Fluids and Lytes
Cerebrospinal fluid, pericardial fluid, pleuralfluid,synovial fluid.
What is transcellular fluid?
Sleep apnea, head trauma, drug overdose
What are causes of respiratory acidosis?
When checking for proper placement of a NG tube, the pH of gastric secretions should be _____.
What is less than 4?
These lab values will be increased with the onset of pancreatitis
What is serum amylase and lipase?
What is inflammatory bowel disease (IBD)?
Measures the nitrogen that results from protein metabolism.
What is BUN (Blood Urea Nitrogen).
Normal: 10-21 m/dL
This electrolyte must be assessed before starting IV insulin treatment.
What is potassium?
The leading cause of cirrhosis in the United States.
What is hepatitis C?
This fluid assists in returning the fluid part of blood to the heart.
What is lymphatic fluid?
As a compensatory response, you assess an increase in your patient's serum bicarbonate level, as well as an increased production of ammonia in the proximal tubule. What type of acid-base disorder is this in response to?
What is respiratory acidosis?
These types of solutions are irritating to peripheral veins?
What are hypertonic solutions?
Periumbilical discoloration and bluish colored flanks that are indicative of internal hemorrhage.
What are Cullen's and Turner's signs?
A sensation of incomplete evacuation, and abdominal pain.
What is tenesmus?
Produced and secreted by the kidneys, this hormone promotes the formation of red blood cells.
What is erythropoietin?
This is the first line of treatment for both DKA and HHS.
What is IV hydration with 0.9% Normal Saline?
This virus is caused by fecal-oral transmission or shellfish caught in contaminated waters.
What is hepatitis A?
Tonicity of fluid given to increase intravascular fluid volume? Can also be used in the treatment of hyponatremia.
What are hypertonic solutions?
Vomiting, diarrhea, NG suctioning, excessive ingestion of baking soda or antacids, kidney failure, excessive IV sodium bicarbonate.
What are conditions that can cause metabolic alkalosis?
This type of nutrition is administered directly into the bloodstream, bypassing the digestive system, and is used when it is not possible to use the digestive tract normally.
What is parenteral nutrition?
Protease, lipase and amylase.
What are three enzymes involved in pancreatitis?
This protein found in wheat, rye, barley, and sometimes in small amounts in mixed oats, can trigger an immune response that can damage the small intestine mucosa and decrease the amount of surface area for nurtrient absorption.
What is gluten?
Caused by sepsis, major surgery, hypovolemia, decreased cardiac output, and nephrotoxic agents.
What is acute renal failure.
Hyperglycemia, ketoacidosis, ketonuria
What is the "triad" of DKA?
This osmotic laxative (synthetic sugar) is given to reduce ammonia levels in the blood.
What is Lactulose?
Tetany, peripheral neuromuscular irritability, perioiral numbness, paresthesias of the hands and feet, carpopedal spasm, laryngospasm, and focal or generalized seizures.
What are signs and symptoms of hypocalcemia?
pH >7.45; HCO3 >28 mEq/L
What is metabolic alkalosis.
An important assessment that must be carried out prior to the insertion of a feeding tube.
What are bowel sounds?
Bile duct obstruction, pleural effusion, and pancreatic cancer, pseudocysts, abscess, necrotizing pancreatitis.
What are possible complications of pancreatitis?
This disorder of the large intestine is characterized by multiple, bloody liquid stools.
What is ulcerative colitis?
Hypotension, hypovolemia and shock.
What are three causes of prerenal acute kidney injury?
In both DKA & HHS, the resultant hyperglycemia creates this kind of diuresis (tremendous amounts of water are lost)...
What is ostmotic diuresis?
Cognitive syndrome that stems from unfiltered or unbroken down toxins that lead to metabolic abnormalities
What is hepatic encephalopathy?
This electrolyte regulates the heartbeat, ensures proper function of the muscles and nerves, and is vital for synthesizing protein and metabolizing carbohydrates.
What is potassium?
Diabetes, severe diarrhea, insulin resistance, kidney failure, COPD, stroke, CNS depressants, disorders that restrict respiratory muscles.
What are conditions that can cause acidosis?
Administration of a large volume with diluted solutions of nutrients into a vein in the arm or back of hand.
What is Partial Parenteral Nutrition (PPN)?
Avoidance of causative agent (alcohol), smoking cessation, analgesics, enzyme therapy, high-protien/high-calorie diet.
What are treatment recommendations for chronic pancreatitis?
An autoimmune disease that can damage the small intestine mucosa and decrease the amount of surface area for nurtrient absorption.
What is celiac disease?
This is the actual working unit of the kidney and where the urine is actually formed.
What is the nephron (about 1 million per kidney)?
In an attempt to blow off CO2 to compensate for the metabolic acidosis of DKA, this type of abnormal respiration is often present...
What are Kussmaul respirations?
A yellow discoloration of skin and mucous membranes caused by hyperbilirubinemia.
Hypotonic solutions should be given to clients with DKA or HHS (when blood is hypertonic) but should be avoided in clients with this condition.
What is increased intracrantial pressure?
(causes cells to swell)
System that exchanges carbon dioxide and bicarbonate between the blood and lungs to maintain the body's acid-alkaline balance and support proper metabolic function.
What is the bicarbonate buffer system?
This type of nutrition is given to clients who have trouble swallowing but have functional GI systems or disease states that contribute to malnutrition.
What is enteral nutrition?
Severe abdominal pain in the upper region of the abdomen that often radiates to the back; nausea/vomiting; diarrhea and fatty stools; and jaundice
What are signs and symptoms of acute pancreatitis?
