Kate Shared "NUR 206 Exam 1" - 39 Picmonics

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NUR 206 Exam 1

IV Solutions
Hypotonic (< 280 mOsm/L)
1/4 Normal Saline (0.225% NaCl)
1/2 Normal Saline (0.45% NaCl)
Isotonic (280-300 mOsm)
Normal Saline (0.9% NaCl)
Lactated Ringer's (LR)
Dextrose 5% in Water (D5W)
Hypertonic (> 300 mOsm)
3% or 5% NaCl
Dextrose 5% in 0.45% NaCl
Dextrose 10% in Water (D10W)
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3 mins
Types of Blood Products
Types
Whole Blood
Packed Red Blood Cells
Fresh Frozen Plasma
Immunoglobulins
Clotting Factors
Albumin
Platelets
Considerations
Use within 24 Hours
Washing Removes Antibodies
Irradiation Destroys WBCs
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2 mins
Hypokalemia
Assessment
< 3.5 mEq/L
Muscle Weakness
Arrhythmia
U Wave
Ileus
Hyporeflexia
Interventions
IV K+ Infusion at 5-10 mEq/hr
Give Orally with Food
Nursing Considerations
Monitor Respiratory Status
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3 mins
Hyperkalemia
Assessment
> 5.0 mEq/L K+
Abdominal Cramps
Muscle Weakness
Diarrhea
Arrhythmia
Tall, Peaked T Waves
Interventions
IV Calcium
Infusion of Glucose and Insulin
Loop or Thiazide Diuretics
Kayexalate
Dialysis
Prevention Education
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2 mins
Hypocalcemia Causes
Hypoalbuminemia
Hypomagnesemia (Less Common Hypermagnesemia)
Hypovitaminosis D
Hypoparathyroidism
Medications
Hyperphosphatemia
Malnutrition
Acute Pancreatitis
Alkalosis
Sepsis
Chronic Kidney Disease
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2 mins
Hypocalcemia
Assessment
< 8.5 mg/dL Ca2+
Decreased Bone Density
Muscle Spasms
Tetany
Chvostek's Sign
Trousseau's Sign
Increased DTR
ECG Changes
QT Prolongation
Considerations
Oral and IV Replacement of Ca2+
Seizure Precautions
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2 mins
Hypercalcemia Causes
Two CHIMPANZEES Acronym
Thyroid Disorders
Calcium Supplements
Hyperparathyroidism
Iatrogenic (Drugs, immobility)
Milk-Alkali Syndrome
Paget's Disease of Bone
Acromegaly or Addison's Disease
Neoplasms
Zollinger-Ellison Syndrome
Excessive Vitamin A
Excessive Vitamin D
Sarcoidosis
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2 mins
Hypercalcemia
Assessment
> 10.5 mg/dL Ca2+
Pathologic Fractures
Lethargy
Hypercoagulation
Constipation
ECG Changes
QT Shortening
Interventions
No Calcium Intake
Chelating Drugs
Calcitonin
Bisphosphonates
Loop Diuretics instead of Thiazide Diuretics
Considerations
Increased Risk for Renal Calculi
Increase Fluids
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3 mins
Hypercalcemia Treatments
Treat Underlying Disorder
Hydration
Dialysis
Calcium Restriction
Bisphosphonates
Calcitonin
Cinacalcet
Glucocorticosteroids
Denosumab
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2 mins
Hyponatremia
Assessment
< 135 mEq Na+
Nausea and Vomiting
Decreased LOC
Confusion / Lethargy
Seizures
Priority Interventions
Assess Airway
Reduce Diuretic Dosage
Fluid Excess Hyponatremia
Mannitol (Osmitrol)
Fluid Restriction
Fluid Deficit Hyponatremia
Hypertonic Solution (3% or 5% NaCl)
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2 mins
Hypernatremia
Assessment
> 145 mEq/L Na+
Change in LOC
Extreme Thirst
Orthostatic Hypotension
Dry Flushed Skin
Muscle Twitching
Seizures
Priority Interventions
Prevent Dehydration
Hypotonic Solutions (0.225% or 0.45% NaCl)
Sodium Restriction
Diuretics
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2 mins
How to Interpret Acid Base Disorders
pH, pCO2, HCO3 (Bicarbonate)
Step 1
pH
Acidosis
Alkalosis
Step 2
pCO2
Opposite Direction As pH
Respiratory Acidosis
Respiratory Alkalosis
Step 3
HCO3 (Bicarbonate)
Same Direction As pH
Metabolic Acidosis
Metabolic Alkalosis
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3 mins
Respiratory Acidosis
Hypoventilation
Increased PaCO2 > 45
Barbiturates Depress Central Respiratory Center of Brain
Opioids Depress Central Respiratory Center of the Brain
Airway Obstruction
Respiratory Muscle Weakness/Paralysis
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3 mins
Respiratory Acidosis Assessment
Assessment
Decreased pH < 7.35
Increased PaCO2 > 45
Reduced Respirations
Anxiety
Change in LOC
Tachycardia
Cyanosis
Increased Electrolytes
ECG Changes
Muscle Weakness
Hyporeflexia
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2 mins
Respiratory Alkalosis Assessment
Assessment
Increased pH > 7.45
Decreased PaCO2 < 35 mmHg
Hyperventilation
Brainstem Stimulation
Head Injury
Shock
Lightheadedness
Tingling Lips or Fingers
Trousseau's
Chvostek's Sign
Anxiety
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2 mins
Metabolic Acidosis Assessment
Characteristics
Decreased pH < 7.35
Decreased HCO3 < 22
Signs & Symptoms
Abdominal Pain
CNS Depression
Coma
Hypotension
Arrhythmias
Increased Respirations
Kussmaul Respirations
Flushed, Warm, Dry Skin
Muscle Weakness
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2 mins
Metabolic Alkalosis Assessment
Signs and Symptoms
Increased pH > 7.45
Increased HCO3 > 26
Excitable State
Arrhythmias
Paresthesias
Muscle Cramps
Muscle Weakness
Decreased Respiratory Effort
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1 min
Respiratory Acidosis Interventions
Improve Respiration
Pharmacologic Interventions
Bronchodilators
Respiratory Stimulants
Drug Antagonists
Nonpharmacologic Interventions
Oxygen
Assisted Ventilation
Prevent Complications
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1 min
Respiratory Alkalosis Interventions
Treat Underlying Cause
Mechanically Ventilated Patients
Decrease Tidal Volume and/or Respiratory Rate
Give Adequate Pain Control and Sedation
Hyperventilation Syndrome
Rebreathing into Paper Bag
Sedatives
Antidepressants
Considerations
Compensatory Drop in Serum Bicarbonate
Correct CO2 Slowly
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2 mins
Metabolic Acidosis Interventions
Interventions
Raise Plasma pH > 7.20
Treat Underlying Cause
Sodium Bicarbonate
Considerations
Follow ABGs
Continuously Monitor Patient
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2 mins

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