Download Nursing Essentials: Fluid Balance, Electrolytes, and Medication Guide and more Exams Nursing in PDF only on Docsity!
2025 Nursing 205 Course Breakdown: Core Concepts,
Clinical Competency Checklists, Patient Care
Strategies, and Comprehensive Exam Preparation for
Nursing Students
Symptoms of FVD - <<>> Thirst
- **high HR
- **low BP
- decrease in wt
- tenting skin
- flat jugular veins
- dry mucous membranes
- clear lungs
- restless
- dark concentrated urine
- **BUN greater than 20
- urine output less than 30 ml/hr Treatment for FVD - <<>> IV fluids
- IV bolus
- Oral fluids
- I&O/ daily weights
- Blood or biproducts
- Freq assessments
- vital signs Causes of FVD - <<>> not drinking enough fluids
- GI losses (diarrhea and vomiting)
- GI suctioning (NG tube)
- insensible fluid loss
- food poisoning
- burns
- NPO status pt's Fluid Volume Excess (FVE) - ****answer***Abnormal retention of fluids and electrolytes. Too much water in not enough out. Hypervolemia Fluid Overload Symptoms of FVE - <<>> **high HR; bounding pulse
- **high BP
- Increased wt
- edema
- JVD
- **SOB/Crackles
- pink frothy sputum
- change in LOC
- diluted/ sediment urine
- low SPO2/ fast resp
diarrhea, alcohol, DKA, excessive laxatives, kussmal breathing Metablolic Acidosis Treatments/Interventions - ****answerMonitor K+ values Seizure precautions Strict I&O monitoring Monitor LOC Sodium bicarb Rehydrate patient Metabolic Alkalosis - ****answerHigh pH (7.45 or higher) High HCO3 (26 or higher) Causes: vomiting, gastric suctioning, dehydrations, overuse of antacids Results in hypokalemia Metabolic Alkalosis Treatment/Interventions - ****answerMonitor signs for resp distress Monitor K+ and Ca+ levels K+ replacement Medications to flush out the excessive bicarb Iv/Oral fluids Administer antiemetic medications Nutrition replacement Seizure precautions Respiratory Acidosis - ****answerLow pH (7.35or lower) High Pc02 (45 or higher)
Causes: COPD, hypoventilation, asthma, pneumonia, pulmonary edema, sedation Respiratory Acidosis Treatment/Interventions - ****answerAdminister 02 as prescribed sit HOB or orthopenic position Encourage fluids to thin secretions Administer respiratory therapies May need suction kit at the bedside Monitor electrolytes Administer respiratory infection antibiotics or steroids Bronchodilators ** Respiratory Alkalosis - ****answerHigh pH (7.45 or higher) Low Pc02 (35 or lower) Causes: Hyperventilation, anxiety, obesity, fever Respiratory Alkalosis Treatment/Interventions - ****answerBreathing techniques into a paper bag Anti anxiety meds Relaxation techniques monitor electrolytes Provide emotional support Hypokalemia - ****answerK+ lower than 3. Causes:
Burns, acute kidney failure, excessive use of K+ supps and intake of K+ foods, intestinal obstruction, cell damage Hyperkalemia S/S - ****answermuscle weakness hypotension diarrhea hyperactive bowel sounds flat P waves Prolonged PR interval Depressed ST Hyperkalemia Treatment/Interventions - ****answerPlace pt on cardiac monitor monitor I&O monitor vital signs enforce K+ restricting diet Give kayexlate Dialysis may be required Hypocalcemia - ****answer***Lower than 8 Causes: Inadequate intake of calcium & vit D Diarrhea Excessive GI loss Diuretics Caffeine Laxatives
Crohns Disease Hypocalcemia S/S - ****answerHIgh HR Tetany Positive Chovostek's or Trousseaus sign Diarrhea Twitching Hyperactive bowel sounds Laryngeal spasm Hypocalcemia Treatment/Interventions - ****answerMonitor GI and cardiac status Administer Ca+ supplements or IV solutions Administer Phosphate and vitamin D Seizure precautions Increase Ca+ foods Rapid-Acting Insulins - ****answerLispro (Humalog) Aspart (Novolog) Glulisine (Apidra) Hypercalcemia - ****answer*Higher than 10 Causes: Excessive intake of calcium supplements or vit D Kidney disease Adrenal insufficiency Hyperparathyroidism
Peak? Duration? - ****answerOnset: 15 minutes Peak: 60 minutes Duration: 3-4 hours Short-Acting Insulins - ****answerRegular (Humulin R, Novolin R) Short-Acting Onset? Peak? Duration? - ****answerOnset: 30 minutes Peak: 2 hours Duration: 8 hours Intermediate-Acting Insulin - ****answerNPH (Humulin N, Novolin N) Intermediate-Acting Insulin Onset? Peak? Duration? - ****answerOnset: 2 hours Peak: 8 hours Duration: 16 hours Long-Acting Insulin - ****answerglargine (Lantus)
detemir (Levemir) Long-Acting Insulin Onset? Peak? Duration? - <<>> Onset: 1-2 hrs
- Peak: None
- Duration: 24 hrs
- DO NOT MIX! Hypoglycemic 15/15 Rule - ****answerLow BS Give 15 grams of glucose/simple carb Recheck BS in 15 minutes (if less than 70 repeat) When educating a type 1 DM, what is a large priority? - ****answerthe risk of hypoglycemia 6 rights of drug administration - ****answerRight patient, right drug, right dose, right route, right time, right documentation 3 medication checks - ****answerCheck MAR/order Check when you pull the medication Check at the patient bedside
