Term
| Fluid Volume excess/ fluid overload/ over hydration |
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Definition
| Fluid intake or retention that exceeds the fluid needs of the body. |
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Term
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Definition
| Dehydration in which the fluid intake of the body is not sufficient to meet the body's fluid needs. |
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Term
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Definition
| when a serum potassium level is higher than 5.0 mEq/L. (High K+) |
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Term
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Definition
| too little calcium.. a serum calcium level less than 3.5 and causes potassium lost through kidneys secondary to K+ wasting diuretics, steroids. S&S of low K+ are cardiac dysrhythmias, EKG changes, n/v, anorexia, leg cramps, muscle weakness, and decreased bowel sounds. |
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Term
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Definition
| essential for stabilizing cell membranes, regulating muscle contraction and relaxation, maintaining cardiac function, & blood clotting. |
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Term
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Definition
| maintains resting membrane potential of nerve/ muscle cells, excess/deficit can cause cardiac or muscle dysfunction. |
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Term
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Definition
| Na+ is greater than 145 mEq/L. |
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
| what does the patient complain of when they have Respiratory Alkalosis? |
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Definition
| Shortness of breath, chest tightness, light-headedness and numbness and tingling in extremities. |
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Term
| What causes hyperventilation during Respiratory Alkalosis? |
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Definition
| Extreme anxiety, elevated body temp., Over ventilation w/ ventilator. Hypoxia, Salicylate overdose..(aspirin OD) |
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Term
| Nursing intervention for a patient in Respiratory Alkalosis |
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Definition
| monitor Arterial Blood gas ABG'S, assist pt. with slower breathing, have client breath in paper bag or give re breather mask for --to inhale CO2 |
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Term
| Clinical manifestation during Respiratory Alkalosis |
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Definition
| Difficult concentrating,blurred vision |
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Term
| Lab Values for Respiratory Alkalosis |
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Definition
ABG=blood ph above 7.45
PaCO2 less than 35mm Hg |
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Term
| What Chronic illness places the client at risk for Fluid and electrolyte imbalance? |
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Definition
| COPD,Asthma, Cystic Fibrosis, Heart Failure (CHF), Kidney DX, Diabetes, Cushing's Dx, Cancer, Addisons, Malnutrition, Anorexia, bulimia, |
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Term
| Who is at risk for acid base and fluid electrolyte imbalance? |
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Definition
| Very old, very young, anyone who is unable to access food & fluids independently |
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Term
| What types of treatments put clients at risk for electrolyte, fluid, and acid base imbalance? |
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Definition
| Chemotherapy, IV & total parenteral nutrition, nasogastric suctioning, Enteral feeding, mechanical ventilation |
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Term
| What medications can lead to an imbalance in electrolytes, acid, base and fluids? |
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Definition
| Diuretics=Lasix, Corticosteroids=Prednisolone,NSAD's=Aleive |
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Term
| What are acute conditions that put client at risk for Fluid, Acid base, and electrolyte imbalance? |
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Definition
| Acute gastroenteritis = stomach virus, Bowel obstruction, Surgery, Head injury or decreased level of consciousness, trauma, ex: burns, crushing injuries, fever, draining wounds, fistulas |
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Term
| Hypotonic Hydration will result in: |
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Definition
| polyuria, Diarrhea, non pitting Edema, Dysrhythmias, & projectile vomiting, |
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Term
| What is Hypotonic Overhydration? |
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Definition
Water intoxication...too much water..
