Fluid and Electrolytes part two

44問 • 2年前

問題一覧

Select causes of hyponatremia.

Vomiting/ diarrhea, Fistulas, Exessive sweating, Burns, NG suction, Diuretic use, Osmotic diuresis

Select interventions for hypovolemic hyponatremia

Treat underlying cause, High Na+ diet, Daily weights, Strict I&Os, Neruo checks, Sodium chloride tabs, Isotonic IV fluids

Both sodium and water are increased in extracellular area but water gain is more than sodium gain. (aldosterone)

Hypervolemic hyponatremia

Select S/S of Hyponatremia

Edema/ third space shifting, Hypertension, Weight gain, Rapid bounding pulse.

Select causes of Hypervolemia hyponatremia

Heart failure, Renal failure, Liver failure, Nephrotic syndrome, Excessive administration of hypotonic fluids, Hyperalderstonism

Interventions hypervolemia hyponatremia

Treat underlying cause, High Na+ diet, Daily weights, Strict I&O’s, Neuro checks, Sodium chloride tabs, Maybe diuretics

Other causes of hyponatremia

NG suction, Diuretics, CHF, Low intake, Too much ADH

A result of hypovolemia or fluid volume loss in which sodium and water are lost from the body proportionally.

Isotonic dehydration

Select S/S of isotonic dehydration

Dry skin, Sunken eyes, Dry mucous membranes, Decreased skin turgor, Increased HR, Decreassed B.P., Headache, Weakness, Decreased output (except diabetes insipidus

Select causes for isotonic dehydration

Vomittin/ diarrhea, hemorrhage, Burns, Heat stroke, Sweating, Lack of intake

Select the assessment findings for hyponatremia “SALT LOSS” in order.

Seizures & stupor, Abdominal cramping & attitude changes, Lethargic, Tendon reflexes deminished, Loss of urine and Loss of appetite, Orthostatic hypotension & Overactive bowel sounds, Shallow respirations, Spasms of muscles

What is dehydration water deficit?

Hypernatremia

Select S/S for Hypernatremia

Restlessness, Confusion, Seizures, Twitching, fever, Agitation, Flushed skin, Coma, Tremors, May appear Hypervolemic: Elevated BP, bounding pulse, dysppnea

Select interventions for Hypernatremia

Free water, Salt free fluids, Na+, Diuretics and water, Use D5/.45% or D5W

Select Causes of Hypernatremia “HIGH SALT” (select in order)

Hypercortisolism (cushings), Osmotic Diuretics, Increased Na+ intake, GI feeding w/out H2O, Hypertonic solutions, Sodium excreation decreased, Aldosterone problems, Loss of fluids (NG suction), Thirst impairment

Select assessment findings for Hypernatremia “no FRIED foods for you”

Fever & Flushed skin, Restlessness, Really agitated/ weakness, Increased fluid retentions/, Edema & extremely confused/ seizures, Dry skin/ decreased turgor/ dry mucous membranes

Assiting in skeletal and HEART MUSCLE contraction, aiding in transmission of nerve impulses, and has an effect on acid base balance is what electrolyte?

Potasssium

True or false? If the balance of K+ changes it changes cell excitability and the ability of cells to fire. Which means that cells fire excessively with little simulation or cells will barely respond to stimulation.

True

Select causes of hypokalemia

Decreased mag, ETOH, Hyperaldostronism, Hepatic disease, Heart failure, Respiratory alkalosis, Burns, Lack of intake, Excessive water intake, Too much output/ NG suction/ Urine GI, Drugs (lasix, steroids, laxatives), Hyperglycemia, Osmotic diuresis, Insulin therapy

Select DITCH for causes of hypokalemia in order

Drugs (laxatives, diuretics, corticosteroids, Inadequate intake K+ (NPO, anorexia N&V), Too much water intake, Cushings Syndrome, Heavy fluid loss (NG suction, N&V, wound drainage, profuse sweating)

Select the assessment findings for hypokalemia. (if its low its slow)

Cardiac (weak irregular pulse palaptions orhtosatic hypotension), Neuromuscular weakness (leg cramps, parenthesia, fatigue, response weakness), Deacreased GI motility, N/V, constipation, Decreased DTR lower extremities first

Select seven Ls that go with hypokalemia.

