ABGs
IV Therapy and Homeostasis
Pharmacologic Therapy
Electrolytes
Physiology
100
ABG result: pH 7.48 PaCO2: 28 mm Hg PaO2: 85 mm Hg HCO3: 22 mEq/L
What is respiratory alkalosis.
100
Type of IV solution, such as 0.9% NaCl and Ringers Lactate (LR -- Lactated Ringers), which resembles the concentration of plasma and increases only extracellular fluid volume.
What is an isotonic solution. Watch for cardiac overload if fluid is overloaded beyond client's tolerance.
100
Given in the case of hyperkalemia.
What is Kayexalate.
100
The main electrolyte in the extracelluar fluid which promotes retention of water.
What is sodium (Na+).
100
This hormone, release by the posterior pituitary, acts on the distal tubule of the kidney to reaborb water.
What is ADH, antidiuretic hormone.
200
ABGs: pH = 7.15 Pa C02 = 68 mmHg HC03 = 22 mEq/L
What is respiratory acidosis -- uncompensated.
200
D5NS (0.9%) and D51/2NS (0.45%) are examples of what type of fluid?
What are hypertonic solutions. Hypertonic solutions increase osmotic pressure and draw fluids from cells. Watch for cellular dehydration if the amount infused is beyond the client's tolerance.
200
This class of drugs causes increased urine output.
What are diuretics.
200
The major anion in extracellular fluid.
What is chloride (Cl-).
200
The loss of water through the skin and lungs, which is hard to measure, is called this.
What is insensible water loss.
300
An infant, three weeks old, is admitted to the Emergency Room. The mother reports that the infant has been irritable, difficult to breastfeed and has had diarrhea for the past 4 days. The infant’s respiratory rate is elevated and the fontanels are sunken. The Emergency Room physician orders ABGs after assessing the ABCs. ABGs: pH = 7.37 Pa C02 = 29 mmHg HC03 = 17 mEq/L
What is metabolic acidosis -- compensated.
300
1/2 NS (0.45%) is an example of what type of fluid?
What is hypotonic. A hypotonic solution lowers osmotic pressure and makes fluid move into the cells. Be careful to monitor for water intoxication.
300
Do not crush this potassium supplement. Supplemental potasssium is also available in liquid form.
What is KDur.
300
One of the major cations of the intracellular fluid. A low level of this cation can cause paralytic ileus, EKG and heart rhythm changes. An elevated level can can also cause EKG changes and cardiac arrest.
What is potassium (K+). Please monitor serum potassium results when giving potassium replacement. Monitor for EKG changes.
300
The hepatic portal system, which is the first system that absorbs nutrients from the GI tract, holds which type of fluid? Intracellular or extracelluar?
What is extracellular fluid (blood plasma). The hepatic portal system is a system of veins, including the hepatic portal vein, which begins to transport nutrients from the GI tract to the rest of the body.
400
A client, 5 days post-abdominal surgery, has a nasogastric tube. The nurse notes that the nasogastric tube (NGT) is draining a large amount (900 cc in 2hours) of coffee ground secretions. The client is not oriented to person, place, or time. The nurse contacts the attending physician and STAT ABGs are ordered. The results from the ABGs come back from the laboratory and show: pH = 7.52 Pa C02 = 35 mmHg HC03 = 29 mEq/L
What is metabolic alkalosis -- uncompensated.
400
Drop in temperature around IV site, local swelling at the site. a slowed infusion, pale skin and a damp IV dressing can indicate which potential complication of IV therapy?
What is infiltration. Infiltration is when the IV fluid "infiltrates" into the surrounding tissues and does not stay in the vasculature. If the IV infiltrates, stop the infusion immediately. ClWhat is infiltration. Infiltration is when the IV fluid "infiltrates" into the surrounding tissues and does not stay in the vasculature. Clamp the tubing. Apply a sterile gauze pad over the site without putting pressure on the vein. Do not use alcohol. Remove the catheter by pulling straight back from the site. Then elevate the extremity and apply pressure for 2 minutes. Assess the catheter for intactness. A catheter that is non intact puts the client at risk for embolus.
400
Used as a drug in the treatment of hypoxemia or respiratory acidosis.
What is oxygen therapy.
400
An elevated level of this electrolyte can be related to kidney stone formation.
What is calcium (Ca+).
400
These two hormones have the opposite effect. The first one, produced in the adrenal cortex, causes reaborption of sodium from the renal tubules leading to water retention in the extracellular fluid. The second hormone is released by the atria of the heart and increases sodium excretion and produces diuresis.
What is aldosterone and ANH (atrial natiuretic peptide or hormone).
500
A two-year-old is admitted to the hospital with a diagnosis of asthma and respiratory distress syndrome. The father of the infant reports to the nurse that he has observed slight tremors and behavioral changes in his child over the past three days. The attending physician orders routine ABGs following an assessment of the ABCs. The ABG results are: The results from the ABGs come back from the laboratory and show: pH = 7.36 Pa C02 = 69 mmHg HC03 = 36 mEq/L
What is respiratory acidosis -- compensated.
500
Central venous catheters are a form of vascular access device which place the fluid or drug straight into the central circulation (largest vessels). They allow for long term therapy. They are inserted by a physician or by an intravenous infusion nurse. This special type of VAD has a plastic or stainless steel injection port with a silicone-rubber septum. Patients can get it wet as long as their is no needle currently placed.
What is an implantable port.
500
Potassium wasting diuretic.
What is Lasix.
500
An emergent complication of low serum calcium levels.
What is laryngeospasm. Please have emergency equipment ready.
500
This hormone, released by the juxtaglomerular cells of the kidneys, promotes vasoconstriction and the release of aldosterone.
What is renin.
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