Glossary of Electrolyte, Acid-Base, Sleep, Adult Dev.
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- How often do you check IV site
- Every hour
- Signs of Phlebitis
- Red, Warm, Tender to touch, harden by IV site, hard venous cord, induration.
- Signs of infiltration
- cool to touch, firm, leaking from site into tissues
- what is endofiltration
- too much fluid to heart, causes cardian valve to fail, inflamation to valves, failure.
- signs of air embolism
- air into blood, cyonotic, increase BP. Heart sounds like turning sound.
- Treatment for air embolism
- treat patient by putting head down, left side. air stays in rt. atrium.
- Prevention of air embolism
- Make sure lines are secured, change lines every 72 hours, clamp hose if air goes into line, call physician
- Treatment of fluid volume excess
- Slow IV down and contact physician.
- Best temperature for sleep
- 68-72 degrees
- what is circadian rhythm
- the 24-hour day, day-night cycle affected by light, temperature, and external factors.
- The stages of sleep
- Wakefulness, NREM Stage 1, NREM Stage 2, NREM stage 3, NREM stage 4, NREM stage 3, NREM Stage 2, REM, NREM stage 2.
- What occurs during REM sleep?
- Dreaming phase, worries, concerns
- Factors creating insomnia
- Pain, anxiety, depression, lung disease, coronary heart disease, nocturia, menopause, restless leg syndrome, surgical removal of ovaries
- What is the criteria for apnea?
- 15 seconds of not breathing.
- What is a treatment for snoring?
- Continuous positive airway pressure CPAP.
- What are some herbal remedies that induce restfulness and sleep?
- Valerian root and Kava
- What type of drugs are sleep inducing?
- What is an example of a hypnotic drug?
- How do you stop benzodiazepines?
- Titrate dose down to prevent withdrawal syndrome.
- What is an alternative hypnotic for older adults with insomnia besides benzodiazepines?
- Restoril (temazepam)
- What benzodiazepine has an effect on the elderly of depression, memory loss, confusion, etc.?
- What drug is often used for sedation during CT scans?
- What medication is given to older adults as a sleep aid?
- Name two short-term barbiturates
- Nembutal (phenobarbital) and Seconal (secobarbital)
- Name a non-benzodiazepine hypnotic
- When is a antihistamine, sedative-hypnotic contraindicated?
- In acute asthma or lower respiratory tract disease since it thickens secretions.
- What does a hypnotic do?
- Induce sleep
- What does a sedative do
- Reduce anxiety.
- What is the normal level for serum sodium?
- 135-145 mEq/L
- Some reasons for Hyponatremia
- Loss of Na in GI Fluids, diuretics, adrenal insuffieincy.
Too much D5W IV, excessive drinking of water, SIADH (excessive ADH is secreted)
- Characteristics of hyponatremia
- Anorexia, N, V
Lethargy, confusion, muscle cramps, twitching, seizures, coma
- Treatment of Hyponatrium
- foods with Na+
Hypertonic saline IV
- Reasons for Hypernatremia
- deprivation of water
hypertonic tube feeding
excessive salt intake
increased water loss
- To have effective ADH, you need normal
- Characteristics of hypernatremia
- thirst, tongue dry, furrowed, swollen
disorientation, hallucinations, lethargy
- Treatment for hypernatremia
- offer fluids
give water with tube feedings every 4 hours 100ccs
monitor I/O and weight
- Funcions of potassium
- Chief regulator of cellular enzyme activity and water content
electric impulses in nerve, heart, skeletal intestinal, lung
acid-base balance by cellular exchange with H+
- Hyperkalemia can lead to
- cardiac arrest.
- Sources of K+
- bananas, peaches, kiwi, figs, dates, apricots, oranges, prunes, melons, raisins, broccoli, potatoes.
- Losses of K+
- Excreted by kidneys
GI secretions, perspiration, saliva.
