Electrolytes
Electrolyte imbalance most likely to cause a cardiac dysrhythmia
What is hyper/hypokalemia?
Best assessment for fluid balance
What is daily weight?
The nurse anticipates a decrease in the vital sign ________ when a patient sits or stands.
What is blood pressure?
Time frame in which an IV "solution" bag should hang
What is 24 hours?
Infuse 1 Liter of 0.9 NS in 4 hours
What is 250 cc/hr?
The causes associated with hypercalcemia
What is immobility, cancer, and parathryroid?
Patient education tips on how to minimize edema
What is:
Take diuretics as prescribed.
Elevate legs when sitting down.
Apply TED hose (anti-embolic stockings) to promote venous return.
Restrict sodium to no more than 2grams/day.
Restrict oral fluid intake (amount per MD order).
Best way to offer a confused patient hydration
What is hourly rounding (offer fluids/nutrition)
What is a CLABSI?
Infuse 1L 0.9 NS over 10 hours. Drop factor is 15gtt/mL. What are the gtt/min?
What is 25 gtt/min?
1. Convert hours to minutes
10x60= 600 min
2. Divide total volume by minutes
1000 / 600=1.666666
3. Multiply the total volume by minutes by the gtt factor
1.666 * 15= 25 gtt/min
Most abundant electrolyte in extracellular space
What is sodium?
Possible causes for hypervolemia
What is heart failure, kidney dysfunction, liver cirrhosis, excessive aldosterone stimulation, or excessive consumption of sodium?
Severe dehydration should receive this type of fluid initially
What is isotonic (0.9 NS or LR)?
Diagnostic test that is required to confirm central line placement
What is a chest x-ray?
How much fluid will a patient receive in 2.5 hours if it is infusing at 100cc/hr?
1. Total time * rate = Volume
2.5 hr * 100 ml/hr=250cc
Two assessment findings that can indicate hypomagnesium
What is a positive Trousseau or Chvostek sign?
These are cues to assess and recognize for fluid volume excess
What are:
Assessment findings- Acute weight gain, distended neck veins (JVD), tachycardia, hypertension, ↑ CVP, bounding peripheral pulses, cough, crackles, SOB, peripheral edema, ascites, ↑ RR, ↑ UOPt, anasarca
Lab values- ↓ hemoglobin and hematocrit, ↓ serum and urine osmolality, ↓ urine sodium and specific gravity
These are cues to assess and recognize for fluid volume deficit.
What are:
Assessment findings- Acute weight loss, flattened neck veins, tachycardia, hypotension (↓ MAP), ↓ skin turgor, thirst, dizziness, weakness, confusion, ↓ CVP, weak peripheral pulses, ↓ cap refill, < urine output
Lab values- ↑ hemoglobin and hematocrit, ↑ serum and urine osmolality and specific gravity, ↓ urine sodium, ↑ BUN and creatinine, ↑ urine specific gravity and osmolality
Complication where IV fluids unintentionally leak out of the vein and into surrounding tissues, often causing swelling and discomfort at the insertion site
What is infiltration?
How long will it take to run a 50ml IVPB at 75 ml/hr?
What is 40 minutes?
1. Divide total volume by rate
50/75= 0.666 hours
2. Multiply hours by 60 minutes
0.666 * 60 =40 minutes
This is the control mechanisms for serum sodium levels
What are thirst, ADH, and the RAAS?
Common diuretic that may affect potassium
What is Lasix?
Lab values to expect with dehydration
What are increased:
Serum sodium and osmolality
Urine osmolality and specific gravity
Hematocrit and BUN
Possibly creatinine
I am a hub, scrub me for ____________
What is 15-30 seconds?
Order 1000mg of cefazolin Q6hr over 15 minutes in 50ml of NS. The drop factor is 20 gtt/min. What is the flow rate in ml/hr?
What is 200 ml/hr?
1. Convert minutes to hours
15 min /60 min=0.25 hrs
2. Divide total volume by hours
50 ml/0.25hrs = 200 ml/hr