Medical Surgical Nursing Exam 2

Medical Surgical Nursing Exam 2 – Review Look at pics for: Endocrine, Integumentary, and STDs Essay Marika-Evisceration Marika-Differences in Sprain and strain- Know nursing assessments and interventions and S/S Marika or Steph E-Compartment Syndrome: Collaborative care, S/S, Treatment, Nursing Assessment/ intervention Steph E-Embolus thrombus(venous thromboembioli?)care,prevention, assessment pg 778 Steph E-Crystalloid solution, Know all solutions Hyper/ Hypo tonic NW5 ….etc Steph-Hyper/Hypo Kalemia: Everything Hyperkalemia = serum potassium 5.0 High serum potassium caused by – Massive intake; Impaired renal excretion; Shift from ICF to ECF Most common in renal failure, Also common in patients with massive cell destruction; Ex: – burn or crush injury, tumor lysis – rapid transfusion of stored, hemolyzed blood – catabolic states (e.g., severe infections) Causes: Certain drugs such as potassium-sparing diuretics nolactone [Aldactone],triamterene [Dyrenium], angiotensin-converting enzyme (ACE) inhibitors (e.g., enalapril [Vasotec], lisinopril [Prinivil]), may contribute to the hyperkalemia. Manifestations: cardiac dysrhythmias, bradycardia, hypotension, may produce cardiac arrest; ECG: peaked T waves; hyperactive bowel sounds, diarrhea, paresthesias, muscle weakness NI: Force K from ECF to ICF by IV insulin or sodium bicarbonate; Reverse membrane effects of elevated ECF potassium by administering calcium gluconate IV; monitor for dysrhythmias. Patients with moderate hyperkalemia should additionally receive one of the treatments to force potassium into cells, usually IV insulin and glucose Hypokalemia = serum potassium 3.5 caused by: Abnormal losses of K+ via the kidneys or gastrointestinal tract (losses of potassium secondary to diarrhea, laxative abuse, vomiting, and ileostomy drainage ) ;Magnesium deficiency –Metabolic alkalosis Manifestations: decreased level of consciousness; weakeness /paralysis; respiratory insufficiency; cardiac dysrhythmias, ECG changes: prominent U waves; shallow ineffective resperations; hypoactive bowel sounds, n/v, constipation; muscle aches, cramps, twitching, decreased deep tendon reflexes.