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55 Cards in this Set
- Front
- Back
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your taking care of a 65 yr old pt and needs plasma proteins. what should you be monitoring pt for?
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your taking care of a 65 yr old pt and needs plasma proteins. what should you be monitoring pt for?
- edema. -- check fluid overload |
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you noticed pt developed dependant edema. which electrolyte has high retention with water?
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you noticed pt developed dependant edema. which electrolyte has high retention with water?
- sodium |
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your pt has low Na level. whats normal Na level?
if pt has low Na level, how do we get it back up? |
your pt has low Na level. whats normal Na level? 135-145
if pt has low Na level, how do we get it back up? restrict fluids |
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your pt has high Na level, how is your pt going to act? LOC?
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your pt has high Na level, how is your pt going to act? LOC? adgitated. restless
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What is the main cation in blood plasma and interstitial fluid?
What is the main intracellular cation? |
Na+ is the main cation in blood plasma and interstitial fluid. K+ is the main intracellular cation.
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Why can’t insensible fluid loss come from the GI tract, Urinary output or from wound drainage?
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Why can’t insensible fluid loss come from the GI tract, Urinary output or from wound drainage?
Because insensible is fluid loss that is unmeasurable. The above is all measurable. |
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what is the best way of assessing a pt’s fluid status?
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what is the best way of assessing a pt’s fluid status?
-Daily Weights |
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After prolonged surgery, what electrolyte are we concerned with pt losing?
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after prolonged surgery, what electrolyte are we concerned with pt losing? - sodium and potassium. more concerned about potassium
- which electrolyte of intracellur is most important? potassium - extracellular is sodium |
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- which electrolyte of intracellur is most important?
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- which electrolyte of intracellur is most important?
potassium |
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What is the important electrolyte of extracellular?
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- extracellular is sodium
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What is the normal potassium level?
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What is the normal potassium level?
3.5-5.0 |
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Extracellular fluid retention manifests in ____, _____, and ______.
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Extracellular fluid retention manifests in
JVD, Ascites, Edema. |
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What is the treatment for hyperkalema?
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What is the treatment for hyperkalema
- Kayexalate |
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K+ level of 2.3- High, normal, or Low?
Na+ 138-- High, normal, or Low? Cl- 110- - High, normal, or Low? Ca+ 9.6- - High, normal, or Low? |
K+ level of 2.3- low
Na+ 138- normal Cl- 110- high Ca+ 9.6- normal |
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Your pt is on lasix. prior giving drug, what electrolyte do you need to check?
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your pt is on lasix. prior giving drug, what electrolyte do you need to check?
- K+ |
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your giving kayexalate, you expect this drug to do what?
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your giving kayexalate, you expect this drug to do what?
decrease K+ |
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Your pt has low serum sodium level due to hypervolemia, what would u expect the dr to order to fix the problem?
A. More salt B. hypertonic solution C. restrict sodium D. restrict fluid |
Your pt has low serum sodium level due to hypervolemia, what would u expect the dr to order to fix the problem?
-> D. Restrict Fluid (the reason sodium is low is b/c there is too much water. Restrict the water to balance out the sodium.) |
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Your pt is admitted to acute care unit, he has elevated sodium level what s/s go along with high sodium level (hypernatremia)?
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Your pt is admitted to acute care unit, he has elevated sodium level what s/s go along with high sodium level (hypernatremia)?
Agitation, restless, “altered mental status” anxiety |
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After prolonged surgery, what electrolyte are we concerned with pt losing?
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After prolonged surgery, what electrolyte are we concerned with pt losing?
- sodium and POTASSIUM. more concerned about potassium |
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what is the most important intracellular electrolyte?
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what is the most important intracellular electrolyte?
- Potassium |
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What is the most important extracellular electrolyte?
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What is the most important extracellular electrolyte?
- Sodium |
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What is the electrolyte that has the most effect on the heart (cardiac muscle)?
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What is the electrolyte that has the most effect on the heart?
- Potassium |
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Your looking through your pt’s chart and you notice elevated potassium level, it’s 6. What is normal for potassium? and is “6” considered low or high?
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Your looking through your pt’s chart and you notice elevated potassium level, it’s 6. What is normal for potassium? and is “6” considered low or high?
Normal range is 3.5-5; 6 is considered elevated. (FYI: Hyperkalemia is higher-than-normal levels of potassium in the blood) |
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Your looking through your pt’s chart and you notice elevated potassium level, it’s 6. What would you do 1st?
