Fluid Balance
Interventions that you would implement for a patient with fluid volume excess
What is:
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
The normal range for serum calcium
What is 8.6 to 10.2 mg/dL
The normal range for sodium (Na)
What is 135 to 145 mEq/L
The normal range for potassium
What is 3.5 to 5.0 mEq/L
Diarrhea
What is hypokalemia and hyponatremia
Interventions that you would implement for a patient with deficient fluid volume
What is:
Monitor daily weight (most accurate way to evaluate fluid balance)
Monitor I & O
Increase fluid intake (PO and IV if severe)
Treat underlying cause
Signs and symptoms of hypocalcemia
What is:
Spasms of face, lips, larynx (can cause stridor) tingling sensation around mouth, mental status changes, increased and irregular heart rate which can lead to cardiac arrest, Trousseau's sign, Chvostek's sign.
Those at risk for developing hypocalcemia
What is/are:
Patients with NPO status, use of diuretics, GI suctioning (especially continuous), decreased aldosterone, excess ingestion of hypotonic fluids
Population that can lead to hypokalemia
What is Acute alcohol intoxication
Laxative misuse
What is Hypocalcemia
Signs/symptoms that you would expect to see in a patient with fluid volume excess
What is:
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.
Is it important to monitor calcium levels following a thyroidectomy
What is:
Parathyroid glands can be accidentally removed during a thyroidectomy causing hypocalcemia.
Parathyroid gland secretes parathyroid hormone which regulates calcium levels in the blood by increasing the levels when they are too low.
Should always have calcium gluconate available post operatively.
Symptoms of hyponatremia
What is:
Can be vague and depends on if has a fluid imbalance as well. Severe hyponatremia presents with weakness, N/V/D and mental status changes such as confusion, disorientation and personality changes due to low sodium and osmolarity which causes more water to collect in and around the brain.
Sign/symptoms of hypokalemia
What are:
Muscle fatigue and cramping, mental status changes, shallow ineffective respirations due to diminished skeletal muscle activity, irregular and weak/thready pulse, dysrhythmias
Water intoxication
Hyponatremia
Are included in a hydration assessment of a patient
Name 2.
What is:
Monitor daily weights
Assess for skin tenting
Assess mucous membranes and tongue for moisture and furrows
Assess for thirst and urine output
Signs and symptoms of hypercalcemia
What is:
Increased BP and pulse, skeletal muscle weakness, decreased GI motility including diarrhea, severe fatigue, confusion.
Signs/symptoms of hypernatremia
What is:
Thirst, mental status changes due to too little water in and around the brain, tremors, seizures, muscle weakness
Signs/symptoms of hyperkalemia
What are:
Muscle twitching and cramps with muscle weakness, hypotension, slow and irregular heart rate with possible dysrhythmias and cardiac arrest.
Furosemide or Lasix
2 answers
What is hypokalemia and hyponatremia
Labs and signs/symptoms would you expect to see in a patient with dehydration?
What is:
Increased Hct and BUN, increased urine specific gravity, low BP, rapid pulse, increased temperature, decreased urine output, skin tenting, dry skin and mucous membranes.
Interventions for hypercalcemia
What is:
Telemetry monitoring, IV fluids, medications including the diuretic Lasix, and meds that slow calcium movement from bones to the blood such as Calcitonin.
Interventions for hypernatremia
What are:
Monitor weight, monitor I & O, administer diuretics, restrict dietary sodium
Food sources of potassium
What are:
Potatoes, sweet potatoes, soybeans, banannas, tomato juice, dried apricots, kidney beans, orange juice, spinach
Breast Cancer
What is hypercalcemia