- What hormone prompts excretion of K+ in urine
- Reasons for hypokalemia
- diarrhea, V, gastric suction
poor intake, anorexia, alcoholism
- Characteristics of hypokalemia
- fatigue, muscle weakness (heart), decreased bowel motility, N, V, anorexia, cardiac arrhythmias, postural hypotension, parasthesias (tingling), polyuria
- Treatment for hypokalemia
- eat foods high in K+
Administer K+ supplements (give with food - hard on stomach)
Administer K+ in IV - too much cardiac arrest!
- Reasons for hyperkalemia
- renal failure
high K+ intake
- Characteristics for hyperkalemia
- muscle weakness, flaccid muscle paralysis, nausea, cardiac arrhythmias, bradycardia, paresthesias, decrease in urine output
- Treatment for hyperkalemia
- insulin added to glucose IVF
Bicarbonate to drive K+ into cell
- Normal level of serum chloride
- 95-105 mEq/L
- Functions of chloride
- Maintains osmotic blood pressure
buffers oxygen & CO2 exchange in RBCs
Found in gastric juices
- Reasons for Chloride deficit
- V, D
Use of diuretics
low sodium diet
too much IV dextrose
- Characteristics of chloride deficit
- hyperexcitability of muscles, tetany, termors, twitching, slow, shallow breathing, BP decrease & dehydration
- Treatment of chloride deficit
- correct K+ deficit along with Cl- deficit
administer normal saline IV
accurately record gastric fluids lost in emesis, suction.
- Characteristics of chloride excess
- weakness, lethargy, coma, deep, rapid breathing to blow off carbon dioxide to reduce acid load.
- Functions of calcium
- nerve impulse transmission
muscle contraction, cardiac function
bones, teeth, cell membranes
- sources of ca+
- cheese, milk, greens, broccoli, salmon, dried beans, vitamin D promotes calcium absorption
- loss of calcium
- excreted in urine, feces, bile, digestive secretions, sweat
- Regulation of Calcium
- parathyroid hormone
High phosphate lowers Ca+
- Reasons for Hypocalcemia
- removal of parathyroid gland
vitamin D deficiency
administration of citrated blood
low albumin levels
increased Mg impairs PTH release
increaased phosphate lower Ca+
- characteristics for hypocalcemia
- numbness, tingling, muscle cramps in extremeties, confusion, irritability, chvostek's and Trousseau's
- Treatment for Hypocalcemia
- seizure precautions, safety precautions, administer calcium, Ca+ gluconate IV
- Reasons for hypercalcemia
- overuse of calcium antiacids
large doses of vitamin D
- characteristics for hypercalcemia
- decreased neuromuscular excitability, weakness, lethargy, decreased memory span, decreased attention span, confusion, polyuria, cardiac arrest
- Treatment for hypercalcemia
- IV furosemide (excretion of Ca+)
dialysis for crisis
promote movement of calcium into bone
- Where is magnesium found
- Intracellular in heart, bone, nerve, muscle
- Functions of Mg+
- regulates neuromuscular activity for skeletal and heart
maintains levels of K+ in cells
Needed for protein synthesis, DNA, RNA
- Sources of Mg+
- green vegetables, nuts, legumes, whole seeds, grains, bananas, chocolate, grapefruit
- Regulation of Mg+
- Absorbed by intestines & excreted by kidneys
- Normal level of Mg+
- 1.3 - 2.1 mEq/L
- Reasons for Mg deficit
- Intestinal malabsorption, diarrhea, NG suction, diabetic ketoacidosis, excessive doses of vitamin D or calcium supplements, diuretics
- Characteristics of Mg deficit
- Neuromuscular irritability, tetany, Chvostek's & Trousseau's signs, (similar to hypocalcemia)
Tachyarrythmias, increased sensitivity to digitalis toxicity
- Characteristics for Mg+ deficit
- mental changes, disorientation, mood changes, intense confusion, hallucinations
- Treatment for Mg+ deficit
- Seizure and safety precautions
increase Mg+ rich foods
Mg sulfate IV
- Reasons for Excess Mg+
- Renal failure
Excessive magnesium administration from laxatives and antiacids
- Characteristics for Mg+ excess
- flushing, skin warmth, depressed respirations, drowsiness, hypoactive reflexes, cardiac abnormalities, weak or absent cry in newborn
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