F&E 4th Semester

  1. Timeframe to transfuse blood or blood products?
    Within 4 hours to the floor
  2. Name teh hypertonic fluids
    • 3% NS
    • D5 in .33% NS
    • D5% in .45% NS
    • D5 in 0.9% NS
    • D5LR
  3. Name the isotonic fluids
    • 0.9% NS
    • LR
    • D5W
  4. What isotonic solution has K+ in it?
  5. Name the hhypotonic solutions
    0.45% NS
  6. What are colloids used for?
    Blood loss/burns
  7. Protein solutions are used for
    Wound healing
  8. Used to treat hyponatremia when serum sodium <115
    3% NS
  9. Fluid used that is good for volume replacement
    0.9% NS
  10. Fluid most like plasma in the body
  11. Good fluid to use after trauma or surgery
  12. Fluid good with K+ replacement
    D5 (becareful of DM)
  13. Fluid used to jump start kidneys
    0.45% NaCl
  14. Can cause hypotnsion and allergic reactions with use
    • Albumin
    • Dextran
    • Plamanate
  15. Funtions like plasma protens to maintain oncotic pressure
    Colloid solutions
  16. Restore body proteins
  17. plasma volume expander
  18. How is albumin administered?
    Slowly, or pulmonary vasculoature fluid retention can result
  19. Can be used instead of plasma nad albumin to replace body protein
  20. Useful in correcting hypovolemai in early shock and increasing cardiac output
  21. Plasma voume expander that can affect blood clotting. 2 concentrations. 40 70, 70 can cause severe dehydration
  22. % of plasma in whole bblood
  23. What meds do you give before blood products?
    Benedryl and aspirin
  24. IVAD
    surgically implanted central line
  25. Central lines need x ray confirmation when?
    After insertion and BEFORE
  26. Sites of insertion for central lines
    Superior vena cava (internal jugular or R/L subclavian vein, inferior vena cava accessed from femoral vein.
  27. Who inserts a central line?
  28. Complications of central lines:
    • -Pneumothorax
    • -Air embolism
    • -infection
    • -phlebitis
    • -thrombus formation-
    • -bleeding
    • -cardiac dysrhythmias
  29. Who can insert a PICC?
    RN - specially trained
  30. PICC confirmation of placement
  31. If hypertonic infultrates, what compress?
  32. If hypotonic infultrates, what compress?
  33. If isotonic infultrates, what compress?
  34. D5 delivered , >3000ml, what can happen?
    water intoxication, dextrose metabolized, water is all that is left.
  35. What do you monitor if pt is receiving fluids?
  36. How long to leave in a primary line?
    72 hours, longer with order
  37. Phlebitis
    • antibiotics,vancomycin, cypro, big need needle/small ein can cause
    • Stop fluid- warm/moist ccompress
  38. 7.35
    Increased C02
    Increased HC03
    Fully compensated respiratory acidosis
  39. 7.41
    decreased C02
    decreased HC03
    Fully compensated respiratory alkalosis
  40. 7.39
    Decreased C02
    Decreased PC03
    Fully compensated metabolic acidosis
  41. 7.43
    Increased CO2
    Increased PC03
    Fully compensated metabolic alkalosis
  42. 7.3 pH
    C02 55
    PC03 20
    Respiratory acidosis partially compensated
  43. 7.48
    C02 30
    HC03 20
    Respiratory alkalosis partially compensated
  44. Decreased pH
    Decreased C02
    Decreased HC03
    Partially compenstated metabolic acidosis
  45. Increased pH
    Increased C02
    Increased PC03
    Partially compenstated metabolic alkalosis
  46. Sodium range
  47. works with K+ and ca+ to maintain neuromuscular irritability and nerve conduction
  48. Regulates acid base balance
  49. what maintains Na+ balance?
    kidneys, neural and hormal mediators
  50. Causes of hypertonic alterations
    • Hypernatremia
    • Water Deficit
    • Hyperchloremai
  51. Causes of hypotonic alterations
    • Hyponatremia
    • Water excess
    • Hypochloremia
  52. Isotonic deficit is...
    a proportional loss of water and electrolytes
  53. Signs of isotonic deficit
    wght loss, dry skin and mucous membranes, decreased urin output and s.s of hypovolemia
  54. Urin specific gravity during isotonic deficit
  55. Phosphate levels
  56. Divorced from phosphorus
  57. care when giving milk...why?
    phosphorus and calcium both inside
  58. what causes isotonic excess?
    too much IV NS, or oversecretion of aldosterone with renal retntion of water and sodium
  59. S/S of isotonic excess
    wght gain, neck ven distention, increased BP, increase pulse, hypervolemia, decreased hematorcrib ant plast protein concentrations. High output urin, decreasec concentration
  60. Late s/s of excess (isotonic excess)
    Edema and CHF
  61. HHypertonic alterations, water in or out of cell
    Out, cells dehydrated.
