COMP4_AcidBaseBalance

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Author:
vanwin
ID:
215238
Filename:
COMP4_AcidBaseBalance
Updated:
2013-04-22 23:47:04
Tags:
fundamental competencies
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Description:
nursing
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  1. Total Body H2O
    • 50-60%
    • newborns: skin turgor test inaccurate because their skin is very elastic regardless
    • women & obese patients have less water concentration due to adipose tissue
  2. Function of H2O
    • Transport to & from cells
    • lube joints
    • temperature regulation
    • medium for food digestion
  3. Movements of H2O & electrolytes
    • Active Transport
    • Diffusion
    • Osmossis
    • Filtration
  4. Fluid Spaces
    • 1st: normal
    • 2nd: edema
    • 3rd: ascites
  5. Hyponatremia causes
    • excess sweating
    • vomitting
    • low sodium diet
    • excess fluid intake
    • diuretics
    • syndrome of inappropriate ADH
    • Renal failure
  6. Hypernatremia causes
    • watery diarrhea
    • diabetes insipidus
    • hyperventilation
    • excess aldosterone
  7. Hyponatremia & hypernatremia signs & symptoms
    • Hypo: CNS
    • Hyper: thirst, dehydration, CNS
  8. Hypo/Hyper natremia interventions
    • Hypo: fluid restriction, hypertonic IV, diuretics
    • Hyper: fluid restriction, salt restriction, diuretics, IV NS wi/o salt

    both: monitor neuro, bp, pulse, I&O, daily weights
  9. Hypokalemia causes
    • decrease intake
    • vomit
    • too much aldosterone
    • potassium wasting diuretics
    • potassium goes into cells (insulin & alkalosis)
  10. Hyperkalemia
    • increased intake
    • kidney failure
    • potassium sparing diuretics
    • potassium leaving cells ( glucagon/ acidosis)
  11. Hyper/Hypokalemia S&S
    • Hypo: shallow respiration, weak pulses
    • Hyper: diarrhea, abd cramps

    both: weak muscles, parathesia, paralytic ilieus, disrythmias,
  12. Potassium Imbalance Interventions
    Hypo: give potassium (PO/IV) (use lidocane for IV). change diuretics to potassium sparing

    hyper: give insulin, glucose, bicarb (to raise pH),

    both: monitor heart, digoxin, magnesium lvls
  13. Hypocalcemia causes
    • Blood transfusions
    • celiac's/crohn's disease
    • endocrine dysfunction
  14. Hypercalcemia causes
    • excess intake
    • bone resorption
    • endocrine dysfunction
    • immobility
  15. Hypocalcemia S&S
    • numbness
    • tingling
    • tetany
    • weak heart contractions
    • positive chvostek & trouseau's signs
  16. Hypercalcemia S&S
    • sluggish
    • lethargy
    • stupor
    • kidney stones (renal calculi)
    • cardiac arrest
  17. Calcium imbalance Interventions
    Hypocalcemia: give Ca PO/IV, give Vitamin D, monitor Ca levels

    Hypercalcemia: IV isotonic solution, Ca binding agents, dialysis, diuretics
  18. Hypomagnesium
    malnutrition/malabsorption

    S&S: similar to Hypocalcemia, CNS irritability, dysrythmias
  19. Hypermagnesia
    tocolytic therapy & decrase renal excretion

    s&S: similar to hypercalcemia, decreased CNS
  20. Complications of IV Therapy
    • infection
    • fluid overload
    • infiltration
    • phlebitis
    • extravasion
  21. Hemolytic reactions
    • d/c transfusion
    • flush w/ saline
    • contact doctor
    • get Urine sample
  22. Blood transfusion
    • normally given over 2-4hrs
    • needs 2 RNs to check it over
    • nurse needs to stay with pt first 15mins
    • possible reactions: cihlls, fever, fatigue, headache, muscle pain
  23. Buffer System
    • immediate: chemicals in your body
    • rapid: pulmonary response
    • slow: kidneys
  24. Respiratory acidosis
    causes: hypoventilation,

    S&S: flushed skin, lethargy, hypotension, confusion
  25. Respiratory Alkalosis
    hyperventilation

    S&S: numbness, tingling, tetany, lethargy, light headed, nausea, vomiting
  26. Metabolic acidosis
    DKA, shock, Potassium out of cells, kidney failure

    S&S: flushed skin, lethargy, hypotension, confusion, kusmaul respiration
  27. metabolic alkalosis
    vomitting, diarrhea, NG suctioning

    S&S: lethargy, numbness, tingling, tetany, lightheadedness, hypoventilation

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