Fluid balance
What assessment data is most reliable in determining fluid loss or gain?
WEIGHT
The patient with an excess of sodium in the blood has?
What is normal lab value?
What is hypernatremia
136-145
What is pH Acidosis?
What is
Occurs when the serum pH falls below 7.35
4 categories of Shock
What is
Hypovolemic
Distributive
Obstructive
Cardiogenic
What is the expected hematocrit lab results with hypovolemia?
Increase
What is the normal Potassium serum lab value?
What is it's function?
What is 3.5-5
heart and muscles
If the serum pH is too high, the condition is called
What is alkalosis
3 types of Distributive shock
What
neurogenic
septic
anaphylactic
A fluid that has a higher osmolarity than blood is said to be
What is hypertonic
Name 3 s/s of hypernatremia?
What is
increased thirst
sticky mucous membranes
decreased urine output/dark urine
fever
lethargy
s/s of hypervolemia
Problem:
pH: 7.48 _______________
PCO2: 20 ______________
HCO3: 22 ______________
What is Respiratory Alkalosis
2 s/s of septic shock
What is
elevated WBC
fever/warm/flushed skin
rapid bounding pulse,
mottled skin
s/s of infection
List 2 important D/C education points regarding nutrition for a pt with hypovolemia?
What
Avoid Beverages with alcohol or caffeine and carbonation
Drink Eight to ten glasses of water per day
Eat sodium rich and potassium rich foods
Water is the cheapest form of fluid accesibility
Don't ignore thirst reflex
Name 2 s/s of hypocalcemia
What is
tetany
muscle cramps
s/s bleeding
tingling mouth/lips
Problem:
pH: 7.30 ________________
PCO2: 36 _______________
HCO3: 20 _______________
What is Metabolic Acidosis
2 Causes of neurogenic shock
What is
spinal cord injury
opioid overdose
general anesthesia
tranquilizers
Name 2 s/s of fluid volume deficit?
What is
hot flushed skin
dark/concentrated urine
dry mucous membranes
elevated temp
slow skin turgor
sunken periorbital area
hypotension
tachycardia
2 functions of Sodium?
What is
fluid balance
nerve impulses
contract/relax muscles
cardiac contraction
A COPD pt is experiencing respiratory acidosis. What is causing the decrease in pH?
What is
The lungs are not able to blow off carbon dioxide
Name 2 mechanisms in compensation stage of shock
What is
catecholamines/SNS
RAAS
ADH/Aldosterone
Which nursing action is anticipated by the nurse to restore colloidal osmotic pressure to clients with third-spacing? (think pharmaceutical intervention)
What is initiate an IV of albumin.
2 S/S of hypomagnesemia
What is
tachycardia, paresthesias,
neuromuscular irritability, HTN, mental changes;
+Chvostek’s sign
What 3 values are measured by an ABG blood draw?
What is
pH, Hc03, PaC02, Pa02
What is an inotropic drug?
What is
Affecting force of muscle contraction of the heart
What are 3 common causes of fluid volume deficit?
What is
vomiting, diarrhea, GI suctioning; decrease in fluid intake; increase in fluid output, such as sweating; massive edema, ascites, hemovacs,
Name an electrolyte disorder in which bruising and bleeding needs to be monitored
What is
Hypocalcemia
What are the systems that maintain acid-base balance.
What is
Lungs; kidneys; chemical buffers.
Name 2 interventions that can be done to replace blood loss on a Jehovah witness pt?
What is
•Admin medication to stimulate bone marrow
•Draw min volume of blood for diagnostic tests
•Reinfuse the client’s own blood via closed circuit container
•Admin factor VIII to stimulate coagulation process