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What is the normal levels of potassium?
normal 3.5-5 meQ/L
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What is it called when the Potassium levels are below 3.5?
Hypokelemia
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What is the cause of hypokelemia?
Too much potassium is loss due to poor dietary intake.
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What are early signs of hypokelemia?
- anorexia
- hypotension
- lethargy
- mental confusion
- muscle weakness
- nausea
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How do you treat mild hypokelemia?
replace with foods rich in potassium
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How do you treat sever hypokelemia?
IV of potassium supplement, potassium chloride
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What is the normal level of Calcium?
Normal serum level is 4-5 mEq/L
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What is the primary role of calcium?
- formation of healthy bones and teeth
- promotes normal blood coagulation
- critical to never conduction
- maintains electrical potential after the rapid sodium-potassium pump
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What is it called with a calcium level below 4 mEq/L?
Hypocalcemia
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What does sever hypocalcemia cause?
- muscle spasms
- cramps
- sharp flexion of the wrist and ankles
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What are the methods to check for severe hypocalcemia?
- Trousseau's Sign
- Chvostek's Sign
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What is hypecalcemia?
- Level of calcium above 5 mEq/L
- a symptom of an underlying disease
- causes excess bone reabsorption with release of calcium
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what is the normal level of Magnesium?
Normal serum level is 1.5-2.5 mEq/L
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What do you assess for when checking for need of electrolyte replacement?
- Taking a history
- obtain clinical measurements
- assessing skin turgor
- neuromusclar irritability
- perform a physical exam
- review labs for fluid & electrolytes
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What are the 6 things to look for in the patients history?
- 1.fluid and food intake
- 2.fluid output
- 3.recent fluid losses
- 4.signs of fluid deficit or excess
- 5.common signs of electrolyte problems
- 6.long term and recent disease processes
- 7.medications and treatments
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What is the best measurement to notice either a deficit or excess of fluid?
daily weight
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If patient has experienced large number of lbs gained in a weak might mean what?
patient has a fluid overload in body
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What type of vital signs would you see in a patient with a fluid deficit?
- Temp increase
- Tachycardia
- pulse decrease
- Blood pressure decrease
- peripheral pulses weak and threading
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What type of vital signs would you notice in a patient with a fluid excess?
- Weight gain
- edema
- pulse increases
- Blood pressure increase
- peripheral pulse strong and bonding
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What are physical signs on a patient that would tell you if there is and defict or excess?
- skin color
- oral cavity
- eyes
- jugular veins
- veins of the hand
- neurologic system (LOC)
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What does the Osmolality lab test tell you?
- solute concentration of urine
- increase osmolality means a fluid devicit
- decrease osmolality means a fluid excess
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What are the normal values for urine osmolatity?
Normal vaules are 500-800 mOsm/kg
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What does the urine pH tell you about the kidneys?
Whether the kidneys are responding appropriately to metabolic acid-base imbalances
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What are the Nursing Dx related to fluid volume?
- Deficient Fluid volume/ Risk
- Risk for imbalanced fluid volume
- Fluid volume excess
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What are the outcomes for pateints with actual or potential F & E imbalances?
- Regain adequate F & E balance
- Avoid potential associate risks
- -skin break down
- -loss of tissue integrity
- -decreased cardiac output
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What are the 3 types of IV fluids to correct imbalances?
- isotonic=equal to blood plasma
- hypotonic=less than blood plasma
- hypertonic=more than blood plasma
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What is a herb?
a plant or part of a plant valued for ite medicinal, savory, or aromatic qualities
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What are some examples of herbs for medicinal purposes?
- Digitalis=foxglove
- snakeroot=source of reserpine
- Willow bark=source of aspirin
- Pacific Yew Tree=source of Taxol
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True/False. Herbs are considered an alternative medicine.
true
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What is the difference between legend drugs and dietary supplements?
- For dietary supplements DSHEA requires: no proof of efficacy
- sets no standards for quality control for products
- do not need approval from the FDA before marketed
- Manufactures does not have to provide FDA with evidence on which it relies to substantiate yhe safety or effectivness of a product
- Manufactures may state an effect but does not need to promise a specific cure on the label
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How many adults use dietary supplements?
