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med surg exam 1 terms
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79
Nursing
Undergraduate 2
10/04/2010

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Term
ions
Definition
charged molecules, positive or negative
Term
anion
Definition
negative electric charge
Term
cation
Definition
positive electric charge
Term
osmolality and normal range
Definition
percent solute in water; range 278-298 mOsm/kg
Term
sodium normal range
Definition
135-145 mEq/L
Term
potassium normal range
Definition
3.5-5.0 mEq/L
Term
calcium normal range
Definition
4.3-5.3mEq/ L
Term
chloride normal range
Definition
100-106 mEq/L
Term
magnesium normal range
Definition
1.5-2.5 mEq/L
Term
phosphate normal range
Definition
1.2-2.6 mEq/L
Term
zinc normal range
Definition
50-150 mcg/dl
Term
primary ICF electrolytes
Definition
potassium, phosphorous, magnesium
Term
primary ECF electrolytes
Definition
sodium, chloride, bicarbonate
Term
EFVD
Definition
extracellular fluid volume deficit; dehydration.
Term
mild dehydration:
Definition
1-2 liters
Term
moderate dehydration:
Definition
3-5 liters
Term
severe dehydration
Definition
5-10 liters
Term
average daily fluid intake
Definition
1500-2500 mL
Term
normal daily output
Definition
1400-1500 mL
Term
5 older adult impairments that cause decreased fluid intake:
Definition
1) cognitive 2) decreased renal function 3)increased percent total body fat 4) drug-drug interactions 5) multiple diseases
Term
intravascular fluids?
Definition
in the bloodstream
Term
intracellular fluid is _ of total body fluids.
Definition
2/3
Term
three components of ECF:
Definition
interstitial fluid, intravascular fluid, transcellular fluid
Term
primary cation of ECF?
Definition
sodium
Term
hyperosmolar/hypertonic fluid deficit?
Definition
water loss greater than electrolyte loss
Term
iso-osmolar/isotonic fluid deficit:
Definition
water and electrolyte loss equal
Term
hypotonic fluid deficit
Definition
electrolyte loss greater than fluid loss
Term
five clinical manifestations of dehydration
Definition
weight loss, I & O changes, vital sign changes, thirst, mental status changes
Term
osmolality findings in dehydration
Definition
above 295 mOsm/kg
Term
BUN levels in dehydration
Definition
above 25 mg/dl
Term
hematocrit in dehydration
Definition
greater than 55%
Term
four nursing interventions for deficient fluid volume
Definition
restore oral fluid intake, administer IV fluids, monitor for complications, control underlying problems
Term
3 nursing interventions for impaired oral mucous membranes
Definition
assessments, oral care every two hours, adequate fluid intake/proper hydration
Term
four nursing interventions for risk for injury related to fluid imbalance:
Definition
assist with ADL's, call light in reach and bed alarm on, educate family and patient about safety plan, safety in position changes
Term
amount of water for every 15 minutes of exercise
Definition
150-200 mL
Term
four educational steps for the patient to prevent fluid loss:
Definition
don't stop drinking w/ incontinence, drink when not thirsty, replace lost fluids during exercise, avoid heat and humidity
Term
hypervolemia vs. third spacing
Definition
both part of fluid overload; HV is in the vascular system and will affect blood pressure, TS is edema
Term
when this decreases, fluid overload can occur
Definition
plasma protein
Term
respiratory and cardiac manifestations of fluid overload
Definition
crackles, cough, bounding pulse, elevated blood pressure, decreased O2 sat
Term
change in osmolality, sodium, BUN, and hematocrit in hemodilution
Definition
they are all decreased below the normal levels
Term
four parts of outcome management in fluid overload
Definition
restrict fluids, restrict sodium,, diuretics, control cardiac (ACE inhibitors)
Term
how much should body weight change when controlling fluid overload?
