Study Guide for Exam 1

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Fluid and Electrolytes
Know the causes, nursing assessment findings and treatments for: Fluid Volume Excess (Overload): heart failure, renal failure, abnormal fluid shift, treat with diuretics and fluid restriction or sodium restrictions, record i&o’s, bounding pulse, JDV, crackles in lungs (from PE), SOB, PITTING EDEMA Fluid Volume Deficit (Hypo-Volemia): shift from plasma into ICF with sodium loss, treat with isotonic fluids, blood products for blood loss, low BP, increase HR, weak thready pulse, no JVD, increase RR, decreased LOC, cool skin POOR SKIN TURGOR SIADH: decrease in plasma osmalility and urine output, too much ADH, hyponatremia Diabetes Insipidus: polyuria, polydipsia, alert LOC, 800-1200ml/hr, decrease in ADH Hypokalemia: caused by excessive diuresis and mag deficiency UWAVE PRESENT LETHAL VENTRICULAR RHYTHMS , SUPPLEMENTS SHOULD NEVER EXCEED 60MEQ/L AND RATE SHOULD NEVER EXCEED 10-20 MEQ/HR Hyperkalemia: potassium sparing diuretics, ACE inhibitors, impaired renal excretion, cramping leg pain PEAKED TWAVE PROLONGED PR INTERVAL WHICH LEADS TO VFIB , effect cardiac electrical receptor cells, treat with lasics and kayexalate, force k+ into ECF to ICF with glucose and insulin Hyponatremia : sodium loss or water gain SIADH, irritability confusion seisures, treat with hypertonic or sodium fluids or vasopresson which blocks ADH, COLD, CLAMMY SKIN Hypernatremia: causes are DI, mannitol, diuretics. Hypertonic fluids, sodium gain or water loss, weakness, intense thirst, agitation, seisures, coma, treat with hypotonic solutions, FLUSHED DRY SKIN Hypomagnesemia: prolonged fasting, starvation, chronic alcoholism , diuretics, hyperactive DTR, tremors, seisures, Hypermagnesemia: renal insufficiency/failure, lethargic, drowsiness, n&v, loss od DTR, treat with calcium gluconate Hypercalcemia: calcitonin stimulated in response, hyperparathyroidism, malignancies, KIDNEY STONES fatigue, constipation, reduced excitability of muscles/nerves , treat with loop...
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