1
Q
ORDER OF HYDRATION
A
- Infant: priority
- older adult/elderly
- male
- female: least
2
Q
High risk for dehydration
A
infants followed by elderly
3
Q
Has delay to thirst regulating center
A
Older adults
4
Q
Thirst regulating center
A
Hypothalamus
5
Q
First sign of dehydration among elderly
A
Constipation
6
Q
Fluid compartment:
Blood vessel (Plasma)
Measurable; 30% fluid
A
Extracellular/ Intravascular
7
Q
Fluid compartment:
Life-threatening dehydration/ Systemic complication
A
Blood vessel (Plasma) or Extracellular/intravascular
8
Q
Fluid compartment:
Cell
most abundant fluid 70%
localized complications
A
Intracellular
9
Q
Fluid compartment:
in between cells
Same manifestation with intracellular
A
Interstitial
10
Q
Low molecular weight (small molecules)
passes through fluid compartments
low oncotic pressure
A
Crystalloid
11
Q
Hypertonic, isotonic, hypotonic
A
Crystalloid (Low oncotic pressure)
12
Q
Stays in blood vessel
high molecular weight
High oncotic pressure
A
Colloid
13
Q
Packed RBC, albumin, Plasma expander
A
Colloid (high oncotic pressure)
14
Q
> 0.9% IVF
A
hypertonic
15
Q
PNSS
A
isotonic
16
Q
PLRS
A
isotonic
17
Q
D5W
A
isotonic
18
Q
0.9% IVF
A
Isotonic
19
Q
0.25% nacl
A
hypotonic
20
Q
0.33% nacl
A
hypotonic
21
Q
0.45% nacl
A
hypotonic
22
Q
<0.9 % IVF
A
Hypotonic
23
Q
D50W
A
Hypertonic
24
Q
D10W
A
Hypertonic
25
D5LR
Hypertonic
26
D50.9% nacl
Hypertonic
27
TPN
Hypertonic
28
D50.45% NACL
Hypertonic
29
IVF MANIFESTATIONS: (Cells to B. vessels)
-hypervolemia
- hypertension
-poluria
-cellular dehydration (dhn)
-dry mouth
-polydipsia
-dry skin
-altered mental status (confusion/ disorientation)
HYPERTONIC overdose
30
IVF MANIFESTATIONS: (B. vessels to cells)
-hypovolemia
-hypotension
-oliguria
-DHN
-edema
-ascites
-Cerebral edema
Hypotonic overdose
31
Normal value: sodium (na)
135-145 meq
32
Normal value: potassium (k)
3.5-4.5 (5.5) meq
33
Normal value: calcium (ca)
4.5-5.5 meq or 8-10 mg/dl
34
Normal value: Magnesium (mg)
1.5-2.5 meq
35
Normal value: Phosphorus (P)
2.5-4.5 meq
36
Normal value: chloride (cl)
95-105 mg/dl
37
Manifestation:
Fluid volume deficit
Late edema
hypernatremia
38
Manifestation:
Fluid volume excess
early/ immediate edema
Hyponatremia
39
Diet for hypernatremia
Na restriction
increase fluid intake :dilute sodium
40
IVF of choice for hypernatremia
hypotonic
41
Diet for hyponatremia
Fluid restriction
Nacl- table salt
NaNitrate- preservatives
NaSaccharide- sweetener
NaAscorbate- alkali vitamin c
NaHCO3- Baking soda
MSG- monosodium glutamate (vetsin)
42
IVF of choice for Hyponatremia
Hypertonic
Isotonic (0.9% nacl)
43
Tall/ peak/ dominant T-waves
Hyperkalemia
44
Flattened T-waves
Hypokalemia
45
ST depression
hypokalemia
46
Presence of U waves
Hypokalemia (digitalis toxicity)
47
ST elevation
Hyperkalemia
48
Widening of QRS
hyperkalemia
49
narrowing of QRS
hypokalemia
50
Diet for hypokalemia
ABCDK
Apple
Banana
Citrus/catalope
Dried fruits (raisins, prune, apricots,
dates)
Kiwi
51
DOC: for hypokalemia (oral)
Kalium durule
52
DOC: for hypokalemia (IV)
KCL
53
Nursing alert for KCL IV:
Never IV push
Incorporate in suloset
54
DOC: Hyperkalemia antidote
Calcium gluconate (antidote)
-it doesn't treat hyperkalemia but lowers HR
-Lower muscle contraction
55
DOC: hyperkalemia
kayexelate
-na polysterone
-exchange sodium to potassium
-eliminate thru stool
56
Side effect of Kayexelate
Hypernatremia
Effect is within 4-6 hours
57
d5w + d50w = iv
glucose-Insulin infusion
-Increase blood sugar = decrease k
-effect: within 30 minutes
-k+ follows glucose into cells
-insulin transport glucose into cells
58
pushes potassium into the cell
salbutamol/albuterol
59
excrete potassium into urine
k+ wasting diuretic (furosemide/lasix)
60
DOC FOR HYPERKALEMIA (SATA)
-kayexelate: exchange na to k
-glucose-insulin infusion: follows glucose in the cell
-salbutamol/ albuterol: pushes k into the cells
-potassium wasting diuretic (furosemide/lasix): excrete k+
-hemodialysis: eliminates excess electrolytes
61
electrolyte that intitiate muscle contracton (large & skeletal muscles)
Calcium
62
The effect of ___ is opposite to ___ electolytes.