Lecthargic, Low shallow respirations, Lethal cardiac concerns (dysrhythmias), Loss of urine, Leg cramps, Limp muscles, Low BP & HR (orthostatic hypotension)

Labs/ Diagnostics for hypokalemia

K+ less that 3.5, Decreased mg (inverse), Increased 24 hour urine level, Elevated pH and bicarbonate, Elevated glucose, Elevated digoxin, ECG changes

Select hypokalemia interventions

Replace K+, High K+ foods, Oral supplements, IV replacement, Never give IV push or bolus has to go in a pump, DO NOT GIVE IV K+ RATE GREATER THAN 10 mEq/hr, Switch to potassium sparing diuretics

Select causes of hyperkalemia.

Tissue injury, Too much intake, Too little output, Drugs (ACE, NSAID, ARB’s K+ sparing), Renal failure, Blood transfusions, Elevated pH, Salt substitutes, Insulin deficit/ DKA

Select assessment findings for Hyperkalemia.

Bradycardia, Hypotension, Cardaic arrest, Irregular pulse, ECG changes, Paresthesia, paralysis, Hyperrefelixa, Resp. distress, Numbness/ tingling, GI cramping decreased urine output

Select interventions for hyperkalemia

Restrict K+ intake, Safety, Teaching, Eliminate K+ from the body, Loop diuretics, Dialysis, Dextrose& insulin, Cardiac monitor, Assess VS,and dig level, Administer calcium chloride or calcium gluconate

True or False? Calcium chloride has three times more calcium than calcium gluconate.

True

What electrolyte has a range of 1.3-2.1 is important for cell metabolism ATP, critical for skeletal muscle contraction vitamin activation, cell growth and energy, and helps Na+ and K+ cross cell membranes?

Magnesium

Select causes for hypomagnesium

Poor intake/ absorption, Increased loss from GI or urinary tract, Sepsis, Cirrhosis, Hypoglycemia, ETOH, DM/ DKA, Renal disease, Elderly @ increased risk, NG suction

Select LOW MAG in order

Limited intake of mag, other electrolyte issues (hypocalcemia, hypokalemia), Wasting via kidneys, Malabsroption, Alcohol (pancreas issues, Glyemic issues (DKA)

Select assessment findings for Hypomagnesemia. “Tiwtching” in order

Trousseaus signs (related to hypocalemia)/ +Chvostek’s, Weak respirations, Irritability, Torsades de pointes (fatal, alcohol abuse, Cardiac changes, Hypotension, Involuntary moments, muscle cramping/ siezures, Nausea, GI issues (decreased bowel sounds and motility)

Select interventions for Hypomagnesemia

Replace mg (oral, IV), Assess pt (VS, LOC, dysphagia, reflexes), Safety, Teaching high mag foods, Decrease stimulation, Neuro checks

What electrolyte provides structure to bones and teeth, maintains cell membrane structure, and impulse transmission, and is required for blood clotting.

Calcium

Calcium absorption requires the active form of what with it?

Vitamin D

When more calcium is needed what hormone is released?

PTH

When excess calcium is present what is secreted by the thyroid gland?

TCT thyrocalcitonin

Select causes for “LOW CALCIUM” in order.

Low parathyroid hormone (destruction or removal), Oral intake inadequate, Wound drainage (GI), Celiacs disease, Acuts pancreatitis, Low VD, Chronci kidney disease, Increased phosphorus leveled, Using meds (mag, laxatives, loop diuretics), Mobility issues (bones)

Select assessment findings for hypocalcemia “CRAMPS” in order.

Confusion, Reflexes will be hyperactive, Arrythmias, Muscle spasm&seizures, Positive Tousseasus, Sign of Chvostek’s

Select interventions for hypocalcemia.

Admin. Ca calcium chloride for calcium gluconate (more commonly used), Mg replacement, VD supplements, Safety/ teaching Ca foods

Select causes of hypercalcemia “HIGH CAL” in order.

Hyperparthyroidism, Increased intake, Glucocorticosteroids, Hyperthyroidism, Calcium excretion decreased, Adrenal insufficiency (addisons), Lithium use

Select assessment findings for hypercalcemia “WEAK” in order

Weakness of muscles, EKG changes, Absent reflexes and abdominal distention, Kidney stone formation

Select hypercalcemia interventions.

Increase Ca excreation (hydration, diuretics, hemodialysis, Block bone rabsorption and GI uptake (steroids, phosphates), Strain urine, Ambulate

What electrolyte has a role in nerve and muscle function, works with Ca for bone structure, plasma levels of calcium and phosphorus exist in a balance reciprocal relationship.

PO4

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ユーザ名非公開 · 15問 · 2年前

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