A. call the lab and have them repeat the test B. mobilize the Cardiac arrest team C. take an EKG D. Take their Vital Signs and notify the physician |
Your looking through your pt’s chart and you notice elevated potassium level, it’s 6. What would you do 1st?
-> D. Take their Vital Signs and notify the physician |
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Pt. with elevaded potassium level, what medication might the Dr. order you to give to get the potassium level lower?
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Pt. with elevaded potassium level, what medication might the Dr. order you to give to get the potassium level lower?
- Kayexlate |
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What clinical indicators would you expect a pt to have who has Hyperkalemia?
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what clinical indicators would you expect a pt to have who has Hyperkalemia?
Hyperkalemia symptoms: * Diarrhea * Bradycardia (slow heart) * weakness (select all that apply question) |
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What is the normal level for the following:
Potassium: Sodium: Chloride: we have 2 Calciums: (on test: you will pick out from a set of electrolytes. what is normal) |
What is the normal level for the following:
Potassium: 3.5 - 5 Sodium: 135-145 Chloride: 95-108 we have 2 Calciums: 4 - 8 & 8 - 10 (you will pick out from a set of electrolytes. what is normal) Example: K+ level of 2.3- low Na+ 138- normal Cl- 110- high Ca+ 9.6- normal |
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Your giving your pt lasix, everyday what electrolyte do you want to monitor for the pt?
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Your giving your pt lasix, everyday what electrolyte do you want to monitor for the pt?
- Patassium |
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Dr. orders 60 mlEq of potassium to a pt. you have a liquid bottle of potassium that has 10 mlEq in 5 ml. How much do you give?
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Dr. orders 60 mlEq of potassium to a pt. you have a liquid bottle of potassium that has 10 mlEq in 5 ml. How much do you give?
30 ml |
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If a pt has Hyperkalemia, what would you expect their sodium to do?
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If a pt has Hyperkalemia, what would you expect their sodium to do?
- Rise |
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If a pt has Hyperkalemia, with increased sodium, what side effects do you get when you increase sodium (decrease potassium)?
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If a pt has Hyperkalemia, with increased sodium, what side effects do you get when you increase sodium (decrease potassium)?
- your going to have retention of fluid. |
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If a pt has Hyperkalemia, with increased sodium (retention of fluid) Where are you going to look for retention of fluid?
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If a pt has Hyperkalemia, with increased sodium (retention of fluid) Where are you going to look for retention of fluid?
- Lower extremities - if pt is bed written their back - check for Ascites, - distended jugular neck veins - check for rolls (crackles in the lungs). |
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What should a pt. belly look like if they have Ascites?
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what should a pt. belly look like if they have Ascites?
- Descended |
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what electrolyte do you need to produce hydrochloric acid?
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what electrolyte do you need to produce hydrochloric acid?
- Chloride (hcl) |
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what is your major intracellular electrolyte?
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what is your major intracellular electrolyte?
- Potassium |
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What is your major extracellular electrolytes?
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What is your major extracellular electrolytes?
- Sodium |
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Your assessing your pt. and they have positive Chvostek’s sign (check twitches), what electrolyte imbalance is that associated with?
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Your assessing your pt. and they have positive Chvostek’s sign (check twitches), what electrolyte imbalance is that associated with?
- Low calcium (hypocalcemia) |
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Your pt serum calcium level is 13mg per deciliter, what would you call that?
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Your pt serum calcium level is 13mg per deciliter, what would you call that?
- Hypercalcemia |
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Your pt serum calcium level is 13mg per deciliter (hypercalcimia) What medication would you anticipate the dr. to order to lower the calcium level?
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Your pt serum calcium level is 13mg per deciliter (hypercalcimia) What medication would you anticipate the dr. to order to lower the calcium level?
- Calcitonin |
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How does Calcitonin work to lower the calcium level in the blood (hypercalcimia)?
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How does Calcitonin work to lower the calcium level in the blood (hypercalcimia)?
- takes the calcium out of the blood and puts it into the bone. |
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Before blood is drawn (arterial blood gas), you should perform a Allen Test. When you do the Allen’s test, what are you checking for?
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Before blood is drawn (arterial blood gas), you should perform a Allen Test. When you do the Allen’s test, what are you checking for?
- to check for adequate ulnar circulation |
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You do the allens test and it is ok (negative) pt has good circulation and you go ahead with the AGB (arterial blood gas) sampling and after the procedure you notice the pt finger and hands remain pale in color, what should you do?
