Fluid Fundamentals
This is the movement of solutes from an area of higher concentration to an area of lower concentration.
diffusion
This is the normal serum potassium range
3.5–5.0 mEq/L
This is the normal serum sodium range.
135–145 mEq/L
These pancreatic cells normally produce endogenous insulin.
beta (β) cells
A blood glucose below this value is considered hypoglycemia in your presentation.
70
A patient's weight increases by 2.2 lb in 24 hours. Approximately this much fluid has been retained.
1 liter (1 kg) of fluid
A potassium level of 2.9 mEq/L places a patient at particular risk for this potentially life-threatening complication.
Cardiac dysrhythmias?
A patient with severe hyponatremia develops altered mental status and seizures. This IV solution may be prescribed cautiously.
3% hypertonic saline
These are the classic "three Ps" associated with diabetes mellitus.
polyuria, polydipsia, and polyphagia
Cold clammy skin, tremors, hunger, tachycardia, dizziness, and slurred speech should make the nurse suspect this complication.
Hypoglycemia
Name the two isotonic crystalloid solutions emphasized in class
0.9% normal saline and Lactated Ringer's?
The nurse receives an order for potassium chloride 10 mEq IV push for a patient with K⁺ 2.7 mEq/L. This is the nurse's appropriate response.
do not administer the potassium IV push
Facial muscle twitching when the nurse taps over the facial nerve is this sign associated with hypocalcemia.
Chvostek sign
Unlike type 2 diabetes, patients with type 1 diabetes have this primary problem
Autoimmune destruction of pancreatic beta cells resulting in absent endogenous insulin
A patient has high blood glucose every morning. The nurse checks the glucose between 2:00 and 4:00 AM and discovers significant nocturnal hypoglycemia. This phenomenon is occurring.
Somogyi effect
A patient has vomiting, diarrhea, BP 82/50, and HR 124/min. This type of IV solution should generally be anticipated first for fluid replacement.
Isotonic crystalloid such as NS or LR
A patient in DKA has an elevated potassium level before treatment. After IV insulin is started, the nurse knows potassium can decrease for this reason.
insulin moves potassium from the blood back into the cells
A BP cuff is inflated above systolic pressure and the patient's hand develops carpal spasm. This finding is called this.
Trousseau sign
In a basal-bolus insulin regimen, rapid- or short-acting insulin given before meals provides this type of coverage.
Bolus/mealtime coverage
A patient has morning hyperglycemia, but the 3:00 AM blood glucose is not low. The elevated morning glucose is associated with the predawn release of growth hormone and cortisol. Name this phenomenon.
Dawn phenomenon
A patient receiving aggressive IV crystalloid replacement develops increasing dyspnea, crackles, and peripheral edema. The nurse should recognize these findings as a potential adverse effect of crystalloid therapy.
Fluid volume excess/pulmonary edema?
A patient with renal failure has K⁺ 6.7 mEq/L and cardiac rhythm changes. The provider prescribes IV regular insulin with dextrose. The nurse understands the purpose of this treatment is to accomplish this.
Shift potassium into the cells to rapidly decrease serum potassium
A patient with severe hypocalcemia develops stridor and difficulty breathing. This complication should be the nurse's immediate concern.
Laryngospasm/airway compromise
The nurse is preparing NPH insulin and notices that the insulin is cloudy. This characteristic is considered this.
Expected/normal for NPH insulin
A patient with diabetes arrives confused and diaphoretic with tremors and slurred speech. Before assuming the patient's behavior is neurologic or psychiatric, the nurse should immediately obtain this bedside assessment.
Blood glucose level
* Hypoglycemia can produce neurologic manifestations including dizziness, unsteady gait, slurred speech, seizures, and coma