Acid Base Interpretation
The range for pH, CO2, and HCO3 are as follows:
pH___________
CO2__________
HCO3 ___________
pH: 7.35-7.45
CO2: 35-45
HCO3: 22-26
Trousseau's sign is performed by ________________, and is associated with this electrolyte abnormality.
applying a tourniquet or BP cuff to the arm for several minutes.
hypocalcemia
describe the difference between dehydration and hypovolemia.
dehydration:loss of water only
hypovolemia: loss of water and electrolytes
Provide 2 examples of a hypertonic IV solution.
3% normal saline
5% dextrose in normal saline or water
10% dextrose in water
You are caring for a patient with hyperkalemia. List 3 foods that you would encourage the patient to avoid.
Banana
Avocado
Baked potato
Fruit and fruit juices
Potatoes
Salt substitutes
Spinach
Broccoli
Salmon
Interpret the following ABG:
pH: 7.33
CO2: 38
HCO3: 20
Metabolic Acidosis (uncompensated)
Abnormalities in this electrolyte are associated with muscle weakness, cramping, and cardiac dysrhythmias/ECG changes.
Potassium
Provide 3 assessment manifestations of a patient in hypervolemia.
fluid overload; crackles, JVD, edema, rapid weight gain, bounding pulses, HTN
Provide 2 examples of isotonic IV fluids.
Lactated Ringers (LR)
0.9% Sodium Chloride or Normal Saline (NS)
You are caring for a patient diagnosed with a magnesium level of 1.0 mEq/L (1.5-2.5 mEq/L).
List 1 expected order to manage this patient.
Magnesium replacement (monitor for flushing, sweating and respiratory depression)
Monitor DTRs
Monitor ECG
Interpret the following ABG:
pH: 7.48
CO2: 33
HCO3: 19
Respiratory Alkalosis (partially compensated)
list 3 signs and symptoms of hyperatremia.
Dehydration symptoms if not in fluid overload (thirst, dry membranes), restless/agitation, confusion, altered mental status, seizures, if fluid overload (edema, weight gain).
For severe dehydration, IV fluids must be administered slowly to prevent this dangerous complication.
Cerebral edema --> seizures
Which IV fluid is the preferred method of replacing electrolytes?
Lactated Ringers (LR)
You are caring for a patient with an alteration in sodium level. you are aware that the priority interventon for any sodium abnormalities is to monitor for ________________.
altered mental status/agitation/confusion ---> Seizures
You are caring for an oncology patient on hospice who is recieving narcotic pain management. BP 107/66, HR 62, RR 10, SpO2 88% on RA. respirations are shallow.
What acid base abnormality would you anticipate?
Respiratory Acidosis (hypoventilation and retaining too much CO2)
List 3 signs of hypermagnesemia.
Lethargy, hypotension, bradycardia, respiratory depression, loss of reflexes, sweating/flushing.
Severe burns can cause this fluid imbalance due to fluid loss through damaged skin.
hypovolemia.
Which IV fluid is prescribed to cause cell shrinkage in the presence of cerebral edema?
hypertonic (3%, or mannitol)
You are caring for a patient with an alteration in potassium level. you are aware that the priority interventon for any potassium abnormalities is to monitor for ________________.
ECG changes, cardiac dysrythmias,
You are caring for a patient with an NG tube on continuous suction due to a bowel obstruction. what acid base abnormality would you anticipate?
metabolic alkalosis --> losing too much acid from the GI system.
Which electrolyte abnormality is closely linked with thyroid and parathyroid disease?
calcium
Provide 1 treatment for a patient experiencing "third spacing" of fluid
paracentesis, albumin
Which IV fluid could cause complications of cellular dehydration, fluid overload, and hyperglycemia?
Hypertonic D5W or D10W
You are caring for a patient with a hyperkalemia. List 2 medication orders that you would anticipate.
IV Insulin --> potassium into the cell
IV dextrose --> to counteract the IV insulin
PO kayexalate --> binds to potassium to excrete in the feces
K+ wasting diuretics
sodium bicarb to neutralize the acidity