ABG's
pH:7.48 PCO2:20 HCO3:24
Respiratory Alkalsosis
Your patient is prescribed Furosemide (Lasix) IVP. Which electrolyte imbalance will you closely monitor for?
Hypokalemia
What is the maximum length of time blood (RBCs) or blood tubing can hang?
4 hours
What systems/parts of the body maintain acid-base balance?
Lungs & Kidneys
____________ are isotonic volume expanders that contain electrolytes & increases circulatory volume without altering the chemical balance in vascular system. Name one example.
Crystalloids (0.9% NS, LR, D5W)
pH:7.30 PCO2:36 HCO3:20
Metabolic Acidosis
Your patient has had severe nausea with vomiting, & diarrhea for several days. The patient had an NG tube placed on intermittent suction. What major electrolyte imbalance is the patient at risk for?
Hypokalemia
What factor blood can Rh+ and Rh- receive?
Rh+ can receive both positive and negative factor blood, while Rh- can only receive negative factor blood.
Patient is anxious and having pain. They ask you to help. What do you think their gas looks like? And what is an intervention you can offer?
Respiratory alkalosis, pH up, CO2 down and bicarb normal...hyperventilating and blowing off all CO2. Offer pain meds, calming environment, breathing exercises, distraction...
This type of fluid causes fluid to shift OUT of cells, causing cell shrinkage, increasing ECF. Name at least one example.
Hypertonic fluids; 3% NS, 5% NS, D5+ 0.9% NS, D5+LR, D10W
pH 7.46 PCO2: 31 HCO3: 16
Partially Compensated Respiratory Alkalosis
Your patient's labs show a serum Na level of 115 mEq/L, which would you most likely expect to observe?A. Fissured, beefy red tongue B. Tall peaked T waves on ECG C. Positive Chvostek's sign D. Cerebral edema
D. Cerebral edema
Your patient identifies themselves as a Jehovah's Witness & does not wish to receive blood products no matter what during their upcoming procedure. What alternative will you anticipate that the HCP write orders for?
Erythropoietin- Epogen or Procrit (administered IV or Subcut.)
Our COPD patient that comes in disoriented and drowsy. What is the resp status? ABG? What is the BIPAP trying to correct?
Shallow, rapid, atelectasis/crackles/diminished. Respiratory acidosis and helps them blow off CO2.
Respiratory, IV, labs, VS
pH:7.36 PCO2:50 HCO3:28
Full Compensated Respiratory Acidosis
Your patient is recovering from a parathyroidectomy & is complaining of numbness & tingling around their lips & their face twitches when you tap their cheek. What electrolyte imbalance is the patient likely experiencing?
Hypocalcemia
What is frequency of vital sign checks while blood is transfusion?
Start of transfusions, 15 minutes after start of transfusion, every 1 hour and 1 hour post transfusion.
Why do we observe Kussmaul's breathing in our DKA patients in metabolic acidosis?
This is respiratory compensation in action—the respiratory system working overtime to try to balance out metabolic acidosis by removing carbon dioxide (lowering PCO₂).
Never give this med IV push, as infusion should never be administered faster than 10mEq/hr.
KCl
pH 7.24 PCO2: 42 HCO3: 12
Uncompensated Metabolic Acidosis
Your patient has just been admitted with Hypocalcemia, which additional electrolyte imbalance might you worry is HIGH in this patient?
Phosphate/hyperphosphatemia (over 4.5); calcium & phosphate are INVERSELY related, when one is LOW the other will be HIGH & vice versa.
What type of blood transfusion reaction leads to DIC (disseminated intravascular coagulation) and renal failure…death: fever, chills, anxiety, back pain, chest pain, hemoglobinuria, increased heart rate, low blood pressure?
Hemolytic Reaction: immune system is killing the donors RBCs. The antibodies in the recipient’s blood match the antigens on the donor’s blood cells….mistyped!!
Our pregnant patient that has N/V, tachycardia, and lethargy has what? What interventions can we provide? Name top 2 priority.
Anti-emetic and fluids.
What assessments and lab values should i nurse watch when administering TPN?
blood sugars because they have high glucose concentration