Fluid Balance
What interventions would you implement for a patient with fluid volume excess?
Monitor daily weight (weight loss indicates successful intervention)
Administer diuretics and O2 as ordered
Fluid and sodium (Na) restrictions
Monitor I & O and put in Fowler's position
What is the normal range for serum calcium?
9 to 11 mg/dL
What is the normal range for sodium (Na)?
135 to 145 mEq/L
What is the normal range for potassium?
3.5 to 5.0 mEq/L
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What interventions would you implement for a patient with deficient fluid volume?
Monitor daily weight (most accurate way to evaluate fluid balance)
Monitor I & O
Increase fluid intake (PO and IV if severe)
Treat underlying cause
What are the signs and symptoms of hypocalcemia?
Numbness and tingling of fingers and toes, positive Chvostek sign (contraction of facial muscles when facial nerve is tapped), muscle twitching and cramping, seizures, and tetany (intermittent muscles spasms).
What are the interventions for air embolism?
Clamp the leak, place patient on left side with head of bed raised, and call rapid response team
What are the priority nursing interventions for patient with hypokalemia?
What is fall prevention and monitoring for constipation?
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What signs/symptoms would you expect to see in a patient with fluid volume excess?
Bounding pulse, increased BP, weight gain, increased and dilute urine output , increased and shallow respirations. May see neck vein distention, pitting edema of lower extremities, crackles in the lungs.
Why is it important to monitor on a severe dehydration patient?
What is postural hypotension?
What is the lab interpretation for pH 7.26, PaO2 68 mm Hg, PaCO2 55 mm Hg and HCO3 24?
What is Respiratory acidosis
What are the steps to start a intravenous infusion for a dehydration patient?
1.vertify order
2 explain procedure.
3. gather supplies
4. wash hands
5. put on gloves
6. insert IV catheter
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What is included in a hydration assessment of a patient?
Monitor daily weights.
Assess for skin tenting (forehead or sternum)
Assess mucous membranes and tongue for moisture and furrows
Assess for thirst and urine output
What are the signs and symptoms of hypercalcemia?
Anorexia, nausea and vomiting, constipation, fatigue, confusion and if severe cardiac arrest.
What assessment does the nurse in a patient at high risk of ECV deficit?
What us fullness of neck veins when supine.
What is the intake and output and the difference between the two
Intake for 12 hours: IV rate 125 ml per hour, oral intake 1 ounce every 6 hours, 1.5 ounce per hour x four, 2 ounces per hour times 2
Output 450 ml and 330 ml.
What is the difference between intake and output?
Intake 1980 ml
Output 780 ml
Difference 1200 ml
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What labs and signs/symptoms would you expect to see in a patient with dehydration?
Increased Hct and BUN, increased urine specific gravity, low BP, rapid pulse, increased temperature, decreased urine output, skin tenting, dry skin and mucous membranes.
What are interventions for circulatory overload of IV solution?
Reduce IV flow rate and notify health care provider, raise head of bed, administer oxygen and diuretics if ordered, monitor vital signs and lab results.
What are the interventions for hypernatremia?
Monitor weight, monitor I & O, administer diuretics, restrict dietary sodium
What are food sources of potassium?
Potatoes, sweet potatoes, soybeans, bananas, tomato juice, dried apricots, kidney beans, orange juice, spinach
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