Peri OP F/E Med Surg (JH)
Terms
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- Sodium- function
- Sodium- function maintain extracellular volume and water balance aids to transmit nerve impulses
- Hypernatremia- causes
- Hypernatremia- causes Decreased water intake Fluid loss Osmotic diuresis Hyperglycemia Salt water intake Profuse diaphoresis accompanied by low water intake Hyperaldosteronism-too much sodium in blood. Diabetes Insipidus
- Hypernatremia- Clinical manifestations
- Hypernatremia- Clinical manifestations Decreased mental status Decreased turgor Dry skin and dry mucous membranes Thirst
- Hypernatremia- interventions
- Hypernatremia- interventions Administer hypotonic IV (0.455% NSS) Water Administer oral hygeine
- Hyponatremia- causes
- Hyponatremia- causes Sweating followed by large plain water intake causes dilution of plasma sodium Increased ADH Adrenal Insufficiency (decreased aldosterone so Na levels fall)
- Hyponatremia- clinical manifestations
- Hyponatremia- clinical manifestations Neurological symptoms due to brain swelling Weight gain Edema Rales Abdominal cramps Low hematocrit Low BUN Orthostatic hypotension
- Hyponatremia- Interventions
- Hyponatremia- Interventions Administer hypotonic IV Diuretics
- Potassium value
- Potassium value 3.5-5 mEq/L
- Potassium- Functions
- Potassium- Functions Cellular metabolism Transmission of neuromuscular impulses supports cardiac cycle Acid base balance Any condition that increases urinary output decreases potassium
- Hypokalemia- Causes
- Hypokalemia- Causes Diuretics GI Losses Adrenal Tumor- may cause excess secretion of aldosterone,which then secretes too much Ka
- Hypokalemia- clinical manifestations
- Hypokalemia- clinical manifestations Malaise Muscle Weakness Leg Cramps Fatigue Decreased reflexes Abnormal ECG and dysrhythmias
- Hypokalemia- interventions
- Hypokalemia- interventions Administer potassium Oral or IV (NEVER IV PUSH potassium, THIS CAN BE FATAL)
- Hyperkalemia- causes
- Hyperkalemia- causes Renal insufficiency Cellular destruction Excessive administration of Ka Adrenal Insufficiency- too little aldosterone.
- Hyperkalemia- clinical manifestations
- Hyperkalemia- clinical manifestations Mental changes Abnormal ECG Lethal disrhythmia Dialysis (#1 cause)
- Calcium value
- Calcium value 8.5-10.5mEq/L
- Calcium- function
- Calcium- function formation of bone and teeth blood clotting myocardial contractility nerve impulse conduction (suppressant effect)
- Calcium- regulation
- Calcium- regulation Vitamin D Parathyroid
- Hypocalcemia- causes
- Hypocalcemia- causes Hypoparathyroid Pancreatitis Low dietary Ca Alkalosis Renal disease (kidneys activate V-D, Vit D helps absorb Ca)
- Hypocalcemia- clinical manifestations
- Hypocalcemia- clinical manifestations hyperactive reflexes tingling in face fingers toes Muscle spasm tetany Decreased blood clotting Bronchospasms (assess by checking trousseau's signs)
- Hypocalcemia- interventions
- Hypocalcemia- interventions Oral or IV calcium (NEVER IM CALCIUM)
- Hypercalcemia- causes
- Hypercalcemia- causes Hyperparathyroidism- causes too much Ca to be retained Malignancies-some cancers produce pth. Osteoporosis Prolonged immobility Decreased renal function
- Hypercalcemia- clinical manifestations
- Hypercalcemia- clinical manifestations Hypotonicity Lethargy Increased blood clotting Extreme thirst Decreased neuromuscular function Kidney Stones Fractures-too much Ca can cause breaks.
- Hypercalcemia- interventions
- Hypercalcemia- interventions Parathyroidectomy Steriods (they decrease GI absorption of Ca) Mitromycin Calcitonin
- Magnesium value
- Magnesium value 1.5-2.5mEq/L
- Hypomagnesemia-causes
- Hypomagnesemia-causes Decreased Mg intake Malnutrition Alcoholism
- Hypomagnesemia-clinical manifestations
- Hypomagnesemia-clinical manifestations tremors hyperactivity tetany positive Trousseau's Confusion Agitation
- Hypomagnesemia- interventions
- Hypomagnesemia- interventions Replace Magnesium- IV (Mg salts)IV Mg can cause cardiac arrest if given too quickly. Oral IM
- Hypermagnesemia- causes
- Hypermagnesemia- causes Renal failure- may be exacerbated by meds containing magnesium.
- Hypermagnesemia- clinical manifestations
- Hypermagnesemia- clinical manifestations Lethargy Slow/Weak pulse Low BP Decreased tonicity Brachypnea
- Hypermagnesemia- interventions
- Hypermagnesemia- interventions Dialysis Stop intake of Mg.
- Magnesium- function
- Magnesium- function Nerve impulse conduction Chemical metabolism Cardiac conduction
- Trousseaus Signs
- Trousseaus Signs BP cuff inflated for 3-4 minutes hand claws up.
- Electrolytes
- Electrolytes - substances which when dissolved in water separate into ions (capable of conducting electricity)
- Intracellular Electrolytes
- Intracellular Electrolytes potassium(K) and magnesium (Mg)
- Extracellular Electrolytes
- Extracellular Electrolytes Sodium and Chloride
- Third Spacing
- Third Spacing - shift of fluid from vascular space to another part of the body (interstitial space)
- Third spacing- causes
- Third spacing- causes increased hydrostatic pressure- as seen in CHF Too much fluid in vessels Decreased plasma proteins Liver disease Increased capillary permeability- sepsis, trauma and burns
- Third Spacing- clinical manifestations
- Third Spacing- clinical manifestations Weak right sided pressure Low albumin levels Protein levels
- Third Spacing- interventions
- Third Spacing- interventions IV albumin Lasix after IV treatment In sepsis, treat cause
- SIADH (Syndrome Of Inappropriate Diuretic Hormone)
- SIADH (Syndrome Of Inappropriate Diuretic Hormone) Excessive ADH production
- Antidiuretic Hormone - function
- Antidiuretic Hormone - function - produced & stored in the hypothalamus - stimulates the kidney to reabsorb water decreasing urine output, supporting BP and blood volume - stimulate peripheral blood vessels to constrict
- Cacitonin - function
- Cacitonin - function - targets bone and kidney cells - to regulate calcium ion concentration in body fluids
- Function T4 - Thyroxine T3 - Triiodothyronine
- Function T4 - Thyroxine T3 - Triiodothyronine - bind to mitochondria and nucleus of cells to increase the rate of ATP production