ABG's
Fluids
Electrolytes
Oxygen Therapy
Surprise!$%*#&
100
7.35-7.45
What is the normal pH value according to ATI?
100
Over-hydration due to illness, nutrition, fluid intake, etc. Nurse would assess and hear crackles, see distended neck veins, palpate bounding pulses, auscultate an increased pulse as well as blood pressure.
Name a cause for fluid volume excess and explain what you would assess on the patient.
100
K: 3.5-5 Ca: 8.0-10 Na: 135-145
List the following normal ranges according to ATI: K: Ca: Na:
100
95-100%
According to ATI, what is the normal oxygen level?
100
Risk of dehydration As patients get older, their thirst mechanism decreases.
What is the nurse's primary concern regarding fluid & electrolytes when caring for an elderly pt who is intermittently confused? 1. risk of dehydration 2. risk of kidney damage 3. risk of stroke 4. risk of bleeding
200
21-26 HCO3 relates to METABOLIC
What is the normal bicarbonate (HCO3) level, according to ATI?
200
Hypo=Hippo Hypotonic solutions make the cell swell up. This would be given when a patient is dehydrated.
What is hypotonic solution and when would it be given?
200
K = think cardiac! Hypo = think slow! Decreased heart rate, respirations, blood pressure
Name some of the major symptoms of hypokalemia
200
Early: RAT (Restlessness, Anxiety, Tachycardia and Tachypnea) Late: BED (Bradycardia and Bradypnea, Extreme Restlessness, and Dysrhythmias).
What are the symptoms for early and late hypoxia?
200
Hyperkalemia Spironolactone is a potassium SPARING diuretic.
A pt prescribed spironolactone is demonstrating ECG changes & complaining of muscle weakness. The nurse realizes this pt is exhibiting signs of which of the following? 1. hyperkalemia 2. hypokalemia 3. hypercalcemia 4. hypocalcemia
300
35-45 PCO2 relates to RESPIRATORY
What is the normal PCO2 level, according to ATI?
300
Dehydration caused by various illnesses, medications, etc Nurse would expect to see flattened neck veins, poor skin turgor, dry mucous membranes, as well as decreased heart rate.
Name a cause for fluid volume deficit and some of the key assessment findings.
300
Hypocalcemia Ca = Reminder*** Think muscles, bones, movement (numbness and tingly feelings).
A client with hypoparathyroidism complains of numbness and tingling in his fingers and around the mouth. The nurse would assess for what electrolyte imbalance? A. Hyponatremia B. Hypocalcemia C. Hyperkalemia D. Hypermagnesemia
300
Venturi Mask (60-100%) It delivers EXACT concentrations, and is the only mask to do so.
What oxygen therapy device would you use for a patient with COPD and why?
300
Hypernatremia
An elderly pt comes into the clinic with the complaint of watery diarrhea for several days with abdominal & muscle cramping. The nurse realizes that this pt is demonstrating which of the following? 1. hypernatremia 2. hyponatremia 3. fluid volume excess 4. hyperkalemia
400
R: Respiratory O: Opposite M: Metabolic E: Equal
Describe the pneumonic ROME and explain how it works with ABG's
400
Fluid deficit
Are headache, lethargy, confusion, and disorientation a sign of fluid deficit or fluid overload?
400
Hypercalcemia Ca = remember think muscles. Hyper means twitching!
With which electrolyte imbalance do you utilize the Trousseu's and Chvostek sign?
400
Clubbing Cyanosis Capillary Refill Mucous Membranes LOC Vital Signs
Name 3 assessment points that a nurse would use when assessing for hypoxia.
400
Increasing Carbon Dioxide in the Blood
The nurse observes a pt's respirations & notes that the rate is 30 per minute & the respirations are very deep. The metabolic disorder this pt might be demonstrating is which of the following? 1. hypernatremia 2. increasing carbon dioxide in the blood 3. hypertension 4. pain
500
Respiratory Acidosis (pH is LOW = Acidic) (PCO2 is HIGH = Respiratory) (HCO3 is NORMAL = NOT Metabolic) REMEMBER: ROME (Respiratory Opposite, Metabolic Equal)
What is the patient suffering from if her levels are as follows: pH: 7.25, PCO2: 60 HCO3-: 26
500
- decreased hematocrit and HGB - decreased BUN, Na+ - decreased serum osmolity
What are lab value changes in fluid volume overload?
500
Hypertonic (Would make the cell shrink).
Nick has had surgery and is having post op edema. Which solution would you expect, as the nurse, to see being used for Nick?
500
It delivers the highest concentration (60-100%) Delivers 6-15L of oxygen
Why would we want to use the Non-Rebreather mask and what oxygen levels does it deliver?
500
Are you using a salt substitute? Salt substitute is HIGH in potassium, low in sodium. Remember, cardiac = potassium. "skipping beats"
WORTH DOUBLE POINTS!!! (Hard Question) An elderly pt with a history of sodium retention arrives to the clinic with the complaints of "heart skipping beats" & leg tremors. Which of the following should the nurse ask this pt regarding these symptoms? 1. "Have you stopped taking your digoxin medication?" 2. "When was the last time you had a bowel movement?" 3. "Were you doing any unusual physical activity?" 4. "Are you using a salt substitute?"
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