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91 Cards in this Set
- Front
- Back
Where does body fluids distributed?
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Intracellular fluid & Extracellular fluid
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Fluid can move between compartments through?
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Selective permeable membranes
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There are varieties of methods of moving fluid through compartments what are theY? 4 ans
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DIFFUSION, ACTIVE TRANSPORT, FILTRATION, OSMOSIS
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This is minerals sometimes called salts that are present in all body fluids?
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ELECTROLYTES
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They help regulate fluid balance and hormone production, strengthen skeletal structures, and act as catalysts in nerve response, muscle contraction ,ad the metabolism of nutrients
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ELECTROLYTES
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When electrolytes dissolved in water or another solvent what happen? 2 ans
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It separate into ions: conduct either POSITIVE OR NEGATIVE electrical current
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Examples of Electrolytes that are cation or positive? 4 ans
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magnesium, potassium, sodium, and calcium
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Examples of Electrolytes that are anions or negative? 4 ans
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phosphate, sulfate, chloride, bicarbonate
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The lab test can reflect the electrolyte concentrations in?
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Plasma not within the cell
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The nurse should familiar the 2 fluid imbalances?
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Fluid Volume deficits and Fluid volume excess
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Fluid volume deficits(FVD's) include? 2 ans
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1. Hypovolemia-isotonic
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What happen of the water and electrolytes in Hypovolemia-isotonic
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Both loss water and electrolytes from ECF
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What happen of the water and electrolytes in Dehyration-osmolar?
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Loss of water, no loss of electrolytes
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It occurs with dehydration that result in increases in Hct, serum electrolytes and urine specific gravity.
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Hemoconcentration
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Compensatory mechanisms include sympathetic nervous system responses that also arise? 3 ans
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Increased thirst, antidiuretic horme (ADH) release, and aldosterone release
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Why is it that older adults have an increased risk of dehydration ?
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due to a decrease in TOTAL BODY MASS, w/c includes total body water content
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Assessment: Causes of HYPOVOLEMIA?
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1. ABNORMAL GI LOSES ( vomiting, diarrhea, nasogastric suctioning.
2. ABNORMAL SKIN LOSSES (Diaphoresis-excessive sweating) 3. ABNORMAL RENAL LOSSES ( diuretic therapy, diabetes insipidus, renal disease, adrenal insufficiency, osmotic diuresis) 4. THIRD SPACING- Peritonitis, Intestinal obstruction, ascites, burns 5. HEMORRHAGE 6. ALTERED INTAKE (NPO) |
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IS Hct increase or dec in Hypovolemia?
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Increased Hct
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HCT:In dehydration is Hemoconcentration Inc. or dec.? what if dehydration casued by Hemorrhage?
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Inc. Hemoconcentration/ not present when caused by hemorrhage
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Serum osmolarity dehydration what happen to Hemoconcentration osmolarity?
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Increased hemoconcentration osmolarity( greater than 300 mOsm/L)=inc protein, BUN, electrolytes, glucose
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In Urine specific gravity and osmolarity dehydration what happen to concetration?
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Increased
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In Serum Na(sodium) dehydration what happen to hemoconcentration?
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Increased
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One of the Collaborative Care in Hypovolemia w/c is monitor I & O and urine output less than ml/hr
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30 ml/hr
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Fluid Volume EXcess (FVE) include? 2 ans
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1. Hypervolemia-isotonic
2. Overhydration-osmolar |
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What happen to the water and Sodium in Hypervolemia-Isotonic?
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Water and sodium are abnormally high
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What happen to the water and electrolytes in overhydration-osmolar?
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water increase than electrolytes
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If severe Hypervolemia it can lead to ? 2 ans
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Pulmonary edema and heart failure
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Hemodilution occurs with overhydration, what happen to Hct, serum electrolytes and protein?
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All decreases
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In Fluid Volume excesses compensatory mechanism include an increased release of natriuretic peptides resulting Inc. or dec loss of sodium and water by the kidneys? and inc. or dec release of aldosterone?
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increase loss/decreased release of aldosterone
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What are the causes of Hypervolemia? 5 ans
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1. Chronic stimulus to the kidney to conserve sodium and water(heart failure, cirrhosis, increased glucocorticosteroids)
2. Abnormal renal function with reduced excretion of sodium and water (renal failure) 3. Interstitial to plasma fluid shifts (hypertonic fluids, burns) 4. Age-related changes in cardiovascular and renal function 5. Excessive sodium intake |
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In hypervolemia the Hct is dec or inc?
