Fluids & Electrolytes
Hypernatremia is most dangerous because it causes this neurological complication.
What is cerebral cellular dehydration?
Which lab trend suggests worsening AKI?
What is rising creatinine?
What is the maximum infusion rate of IV dextrose in a fragile elderly patient?
What is per ordered titration to avoid fluid shifts?
First assessment priority after a fall.
What is neurological status?
Poor intake + depression + dehydration can trigger this cognitive condition.
What is acute delirium?
Task that cannot be delegated to NAC/CNA.
What is initial assessment?
The safest correction rate for sodium is no more than this per hour.
What is 8–12 mEq/24 hours?
Urine specific gravity >1.030 means this
What is concentrated urine?
The nurse should hold this medication if the patient is NPO and glucose is 58.
What is insulin?
When glucose is 62 and sodium is 151, which imbalance do you treat first?
What is hypoglycemia?
Elderly patients often develop this instead of fever.
What is confusion or lethargy?
Which patient should be seen first?
What is the one with new-onset confusion?
Elevated CK leads to release of this electrolyte from damaged muscle.
What is potassium?
The most reliable early indicator of sepsis in elderly patients.
What is acute mental status change?
Which pain medication should be avoided in AKI?
What is NSAIDs?
Dark urine + CK elevation indicates the need for this urgent lab.
What is BMP (for creatinine & K+)?
Geraldine’s unsteady gait + dehydration = extreme risk for this.
What is falls?
Which action is required before giving a new medication?
What is verify allergies?
The body produces ketones in dehydration secondary to this physiologic state.
What is low carbohydrate intake/starvation?
A CK level over 5,000 with oliguria suggests this condition.
What is impending renal failure?
Tachycardia, rigidity, and dark urine require this rapid treatment action.
What is high-rate isotonic fluids?
In delirium, the nurse’s first priority is always this.
What is safety?
Chronic illness + medication burden contribute to this geriatric syndrome.
What is frailty?
Most important intervention after finding oliguria in rhabdomyolysis.
What is increase fluids as ordered?
The acid-base imbalance most associated with rhabdomyolysis.
What is metabolic acidosis?
Which electrolyte imbalance is the silent killer in rhabdomyolysis?
What is hyperkalemia?
An elderly patient on diuretics and metformin is at risk for this metabolic emergency.
What is lactic acidosis?
Correct sequence of actions for suspected rhabdomyolysis.
What is IV access → high-rate fluids → monitor potassium → strict I&O?
***VIDEO CLUE***
Severe dehydration with hypernatremia and hypoglycemia--initiate immediate orders for fluids and glucose stabilization
Which patient requires the RN, not LPN?
What is the patient requiring IV titration or complex assessment?