Insulin Hormone - ****answerNecessary for carb regulation and glucose control Hormones - ****answerChemical messengers, mostly those manufactured by the endocrine glands, that are produce metabolic change Normal BS - ****answer70- 120 Fasting BS - ****answer70- 100 Pre-diabetic BS - ****answerover 140 Mild Hypoglycemia Symptoms - ****answerHunger Nervousness Palpitations Sweating Tachycardia Tremor Moderate Hypoglycemia Symptoms - ****answer***Confusion Double Vision Drowsiness Emotional Changes Headache Impaired Coordination Inability to concentrate
Irrational or combative behavior Lightheadedness Numbness of the lips and tongue Slurred speech Severe Hypoglycemia Symptoms - ****answerDifficulty arousing Disoriented behavior Loss of consciousness Seizures Hyperglycemic Symptoms - ****answerPolydipsia (increased thirst) Polyphasia (Increase hunger) Polyuria (increased urination) Warm, flushed skin Blurred vision Poor wound healing Diabetic Keto acidosis (DKA) - ****answerHigher than 300 glucose Ketones in urine Kussmal breathing Acetone (fruity) breath Tachycardia N/V Severe abdominal pain DKA Treatments - ****answerRapid IV fluids
What are the components of the lipid panel? - ****answerHDL LDL Triglycerides BS over 140 can start to _____________________ - ****answerPut stress on the beta-cells BS over 170 can start to cause _____________________ - ****answer***Damage of the small blood vessels in the body which causes vascular problems Type 1 Diabetes - <<>> INSULIN DEPENDENT
- Born w/o beta cells in the pancreas
- Rapid onset of diagnosis
- Usually happens early in life (genetic)
- Need lifelong insulin treatments (pump etc.)
- DKA's very common
- Must eat regularly 5-6 times/day
- Cannot take oral glycemic meds Type 2 Diabetes - <<>> Pancreas is worn out by too much carb/sugar intake that it becomes INSULIN RESISTANT
- Happens later in life
- Slow onset of diagnosis
- Increased obesity, sedentary lifestyle, poor nutrition Chronic Complications of Diabetes - <<>> Stroke
- Heart attack
- Peripheral artery disease
- Diabetic retinopathy
- Cataracts
- Glaucoma
- Neuropathy
- Skin conditions
- Poor wound healing Statins - ****answer***drugs used to lower cholesterol in the bloodstream
- reduce the risk of MI and stroke Oral hypoglycemic agents - ****answer***These medications promote insulin release from the ilet cells in the pancreas. Examples of oral hypoglycemics - <<>> Metformin
- Glypiside Do not give oral hypoglycemics to who? - ****answerType 1 diabetics Metabolic Syndrome - ****answerA cluster of conditions like high BS, high BP, excessive wasting, body fat, abnormally high lipids acting together that increase the risk of heart disease, stroke, and diabetes. Type 1 DM Glycogen - ****answer***Found in the pancreas; stores glucose (stored sugar for energy source)
intracellular fluid - ****answerFluid inside cells; majority of fluids are inside cell extracellular fluid - ****answerbody fluids located outside of cells Third-spacing - ****answerthe accumulation and sequestration of trapped extracellular fluid in an actual or potential body space as a result of disease or injury Edema - ****answerAbnormal accumulation of fluid in interstitial spaces of tissues. Occurs as a result of conditions such as cardiac, renal or liver disease Body Fluids - ****answerTransport nutrients to the cell and then carry waste products from the cells isotonic Solution - ****answerA solution whose solute concentration is EQUAL to the solute concentration inside a cell Hypotonic solution - ****answerSolute concentration is less than that inside the cell; cell gains water (SWELLS) Hypertonic Solution - ****answerSolute concentration is greater than that inside the cell; cell loses water (SHRINKS) Insensible water loss - ****answerthe loss of water not noticeable by a person, such as through evaporation from the skin and exhalation from the lungs during breathing Substances that are transported actively throughout the cell membranes include? - ****answerSodium potassium
calcium iron hydrogen Some sugars amino acids Severe diarrhea results in - ****answerloss of large quantities of fluids and electrolytes Which organ plays a large roll regulating fluid and electrolyte balance and excrete the largest quantity of fluid? - ****answerKidneys Antidiuretic hormone - ****answerhormone secreted by the posterior pituitary gland which aids in water reabsorption by the kidney Normal BUN - ****answer10- 20 Normal creatinine - ****answer0.6-1. Normal Potassium - ****answer3.5- 5 Normal Sodium - ****answer135- 145 Fluid Volume Deficit (FVD) - ****answerLoss of fluids and electrolytes. Too much out not enough in. Hypovolemia
