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56 Cards in this Set

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you got to know your equivilenceys. See knows 240 mL per ...
see doesn't want 500 mL for a pint, she wants 480 mL!
cup and she goes from there.
but its our responsibility to know and apply equivilants
in a multiple choice, pick the closest if your math doesn't work. her queue is ?
240mL is in 8 oz.s and goes from there
so baseline, how do you get a patients baseline?
how much they take in every day.
what tells us our thirsty?
chemo reseptors are measuring salt in your body and will tell you to drink
old people in old age will generally drink what they drank when they were young. so start drinking a gallon a day so when your old your ...
use to drinking a gallon a day
a patient baseline is what they drink each day. cowboys drink coffee all day and so ...
they have a hard time drinking water in an old folk home!
caffeine is a diuretic. so the more you drink, the more you want to drink b/c ...
its dehydrating you so drink water
know the disease process and how that relates to I & O. So, what does Marsha think?
your sick enough to be in the hospital, you should be doing a I & O for a week to develop a baseline.
if something happened to their heart and they die, who's resonsible?
the nurse is responsible, not the doctor. they don't get the right fluids, and the nurse didn't order I&O, its her fault the guy died!
data collection is our responsiblility, documentation of I&O! Whoever is putting a food tray or pee drains are emptied, all that is what?
documented.

Its the nurse job and recording intake or output. so you can notice a sudden change so you can report that to the primary provider, doc, etc
the purpose of I&O is to establish a detect a trend and to report ...
est. a trend and go from there, and 24 hrs won't do it.
the concept of alterations of fluids and balance. who would be a good canditate for alterations in fluids and balance?
congestive heart failure patient. why? b/c the heart doesn't work well, there's back pressure so fluid goes into the tissue, then the kidney's don't get the fluid and output goes down!
I&O can be an indicator of well being. what about a patient in shock? what happens there?
someone in shock, the pipes are too big, so no blood pressure, kidneys are not profussed, so they don't put out pee. People in shock are in a dangerous situation of balancing with adding fluids but not too much too
chronic renal failure...they will be limited in fluid intake ie on dialysis. so they basically don't have output. what color is pee from bad kidney?
clear b/c kidney's are concentrating urine
people w/ diabetes.
skin integrity
young skin has turgidity
old skin needs this checked to see what?
how dehydrated the are. pinch the skin at the chest and ck the turgidy
you got to know your equivilenceys. See knows 240 mL per ...
see doesn't want 500 mL for a pint, she wants 480 mL!
cup and she goes from there.
but its our responsibility to know and apply equivilants
in a multiple choice, pick the closest if your math doesn't work. her queue is ?
240mL is in 8 oz.s and goes from there
so baseline, how do you get a patients baseline?
how much they take in every day.
what tells us our thirsty?
chemo reseptors are measuring salt in your body and will tell you to drink
old people in old age will generally drink what they drank when they were young. so start drinking a gallon a day so when your old your ...
use to drinking a gallon a day
a patient baseline is what they drink each day. cowboys drink coffee all day and so ...
they have a hard time drinking water in an old folk home!
caffeine is a diuretic. so the more you drink, the more you want to drink b/c ...
its dehydrating you so drink water
know the disease process and how that relates to I & O. So, what does Marsha think?
your sick enough to be in the hospital, you should be doing a I & O for a week to develop a baseline.
if something happened to their heart and they die, who's resonsible?
the nurse is responsible, not the doctor. they don't get the right fluids, and the nurse didn't order I&O, its her fault the guy died!
data collection is our responsiblility, documentation of I&O! Whoever is putting a food tray or pee drains are emptied, all that is what?
documented.