k+ & ca+
63
Electrolyte manifestation:
increase Muscle contraction
high RR (hyperventilation)
increase mental alertness
insomnia
muscle spasm
leg cramps
fatigue (hypercontraction)
facial twitching
extreme facial twitching
osteoporosis
hypocalcemia
64
decrease muscle contraction (relaxation)
low HR & RR (hypoventilation)
decrease mental alertness
drowsiness
lethargy
muscle weakness
fatigue
apathy
renal calculi (stones)
hypercalcemia
65
DIET: hypercalemia
Low calcium
High sodium: it excretes ca+
increase fluidi ntake
66
DOC for hypocalemia
calcium gluconate & Amphogel
calcium gluconate
-never give ca+ in NSS
-Given in D5 containing IV
"SODIUM LOSSES CALCIUM"
Amphogel
-phosphate binder
-increase ca+ in blood
67
DOC for hypercalcemia
Mitharcin & Magnesium Sulfate
Mitharcin
-block parathyroid hormone to absorb ca+ in blood
Magnesium Sulfate
-maintains ca+ in bone
68
DIET: HYPOCALCEMIA
-Increase ca+ diet
-milk dairy products
-anchioves (cheapest)
-ca+ supplement
-vit D supplement= absorb of calcium
69
CARDIAC ARREST
METABOLIC ACIDOSIS
=(-) blood flow; leads to cell deprivation of O2 (alkaline) ; results to METABOLIC ACIDOSIS.
=Give sodium bicarbonate
70
IVF for crash collision
Mannitol
-Returns fluids into blood vessels from cells
71
DM pt with 300mg/dl RBS; Whats the nursing Dx
FLUID VOLUME DEFICIT
-Excess sugar dehydrates the Cell.
72
Mr. Rey is admitted in the ER. Suffered from vehicular accident and develops cerebral edema. Unconscious GCS=6. Which fluid should the nurse questioned?
A.D5LRS
B.D50.9% NaCl
C.0.33% NaCl-
D.D5 half saline
A.D5LRS-hyper
B.D50.9% NaCl -hyper
////***C.0.33% NaCl- hypo
D.D5 half saline--hyper
73
The nurse is caring for Mrs. C with dx DM insulin dependent. Pt complains of Excess thirst. Blood sugar= 200 mg/dl and pt develops polyuria at night. Which fluids should be administered.
HYPOTONIC IVF.
74
What electrolytes is being withhold with pt. Mieniere Disease?
Ménière disease -is a disorder caused by build of fluid in the chambers in the inner ear.
Nurses withhold sodium minerals.
-Sodium restriction to reduce fluid pressure in the inner ear.
75
presence of U-wave is due to
Hypokalemia due to Digitalis toxicity
76
initiate contractions
ca+
77
maintains Contractions; life threatening electrolytes
k+
78
Pt. With renal failure has a potassium level of 6.8 MEQ. what should the nurse monitor?
HR & pulse rate
79
IVF that promotes peristalsis. Post-op
KCL
80
pt with renal failure with K+ level of 6.8 meq was given calcium gluconate, what is the primary purpose of Calcium gluconate
TO PREVENT ARRYTHMIA AND LOWERS HEART RATE, NOT LOWERS POTASSIUM LEVEL.
81
What is the initial nursing action or drug to be given first for patient with hyperkalemia?
A.Glucose insulin Infusion
B.Calcium gluconate
C.Kayexelate
A.Glucose insulin Infusion
///***B.CALCIUM GLUCONATE
C.Kayexelate
82
First sign of MGSo4 toxicity
Absence of knee jerk reflex
83
high and fast
K+
84
Everything is low and slow
ca+ & mg+
85
GENERAL- TOP8
flashcards
Decks in class (25)
# Cards
-
CAUSATIVE AGENT3
-
DRUG OF CHOICE82
-
NORMAL LAB VALUES23
-
FORMULAS31
-
PATHOGNOMONIC SIGN67
-
NURSING THEORIST29
-
ANTIDOTE0
-
PALMR40
-
BIOETHICAL PRINCIPLES52
-
RESEARCH53
-
LEADERSHIP & MANAGEMENT1
-
CHN 1188
-
CHN II337
-
REPUBLIC ACTS54
-
PEDIATRICS216
-
Maternal Nursing283
-
DEVELOPMENTAL MILESTONES19
-
ELECTROLYTES85
-
CARDIOVASCULAR SYSTEM132
-
GASTROINTESTINAL TRACT119
-
DM1
-
FUNDAMENTALS2
-
CHN CHAPTER 133
-
CHN CHAPTER 245
-
CHN CHAPTER 3172