Definition
0.5 to 1 lb/day decrease
Term
three clinical manifestations of water intoxication
Definition
increased intracranial pressure, pupils unresponsive, ALOC
Term
2 steps of nursing management for water intoxication
Definition
monitor I&O, IV, and daily weight. Encourage sodium rich foods
Term
two causes of third spacing
Definition
protein malnutrition, massive burns
Term
four common signs of third spacing:
Definition
pallor, cool limbs, hypotension, oliguria
Term
labs in third spacing:
Definition
elevated BUN, sodium, hematocrit, and urine specific gravity
Term
nursing management of third spacing (four steps)
Definition
prevent skin breakdown, monitor for signs of fluid overload, assessment, measure abdomen/extremities for edema changes
Term
four body secretions containing sodium:
Definition
bile, feces, tears, urine.
Term
four body secretions containing sodium:
Definition
bile, feces, tears, urine.
Term
7 clinical manifestations of hyponatremia
Definition
confusion, headaches, crackles/dyspnea, low BP with elevated HR, thready pulse, dry mucous membranes, nausea/vomiting
Term
nursing interventions for risk for hyponatremia
Definition
monitor lab values, encourage fluid intake, encourage balanced diet, prevent sodium loss (vomiting, diarrhea)
Term
four early/ six late symptoms of hypernatremia
Definition
anorexia, polyuria, restlessness, and weakness/ coma, seizures, tremors, rigid muscle paralysis, confusion, muscle twitching
Term
what is the fluid replacement for hypernatremia?
Definition
hypo-osmolar solution
Term
3 isotinic solutions:
Definition
D5W, lactated ringers, 0.9% NS
Term
3 hypotonic solutions
Definition
0.45% NS, 0.33% NS, 2.5% dextrose
Term
3 hypertonic solutions
Definition
D5 0.45% saline, D5NS, D5LR
Term
primary cation of ICF
Definition
potassium
Term
major problem of hypokalemia
Definition
slowed neuronal excitability
Term
7 manifestations of hypokalemia
Definition
ECG changes and dysrhythmisa, anorexia, weakness and leg cramps, confusion, convulsions
Term
two nursing diagnosis for hypokalemia
Definition
risk for injury, imbalanced nutrition less than body requirements
Term
trauma most often causes
Definition
hyperkalemia as potassium is released from the cells
Term
major effect of hyperkalemia
Definition
altered excitability of nerves and muscles
Term
clinical manifestations of hyperkalemia
Definition
low BP, cardiac arrest r/t muscle paralysis, muscle irritability, diarrhea
Term
cation exchange resin used in management of
Definition
hyperkalemia
Term
in patient self care for hyperkalemia, what is a major point?
Definition
avoid salt substitutes, as they usually contain potassium.
Term
best diagnostiic test of hyperkalemia?
Definition
ECG- tall, narrow peaked T wave
Term
major drug in treatment of hyperkalemia?
Definition
kayexalate- allows secretion of K+
Term
diabetes insipidus
Definition
excessive fluid loss
Term
nephrogenic vs. neurogenic diabetes insipidus
Definition
Nephro= kidneys unresponsive to ADH. Neuro= lack of secretion/production of ADH
Term
symptoms of diabetes insipidus
Definition
polyuria, polydipsia (excessive thirst), serum osmolality rises as urine osmolality falls.
Term
five reasons why geri patients more at risk for fluid loss
Definition
1)impaired thirst mechanism 2) multidrug interaction 3) increase in body fat to water ratio 4) decreased renal functioning 5) altered ADH response
Term
EKG changes with hypokalemia
Definition
depressed/prolonged ST segment, inverted T waves, prominent U waves
Term
consequences of overactive/underactive adrenal glands
Definition
over: sodium, chloride, and water retention excessive, under: K+ retained while water, sodium, and chloride are lost in urine.
Term
xanthine drugs can cause
Definition
diuresis
Term
three xanthine drugs
Definition
theophylline, aminophylline, diphylline
Term
minimal urine output for 8 hrs is
Definition
240 mL
Term
macrodrop calculated at
Definition
10, 15, or 20 ggt/mL
Term
microdrip calibrated at
Definition
60 gtt/mL
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