MEDICAL SURGICAL NURSING; GOOD REVIEWED SUMMARY FOR EXAM REVISION

manifestations of dehydrations weight loss, dry mucous membranes, increased HR, increased respirations, thready pulse, cap refill greater than 3 seconds, weakness, fatigue, orthostatic hypotension, poor skin turgor late signs- oliguria, decreased CVP, flattened neck veins isotonic fluids treatment of vascular system fluid deficit, concentration is equal to plasma - 0.9% normal saline - lactated ringers - D5W hypotonic fluids treatment of intracellular dehydration, shift fluid from ECF to ICF - 0.45% normal saline - 2.5% dextrose in 0.45% saline hypertonic fluids used only when serum osmolality is critically low, shift fluid from ICF to ECF - 10% dextrose in water - 50% dextrose in water - 5% dextrose in 0.9% saline - 5% dextrose iin 0.45% saline - 5% dextrose in LR major intracellular electrolytes - potassium - phosphorus - magnesium major extracellular electrolytes - sodium - calcium - chloride - bicarbonate hypokalemia causes- meds (steroids, diuretics, digitalis, laxatives), body fluid loss, kidney disease, alkalosis manifestations- muscle weakness, cramping, fatigue, nausea, vomiting, irritability, confusion, paresthesia, dysrhythmias, flat or inverted T waves * if client is not peeing, do not administer potassium hyperkalemia causes- renal failure, adrenal insufficiency, acidosis, meds (ACE inhibitors, potassium sparing diuretics) manifestations- peak T waves, ventricular dysrhythmias, muscle twitching and paresthesia, ascending muscle weakness, increased bowel motility treatment- dialysis, kayexalate, 50% glucose with insulin, calcium gluconate, bicarbonate hyponatremia causes- GI loss, SIADH, adrenal insufficiency, NPO, restricted diet, water intoxication, excessive diaphoresis, meds (diuretics, anticonvulsants, SSRIs, lithium, demeclocycline manifestations- weakness, lethargy, confusion, seizures, headache, anorexia, nausea, vomitng, muscle cramps, twitching, hypotension, tachycardia, weigh gain, edema hypernatremia causes- dehydration, GI loss, hyperaldosteronism, hypertonic tube feedings, diabetes insipidus, kidney failure, burins, heatstroke, steroids manifestations- fever, swollen dry tongue, sticky mucus membranes, hallucinations, lethargy, seizures, irritability, tachycardia, hypertension, hyperreflexia, pulmonary edema treatment- infusion of hypotonic or isotonic fluid hypocalcemia causes- hypoparathyroidism, hypomagensium, kiddy failure's, vitamin D deficiency, GI loss manifestations- tetany, cramps, paresthesia, dysrhythmias, trousseaus sign, chvosteks sign, seizures, hyperrflexia, impaired clotting hypercalcemia causes- hyperparathyroidism, malignant disease, prolonged immobilization, dehydration, vitamin D excess, lithium , glucorticoids, dig toxicity, hyperthyroidism manifestations- muscle weakness, kidney stones, dysrhtymias, lethargy, coma, hyporeflexia, fracture, flank pain, deep bone pain, polyuria, polydipsia, dehydration, hypertension, nausea, vomiting treatment- isotonic IVF, dialysis, furosemide, calcitonin, glucocorticoids, biphosphonates, calcium chelators pH 7.35-7.45 pCO2 35-45 HCO3 range 22-26 fully compensated when two ABGs are abnormal, and pH has returned to normal partially compensated all three ABGs are abnormal metabolic acidosis causes- diarrhea, fever, hypoxia, starvation, seizure, overdose, renal failure, DKA, dehydration manifestations- bradycardia, week pulses, tachypnea, hypotension, confusion, lethargy pH- low pco2- normal hco3- low metabolic alkalosis causes- ingestion of antacids, GI suction, hypokalemia, TPN, blood transfusions, prolonged vomiting manifestations- dizziness, paresthesia, hypertonic muscles, decreased respirations pH- high pco2- normal hco3- high respiratory acidosis causes- resp depression, pneumothorax, airway obstruction, inadequate ventilation manifestations- dizziness, palpitations, muscle twitching, convulsions pH- low pco2- high hco3- normal respiratory alkalosis causes- hyperventilation, hypoxemia, altitude, asphyxiation, asthma, pneumonia manifestations- tachypnea, anxiety, paresthesia, palpitations, chest pain pH- high pco2- low hco3- normal allen test