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You do the allens test and it is ok (negative) pt has good circulation and you go ahead with the AGB (arterial blood gas) sampling and after the procedure you notice the pt finger and hands remain pale in color, what should you do?
- Call the Dr. immediately |
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if pts hand twitches, what is that called?
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if pts hand twitches, what is that called?
trousseau |
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your pt comes in with metabolic acidosis, you know that the bicarbonate buffer system is going to preserve the normal PH, if you are looking for compensatory changes, what 2 systems are you going to monitor?
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your pt comes in with metabolic acidosis, you know that the bicarbonate buffer system is going to preserve the normal PH, if you are looking for compensatory changes, what 2 systems are you going to monitor?
- Respiratory (to blow off the Co2) - Urinary (for increase the production of bicarb) |
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pt with chronic renal failure, often have accumulation of ammonia (ammonia is secreted by the kidneys), if the ammonia levels are too high what does that do to your acid base balance?
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pt with chronic renal failure, often have accumulation of ammonia (ammonia is secreted by the kidneys), if the ammonia levels are too high what does that do to your acid base balance?
- Raises the acidity, lower the PH (developing metabolic acidosis) |
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when you are looking at the PaCo2 level, what is your normal range?
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when you are looking at the PaCo2 level, what is your normal range?
- 35- to- 45 |
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what does the PaCo2 level reflect? what system?
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what does the PaCo2 level reflect? what system?
- respiratory, lung function |
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a blood gas, your PH is within the normal range, your co2 is high, oxygen is “Ok”, bicarb is high, what do we have?
A. uncompensated metabolic acidosis B. compensated respiratory alkalises C. compensated metabolic alkalises D. compensated respiratory acidosis |
a blood gas, your PH is within the normal range, your co2 is high, oxygen is “Ok”, bicarb is high, what do we have?
-> D. compensated respiratory acidosis (the PaCo2 being high means that there is respiratory acidosis) |
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You have an anxious client who is hyperventilating, they are having carpal-pedal spasms, why do you cover the pt. nose and mouth with a paper bag?
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You have an anxious client who is hyperventilating, they are having carpal-pedal spasms, why do you cover the pt. nose and mouth with a paper bag?
- help to retain the co2 (carbon-dioxide). Have pt re breath the co2. because when they are hyperventilating, they are breathing off the co2. And when they blow off too much co2, they get carpal pedal spasms. - Carbon dioxide mixed with water makes carbonic acid= resp alkalises when pt hyperventilates, your give them the paper bag to have them re-breath the carbon dioxide. (I know! Long freeking answer. It's 12:15am and I'm tired!) |
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What is your normal body blood PH?
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What is your normal body blood PH?
- 7.35 - 7.45 |
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Ph is low, Paco2 is normal, your bicarb is normal, what do you have?
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Ph is low, Paco2 is normal, your bicarb is normal, what do you have?
- metabolic acidosis |
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Pt with low PH (metabolic acidosis), what medication would the dr. order?
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Pt with low PH (metabolic acidosis), what medication would the dr. order?
- IV sodium bicarbonate |
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FYI CARD:
youre looking at ABG levels and PaCO2 levels. levels are high then their breathing is slow and shallow. breathing fast then PaCO2 levels are low if Co2 levels are high, it is respiratory acidosis low CO2 levels = alkalosis brown paper bag- use when they are hyperventalating when your blowing off CO2, you may end up with carbonic acid deficit. may be called resp. alkalosis. your pt pH is 7.30. PaCO2 is 40 HCO3 is 20 - pH is low = acidosis - PaCO2 is normal - HCO3 is abnomal = metabolic acidosis |
FYI CARD:
youre looking at ABG levels and PaCO2 levels. levels are high then their breathing is slow and shallow. breathing fast then PaCO2 levels are low if Co2 levels are high, it is respiratory acidosis low CO2 levels = alkalosis brown paper bag- use when they are hyperventalating when your blowing off CO2, you may end up with carbonic acid deficit. may be called resp. alkalosis. your pt pH is 7.30. PaCO2 is 40 HCO3 is 20 - pH is low = acidosis - PaCO2 is normal - HCO3 is abnomal = metabolic acidosis |
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pt comes in with metabolic acidosis and has diarrhea for a couple days. what drug can reverse this met. acidosis fast?
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pt comes in with metabolic acidosis and has diarrhea for a couple days. what drug can reverse this met. acidosis fast?
- IV sodium bicarbonate |
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what two body systems regulate pH?
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what two body systems regulate pH?
- kidneys and lungs |
