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59 Cards in this Set
- Front
- Back
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What conditions causes fluid volume overload? |
Excessive sodium intake Adrenal gland dysfunction Use of corticosteroids Poorly controlled IV therapy |
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How does adrenal dysfunction cause fluid retention? |
The body produces more Aldosterone/ADH which blocks water from leaving the kidneys |
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What are corticosteroids used for? |
Prevent organ rejection in transplant patients by suppressing the immune system To treat inflammation such as arthritis..asthma |
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How does corticosteroids cause fluid retention/excess? |
The drug is used to regulate water, sodium and other electrolytes.. if used whilst there is a fluid overload can make the condition worse |
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What are the vital signs changes seen in a patient with fluid excess? |
High BP Pulse bounding Increase labored respiration/dyspnea Jugular Vein Distention Edema Pale cool skin Increase urine output Rapid weight gain Moist crackles in the lung |
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Why would there be moisture in the lung from a fluid overload? |
Excessive water to the heart will leak into the lungs |
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Why are respiration increased with fluid overload? |
When excessive fluid gets in the lung it makes the individual having to breathe heavier to obtain oxygen |
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Acute fluid excess leads to this complication? |
Heart failure |
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Lab tests for fluid overload? |
BUN Hematocrit Specific gravity |
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What nursing intervention should the nurse do to facilitate breathing? |
Bring the patients bed to semi-fowler or high fowler |
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Do you give oxygen therapy before or after raising the semi fowler position if the patient has fluid overload |
No |
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What vital signs are important for a person receiving oxygen therapy |
Pulse ox Respiration |
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What drug is given to a patient wfluid overload |
Diuretics- Furosemide aka Lasix |
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If a patient is drinking 1500 mL of water everyday but is voiding in small amounts what does that tell you? |
They're retaining fluid |
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What is the most reliable indicator of fluid retention and dehydration? |
Weight gain and weight loss |
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If your patient weight 1kg more than yesterday and no change is done to his diet what would you do? |
Check decrease urine output Check for edema Check for increased blood pressure Check lungs for crackles Check if shortness of breath/dyspnea Tachycardia |
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When on Furosemide what electrolyte MUST be constantly evaluated? |
Potassium |
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This type of water contains sodium? |
Mineral water |
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What foods should you avoid when you have fluid overload? |
Cheeseburger Luncheon meat Pasta White bread Pizza American cheese Potato chips Ramen noodles |
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What effect does fluid overload have on the brain |
It can cause cerebral edema which leads to seizures because of intracranial pressure |
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What is the normal range for sodium? |
135 - 145 mmol/L |
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Serum sodium less than 135 is known as |
Hyponatremia |
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What is the role of sodium in terms of osmotic pressure? |
It controls the water-pushing pressure |
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What effect does low sodium have on the muscle? |
Muscle cramps/spasms Muscle weakness |
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What effect does low sodium have pn the brain... Explain |
It causes seizures because the sodium pump needs sodium to regulate the flow of water and with low salt the pump will build up pressure and push fluid in the brain |
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If a patient sodium is 124 mEq/L and is becoming confused what action should be taken? |
Look for seizures and create a safe environment to protect from injury |
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This electrolyte is depleted with sodium? |
Chloride |
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How does the muscles present with hypernatremia |
More excitable ....tremors |
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Both hyponatremia and hyponatremia have this reaction on the brain? |
Agitation Confusion Seizures Personality changes |
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When hypernatremia excites the muscles what is the first outcome and the final outcome |
First - muscle twitching Final - muscle weakness |
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Can hypernatremia cause respiratory problems.... explain? |
Yes .... the diaphragm is a muscle and if weaken can cause respiratory complications leading to death |
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For hyperkalemia would a patient present with metabolic acidosis or alkalosis |
Metabolic acidosis |
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Is diabetes mellitus metabolic alkalosis or acidosis |
Metabolic ACIDOSIS |
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What causes hyperkalemia |
Use of spironolactone (POTASSIUM SPARING DIURETIC) Excessive use of oral or IV potassium supplements |
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How would a patient present with hyperkalemia (What are the manifestations) |
Muscle twitches, muscle cramps followed by muscular weakness, GI motility, slow & irregular heart rate, weak pulse, and decreased blood pressure |
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What effect does hyperkalemia have on the heart and pulse |
Irregular, slow heart rate, decreased BP & a weak pulse |
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What effect does hyperkalemia have on the GI system |
Diarrhea |
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Would you give potassium sparing diuretic to patient who has low kidney function |
No |
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What drug would you give to a patient with low kidney function and where would the potassium be excreted |
Sodium polystyrene sulfonate, the potassium will be excreted through the stool |
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What is the normal lab value for calcium |
8.2 to 10.2 mg/dL or 2.1 to 2.6 mmol/L |
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What two conditions is as a result of inadequate absorption of calcium from the intestines |
Crohn's Disease which is a chronic inflammatory bowel disease |
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What two endocrine glands can cause hypocalcemia, explain why |
Thyroid and parathyroid, because these two glands stimulate the bone to release calcium in the blood even though the bone has a high level of calcium, the removal of these two hormones will cause no calcium in the blood. |
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Which electrolyte has an inverse relationship with calcium, explain the inverse effect |
Phosphate, inverse effect is that if it increases then calcium decreased (high phosphate can cause hypocalcemia) |
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A person who does not require vitamin D can be given this drug as a source of calcium |
Calcium carbonate (TUMS) |
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What is a natural source of vitamin D |
Sunlight |
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Would you give a person that is always exposed to sunlight vitamin D along with calcium carbonate |
No |
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How does hypocalcemia affect your heart rate and blood pressure |
Heart rate goes up while blood pressure is decreased |
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Explain why there is a mental status change with low calcium |
Because of the decrease in blood pressure, there will be no fluid going to the brain which can alter thevmental status |
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What are the two signs that a nurse can use to test for hypercalcemia |
Trousseau signs and Chvostek signs |
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How can the nurse test for Trousseau signs |
Inflate a blood pressure cuff around the upper arm for 1-4 Minutes, if the patient has hypocalcemia the hand will become spastic and going to palmar flexion |
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How can the nurse check for Chvostek signs |
Tsp the face just below and in front of the ear |
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How do you know that the chovstek sign is positive |
You will have a facial twitching or spasms on that side of the face. |
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what is used to treat mild or chronic hypocalcemia |
Oral calcium supplements with or without vitamin D |
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Should calcium supplements be administered before or after meals, how long and why |
after meals, one to two hours, because it will increase the absorption |
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What medication is given to patients with acute or severe hypocalcemia |
IV calcium gluconate or calcium chloride |
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If a patient present to the hospital with hyperphosphatemia and has hypocalcemia, what drug should be given to fix the issue and explain why |
Aluminum hydroxide to decrease phosphates because when phosphates are high then calcium is low |
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Name foods rich in calcium |
Cereals, tofu, mustard spinach, white beans, chia seeds, sardines, milk, yogurt, cheese |
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Whats the serum calcium level for hypercalcemia |
11 mg/dL |
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Normal serum level for magnesium |
1.6 - 2.2 |
