonged resp failure can result in (which acid/base cond)?
|
metabolic acidosis
|
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fever (increases/decreases) metabolic rate
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increases
|
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an increased metabolic rate (inc/dec) resp rate?
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increases
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hypoventilation causes which acid/base cond?
|
resp acidosis
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hyperventilation causes which acid/base cond?
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resp alkalosis
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lactic acid causes which acid/base cond?
|
metabolic acidosis
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primary symptom of hypercapnia
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headache
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s/s of hypoxia (5)
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anxiety, restlessness, confusion, agitation, lethargy
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(carbs/proteins) metabolism causes more co2 production?
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carbs. limit them for resp pt
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preload is (volume/pressure)?
|
volume
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afterload is (volume/pressure)?
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pressure
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inotropic drugs do what? whats an example?
|
make the heart beat stronger
digoxin |
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left sided heart failure causes (3)
|
pulmonary edema
hypoxia hypercapnia (left side gets blood from lungs so s/s will be resp related) |
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right sided heart failure causes (2)
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distended abdomen
tissue edema (right side gets bllod from circulation so s/s will not be resp related) |
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essential parts of breathing (3)
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ventilation, perfusion, diffusion
|
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high altitudes can lead to
|
hypoxia
|
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airway obstruction would cause which acid base imbalance?
|
resp acidosis
|
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chest wall trauma would cause which acid base imbalance?
|
resp acidosis
|
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conditions that depress the resp center would cause which acid base imbalance?
|
resp acidosis
|
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conditions that increase respirations would cause which acid base imbalance?
|
resp alkalosis
|
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liver failure would cause which acid base imbalance?
|
resp alkalosis
|
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excessive gi losses would cause which acid base imbalance?
|
met alkalosis
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hypokalemia is commonly associated w/ what acid base imbalance?
|
met alkalosis
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GI suctioning can cause which acid base imbalance?
|
met alkalosis
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moves with na+ and k+
|
chloride
|
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kussmauls respirtions are
|
deep and rapid
|
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aids digestion and enzyme activation
|
chloride
|
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works inversely with calcium
|
phosphorus
|
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calcium mainly effects (3)
|
muscle contraction
blood clotting hormone balance |
|
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calcium binds to
|
albumin
|
|
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promotes calcium absorption
|
vit D
|
|
|
hypocalcemia causes (2)
|
hypoalbuminemia
parathyroid/thyroid surgery |
|
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hypocalcemia s/s (4)
|
tetany
trousseaus sign chvosteks sign paresthesia (most s/s will be cardiac and nueromuscular) |
|
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hypercalcemia s/s (4)
|
altered mental status
bone pain anorexia extreme thirst (most s/s will be heart, skelatal and nervous sys) |
|
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colloid osmotic pressure
|
the drawing power created by proteins at the venous end of cap bed
pulls in water, elec, cell wastes a.k.a. oncotic pressure |
|
|
hydrostatic pressure
|
caused by pumping action of the heart
pushes water, elec, nutrients thru cap walls at the arteriol end |
|
|
effusion
|
escape of fluid into a part
|
|
|
2 layers of plaura
|
viseral - covers lungs
pueridal - covers thoracic cavity space between them plaural space w/ plaural fluid pressure is neg to keep lungs from collapsing |
|
|
upper airway consists of (4)
|
nose, pharynx, larynx, eppiglotis
|
|
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upper airway functions (3)
|
warm
humidify filter |
|
|
lower airway (4)
|
trachea
bronchi (bifercate at corina) segmented bronchi terminal bronchiols |
|
|
stimulus to cough
|
when secretions get to corina
|
|
|
main function of lower airways (3)
|
conduct air
mucociliary clearance surfactin production |
|
|
surfactin
|
phospholipid that reduces surface tension - prevents lungs from collapsing
|
|
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only vein in body containing oxygenated blood
|
pulmonary vein
|
|
|
(o2/co2) diffuses faster
|
o2
|
|
|
diffusion
|
exchange of gasses at alviolar level
|
|
|
perfusion
|
blood flow to lungs and tissue
|
|
|
external respiration
|
the diffusion that occurs at the alviolar level
|
|
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internal respiration
|
exchange of gasses at cellular level
|
|
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ventalation
|
inhalation (active)
exhalation (passive) |
|
|
stimulus to breathe
|
medulla notices increased co2 and H+ in blood
|
|
|
dyspnia (obj/subj)
|
subjective
labored breathing is obj |
|
|
oxyhemoglobin
|
sao2
measure of hemoglobin thats saturated with o2 |
|
|
carboxyhemoglobin
|
carbon monoxide stuck to hemoglobin
|
|
|
often the first sign of hypoxia
|
confusion
|
|
|
s/s of hypoxia (8)
|
altered thought processes
confusion anxiety restlessness dyspnia pulse pressure narrows inc bp, hr, resp rate cyanosis |
|
|
transport hypoxia
|
reduced carrying capability in blood
|
|
|
obesity, scoliosis and kephosis effect
|
respitory function
|
|
|
narcotics and analgesics effect
|
respitory function
|
|
|
how does a COPD person breathe?
