IV FLUIDS
Russell is a 46-year-old runner. He runs 10 miles a day. Russell forgot his drink when he was going for a run. Russell passed out and was taken to the ED. V/S are as follows: 36.5, HR-120, 24, 95%RA. Labs are as follows: Na 135, K 4.2, BUN 30, creatinine 1.5. What is going on with Russell? What type of IVF are you about to give to this patient, and why?
0.9 NaCl (Isotonic)
A medication that is used to treat Hyperkalemia (not part of the cocktail).
Kayexalate Sodium Polysterene
An 85-year-old female who lives in a nursing home was brought to the ED due to confusion, high fever, productive cough, and a pulse oximetry reading of 92% on room air. What is going on with this patient?
PNA
PH- 7.31, PaCo2- 35, HCO3- 20
Uncompensated metabolic acidosis
Which electrolytes have an indirect relationship to each other?
Na and K, Ph and Ca
Normal Na level
135-145
What type of IVF would you give to a hyponatremic patient?
Hypertonic (3%NaCl)
What kind of medications would you expect the doctor to order for a patient who has PNA?
Antibiotic
If the patient is on a diuretic, what would you expect with the K level? High or low, and why? What type of diuretic?
Low, potassium wasting or Loop diuretic
Ph-7.29, PaCo2- 24, HCO3- 20
Partially compensated metabolic acidosis
What would you expect on the ECG if the patient has hyperkalemia?
Tall T wave/ peaked T wave
Normal K level
3.5-5.3
A type of IVF that causes no movement of fluid between spaces.
ISOTONIC
What would you instruct as part of your patient education if the patient is taking TB medications?
No alcohol
A 92-year-old female who smokes 4 packs a day was brought to the ED by her granddaughter due to SOB. The patient uses 3L of O2 via NC. She reports a moist cough and denies fever; wheezing was noted on auscultation. Staff observed the patient in an orthopneic position. She denies hx of COPD. Per patient, the last time I was in the doctor's office was when I was 12 years old.
COPD
ph- 7.48, PaCo2- 25, HCO3- 28
Uncompensated Respiratory Alkalosis
What would you expect on the ECG if the patient has hypokalemia?
Flattened or inverted T waves
Normal pH level
7.35-7.45
A type of IVF that causes fluid to move from interstitial spaces into cells.
Hypotonic
A type of TB medication that causes urine to turn bright red or reddish-brown.
Rifampicin
Shaddiel is a 75-year-old RN who works in the ER. Shaddie was busy and couldn't take his lunch break because the unit was understaffed. Shaddie complains of dizziness and a headache. Katherine, Shaddie's colleague, noticed a weak, thready pulse, poor skin turgor, and dry lips. Shaddie shared that he last voided 10 hours ago. Shaddie denies any medical history. Per Shaddie, "I am very healthy young fella, despite I'm 75 years old, I played soccer 5 times a week despite I just work 12 hours." What's going on with Shaddie? What kind of fluid imbalance is Shaddie manifesting?
FVD (Fluid Volume Deficit)
ph- 7.46, PaCo2- 27, HCO3- 20
Partially Compensated Respiratory Alkalosis
If you have a patient who has a Na level of 125. What precautions would you implement for the patient? Due to risk of?
Seizure precautions
Normal PaCo2
35-45 mmHg
A type of IVF that causes fluid to move out of cells and into the intravascular space is used for increased ICP, edema, and hyponatremia.
Hypertonic
How would you treat Metabolic acidosis?
Treat the cause, Bicarb.
What would you expect the urine specific gravity to be when a patient has fluid volume excess?
Decrease
pH- 7.36, CO2- 48, HCO3- 19
Fully compensated metabolic acidosis
With alkalosis, what would you expect the K level to be: high, low, or normal?
Low (Alkalosis; all K is low
Normal Bicarb
22-26