Electrolytes
What interventions maybe used to treat a potassium level of 6.0mEq/L?
Stop potassium supplement (IV or oral)
Give potassium wasting diuretic (lasix, HCTZ)
Give a potassium removing agent such as Kayexelate
Give both insulin and dextrose push
Dialysis
What kinds of food must be limited for a client who has a sodium level of 163mEq/L?
Processed foods: hot dogs, deli meats, cheese, bakery items, most canned soups, chips and crackers
Which two hormones play a large part in causing fluid imbalances?
ADH ( antidiuretic hormone)
Aldosterone
Both caise kidneys to retain fluid which may lead to FVE
For a client receiving chemotherapy, which laboratory result is of particular importance?
1.) prothrombin time
2.) white blood cell count
3.) Electrolyte levels
The white blood cell count is important because chemotherapy can decrease white blood cells, particularly neutrophils and this leaves the client vulnerable to infection.
What hormone causes an increase in calcium level? Why?
Parathyroid hormone. PTH is released/stimulated when calcium level is low and signals the body to retain calcium.
What assessment finding does the nurse expect in a client with a magnesium level of 3.2 mEq/L?
LOW and Slow.... bradycardia/EKG changes, slow, shallow respirations, fatigue, drowsy, lethargy and decreased DTR's
What kinds of foods must be limited in a client who has potassium level of 5.4mEq/L?
dried fruit, bananas, oranges, potatoes, tomatoes, dried peas, meats and avocado
What fluid stays directly in the vasculature and is used frequently to increase BP?
Isotonic fluid such as Normal saline
What labs would the nurse monitor for a client having a severe bout of ulcerative colitis?
WBCs due to infection...."itis"
ESR due to inflammation
H&H due to bloody diarrhea
Electrolytes due to loss during diarrhea
What hormone causes a decrease in calcium level?
Calcitonin - when the body senses elevated calcium levels, Calcitonin is released>>>prevents bone breakdown ( and release of calcium into bloodstream) and increases elimination of calcium through the kidneys
What kind of electrolyte problems may occur in a client who has renal problems?
If kidneys are unable to eliminate electrolytes, client might develop hyperkalemia and hypernatremia
If kidneys over diurese, client may have problems with hypokalemia and hyponatremia
What kinds of food are considered goitrogens?
Goitrogens disrupt the production of thyroid hormones.
cabbage, turnip, brussel sprouts, breads, pasta and broccoli
Name three causes of dehydration (FVD)?
How can dehydration be treated?
Not enough fluid in or too much fluid out. NPO status, vomiting, diarrhea, sweating, wound drainage, hemorrhage, GI suction, severe burns, too much diuretic
Tx: IVF, stop diuretics, prevent fluid loss ( vomiting, diarrhea, hemorrhage)
A client with human immunodeficiency virus (HIV) who has been started on antiviral therapy is seen in the clinic for follow up. Which test will be best to monitor when determining the response to therapy?
1.) CD4 level
2.) CBC
3.) Viral load
The viral load test measures the amount of HIV genetic material in the blood, so a decrease in viral load indicates that the antiviral therapy is effective.
What are the three thyroid hormones? What do they do?
Thyroid hormones play an important role in the regulation of metabolism, energy expenditure, protein, carbohydrate and lipid metabolism
Three thyroid hormones are:
Triiodothyronine T3
Thyroxine T4
Calcitonin...lowers calcium in your blood and places back into your bones
A client is admitted to the unit with a diagnosis of syndrome of inappropriate antidiuretic hormone secretion (SIADH). for which electrolyte abnormality would the nurse be sure to monitor?
Hyponatremia
What diet is recommended for chronic pancreatitis?
High protein, low fat, low carbohydrates
Ex. fruits,, vegetables, lean protein
Avoid alcohol, sugary drinks, fatty fried foods and red meat
What is 'Third spacing?" What symptoms are expected and why?
Third spacing is when fluid accumulates in the #rd space/interstitial space ( not in cells, not in the vessels)-usually related to FVO and/or low albumin levels
Expect to see pitting edema especially in dependant (low lying) body parts, crackles in lungs if fluid accumulation around aveoli in lungs
A client who has just arrived at the Emergency Department reports substernal chest pain and left arm discomfort that has been going on for 3 hours. Which laboratory test will be most useful in determining whether the nurse should anticipate implementing the acute coronary syndrome standard protocol?
1.) Creatine kinase MB level
2.) Troponin I level
3.) C-reactive protein level
Cardiac troponin levels are elevated three hours after the onset of myocardial infarction and are very specific to cardiac muscles or infarction.
What section of the brain is responsible for hormone production?
The hypothalamus produces releasing and inhibiting hormones to maintain homeostasis.
What is the normal calcium level?
What are two tests that a nurse may perform to check for tetany.
Normal calcium level is 8.5 to 10.5 mg/dL
Chvosteks sign is twitching of the facial muscles when gently tapping a clients cheek.
Trousseaus sign is when a BP cuff is inflated and induces a hand spasm in the setting of tetany.
What is suggested for a liver disease diet?
Carbohydrates should be the major source of calories . Eat a moderate intake of fat, the carbs and fat will help prevent protein breakdown in the liver.
Also, liver clients need to limit their sodium intake
What may contribute to fluid overload? How can fluid overload be treated?
Excess fluid intake, not enough fluid going out, heart failure, renal failure, excess sodium intake
The nurse is reviewing the complete blood test for a client who has been admitted for knee arthroscopy. Which value is MOST important to report to the health care provider before surgery?
1.) Hematoctrit of 33%
2.) Hemoglobin level 10.9 g/dL
3.) Platelet count 426,000/mm3
4.) WBC of 16,000/mm3
CDC guideline for the prevention of surgical site infections indicate surgery should be postponed when there is evidence of a preexisting elevation such as an elevation in WBC.
What gland is referred to as "the master gland"?
The pituitary gland is referred to as the "master gland" because it monitors and regulates many bodily functions through the hormones that it produces.