Its the nurse job and recording intake or output. so you can notice a sudden change so you can report that to the primary provider, doc, etc
the purpose of I&O is to establish a detect a trend and to report ...
est. a trend and go from there, and 24 hrs won't do it.
the concept of alterations of fluids and balance. who would be a good canditate for alterations in fluids and balance?
congestive heart failure patient. why? b/c the heart doesn't work well, there's back pressure so fluid goes into the tissue, then the kidney's don't get the fluid and output goes down!
I&O can be an indicator of well being. what about a patient in shock? what happens there?
someone in shock, the pipes are too big, so no blood pressure, kidneys are not profussed, so they don't put out pee. People in shock are in a dangerous situation of balancing with adding fluids but not too much too
chronic renal failure...they will be limited in fluid intake ie on dialysis. so they basically don't have output. what color is pee from bad kidney?
clear b/c kidney's are concentrating urine
people w/ diabetes.
skin integrity
young skin has turgidity
old skin needs this checked to see what?
how dehydrated the are. pinch the skin at the chest and ck the turgidy
regular people take in 2300 mL a day. 200 comes from metabolism. hows that work?
Krebs cycle, the metabolism of carboydrates...byproduct is CO2 and water. so expect a patient to take in 200 mL daily from just that. But doctors account for it.
old people need more intake than regular people. how much more and why?
2400 mL instead of 2300, b/c old people's body's are as much muscle but fat so fat doesn't hold water as well as muscle does. so they need more water!
now, water loss, just sitting around we loss about 350 mL a day! sweat about 100, feces about 100, and so what?
input will balance output
what kinds of things affect a person's hydration?
metabolism
sea level
disease
etc
what about an old person trying to drink a huge tank of water?
they can't handle those things so get them a small cup instead!
will fever increase metabolism thus use up more water so they need more intake?
yes!
if someone is ingesting 2400 a day the output will be ...
somewhat less
but check for edema,
ck for crackling in their lungs
ck output pee
look for increase in blood pressure
if they are retaining fluid in their lungs (crackling)
the prevelence of dehydration
on a month in a old folk place experience...
dehydration!
more than 1/2 patients hospitalized are from dehydration!
dehydration causes...
confusion
impaction
watch for patient using laxatives...think!!! what is their intake!
dizzy and weak can result in falls so dehydration does this
dehydration causes stroke b/c their blood vicosity is thick and not flowing well, hence, stroke from dehyration
what are some clinical signs of dehydration?
dry tongue
dry muccous membranes
dry skin
confusion
headaches
dark pee
by the time your eyes look sucken, dehydration has set in. Furrowed tongue. Education to fix this. we have what kind of winters here?
dry winters plus wood stoves so the inside will be very dry which dehydrates people. so do infection dehyrate people. humidifier bottles on O2 concentrators thats all old fashion b/c it can be a growth medium.
more than 7 or 8 meds then someone should what?
evaluate why that guy is on so many meds BECAUSE all these meds can affect water balance.
a high protein diet can affect what?
nitrogen wastes and products of protein metabolism can whip out your kidneys from ammonia wastes. high protein diets not a good thing
prevention
education
teach your kids to drink now whY?
so whent they are old, their use to getting their water and won't complain about having to drink so much
how much fluids do kids needs
*****************************
do some math here on the test
6 months = 150-200 mL/kg/day
12 months 90-100 mL/kg/day
I&O is on a 24 hour thing, but also depends on shifts. depends on what
the order.
includes iv fluids.etc
tpn = runs on a pump
know whats going on in your next assessment. whats hanging in there.
******************
whats the formula? figure it out for this next thing.
test question.
the formula for an uncompromised adult, a healthy person needs a minimun of :

30 cc of fluid per Kg of body weight. so ...the very mimimun of water you need to drink in a day is ...
so 195lbs X 0.45 X 30cc
or how much you weigh converted to kilograms multipling it by 30cc. This is the minimun.
a weight gain of 2 pounds = how much fluid gain?
a liter gain from adding 2 lbs.
we need to know the morning weight. BEFORE that person has breakfast, gets dressed, naked weight. In long term care, the terra weight includes a wheel chair so it better be the same chair
some people might gain 4 pounds in a day, alot of water. how many mL in a gallon?
3.8 liters.
vomit needs to be recorded, blood loss on the floor or in the toliet, gastric suction, always measure that, any kind of drain.
indications...
all post op are on I&O
with output, you look and see that in the cater bag and nothing there?
make sure its draining. is the tube kinked or their sitting on it. suppose they can't tell you their about to explode? make sure its draining
50 mL an hour or less like 30 mL is real trouble, kidneys are shutting down. about 50 mL get into panic mode. what do you do?
ck their lungs, look for edema, or lungs b/c its going somewhere! feet or lungs. are they caterized? check hourly output and if around 50, thats trouble
would output do down at night? why?
normally at night, they peed b/f going to bed, no IVs running, after first void, they should be have low output but after first void, back to normal output
nausea, vomiting, diarehha
that creates what?
measure vomit and direhha needs to be measured. pneumonia will tax the heart to get the o2 thru the body b/c the lungs are in trouble!
old people cant' remember to drink becuause of
dementia
a new behavior
confusion behavior
want to fight
it could be ...
dehydration
so every time you do something with them, get them to drink something. You took them to potty, then have a drink of water. everytime you go in there, get them to drink something.
self acutualization needs, your talking to them, your hydrating them. its important. documentation is about acruacy, acuracy, acuracy. don't quess! why?
the doctor might change the patients meds from what your writing down!
what is the purpose of I O ?
to detect trends

it takes more than 24 hours