o Calcium has an inverse relation to phosphorus
• When Calcium goes up, Phosphorus goes down
(Hypophosphatemia) and vice versa
o Sodium has an inverse relation to Potassium
• When sodium goes up, Potassium goes down
and vice versa
⟶ HyperParathyroidsm = HYPERCALCEMIA = HYPOPHOSPATEMIA
Every time you see Hyperparathyroidism that’s the same exact thing as
Hypercalcemia
o Epinephrine is secreted – vasoconstrictor
When Hypovolemic (blood volume deficit), ADH and aldosterone will be secreted so keep
blood volume up
**Weight is the best indicator for fluid status EXCEPT for Burns, Its Urine Output**
Also for ventilator alarms
HOLD
High alarm- Obstruction due to incr. secretions, kink, pt. coughs, gag or bites
Low press alarm- Disconnection or leak in ventilator or in pt. airway cuff, pt. stops
spontaneous breathing
To remember blood sugar:
hot and dry-sugar high (hyperglycemia)
cold and clammy-need some candy (hypoglycemia)
Eu = Normal for example: Euthyroid is normal thyroid
Increase of LDL, THINK Coronary Artery Disease
Increase secretion of PTH makes serum calcium go up
,Decrease secretion of PTH makes serum calcium go down
You dangle artery problems and you elevate vein issue
problems
,IMPORTANT
WHEN IT ASKS FOR PRIOIRTY, ASK YOURSELF YOURE
GOING TO DO THAT OVER AND OVER AGAIN AND
NOTHING ELSE EXAMPLE: client is hemorrhaging, do you check for
vital signs or call the HCP
, Hypervolemia: Too much fluid in the vascular space (too much water in the hose)
Will Cause: HF Weak Heart low Cardiac output Low Urine Perfusion LowUrine
Output
Heart Failure
Renal Failure
S/S: Bounding Pulse
SOB; Dyspnea
Crackles/ wet lung sounds (listen to the low area in the back)
Distended Neck (JVD) and Peripheral Veins
Peripheral Edema (sacrum area) and Third spacing
Rapid Weight gain
Low urine output (specific gravity of 1.010 or less)
Central Venous Pressure (CVP): More volume (Hypervolemia) = More Pressure
CVP normal is 2-8 Low volume (Hypovolemia) = Low Pressure
Position: Semi Fowler; BED REST FOR THESE PATIENTS (hyper & Hypo)
Diet: Hypertension, heart failure, CAD—low sodium, calorie-restricted, Low fat
Treatment: Hydrochlorothiazide: Will make you lose Potassium
Furosemide: Will make you lose Potassium
Bumetanide: Will make you lose Potassium
• Give SPIRONOLACTONE to retain Potassium but watch for
Hyperkalemia
o KEEP CLIENT ON BED REST (helps reduce sodium and water)
Teaching: Check Daily weights and Input and Output
***clients with History of HF and Kidney, give fluids slow and
watch for Hypervolemia***
• When Calcium goes up, Phosphorus goes down
(Hypophosphatemia) and vice versa
o Sodium has an inverse relation to Potassium
• When sodium goes up, Potassium goes down
and vice versa
⟶ HyperParathyroidsm = HYPERCALCEMIA = HYPOPHOSPATEMIA
Every time you see Hyperparathyroidism that’s the same exact thing as
Hypercalcemia
o Epinephrine is secreted – vasoconstrictor
When Hypovolemic (blood volume deficit), ADH and aldosterone will be secreted so keep
blood volume up
**Weight is the best indicator for fluid status EXCEPT for Burns, Its Urine Output**
Also for ventilator alarms
HOLD
High alarm- Obstruction due to incr. secretions, kink, pt. coughs, gag or bites
Low press alarm- Disconnection or leak in ventilator or in pt. airway cuff, pt. stops
spontaneous breathing
To remember blood sugar:
hot and dry-sugar high (hyperglycemia)
cold and clammy-need some candy (hypoglycemia)
Eu = Normal for example: Euthyroid is normal thyroid
Increase of LDL, THINK Coronary Artery Disease
Increase secretion of PTH makes serum calcium go up
,Decrease secretion of PTH makes serum calcium go down
You dangle artery problems and you elevate vein issue
problems
,IMPORTANT
WHEN IT ASKS FOR PRIOIRTY, ASK YOURSELF YOURE
GOING TO DO THAT OVER AND OVER AGAIN AND
NOTHING ELSE EXAMPLE: client is hemorrhaging, do you check for
vital signs or call the HCP
, Hypervolemia: Too much fluid in the vascular space (too much water in the hose)
Will Cause: HF Weak Heart low Cardiac output Low Urine Perfusion LowUrine
Output
Heart Failure
Renal Failure
S/S: Bounding Pulse
SOB; Dyspnea
Crackles/ wet lung sounds (listen to the low area in the back)
Distended Neck (JVD) and Peripheral Veins
Peripheral Edema (sacrum area) and Third spacing
Rapid Weight gain
Low urine output (specific gravity of 1.010 or less)
Central Venous Pressure (CVP): More volume (Hypervolemia) = More Pressure
CVP normal is 2-8 Low volume (Hypovolemia) = Low Pressure
Position: Semi Fowler; BED REST FOR THESE PATIENTS (hyper & Hypo)
Diet: Hypertension, heart failure, CAD—low sodium, calorie-restricted, Low fat
Treatment: Hydrochlorothiazide: Will make you lose Potassium
Furosemide: Will make you lose Potassium
Bumetanide: Will make you lose Potassium
• Give SPIRONOLACTONE to retain Potassium but watch for
Hyperkalemia
o KEEP CLIENT ON BED REST (helps reduce sodium and water)
Teaching: Check Daily weights and Input and Output
***clients with History of HF and Kidney, give fluids slow and
watch for Hypervolemia***
