NCLEX__ NURS 7755 study guide

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  Low Urine 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*** HYPOVOLEMIA: Fluid not in the vascular space  SHOCK (COLD AND CLAMMY) Look for Hypovolemia in (anything that causes losing fluid): Trauma SURGERY patients NG tube Paracentesis  you losing fluid Vomiting and diarrhea Ascites: fluid in the abdomen; Edema: Fluid in the wrong spot so check for Hypovolemia Polyuria: Fluid in the wrong spot so check for Hypovolemia Will Cause: Third spacing: When fluid goes somewhere else other than Other than the vascular space Ascites: fluid in the abdomen  People with liver Disease will have this Edema Polyuria: When you see this, THINK Shock First ** When you go into HYPOVOLEMIC STATE (Hemorrhage, vomiting, or anything that causes you to lose water), the ALDOSTERONE hormone secretion will increase to preserve/retain sodium and water*** S/S: I