excessive fluid moves into the intracellular spaces = all body compartments expand |
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Term
| How does hypotonic overhydration affect the respiratory system? |
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Definition
| ^ resp rate, (shallow respiration) Dyspnea,moist crackles can be heard on Auscultation.. |
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Term
| NURSING INTERVENTION: hypotonic overhydration: |
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Definition
| monitor Cardio system, resp system, neuromuscular, renal, skin, and gastro status, prevent more overload, & restore normal fluid balance, administer diuretics, restrict fluid intake, monitor I & O and weight. Monitor electrolyte values. |
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Term
| Average daily fluid output for an adult: |
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Definition
URINE= 1,400-1,500 mL
insensible losses= lungs(350-400), skin(350-400), sweat(100), feces(100-200) |
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Term
| This is a certain type of fluid loss that the body has to have to maintain normal body function: |
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Definition
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Term
| This type of loss is not able to be measured as it is excreted from the body: |
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Definition
Ex:Lungs =through respiration and the skin
(Insensible losses) |
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Term
| what foods are rich in (K+) potassium? |
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Definition
| Banana, avocado, Raw carrot, baked potato, Apricot, dried fruits(raisins, dates), cantaloupe, orange, spinach, raw tomato, beef, cod, pork, veal, milk, O.J., Apricot nectar |
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Term
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Definition
| serum calcium levels higher than 10.5 mg/dL or an ionized calcium level greater than 5.0 mg/dL |
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Term
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Definition
| When the bicarbonate levels are low compared to the amount of carbonic acid in the body , and PH falls... |
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Term
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Definition
| the amount of bicarbonate in the body exceeds the normal 20:1 ratio. |
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Term
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Definition
| When the person hyperventilates, more CO2 than normal is inhaled, carbonic acid levels fall and the PH rises to more than 7.45. |
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Term
| What are common causes of respiratory acidosis? |
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Definition
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Term
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Definition
| HYPOvetilation & CO2 retention cause carbonic acid levels to increase ^ and PH falls Below 7.35 |
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Term
| how are acid-base imbalances usually classified? |
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Definition
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Term
| What are some clinical manifestations with respiratory Acidosis? |
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Definition
| Increased pulse rate, Headache, dizziness, confusion, decreased level of consciousness, Convulsions, Warm flushed |
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Term
| What are the lab values with respiratory acidosis? |
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Definition
| ABG= blood PH less than 7.35 and PaCO2 above 45 mm Hg HCO3 normal or slighlty elevated in acute: above 26 mEq/L in chronic |
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Term
| Normal values for (ABG's) Arterial Blood gas |
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Definition
PH= 7.35-7.45
PaO2=80-100 mm Hg
PaCo2= 35 mm Hg
HCO2= 22-26 mEq/L
Base excess= -2 to +2 mEq/L
o2 saturation 95-98% |
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Term
| Normal (SODIUM)electrolyte values |
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Definition
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Term
| Normal (K+) potassium electrolyte value for an adult |
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Definition
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Term
| Normal Chloride electrolyte value |
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Definition
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Term
| Normal Calcium electrolyte value for an adult |
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Definition
| 4.5-5.5 mEq/L or 8.5-10.5 mg/dL |
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Term
| Normal Magnesium electrolyte level for an adult |
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Definition
| 1.5-2.5 mEq/L or 1.6-2.5 mg/dL |
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Term
| Normal phosphate electrolyte level for an adult |
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Definition
| 1.8-2.6 mEq/L or 2.5-4.5 mg/dL |
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Term
| Normal serum osmolality for an adult in electrolyte values |
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Definition
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Term
| What veins are best when choosing an IV site? |
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Definition
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Term
| What are some variables which dictate the IV site? |
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Definition
| Client's age, how long the infusion is set for, the type of solution being run, and condition of veins. |
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Term
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Definition
Adult=Arm & hand
Infants=Scalp & Dorsal foot |
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Term
| When is a central Venous catheter used? |
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Definition
| When the pt./client will be receiving long-term IV therapy or parenteral feedings, or the medications being given are damaging to the veins. EX: Chemotherapy |
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Term
| Where is a central Venous Catheter inserted? Is this a sterile procedure? |
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Definition
subclavian or Jugular Vein.....
YES, it is sterile! |
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Term
| Can an RN do a central venous line? |
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Definition
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Term
| Where is the distal tip of the Central Venous line/catheter while it is inserted? |
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Definition
| it rests in the superior vena cava above the rt. atrium. |
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Term
Which veins are commonly used for IV?