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decrease
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in Overhydration the Hct is inc or dec?
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decrease
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Overhydration minus decreased Hct=
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Hemodilution
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In serum osmolarity the overhydration wil inc or decrease hemodilution (omolarity lessthan 270 mOsm/L)
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Decrease
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the Electrolytes, BUN, and creatinine ill increase or dec? in overhyration/hypervolemia
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Decrease all
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What is the result of x-rays as a diagnotic tool in the lungs having hypervolemia
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Pulmornay congestion
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What are the Major electrolytes in the body? 6 ans
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Na, K, Chloride, Mg, Phosphorus, and Calcium
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It is important to reconize the ________ of elctrolyte imbalance?
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sign & symtoms
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The clients that has greates risk for electrolyte imbalance are?
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Infants, children, older adults, clients w/ cognitive disorders, and w/ chronic illness
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What one of the jamfor electrolyte found in ECF?
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Sodium(Na+)
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It is essential for maintenace of acid-base balance, active and passive transport mechanisms, and irritability and conduction of nerve and muscle tissue
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Sodium
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What is the expected serum sodium levels?
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136-145 mEq/L
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serum sodium level less than 136 mEq/L
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Hyponatremia
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It is a net gain of water or loss of sodium-rich fluid
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Hyponatremia
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What happen to the depolarization of membranes on Hyponatremia?
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delay and slow
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In hyponatremia the water will move from the ECF to ICF or ICF to ECF?;w/c causes cells to swell(cerebral edema)
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ECG to ICF
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What are the serious complications of acute hyponatremia if untreated ?3 ans
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coma, seizures, respiratory arrest
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Cause of Hyponatremia(loss of sodium) deficient of ECF vol or ICF?
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ECF vol
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Abnormal GI losses is risk factors of hyponatremia what are the examples?
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vomiting, diarrhea, NG suctioning, tap water enemas
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Edema risk of hypnatremia include illness? 3 ans
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Heart failure, cirrhosis, nephrotic syndrome
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The client's riks factors of hyponatremia is __________ why?
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older adult clients( inc. incidence of chronic illnesses, use of diuretic medications and risk for insuff. sodium intake
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Serum Na Hyponatremia? less than ___meq/L
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136
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Serum osmolarity of Hyponatremia is dec less than --------------- mOsm/L
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280
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A serum sodium level that is greater than 145 mEq/L. It is a serious electrolyte imbalance. It can cause__________(3) ans?
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1. Hypernatremia.
2. neurological, endocrine, and cardiac disturbances |
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Incr. Na causes hypertonicity of the serum. What happen to the water in our cell or body?
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water out of the cells making the cells dehydrated
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What are the risk factors of hypernatremia? (loss of Na)
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1. water deprivation(NPO)
2. escessive Na intake 3. Excessive sodium retention 4. Fluid losses 5. Age-related changes 6. compensatory mechanisms with inc thirst and inc. production of ADH |
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One of the causes of hypernatremia is age-related changes in old age why?
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dec. total body water content and inadequate fluid intake related to an altred thirst mechanism
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Hypernatremia,The serum sodium will increase greater than ______mEq/L
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145
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Hypernatremia:Serum osmolarity in Hypernatremia will inc greater than _________mOsm/L
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300
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What is the major cation in ICF that plays vital role in Cell Metabolism;transmission of nerve impulses;functioning of cardiac, lung, and muscle tissues; and acid-base balance
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Potassium(K+)
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________ is the major cation in ICF that plays a vital role in cell metaboism; transmission of nerve impulses; functioning of cardiac, lung, and muscle tissues; and acid-base balance
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Potassium(K+)
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K has reciprocal action with ______
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Na
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Expected serum potassium levels
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3.5 to 5 mEq/L
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the result of an inc. loss of K from the body or movement of K into the cells. Levl below 3.5 mEq/L
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Hypokalemia
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Risk factors of hypokalemia(loss of potassium)
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1. Abnormal GI losses (vomiting, diarrhea, NG suctioning , inaappropriate laxative use)
2Renal losses=excessive use of diuretics =furosemide(lasix), corticosteroids 3. Skin Losses-diaphoresis, wound losses 4.Insuffiecient K 5. Inadequate dietary intake(rare) 6. Prolonged administration of non-electrolyte(IV sloutions such as 5% dextrose in water) 7. ICF-metabolic alkalosis,afer correction of acidosis, during periods of tissue repair(burns, trauma, starvation) total parenteral nutrition 8. Age-related factors |
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The client that is risk for hypokalemia and why?
