AM - GAlen 170 Exam 1 (Perioperative,
Comfort, Anemia)
20-30 (Fluid & Electrolytes, Acid Base)
20-30
1.Best indicator for fluid volume overload?: Weight
2.Assessment for FVO: - Bounding + increase pulse
- High BP
- Dyspnea, crackles, edema
- Decreased hematocrit, serum sodium, and urine specific gravity
3.Causes of FVO: - ESRD, CHF, water intoxication, SIADH, corticosteroid therapy, rapid fluid replacement
4.Treatment for FVO: - Diuretics
- Fluid Restriction
- Salt restriction
- Monitor I&O's
5.intracellular fluid: fluid within cells; 66%; 25 L
6.Extracellular fluid: - Fluid outside the cell; 33%; 15L
- Most important for homeostasis
7. Homeostasis: - Proper functioning of all body systems
- Extracellular (intravascular and interstitial fluid)
8. Fluid balance: - 2 to 3 liters a day
- urine output 400-600 ml per day
- increases during stress, fever and tachy
9. Fluid Volume Deficit (FVD) (dehydration): - Increased HR; decreased B/P
- Lethargy; decreased UOP; dry mucous membranes; constipation; thirst
,- Increased hemoconcentration; BUN; sodium; urine specific gravity
10. Causes of FVD: vomiting, diarrhea, ileostomy, laxitives, burns, fever, diuretics, GI suctioning and NPO
11. Interventions of FVD: - Halt OTC
- Outdoor activity
- Weight gain/loss
- Diet habits
12. BUN and Creatinine are?: Kidney markers and are sensitive to decreased blood flow.
13. Normal BUN levels: 10-20 mg/dL
14. Normal creatinine levels: 0.6-1.2
15. BUN and creatinine rise when: - Nitrogenous wastes are found in the blood indicating kidney impairment. - Also
dehydration
16. Hypernatremia: - Due to sodium loss, water gain, or inadequate intake
- Diuretics, Anticonvulsants, SSRI's
- Water Gain: CHF, SIADH, polydipsia
- Dehydration
- Common: Restlessness or agitation, anorexia, N/V, weakness, lethargy, confusion, crave water
- Worst case scenario: Decreased LOC, seizures, coma
- Treatment: Fluids! PO/IV; what type of IVF?- - Nursing implications: Frequent VS, Monitor neurologic status, Seizure/fall
precautions, strict I/O's, assess skin/MM, oral care, monitor labs
17. Hypokalemia: - Not enough in: Inadequate K+ intake
- Too much out: GI fluid losses
- Depleting drugs: Diuretics, corticosteroids, insulin, excessive laxative use, albuterol - Black licorice?
- Common: Cardiac arrhythmias, leg cramps (hallmark), muscle weakness, decreased GI motility (decreased BS, constipation,
N/V), decreased DTR's, muscle weakness, alkalosis
- Worst case scenario: Life threatening cardiac arrhythmias/Cardiac arrest!
- **Hypokalemia may potentiate dig toxicity**
- Treatment: Increase dietary intake of potassium, K supplementation. Give IV potassium SLOWLY!!!
, AM - GAlen 170 Exam 1 (Perioperative,
Comfort, Anemia)
20-30 (Fluid & Electrolytes, Acid Base)
20-30
- Nursing implications: Frequent VS, cardiac monitoring, patent IV, monitor labs (recheck after supplementation), NEVER give
potassium IVP or bolus!
18. Hyperkalemia: - Too much intake: Increased dietary intake, salt substitutes, potassium supplements - Donated blood
- Drugs: K-sparing diuretics, -- ACE-I's, ARBS, NSAIDS
- Not enough excreted: Renal failure
- Crush injury: Intracellular K released
- Common: Cardiac arrhythmias, Muscle weakness (which may lead to flaccid paralysis), increased GI motility, decreased DTR's,
acidosis
- Worst case scenario: Life threatening cardiac arrhythmias/cardiac arrest
- Treatment: Potassium restricted diet; if critical/symptomatic will require drug therapy (such as?)