12-61%
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what is alternative medicine?
the use of herbal products and nontraditional remedies
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What is complentary medicine?
The use of both traditional medicine and alternative medicine at the same time.
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Why do people believe herbal medicines are better?
plants contain natural substances that can promote health and alleviate illness.
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What are the most common things herbal medicines are used to treat?
- anxiety
- arthritis
- colds
- constipation
- cough
- depression
- fever
- headache
- infection
- insomnia
- intestinal disorders
- premenstrual syndrome
- menopausal symptoms
- stress
- ulcers
- weakness
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What can affect a persons response to a drug? OTC, prescription, or herbal.
- beliefs
- values
- genetics
- culture
- race
- ethnicity
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what are some harmful concerns about herbs?
- contamination
- interaction with conventional drugs
- can effect lab results
- increase BP
- cause palpitations and stroke
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Why are dietary supplements popular?
- 1. available without prescription
- 2. cheaper
- 3. aggressive marketing
- 4. cultural practices and beliefs
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According to FDA, who do you report adverse effects of dietary supplements, drugs, or medical devices to.
Med Watch toll free number
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What are some commonly used herbal products?
aloe, black cohosh, chamomile, echinacea, feverfew, garlic, ginger, ginseng, ginko biloba, golden seal, hawthorne, kava, saw palmetto, St John's Wort, Valerian
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Before getting an anesthetic what should you do about herbs?
- 1. stop taking herbal products 2 weekd prior
- 2. inform surgeon and anesthesia that you are taking herbal products
- 3. bring container in to know whats exactly in in
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true/false. Herbal products are not treated as medicine.
False
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What are the 6 herbal products that affect clotting?
- 1. Dong Quai (Angelica)
- 2. Garlic
- 3. Ginger
- 4. Ginkgo
- 5. Ginseng
- 6. Feverfew
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What are the 8 herbal products that affect glucose levels?
- 1. bay
- 2. basil
- 3. Bee pollen
- 4. Ephedra (Ma-huang) - causes hyperglycemia
- 5. Garlic- causes hypoglycemia
- 6. ginseng
- 7. milk thistle
- 8. sage
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What are the 5 herbal products that are used for healing?
- 1. Aloe
- 2. Chamomile
- 3. Evening primrose
- 4. Goldenseal
- 5. St John's wort
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Who should be very cautious of taking herbal products?
- infants
- young children
- pregnant women
- nursing mothers
- older adults with liver or CV diseases
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List 2 important things about Aloe.
- 1. used for laxatives & healing of wounds
- 2. may increase hypokalemia
- 3. use cautiously in patients with renal disease, f&E imbalance, diabetes
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List 3 important things about black cohosh.
- 1. causes decrease in BP
- 2. May increase bleeding
- 3. manages menopausal sysmptoms
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What is Chamomile used for?
used for healing
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List 7 important things about Echinacea.
- 1. causes immune suppression
- 2. cause liver inflammation
- 3. used for bacterial and viral infections
- 4. prevents and treats colds, coughs, flu, and bronchitis
- 5. used for wound healing
- 6. reduces inflammation of the mouth and pharynx
- 7. used for UTI's and vaginal candidiasis
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What can cause hypocalcemia?
- 1. transfusion of blood
- 2. alkalosis
- 3. kidney disease
- 4. drainging fistula
- 5. inadequate dietary intake
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What are some effects of hypocalcemia?
- 1.BONES: osteoporosis > fractures
- 2.CNS: tingling > convulsions
- 3.GI TRACT:increased peristalis > N/V and diarrhea
- 4.MUSCLES: Muscle spasms > tetany
- 5.CV: dysrhythmias > cardiac arrest
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What are some effects of hypercalcemia?
- 1.BONES: bone pain> osteoporosis > fractures
- 2.CNS: decreased deep tendon reflexes > lethargy > coma
- 3.KIDNEY: kidney stones > kidney damages
- 4.MUSCLES: muscle fatigue hypotonia > decrease GI tract motility
- 5. CV: depressed activity > dysrhythmias > cardiac arrest
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What are some causes of hypercalcemia?
- 1. loss from bones
- 2. excess intake
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