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older adult because due to increase use of diuretics, and laxatives
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laboratory findings of serum K hypokalemia dec and less than
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3.5 mEq/L
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laboratory finding so arterial blood gases metabolic alkalosis pH greater
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than 7.45
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Diagnostic procedures in hypokalemia is _________ what are the finding?
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will show findings of dysrhthmias, such as PVCs, ventricular tachycardia, inverted T waves, and St depression
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Collaborative nursing care of hypokalemia to replace potassium by
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1. encourage foods high in potassium (avocado, brocolli, dairy products, dried fruit, cantaloupe, bananas
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A serum potassium level greater than 5 mEq/L. It is the result of an increased intake of K, movement of K out of the cells, or inadequate renal excretion
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Hyperkalemia
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Risk factors of hyperkalemia? 5 ans
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1. Increased total body potassium-IV K administration, salt substitutes
2.ECF shif- dec. insulin, acidosis(diabetic ketoacidosis), tissue catabolism(sepsis, trauma, surgery, fever, myocardial infaction) 3.Hypertonic states-uncontrolled diabetes mellitus 4. Decrased excretion of potassium-Renal failure, severe dehydration, potassium sparing diuretic, ACE inhibitors, NSAIDs, adrenal insufficiency 7. Older adult clients |
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What client is risk of hyperkalemia?why?
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older adult. Due to inc. use of salt substitues, angiotensin-converting enzyme inhibitors, and K-sparing diuretics
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if potassium levels are extremely high what will be required?
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dialysis
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_______ found in the bones and the teeth. Plentiful in the body. what its normal values?
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calcium. 9 to 10.5 mg/dl for ionized calcium
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it is essential for proper functioning of the cardiovascular, neuromuscular, and endocrine systems, as well as blood cotting and bone and teeth fomation
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calcium
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it is a serum calcium level less than 9 mg/dL
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hypocalcemia
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What are the risk of Hypocalcemia? 5 ans
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1.Malabsorption syndromes, such as Crohn's disease
2. End-stage renal disease 3. Post thyroidectomy 4. Hypoparathyroidism 5. Reapeated transfusion |
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What happen to the Cardiovascular in hypocalcemia?
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dec. myocardial contractility(dec heart rate and hypotension)
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What exam of GI in hyocalcemia?
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Hyperactive bowel sounds, diarrhea, abdominal cramping
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what happen to the Central Nervous System in hypocalcemia
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seizures due to overstimulation of the CNS
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Lab finding is hypocalcemia, calcium level less
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than 9 mg/dL
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Lab findings of hypocalcemia?
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ECG. prolonged QT interva;
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examples of foods high in calcium?
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dairy products and dark green vegetables
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Where does most Magnesium found in our body. Which is found less in our body?least found
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1. mostly in the bones
2. smaller amounts in body cells. 3. least in ECF |
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Most of the ____________ found in the bones. ___________ in smaller amounts found within body cells. Very small amount is found in ECF. What is this called?
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Magnesium
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What is the Normal values of Magnesium level?
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1.3 to 2.1 mEq/L
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A serum magnesium level less than 1.3 mg/dl
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Hypomagnesemia
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What are the risk factors of hypomagnesemia? 2 ans
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1. Malnutrition(insufficient magnesium intake)
2. Alcohol ingestion(magnesium excretion) |
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In subjective and Objective data of Hypomagnesemia
1. Neuromuscular will? 3 ans 2. What happen of the GI? 4 ans |
1. Inc. nerve impulse transmission (hyperactive DTRs, Paresthesias, Muscle tetany, positive Chvostek's and TRousseau's sign
2. Hypoactive bowel sound, constipation, abdominal distention, paralytic ileus |
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What are the Nursing Care for hypomagnesemia? 3 ans
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1. Discontinue medications that decrease Mg (exam=. loop diuretics
2. Administer oral or IV Mg sulfate following safety protocols. IV route is used because IM can cause pain and tissue damage. Oral Mg can cause diarrhea and Inc. Mg depletion. MONITOR CLOSELY 3.Encourage foods high in MG (dairy prod. and dark green Vegetables |