Metabolism
What is the BMI for overweight adults and the three classes of obesity in adults?
Overweight: 25-29
Obesity:
- Class 1: 30-35
-Class 2: 35-40
-Class 3: 40+
What does magnesium do for your body?
skeletal muscle contraction, carb metabolism, generation of energy storage, vitamin activation, blood coagulation, cell growth, health and maintenance of cardiac muscle, helps maintain balance of calcium and potassium
What are signs and symptoms of respiratory alkalosis and acidosis?
Alkalosis- tachycardia, anxiety, confusion, diaphoresis, dizziness, coma
Acidosis- bradycardia, hypotension, agitation, confusion, lethargy,coma
What are complications of PICC line/ TPN?
PICC
- pneumothorax, hemothorax
TPN
- air embolism
-infection
-hyperglycemia
What do you do if you are waiting for TPN to arrive from the pharmacy and do not have any to give in the meantime?
give D10W
Gastric Bypass
What are post-op complications
Discharge teaching
Back pain, tachycardia, restlessness, perotonitis, sepsis
Liquid diet then puree and slowly introduce solid food- multivitamins needed
Home care management
Paralytic ileus may result from __ because it can __ or __ peristalsis.
- hypercalcemia or hypomagnesemia
- stop
-decrease
Acidosis- headache, lethargy, Kussmaul's respirations, nausea, vomiting, confusion, coma
Alkalosis- weakness, muscle cramps, hyperactive reflexes, tetany, confusion, slow and shallow respirations, nausea, seizures
Which fluid contains calcium?
Lactated ringers
What type of patients do not get lactated ringers?
Patients with liver disease or lactic acidosis
Signs and symptoms of FTT
weakness, feeding resistance, not crying when hungry, avoiding eye contact when feeding, not meeting milestones (not sitting on their own, not holding their neck up on their own)
Symptoms of hypercalcemia
- muscle weakness, abdominal pain, bone pain, confusion, fatigue, increased thirst, increased urination
How do you treat respiratory alkalosis?
treat underlying cause, breath into paper bag/ non-rebreather mask, IV chloride containing solution (chloride ions replace lost bicarb ions)
What are some nursing interventions for blood administration?
2 nurses check blood, given with Normal Saline, nurse stays with the client first 15 minutes, assess vitals before infusion, 15 minutes into infusion, hourly, and then upon completion
Monitor for infusion reactions and if they occur, stop and disconnect, hang saline, notify provider and blood bank
What is the first warning of magnesium toxicity?
Loss of patellar reflex
What labs indicate undernutrition in an adult patient?
CHOLESTEROL, hemoglobin, hematocrit, serum albumin, thyroxine-binding prealbumin (PAB), transferrin
How does the parathyroid hormone impact calcium in the body?
Increases serum calcium levels by releasing free calcium from bone storage sites, stimulating vitamin D activation to help increase intestinal absorption of dietary calcium, inhibiting kidney calcium excretion, and promoting kidney calcium reabsorption.
What are the causes of metabolic acidosis/alkalosis?
Acidosis- diarrhea, accumulation of acids, failure of kidneys to excrete hydrogen
Alkalosis- excess vomiting, excessive use of alkaline drugs, certain diuretics, endocrine disorders, heavy ingestion of antacids, severe dehydration
Which electrolyte change is most commonly seen with metabolic acidosis?
Hyperpotassium
What is the most common cause of hypercalcemia?
Dehydration
Differentiate marasmus and kwashiorkor.
Marasmus- deficiency in all macronutrients, visible wasting of fat and muscle under the skin giving bodies an emaciated appearance. Causes stunted growth in children
Kwashiorkor- Similar to marasmus except the main symptom is too much fluid in body's tissues cause under the skin swelling
What medications cause magnesium imbalance? (hypo and hyper)
loop and thiazide diuretics for hypomagnesemia
antacids and laxatives for hypermagnesemia
What are the causes of respiratory acidosis/alkalosis?
Acidosis- hypoventilation, respiratory depression, respiratory muscle weakness, asthma, COPD, pneumonia, pulmonary edema
Alkalosis- hyperventilation, hypermetabolic states (fever, anemia, septicemia), anxiety, fear, pain, pneumothorax
A pediatrician prescribes an IV solution of 5% dextrose and 1/2 N.S. with 40 mEq of potassium chloride for a child with hypotonic dehydration. The nurse performs which priority assessment before administering this IV prescription?
A. Obtains weight
B. Takes the temp
C. Take blood pressure
D. Checks amount of urine output
D
Potassium chloride would never be administered in the presence of oliguria or anuria.
The nurse reviews the arterial blood gas results of a client and notes: pH 7.45, PaCO2 30, HCO3 20. The nurse analyzes these results as indicating which condition?
A. Metabolic acidosis, full compensation
B. Respiratory alkalosis, full compensation
C. Metabolic alkalosis, partial compensation
D. Respiratory acidosis, partial compensation
B