A chronic inflammatory disease of the gastrointestinal tract and is divided into Crohn disease and ulcerative colitis.
Acid-base balance, water balance, electrolyte balance, toxin removal, blood pressure control, erythropoietin production, D vitamin production.
What are functions of the kidneys?
An increase in these counterregulatory hormone levels can contribute to the elevated glucose levels seen in DKA and HHS.
What are Glucagon, Catecholamines (Epinephrine), Cortisol and Growth Hormone?
This disorder is characterized by fibrosis and nodule formation of the liver secondary to chronic injury, leading to alteration of the normal lobular organization of the liver.
What is cirrhosis of the liver?
This electrolyte helps to regulate fluids and electrolytes, plays a key role in blood pressure control, and supports nerve and muscle function.
What is sodium?
Inadequate elimination of hydrogen ions, DKA, kidney failure
What are causes of metabolic acidosis?
Electrolyte and acid-base imbalances, catheter-associated infection, elevated blood glucose levels, thrombosis.
What are some risks associated with the adminsitration of TPN?
Head, tail and body.
What are the main parts of the pancreas?
A transmural disease characterized by skip lesions and granulomas.
Glomerular injury, acute tubular necrosis, pharmacological adverse effects, radiocontrast dye, infections, and vascular disease.
What are causes of intrinsic acute kidney injury?
Patients with HHS present with acute elevations of these lab tests secondary to prerenal azotemia from volume depletion.
What is BUN and creatinine?
Varices, ascites, hepatic encephalopathy, hepatopulmonary hypertension, hepatocellular carcinoma, hepatorenal syndrome, spontaneous bacterial peritonitis, and coagulation disorders.
What are complications of cirrhosis of the liver?
Fatigue, drowsiness, headache, nausea, and confusion.
What are signs and symptoms of hyponatremia?
As a compensatory response, you assess that your patient's rate and depth of breathing has increased and concur that they are hyperventilating. What type of acid-base disorder is this in response to?
What is metabolic acidosis?
This method is considered the 'gold standard' in routine confirmation of NG tube placement prior to use.
What is measuring the pH of gastric aspirate?
Gallstones (choledocholithiasis) and chronic alcohol use or abuse.
What are the two most common causes of acute pancreatitis?
A sign of fat malabsorption characterized by frothy, oily, foul-smelling stool that floats.
What is steatorrhea?
The kidney secretes this hormone in order to maintain blood pressure within normal limits. (If blood pressure falls, it will be secreted to constrict the small blood vessels).
What is Renin.
Over secretion can cause hypertension.
A clinical condition most commony seen in clients with diabetes type 2 that is characterized by profound hyperglycemia and glycosuria and results from an absolute or relative deficiency of insulin.
What is hyperosmolar hyperglycemic syndrome (HHS)?
Yellow color of skin and mucous membranes due to accumulation of bile pigments in blood and their deposition in body tissues.
What is jaundice?
An essential mineral that your body needs to perform over 300 functions. It activates hundreds of enzymes and participates in thousands of biochemical reactions that regulate blood pressure, metabolism, protein synthesis, and various other processes.
What is magnesium?
Kidneys retain extra HCO3 and excrete extra H+ ions into the urine.
What is compensation for respiratory acidosis?
A potentially fatal condition that can occur when a patient is reintroduced to food after a prolonged period of malnutrition, and the reason that TPN must be judiciously tapered before discontinuation.
What is refeeding syndrome?
What are ways to manage clients who present with acute pancreatitis?
An idiopathic inflammatory condition of the colon that is restricted to the mucosa and submucosa of the colon and results in diffuse friability and superficial erosions on the colonic wall associated with bloody diarrhea with our without mucus.
What is ulcerative colitis?
Calculi, strictures, blood clots, tumors, benign prostatic hyperplasia, trauma, fibrosis, nephrolithiasis.
What are causes for postrenal acute kidney injury?
This type of insulin is the only insulin that can be given intravenously.
What is human regular insulin?
An acute infection of abdominal fluid (ascites) that can occur in patients with cirrhosis of the liver and is suspected when the patients present with abdominal pain, fever, or altered mental status.
What is spontaneious bacterial peritonitis (SBP)?
Both calcium and magnesium have an inverse relationship to this mineral. It is essential for human health and is a component of bones, teeth, DNA, RNA, phospholipids and ATP.
What is phosphorus?
Acid-base imbalance that could result from excessive gastrointestinal suctioning.
What is metabolic acidosis?
Which of the following is designed for long term enteral access: Dobhoff, NGT, OGT, PEG?
What is a percutaneous endoscopic gastrostomy (PEG) tube?
Secretion of digestive enzymes into the duodenum, secretion of the hormones insulin and glucagon, secretion of large quantities of sodium bicarbonate into the duodenum that is needed to neutralize the acid coming from the stomach.
What are 3 major functions of the pancreas?
A chronic transmural inflammatory condition of the gastrointestinal tract, which usually leads to structural damage and significant disability.
What is Crohn's disease?
A specialized extracellular matrix that surrounds the glomerulus and acts as a filter allowing only water and small molecules to pass into the urine, while preventing larger molecules and cells from being filtered.
What is the glomerular basement membrane?
A life-threatening complication of diabetes due to insulin deficiency and increased counter-regulatory hormones that lead to ketonemia and metaboic acidosis.
What is diabetic ketoacidosis?
Synthetic version of natural somatostatin that is given to help reduce portal pressure (acute bleeding varices).
What is octreotide/Sandostatin?