■ NUR 242 EXAM 2 — BABY VERSION + MEMORY TRICKS ■
Chapters 3 · 4 · 5 · 6 | Everything Explained Super Simple | All NSPs + Safety Boxes + Drug Alerts Included
■ HOW TO USE THIS GUIDE
Imagine I am sitting next to you explaining everything like you are 5 years old.
Every big scary nursing word gets broken down into something simple and fun.
Every time you see ■ = there is a MEMORY TRICK to help you remember!
Every time you see ■ = this is a DANGER thing — an emergency or a never-do.
■ Blue boxes = what to TEACH the patient.
■ Green boxes = your GALEN lab values — use these ONLY on exams.
■ = the most tested thing in that section — do not skip it!
■ UNIT 3 — Ch 13: FLUIDS & ELECTROLYTES (pp.255–268)
■ MEMORY TRICK:
"Your body is like a FISH TANK. The water level and chemical balance must be
PERFECT."
Too little water in the tank = fish gasp and struggle (dehydration). Too much water = tank overflows and fish get sick (fluid overload).
Wrong chemicals in the water = fish twitch, stop moving, or die (electrolyte imbalances). Your job as a nurse = keep the tank
PERFECT for your patients!
■ DEHYDRATION vs ■ FLUID OVERLOAD — BOX 13.1 + BOX 13.3
, ■ DEHYDRATION — Not Enough Fluid (BOX 13.1) ['THINK: The fish tank is running LOW — not enough
water', 'Causes: Vomiting, diarrhea, burns, sweating,
•■
ileostomy, NPO, fever, diuretics, GI suction', '❤■
•
Tachycardia + THREADY (weak) pulse + ↓BP', '■■ Poor
•F
skin turgor (skin stays tented when pinched)', '■ Dry
•L mucous membranes (dry mouth)', '■ Dark concentrated
•U urine (like apple juice)', '■ Confusion, lethargy,
•I restlessness', '■■ Sudden WEIGHT LOSS (best
•D indicator!)', '■ Older adults: skin turgor LESS
• RELIABLE — check mouth and behavior instead', 'FIX:
Mild = drink fluids | Severe = IV 0.9% Normal Saline']
•O
•V • THINK: The fish tank is OVERFLOWING — too much water
•E • Causes: Too many IV fluids, heart failure, kidney failure (late),
•R SIADH, corticosteroids
•L • ❤■ Tachycardia + BOUNDING (strong) pulse + ↑BP
•O • ■ MOIST CRACKLES in the lungs (hear fluid)
•A • ■ Shortness of breath, fast shallow breathing
•D • ■ PITTING EDEMA (press skin → leaves dent)
• • ■ Confusion, headache, visual changes
•— • ■ Distended NECK VEINS (JVD)
• • ■■ Sudden WEIGHT GAIN (best indicator!)
•T • FIX: Fluid restriction + sodium restriction + furosemide + HOB up
•o + O2
•o
•
•M
•u
•c
•h
•
•F
•l
•u
•i
•d
•
•(
•B
•O
•X
•
•1
•3
•.
•3
•)
■ MEMORY TRICK:
"WEIGHT = WATER. 1 pound gained overnight = about 500 mL of extra fluid. 1 kg gained
= 1 LITER of fluid!"
This is why we weigh patients EVERY MORNING on the SAME scale at the SAME time. Weight is MORE RELIABLE than looking at
swelling in the legs (edema shows up LATE). ■ 3 lbs in 1 WEEK or 1–2 lbs OVERNIGHT = call the provider immediately!
, ■ CRITICAL RESCUE — Fluid Overload (BOX 13.3, p.259)
■ Assess the patient with fluid overload EVERY 2 HOURS for signs of pulmonary edema
■ If you see: bounding pulse + rising JVD + crackles spreading up lungs + decreasing urine output...
■ → NOTIFY the provider IMMEDIATELY — this is turning into pulmonary edema (can cause death)
■ Patient is also at HIGH RISK for skin breakdown — check pressure areas DAILY (heels, coccyx, elbows)
■ SODIUM (Na+) — BOX 13.4 + BOX 13.5
■ GALEN: Sodium (Na+) 135–145 mEq/L
■ MEMORY TRICK:
"SODIUM = The SPONGE in your blood. Wherever sodium goes, WATER must follow!"
Imagine sodium is a magnet and water is metal shavings. Sodium pulls water everywhere it goes. ■ LOW sodium in blood → water
rushes INTO brain cells → brain SWELLS like a wet sponge → Confusion, seizures (brain is drowning) ■ HIGH sodium in blood →
water gets pulled OUT of brain cells → brain SHRINKS like a dried raisin → Agitation, intense thirst (brain is dehydrating) ■ BOTH
need to be corrected SLOWLY — fix too fast and you damage the brain going the other direction!