|
rapid, shallow breaths in a tripod position
|
|
|
diaphragmatic breathing
|
inhale belly should go out
exhale belly should go in and chest should go out |
|
|
order of lung assessment (4)
|
inspection - labored?
ascultate - ant, post, lateral palpate percussion |
|
|
what sound do you hear in pt with congested lungs?
|
rhonchi
|
|
|
best cough suppressant
|
has codeine
|
|
|
liquify secretions (2)
|
water
expectorants (musinex) |
|
|
Nutrition in person w resp probs
How to help? (3) |
6 small meals
breathing treatment, then rest, then meal mouth care |
|
|
atelectasis
|
alvioli collapse
(gave too high of a concentration of o2) |
|
|
max o2 to give COPD pt
|
4 L
|
|
|
add humidity if running o2 above what level?
|
4 L
|
|
|
COPD pt's can only use which o2 devices? (2)
|
nasal cannula
venturi |
|
|
hi flow o2 masks (2)
|
non rebreather
venturi |
|
|
low flow o2 masks (4)
|
nasal cannula
simple face mask trach collar (connects tracheostomy to o2) partial rebreather (pt rebreathes 1/3 of his exhaled air. keep bag inflated at all times) |
|
|
regulate ABG's (2)
|
hormones
kidneys |
|
|
Acidosis (stimulates/depresses) CNS?
|
depresses
s/s not alert, etc |
|
|
Alkalosis(stimulates/depresses) CNS?
|
stimulates
s/s tingling fingers, toes, etc |
|
|
hypercapnia level
|
PaCO2 > 45
respitory acidosis |
|
|
conditions that cause respitory acidosis (6)
|
resp failure
pnuemonia cystic fibrosis (thick mucous) airway obstruction chest wall injury hypoventalating think: in all these cases the lungs cant exhale CO2 |
|
|
conditions that cause respitory alkalosis (7)
|
asthma
anxiety tylonol overdose CNS disorders pnuemonia hypermetabolic states hyperventalating think: in these cases you are breathing faster and blowing off CO2 |
|
|
what condition can cause either resp acidosis or resp alkalosis and why
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pnuemonia
acidosis when pt cant exhale co2 alkalosis when too much is exhaled because they are breathing fast to get air how do you know which? assess pt |
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most important protein buffer
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hemoglobin
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20 : 1 ratio
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bicarbinate : carbonic acid
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cause metabolic alkalosis (7)
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vomiting (lost HCL)
prolonged suction (lost HCL) hypercalcemia Hypokalemia excess aldosterone steroids diuretics (elec shifts) |
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cause metabolic acidosis (7)
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diabetic ketoacidosis
starvation (atkins diet) renal failure heavy exercise (lactic acid) use of drugs (asprin) renal tubular acidosis diarrhea (elec shift) |
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hydrogen ions are (up/down) when the pH is up
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down
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hydrogen ions are (up/down) when the pH is down
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up
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s/s resp acidosis (1)
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muscle twitching
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s/s resp alkalosis (1)
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tingling / numbness
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s/s met acidosis (1)
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flushed skin
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s/s met alkalosis (1)
Associated w/: hypokalemia & hypercalcemia |
tetany (involuntary muscle contraction)
dizziness |
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tetany
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involuntary muscle contractions
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3 functions of the stomach
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stores
mixes empties |
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when too much water is absorbed in the intestine, this condition occurs
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constipation
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when not much water is absorbed in the intestine, this condition occurs
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diarrhea
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water, nutrients and electrolytes are absorbed in
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small intestine
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primary organ of elimination
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large intestine
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most vitamins are made in
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large intestine
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feces is stored in
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sigmoid colon
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parastalsis occurs every
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3 - 12 mins
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large intestine segmentation is called
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haustral churning
its the back and forth movement of chime this is what we listen for |
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segmentation happens in the
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small intestine
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mass parastalsis occurs how often?
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1 - 4x / day
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valsalva (inc/dec) heart rate
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decreases
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what would create a white stool?
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barium enema
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what would create a black stool?