  62. What IV solution for hypertonic alteration
  63. Deficit in free water results in
    • hypovolemia
    • hyperchloremia
  64. excess of aldosterone can cause
  65. cushings syndrome can cause
  66. what can cause oversecreation of aldosterone
    adrenal gland tumor
  67. What is increaed with fever or respirtory infections?
    Increased sodeium secondary to water loss
  68. DI can cause
  69. Diarrhea can cause
    greater water loss in relation to sodium
  70. decredased free water intake can cause
  71. S/S of hypertonic hypernatremia
    • Convulstions
    • Pulmonary edema
    • Thirst
    • Fever
    • Drym ucous membranes
    • hypotension
    • tachycardia
    • low jugular venous pressure
    • restlessness
  72. Evaluation findings of hypertonic hypernatremia
    Increased sodium serum and specific gravity >1.030, hematocrit and plasma protein level
  73. Treatment of hypertonic hypernatremia
    D5% in water until sodium returns to normal
  74. Appropriate term for hypertonic alterations caused by water deficit
  75. How is water lost in water deficit hypertonic alterations
    • urine
    • sweat
    • feces
    • insensible losses
  76. s/s of water deficit
    • thirst
    • dry skin and mucous membranes
    • elevated temp
    • weight loss
    • concentrated urin
    • skin turgor may be normal
  77. treatment of dehydration
    • give water
    • When IV therepy is used d5% in water...pure water can cause lysis
  78. Both ICF volume and ECF volume increase with
    Free water excess
  79. s/s of hypervolemia and water intoxication with cerebral and pulmonary edema occur
    Free water excess
  80. Does water move in or out of cell in hyponatremia
    into cell
  81. Behavioral and neruo changes
  82. lethargy and confusion
  83. apprehension
  84. seizures and coma
  85. Decreased urin specific gravity with hyper or hyponatremia
  86. treatment of hyponatremia
    restrict water intakee with dilutional hyponatremia
  87. Confusion and convulsions
    hypotonic aleration from water excess
  88. weakness, nausea, muscle twitching headache and weight gain
    hypotonic alteration from water excess
  89. treatment of hypotonic water excess
    Restrict fluids for 24 hours, if no convusions IV hypertonic sodium chlorides with severe s/s
  90. alkalosis and K+
  91. wahat can alter K+ levels
    Catecholamines (epinepherine, norepinepherine), alpha and beta adrenergics....sudden increase can be fatal
  92. insulin can be used to
    correct hyperkalemia
  93. muscle weakness, neromuscular irritability, tingling of lips and fingers, restlessness, intestinal cramping and diarrhea, severe: loss of muscle tone, paralysis
  94. T waves changed, slow heart rate, prolonged PR interval and widened QRS complex, v fib, cardiac arrrest
  95. hyperkalemia level is
  96. causes of hyperkalemia
    renal disease, massive trauma, insulin deficeincy, addison's disease, use of K+ salt sub., metabolic acidosis
  97. spiralactone
    holds onto K+
  98. Hold dig if <
    60 bpm
  99. tx of hyperkalemia
    calcium gluconate, adminsiter insuine, sodium bicarb (due to acidosis), adminst: Kayexalate (binds K+ in poop)
  100. ECG hypokalemia
    • sinus brady
    • AV block
    • U waves
  101. neuromuscular decrease
  102. paralytic ileus
  103. calcium levels
  104. how is calcium lost?
    Urin and feces
  105. hypocalcemia caused by
    Decreased PTH, vit D, renal dysf, electolyte influences
  106. circumoral numbness
  107. confusion and parasthesia around the mouth and digits
  108. hand feet spasms, hyperreflexia, anxiety tentancy and convusions
  109. Chvostek and Trousseau
  110. tx of hypocalcemia
    • Non severe: Tums, increase phosphorus in diet
    • Severe: IV 10% calcium gluconate diluted in 5% dextrose water (D5W)
  111. do not dilute calcium in what?
    0.9% NaCL
  112. common cause of hypercalcemia
    hyperparathyroidism, breat, prostate, cervica, GI , ovariun cancer, excess Vit D,
  113. depressions, signs of heart block , ekg changes, deep pain over boney areas, flank pain
  114. kidney stones
  115. tx for acute illness for hypercalcemia
    normal saline to help kidneys excrete
  116. calcitonin
    makes calcium go back INTO the bone
  117. #1 causwe of hypophosphatemia
  118. hyperparathyroidism
    promotes excretion of phoshate, causing hypophosphatemia
  119. magnesium and alunim antacids can cuasee
  120. respiratory alkalosis can cause what electrolyte imbalance
  121. neruso irregularities, weakness and tremors, hematologic, possible hypoxia and cardiopulmonary abnormalities, weak pulses, abnormal serum levs, hyperventilation
  122. tx of hypophosphatemia
    oral or iv supplememnts
  123. hyperphosphatemai is primarily related to
    low calcium levels
  124. tx of hyperphosphatemia
    aluminum hydroxide and hemodialysis
  125. magnesium levels
  126. magnesium is regulated by
  127. fx of magnesium
    neruomus excitability, cardiac contractions (aids others), influences utilization of K+, Ca+ protein
  128. loop and thiazide diuretics can cause
  129. malnutrition is the number one cause of
  130. clinical manifestations of hypomagnesemia are similar to
  132. hypermagnesemia caused by
    magnesium containing antacids, renal failure
  133. Too much mag, does what?
    depresses skeletal muscle contraction and nerve function
  134. N/V, muscle weakness, hypotension, bradycardia, respiratory depression, loss of DTrs, flushing
  135. prolonged QT interval
  136. tx of hypermagnesemia
    tx off underlying causeand by IV saline or calcium salts, dialysis
Card Set
F&E 4th Semester
F&E 4th Semester