- Nursing implications: Cardiac monitoring, frequent labs, VS, monitor for hypoglycemia if insulin IVP given
19. Electrolyte Imbalances: Etiology;
Hypocalcemia: Inadequate intake, malabsorption, calcium loss, others (?): -
Inadequate intake: Calcium and Vit D
- Malabsorption: Post-menopausal women, diseases that affect the small bowel, drugs (anticonvulsants) - Calcium Loss:
Loop Diuretics
- Others: Renal failure, hypoparathyroidism, low magnesium, multiple blood transfusions, alkalosis, low albumin levels
20. Electrolyte Imbalances: Etiology;
Hypercalcemia: Increased resorption from the bone: - Hyperparathyroidism
- Cancer
- (Thazide diuretics)
21. Electrolyte Imbalances: Etiology
Hypomagnesemia - Poor intake, poor GIT absorption, excessive GIT loss, exces-
Comfort, Anemia)
20-30 (Fluid & Electrolytes, Acid Base)
20-30
1.Best indicator for fluid volume overload?: Weight
2.Assessment for FVO: - Bounding + increase pulse
- High BP
- Dyspnea, crackles, edema
- Decreased hematocrit, serum sodium, and urine specific gravity
3.Causes of FVO: - ESRD, CHF, water intoxication, SIADH, corticosteroid therapy, rapid fluid replacement
4.Treatment for FVO: - Diuretics
- Fluid Restriction
- Salt restriction
- Monitor I&O's
5.intracellular fluid: fluid within cells; 66%; 25 L
6.Extracellular fluid: - Fluid outside the cell; 33%; 15L
- Most important for homeostasis
7. Homeostasis: - Proper functioning of all body systems
- Extracellular (intravascular and interstitial fluid)
8. Fluid balance: - 2 to 3 liters a day
- urine output 400-600 ml per day
- increases during stress, fever and tachy
9. Fluid Volume Deficit (FVD) (dehydration): - Increased HR; decreased B/P
- Lethargy; decreased UOP; dry mucous membranes; constipation; thirst
,- Increased hemoconcentration; BUN; sodium; urine specific gravity
10. Causes of FVD: vomiting, diarrhea, ileostomy, laxitives, burns, fever, diuretics, GI suctioning and NPO
11. Interventions of FVD: - Halt OTC
- Outdoor activity
- Weight gain/loss
- Diet habits
12. BUN and Creatinine are?: Kidney markers and are sensitive to decreased blood flow.
13. Normal BUN levels: 10-20 mg/dL
14. Normal creatinine levels: 0.6-1.2
15. BUN and creatinine rise when: - Nitrogenous wastes are found in the blood indicating kidney impairment. - Also
dehydration
16. Hypernatremia: - Due to sodium loss, water gain, or inadequate intake
- Diuretics, Anticonvulsants, SSRI's
- Water Gain: CHF, SIADH, polydipsia
- Dehydration
- Common: Restlessness or agitation, anorexia, N/V, weakness, lethargy, confusion, crave water
- Worst case scenario: Decreased LOC, seizures, coma
- Treatment: Fluids! PO/IV; what type of IVF?- - Nursing implications: Frequent VS, Monitor neurologic status, Seizure/fall
precautions, strict I/O's, assess skin/MM, oral care, monitor labs
17. Hypokalemia: - Not enough in: Inadequate K+ intake
- Too much out: GI fluid losses
- Depleting drugs: Diuretics, corticosteroids, insulin, excessive laxative use, albuterol - Black licorice?
- Common: Cardiac arrhythmias, leg cramps (hallmark), muscle weakness, decreased GI motility (decreased BS, constipation,
N/V), decreased DTR's, muscle weakness, alkalosis
- Worst case scenario: Life threatening cardiac arrhythmias/Cardiac arrest!
- **Hypokalemia may potentiate dig toxicity**
- Treatment: Increase dietary intake of potassium, K supplementation. Give IV potassium SLOWLY!!!
, AM - GAlen 170 Exam 1 (Perioperative,
Comfort, Anemia)
20-30 (Fluid & Electrolytes, Acid Base)
20-30
- Nursing implications: Frequent VS, cardiac monitoring, patent IV, monitor labs (recheck after supplementation), NEVER give
potassium IVP or bolus!
18. Hyperkalemia: - Too much intake: Increased dietary intake, salt substitutes, potassium supplements - Donated blood
- Drugs: K-sparing diuretics, -- ACE-I's, ARBS, NSAIDS
- Not enough excreted: Renal failure
- Crush injury: Intracellular K released
- Common: Cardiac arrhythmias, Muscle weakness (which may lead to flaccid paralysis), increased GI motility, decreased DTR's,
acidosis
- Worst case scenario: Life threatening cardiac arrhythmias/cardiac arrest
- Treatment: Potassium restricted diet; if critical/symptomatic will require drug therapy (such as?)
- Nursing implications: Cardiac monitoring, frequent labs, VS, monitor for hypoglycemia if insulin IVP given
19. Electrolyte Imbalances: Etiology;
Hypocalcemia: Inadequate intake, malabsorption, calcium loss, others (?): -
Inadequate intake: Calcium and Vit D
- Malabsorption: Post-menopausal women, diseases that affect the small bowel, drugs (anticonvulsants) - Calcium Loss:
Loop Diuretics
- Others: Renal failure, hypoparathyroidism, low magnesium, multiple blood transfusions, alkalosis, low albumin levels
20. Electrolyte Imbalances: Etiology;
Hypercalcemia: Increased resorption from the bone: - Hyperparathyroidism
- Cancer
- (Thazide diuretics)
21. Electrolyte Imbalances: Etiology
Hypomagnesemia - Poor intake, poor GIT absorption, excessive GIT loss, exces-