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iron
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temporary stop of parastalsis
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paralytic ilius
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has a laxative effect (2)
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alcohol
hot liquids |
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drugs that can cause constipation (4)
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narcotics
anesthetics steroids iron |
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drugs that can cause diarrhea
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antibiotics
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melena
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black tarry stool
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color of stool w/ upper GI bleed
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melana
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color of stool w/ lower GI bleed
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bright red
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4 things re: digital impaction
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order reqd
sims position lube gloves oil retention enema |
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order of abdominal assessment (4)
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inspection
ascultation x 4 quad for 5 mins palpate purcuss |
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what does metamusil do?
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adds bulk
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restores the normal flora of the gut
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yogurt
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colase is a
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stool softener
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dulcalax is a
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stimulant laxative
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mineral oil is a
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lubricant
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dont give laxative to pt with
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severe ab pain
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immodium is for
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diarrhea
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loc (2)
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level of conciousness
laxative of choice |
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lomotil is a
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opiate to releive diarrhea
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carminative enemas
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expel gas
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2 meds sometimes used for their side effects of stimulating a bm
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kayaxalate, lactulose
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what position for an enema?
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sims
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how far to insert enema
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3-4 inches
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the body (can/cannot) conserve potassium
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cannnot
must eat it daily |
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effective osmoles (3)
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salt
protein mannitol (they draw water to them because they are too big to get thru membrane) |
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ineffective osmoles (3)
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alcohol
uria glucose (do not draw water to them, they can fit thru membrane) |
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example of facilitated diffusion
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glucose carried by insulin
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ADH is made where?
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hypothalamus then stored in pituitary
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normal osmolarity
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in the upper 200's
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suppresses ADH
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alcohol
you will pee |
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whats the difference between a fluid volume deficit and a water deficit?
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FVD:
hypovolemia isotonic you lose h2o and electrolytes... hemorrhage WATER DEFICIT: dehydration hypertonicity lose water only... sweating |
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if low volume, can you see JVD in supine pt?
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no
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brawny edema
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stretched so bad you cant dent it
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how many mm is pitting edema +3?
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6
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(should/should not) see JVD in pt laying flat?
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should
if you cant see them they are low in volume |
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sodium goes into cell by what process?
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diffusion
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sodium goes out of cell by what process?
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ATP
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K+ goes into cell by what process?
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ATP
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sodium goes out of cell by what process?
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diffusion
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enhances the side effects of Digitalis
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hypokalemia
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in what situation would you give Phosphate and why?
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hypercalcemia
moves Calcium out |
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what IV solution is full of calcium?
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ringers lactate
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Phosphorus works inversely with
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calcium
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the regulation of calcium is by
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protein
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a thyroid surgery pt is at risk for
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hypocalcemia
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milk of magnesia can cause
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hypermagnesium
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overuse of antacids can cause
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hypermagnesium
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hypomagnesemia is associated with (3)
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hypokalemia
(mg down, k+ down) alcoholism malnutrition |
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magneseum has what effect on the body
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depressive
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magnesium maintains
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electricity in the heart
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cobolt is associated with
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pernicious anemia
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What are the causes of Hyponatremia?
Fluid shifts _____ the cell |
Fistula Drainage
Burns into |
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What are the causes of Hypernatremia?
Fluid shifts ____ of the cell |
Increased intake of salt
Iatrogenic: decreased fluids (h20) Diabetes Insipidus Alka-seltzer out |
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Nursing Interventions: Hyponatremia
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Fluid restriction
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Nursing Interventions: Hypernatremia
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Hydrate patient
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S&S: Hyponatremia
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Neuro
Muscle twitching Ortho hypotension (depletional) Weight Gain (Dilustional) |
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S&S: Hypernatremia
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Neuro
Thirst Fever |
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What causes HypoKalemia?
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Skeletal muscle
U wave Constipation Toxic effect of digoxin Irregular, weak pulse Orthostatic hypotension Numbness Diuretics Diabetic Ketoacidosis Aldosteronism Polyuria Cushing Syndrome |
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What causes HyperKalemia?
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Salt Substitute
Cell Damage (Ex: burns) Metabolic Acidosis (COPD, CRF) Iatrogenic Antacids |
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Nursing Interventions: HypoKalemia
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Give oral
IV drip K+ |
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Nursing Interventions: Hyperkalemia
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CBIGKD -
Calcium Bicarb Insulin Glucose Kayaxalate Dialysis |
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S&S: Hypokalemia
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Muscle Weakness
decreased deep tendon reflexes increased dig toxicity |
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S&S: Hyperkalemia
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Dysrhymias
decreased BP Irritability |
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What causes Hypocalcemia?
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Hypoalbuminemia
thyroid surgery hypoparathyroidism |
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What causes Hypercalcemia?