Actual Names: |
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Definition
| metacarpal, basilic, & cephalic |
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Term
| can a central line be done at the bedside? |
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Definition
| YES! For longer term access it will be done surgically. |
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Term
| What are some complications which can arise from Central Venous Catheters? |
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Definition
| Hemothorax or Pneumothorax, Cardiac perforation, thrombosis, and infection |
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Term
| What gauge cannula should be used for intravenous therapy? |
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Definition
| the smallest that will allow good flow & still accommodate therapy. Most hydration and intermittent therapies use 22-27 gauge. |
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Term
| What gauge cannula will clients with fragile veins get with an IV? For ex: infants or neonates/ |
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Definition
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Term
| What are some tips before inserting an IV: |
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Definition
| a warm compress can be placed over the area, the client may take a hot shower or have a hot drink: This will act as a vasodilator and make the first attempt easier unless contraindicated. |
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Term
| Why should a hand be the last choice for an IV? |
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Definition
| the possibility of nerve injury, mainly in older adults who have thin skin. |
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Term
| What should the RN do if the IV therapy is to last longer than a few days and is irritating to the client's veins? |
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Definition
| consult with the IV NURSE or the provider to see if a central line or another type of catheter would be better for this client. |
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Term
| How many attempts should you try when inserting an IV before soliciting help from others? |
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Definition
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Term
| What position should the patient be in for IV insertion/ |
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Definition
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Term
| How may gravity help when inserting an IV? |
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Definition
| by dangling the client's arm off the beside to encourage blood flow to that area. |
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Term
| When should the RN avoid using a certain arm on a client when inserting an IV? |
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Definition
| Hemiplegia( paralyzed on tat side) or dialysis access or the side of a Mastecomy |
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Term
| What is a LACTATED RINGER'S Solution? |
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Definition
| An alkalinizing solution that may be given to treat metabolic acidosis |
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Term
| At what stage during the client's discharge should the RN remove the IV? |
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Definition
| The IV should be removed last because it may need to be accessed if the pt's condition suddenly changes. |
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Term
| List types of Isotonic Solutions; |
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Definition
0.9%(Normal saline)
Lactated Ringer's (balanced electrolyte solution)
5% dextrose in water(D5W) |
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Term
| What type of isotonic solution remains in the vascular compartment causing the expansion of vascular volume? |
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Definition
| Normal saline and lactated ringers |
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Term
| Once the pt. has been given an isotonic solution what should the RN watch for? |
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Definition
| the RN should assess the pt.for a bounding pulse and shortness of breath (signs of hypervolemia) |
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Term
| What pt or client should not be given the isotonic solution D5W and why? |
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Definition
| Anyone at risk for increased intracranial pressure(IICP) b/c D5W (Dextrose in water) can increase cerebral edema. |
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Term
| List types of hypotonic solutions: |
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Definition
0.45% NaCl (half normal saline)
0.33% NaCl (one-third normal saline) |
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Term
| Why are hypotonic solutions used? |
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Definition
| To provide free water and treat cellular dehydration. |
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Term
| What effect do hypotonic solutions have on the kidneys? |
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Definition
| They promote the kidneys to eliminate waste. |
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Term
| What pt/client should avoid hypotonic solutions? |
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Definition
| Those At risk for (IICP) or third space fluid shift. |
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Term
| How does the client appear clinically (neurologically) in metabolic Acidosis? |
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Definition
Drowsy, Headache, confused, and possible coma
(There is a decrease in HCO3-) |
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Term
| How does the client appear clinically (neurologically) in Respiratory acidosis? |
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Definition
Drowsiness, Disorientation, Dizziness, Headache, and possible coma
(there is an increase in Pco2) |
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Term
| How does respiratory acidosis effect the Cardiovascular system? |
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Definition
| Low BP, Ventricular fibrillation, Warm flushed skin |
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