Chapters 3 · 4 · 5 · 6 | Everything Explained Super Simple | All NSPs + Safety Boxes + Drug Alerts Included
■ HOW TO USE THIS GUIDE
Imagine I am sitting next to you explaining everything like you are 5 years old.
Every big scary nursing word gets broken down into something simple and fun.
Every time you see ■ = there is a MEMORY TRICK to help you remember!
Every time you see ■ = this is a DANGER thing — an emergency or a never-do.
■ Blue boxes = what to TEACH the patient.
■ Green boxes = your GALEN lab values — use these ONLY on exams.
■ = the most tested thing in that section — do not skip it!
■ UNIT 3 — Ch 13: FLUIDS & ELECTROLYTES (pp.255–268)
■ MEMORY TRICK:
"Your body is like a FISH TANK. The water level and chemical balance must be
PERFECT."
Too little water in the tank = fish gasp and struggle (dehydration). Too much water = tank overflows and fish get sick (fluid overload).
Wrong chemicals in the water = fish twitch, stop moving, or die (electrolyte imbalances). Your job as a nurse = keep the tank
PERFECT for your patients!
■ DEHYDRATION vs ■ FLUID OVERLOAD — BOX 13.1 + BOX 13.3
, ■ DEHYDRATION — Not Enough Fluid (BOX 13.1) ['THINK: The fish tank is running LOW — not enough
water', 'Causes: Vomiting, diarrhea, burns, sweating,
•■
ileostomy, NPO, fever, diuretics, GI suction', '❤■
•
Tachycardia + THREADY (weak) pulse + ↓BP', '■■ Poor
•F
skin turgor (skin stays tented when pinched)', '■ Dry
•L mucous membranes (dry mouth)', '■ Dark concentrated
•U urine (like apple juice)', '■ Confusion, lethargy,
•I restlessness', '■■ Sudden WEIGHT LOSS (best
•D indicator!)', '■ Older adults: skin turgor LESS
• RELIABLE — check mouth and behavior instead', 'FIX:
Mild = drink fluids | Severe = IV 0.9% Normal Saline']
•O
•V • THINK: The fish tank is OVERFLOWING — too much water
•E • Causes: Too many IV fluids, heart failure, kidney failure (late),
•R SIADH, corticosteroids
•L • ❤■ Tachycardia + BOUNDING (strong) pulse + ↑BP
•O • ■ MOIST CRACKLES in the lungs (hear fluid)
•A • ■ Shortness of breath, fast shallow breathing
•D • ■ PITTING EDEMA (press skin → leaves dent)
• • ■ Confusion, headache, visual changes
•— • ■ Distended NECK VEINS (JVD)
• • ■■ Sudden WEIGHT GAIN (best indicator!)
•T • FIX: Fluid restriction + sodium restriction + furosemide + HOB up
•o + O2
•o
•
•M
•u
•c
•h
•
•F
•l
•u
•i
•d
•
•(
•B
•O
•X
•
•1
•3
•.
•3
•)
■ MEMORY TRICK:
"WEIGHT = WATER. 1 pound gained overnight = about 500 mL of extra fluid. 1 kg gained
= 1 LITER of fluid!"
This is why we weigh patients EVERY MORNING on the SAME scale at the SAME time. Weight is MORE RELIABLE than looking at
swelling in the legs (edema shows up LATE). ■ 3 lbs in 1 WEEK or 1–2 lbs OVERNIGHT = call the provider immediately!
, ■ CRITICAL RESCUE — Fluid Overload (BOX 13.3, p.259)
■ Assess the patient with fluid overload EVERY 2 HOURS for signs of pulmonary edema
■ If you see: bounding pulse + rising JVD + crackles spreading up lungs + decreasing urine output...
■ → NOTIFY the provider IMMEDIATELY — this is turning into pulmonary edema (can cause death)
■ Patient is also at HIGH RISK for skin breakdown — check pressure areas DAILY (heels, coccyx, elbows)
■ SODIUM (Na+) — BOX 13.4 + BOX 13.5
■ GALEN: Sodium (Na+) 135–145 mEq/L
■ MEMORY TRICK:
"SODIUM = The SPONGE in your blood. Wherever sodium goes, WATER must follow!"
Imagine sodium is a magnet and water is metal shavings. Sodium pulls water everywhere it goes. ■ LOW sodium in blood → water
rushes INTO brain cells → brain SWELLS like a wet sponge → Confusion, seizures (brain is drowning) ■ HIGH sodium in blood →
water gets pulled OUT of brain cells → brain SHRINKS like a dried raisin → Agitation, intense thirst (brain is dehydrating) ■ BOTH
need to be corrected SLOWLY — fix too fast and you damage the brain going the other direction!