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Hyperparathyroidism
Cancer excess milk/antacids immobilization |
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Nursing Interventions: Hypocalcemia
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Give Tums
Calcium Glutinate IV |
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Nursing Interventions: Hypercalcemia
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Keep hydrated
Diuretics Give phosphate Give Calcitonin |
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S&S: Hypocalcemia
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Tetany (spasms)
Osteomalasia Neuromuscular & Cardiac (+) Chvostek Sign (+) Trousseaus |
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S&S: Hypercalcemia
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Cardiac, Skeletal Muscle, Nervous
Bone Pain Flank Pain (kidney trouble) Personality Change Hypoactive Bowel Sounds |
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Magnesium is important for:
____ mEq/L ___ the cells |
Metabolism of fats/proteins
maintains electrical activity Blood clotting Muscle contraction (neuromuscular) 1.4-2.3 Inside |
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Hypomagnesemia is associated with
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hypokalemia
Alcoholism & Nutrition |
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Mg+ relationship to K+
decreased Mg+ increases: ___ & ____ resulting in K+ ____ and _____ K+ |
Renin & Aldosterone
excretion & decreased |
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S&S: Hypermagnesium
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Hypotension
Flushing Sweating |
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S&S: Hypomagnesium
associated with: |
Superventricular Tachycardia
hypokalemia Malnutrition & alcoholism |
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Treatment of Hypermagnesium
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Dialysis
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Phosphate has an inverse relationship with: _____
___ - ____ mEq/L It is a ____ ion |
Calcium (ex: increased Ca+, decreased PO4-)
1.7-2.6 Buffer |
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Trace elements:
C C I Z M |
cobalt-pernicious anemia (<rbc d/t b12 def)
copper-iron defeciency anemia Iodine-hypothyroidism Zinc-wound healing Manganese-skeletal growth |
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How do you get K+ in the cell?
How do you get K+ out of the cell? |
ATP
Diffusion |
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K+ dietary foods:
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bananas, canteloupes, oj, avocados, lobster, chocolate, broc, yams, spinach, macadamian nuts, almonds, tuna fish
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K+:
1 mEq/L = ___ mg |
39mg
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K+ moves from the cell into the IVS b/c the body preserves the vascular space at all costs!
Within the cell we are ______! |
Hypokalemic
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metabolic acidosis is caused by an ____ in H ions production and is characterized by a PH ___ __ and a HCO3- __ ____mEq/L
This ___ the CNS |
increase
<7.35 <22 depresses |
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Metabolic alkalosis is caused by a ___ in H ion production, characterized by a blood ph above ____ and accompanied by HCO-3 level above ____
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decrease
7.45 26 mEq/L |
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Metabolic alkalosis is associated with:
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hypokalemia from the use of thiazides, furosemide, etharynic acid, and other diuretics that deplete K+
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in hypokalemia the kidneys reserve conserve _____ and at the same time the kidneys increase excretion of ___ which prompts ____ from the loss of acid
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K+
hydrogen ions alkalosis |
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ABG results in metabolic acidosis:
Ph - Paco2 - HCO3 - |
<7.35
normal <22 |
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ABG results in metabolic alkalosis:
Ph- Paco2- HCO3- |
>7.45
normal >26 or normal |
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CBC:
RBC count Hemoglobin Hematocrit |
Males: 4.7-6.1, Females: 4.2-5.4
Males: 14-18,Females: 12-16 g/100dl Males: 42-52%, Females: 37-47% |
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Pts w/ upper/lower respiratory tract infections & pulmonary disease treatment:
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deep breathe and cough every 2 hours while awake
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Post-op pts deep breathing and cough techniques include:
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cascade -slow, deep breath and hold for 2 sec. The client opens mouth and coughs thruout exhalation--promotes airway clearance and patent airways
Huff-while exhaling the pt says the word huff w/ more air pt can progress to cascade Quad-w/out ab muscle control (spinal cord injuries) pt breathes outw/ max exp effort and pshes inward/upward on ab muscles to ward diaphragm, causing cough |
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Pursed lip breathing
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sitting up
deep breath exhale slowly thru pursed lips, blowing out candles |
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reasons you might lose protein (lowering osmotic pull) (4)
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burns, malnutrition, nephrosis, liver disease
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third spacing can be caused by
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burns (the damage allows protein to be rlsed into the ISS and it sucks more water to itself)
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prostaglandins
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increase blood flow to the kidney
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glucose attracts
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water
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what is needed to make ATP?
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glucose and oxygen
so, if pt is hypoxic they wont make enuf ATP for the NA - K pump and NA will stay in the cell and swell who knew? |
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hypotonic solutions cause cells to
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swell
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hypertonic solutions cause cells to
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shrink
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