RN Med-Surg Exam 2 Flashcards
Card 1 — Hypercalcemia
Patho: Too much calcium in the blood decreases neuromuscular excitability and
can affect cardiac conduction.
Clinical manifestations: Weakness, constipation, kidney stones, confusion,
decreased reflexes.
Priority assessment: LOC, cardiac rhythm, hydration status, kidney stone pain.
Critical labs: Calcium >10.2 mg/dL.
RN intervention: Encourage fluids if not contraindicated, administer loop
diuretics/calcitonin as ordered, monitor ECG.
Teaching: Increase hydration, avoid excess calcium/vitamin D unless prescribed.
NCLEX clue: “Bones, stones, groans, psychiatric overtones.”
Card 2 — Hypocalcemia
Patho: Low calcium increases neuromuscular excitability.
Clinical manifestations: Tingling, tetany, muscle spasms, seizures, positive
Trousseau and Chvostek signs.
Priority assessment: Airway, seizure activity, laryngospasm.
Critical labs: Calcium <8.6 mg/dL.
RN intervention: Seizure precautions, airway support, administer calcium
replacement as ordered.
Teaching: Take calcium/vitamin D as prescribed; report numbness, tingling, or
spasms.
NCLEX priority: Laryngospasm = airway emergency.
,Card 3 — Hypokalemia
Patho: Low potassium disrupts muscle and cardiac electrical activity.
Clinical manifestations: Weakness, leg cramps, constipation, dysrhythmias,
shallow respirations.
ECG: Flat T waves, ST depression, U waves.
Priority assessment: Cardiac rhythm.
Critical labs: K⁺ <3.5 mEq/L.
RN intervention: Place on telemetry, replace potassium safely, monitor IV site.
Critical safety: Never give potassium IV push.
Teaching: Eat potassium-rich foods if appropriate: bananas, oranges, potatoes,
spinach.
Card 4 — Hypernatremia
Patho: Too much sodium or too little water causes cellular dehydration, especially
brain cells.
Clinical manifestations: Thirst, dry mucosa, restlessness, agitation, confusion,
seizures if severe.
Priority assessment: Neuro status and hydration.
Critical labs: Na⁺ >145 mEq/L.
RN intervention: Replace fluids slowly, monitor I&O, daily weights, neuro checks.
Teaching: Maintain hydration; older adults may not feel thirst strongly.
NCLEX clue: Hypernatremia = dry, thirsty, confused.
Card 5 — Hypermagnesemia
Patho: Excess magnesium depresses neuromuscular and cardiac function.
Clinical manifestations: Lethargy, hypotension, bradycardia, decreased reflexes,
respiratory depression.
, Priority assessment: Respiratory rate, deep tendon reflexes, cardiac rhythm.
Critical labs: Magnesium above normal range.
RN intervention: Stop magnesium source, monitor respirations, prepare calcium
gluconate if severe.
NCLEX priority: Respiratory depression = immediate action.
Card 6 — Hypomagnesemia
Patho: Low magnesium increases neuromuscular irritability and dysrhythmia risk.
Clinical manifestations: Tremors, hyperreflexia, seizures, dysrhythmias.
Priority assessment: Cardiac rhythm and seizure risk.
Critical labs: Low magnesium.
RN intervention: Magnesium replacement as ordered, seizure precautions,
telemetry.
Teaching: Avoid alcohol excess; maintain nutrition.
NCLEX clue: Low Mg²⁺ can cause torsades/dysrhythmias.
ABG Flashcards
Card 7 — ABG Normals
pH: 7.35–7.45
PaCO₂: 35–45 mmHg
HCO₃⁻: 22–26 mEq/L
PaO₂: 80–100 mmHg
Card 1 — Hypercalcemia
Patho: Too much calcium in the blood decreases neuromuscular excitability and
can affect cardiac conduction.
Clinical manifestations: Weakness, constipation, kidney stones, confusion,
decreased reflexes.
Priority assessment: LOC, cardiac rhythm, hydration status, kidney stone pain.
Critical labs: Calcium >10.2 mg/dL.
RN intervention: Encourage fluids if not contraindicated, administer loop
diuretics/calcitonin as ordered, monitor ECG.
Teaching: Increase hydration, avoid excess calcium/vitamin D unless prescribed.
NCLEX clue: “Bones, stones, groans, psychiatric overtones.”
Card 2 — Hypocalcemia
Patho: Low calcium increases neuromuscular excitability.
Clinical manifestations: Tingling, tetany, muscle spasms, seizures, positive
Trousseau and Chvostek signs.
Priority assessment: Airway, seizure activity, laryngospasm.
Critical labs: Calcium <8.6 mg/dL.
RN intervention: Seizure precautions, airway support, administer calcium
replacement as ordered.
Teaching: Take calcium/vitamin D as prescribed; report numbness, tingling, or
spasms.
NCLEX priority: Laryngospasm = airway emergency.
,Card 3 — Hypokalemia
Patho: Low potassium disrupts muscle and cardiac electrical activity.
Clinical manifestations: Weakness, leg cramps, constipation, dysrhythmias,
shallow respirations.
ECG: Flat T waves, ST depression, U waves.
Priority assessment: Cardiac rhythm.
Critical labs: K⁺ <3.5 mEq/L.
RN intervention: Place on telemetry, replace potassium safely, monitor IV site.
Critical safety: Never give potassium IV push.
Teaching: Eat potassium-rich foods if appropriate: bananas, oranges, potatoes,
spinach.
Card 4 — Hypernatremia
Patho: Too much sodium or too little water causes cellular dehydration, especially
brain cells.
Clinical manifestations: Thirst, dry mucosa, restlessness, agitation, confusion,
seizures if severe.
Priority assessment: Neuro status and hydration.
Critical labs: Na⁺ >145 mEq/L.
RN intervention: Replace fluids slowly, monitor I&O, daily weights, neuro checks.
Teaching: Maintain hydration; older adults may not feel thirst strongly.
NCLEX clue: Hypernatremia = dry, thirsty, confused.
Card 5 — Hypermagnesemia
Patho: Excess magnesium depresses neuromuscular and cardiac function.
Clinical manifestations: Lethargy, hypotension, bradycardia, decreased reflexes,
respiratory depression.
, Priority assessment: Respiratory rate, deep tendon reflexes, cardiac rhythm.
Critical labs: Magnesium above normal range.
RN intervention: Stop magnesium source, monitor respirations, prepare calcium
gluconate if severe.
NCLEX priority: Respiratory depression = immediate action.
Card 6 — Hypomagnesemia
Patho: Low magnesium increases neuromuscular irritability and dysrhythmia risk.
Clinical manifestations: Tremors, hyperreflexia, seizures, dysrhythmias.
Priority assessment: Cardiac rhythm and seizure risk.
Critical labs: Low magnesium.
RN intervention: Magnesium replacement as ordered, seizure precautions,
telemetry.
Teaching: Avoid alcohol excess; maintain nutrition.
NCLEX clue: Low Mg²⁺ can cause torsades/dysrhythmias.
ABG Flashcards
Card 7 — ABG Normals
pH: 7.35–7.45
PaCO₂: 35–45 mmHg
HCO₃⁻: 22–26 mEq/L
PaO₂: 80–100 mmHg
