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antidiuretic syndrome. specific gravities assess what?
fluid vol. status.
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renal failure. mg levels high. assess what?
DTR
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burn unit, 3rd spacing. fluid shift. expect pt to demonstrate?
hypovolemia.
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hyperventilation is most common cause of what acid base imbalance?
resp. alkalosis.
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oh 7.26, co2 28, bicarb 11.
metabolic acidosis, compensating alkalosis.
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edema around insertion site. what is it?
infiltration
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skin turgor. what do you remember?
inelastic skin turgor is normal part of aging.
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periph IV before pt goes to OR, selecting a site.
choose distal site
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medical ICU, hypertonic solution, low blood pressure. how?
osmosis and osmolality
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65 female. renal failure. tingling lips and fingers. spasm in wrist and hands.
hypocalcemia.
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patient in renal failure ability to regulate ph. what is the cause...
the kidneys regenerate and reabsorb bicarb to maintain stable ph
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65yom. pyloric stenosis, NG tube suction for 72 hours.
metabolic alkalosis
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preparing IV site.
ask patient if allergic to latex
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SOB, ABGs drawn. ph 7.21, co2 64, bicarb 23, what is it.
resp acidosis.
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oliguric , acute care NP orders fluid challenge. why?
help distinguish reduced renal blood flow from reduced renal fx.
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home health nurse, 84, poor skin turgor
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limiting fluids, adjusting timing of fluids.
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74M, slip carpet on home. hip fx. axious and thirsty.
sympathetic rx.
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skills lab IV technique. excess hair?
shave.
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evaluating lab results. cause release of ADH?
increased NA+
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admitting pt with ephysema. co2 56-64. cautious admitting oxygen?
hypercarbia
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electrolytes arterial to capillary fluids.
hydrostatic. pumping of heart.
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77M fell off roof. creatinine levels increased?
reduced renal fx.
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IV site infltration of med. what is it?
extravasation of site
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post colon resection. ng tube patent. cramps. tingling feet.
dilute of urine.
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oncoogy floor. metastatic brain CA.
hypercalcemia.
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multiple traumas, ABGs x4. assess what?
hco3 buffer system.
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met acidosis. role of kidneys in this?
kidneys excrete hydrogen ions
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ICU, resp acidosis, what dx can cause this?
guillian barre
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ICU, trauma, trouble breathing, abd pain.
mixed metabolic acidosis with resp acidosis.
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isotonic fluids close to ECF. infuse electrolytes when?
never. rupture RBCs
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family concerns with status. tachy, lethargic, weak, edema. what is it?
hyperchloremia
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met acidosis 2 forms. what causes normal anion gap?
excessive administration of chloride
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met. alk. ng tube. bowel obstruction. what drug to have?
semetidine (antacid)
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pancreatitis. malnourished. TPN. why would you know to do it slowly?
hypocalcemia. avoid shifts in electrolytes.
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secondary hypermag. assess what?
shallow resp.
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increase K+ with diet?
bananas.
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chvostek sign.
hypocalcemia.
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DM, criteria?
fasting blood glucose of greater 126
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new DM2. guidelines to teach?
control cal intake resonable body wt.
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what will decrease body need to insulin.
exercise.
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humolog. teach what?
have meal tray available.
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dx with type 2. sick day rules.
do no limit insulin with nausea and vomit.
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what type of oral dm agent?
biguinide
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students, studying DM, macrovascular complication?
stroke. MACRO.
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senior health class, risk factor for DM, what can't be modified?
advanced age.
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sx of hyperglycemia. DM, 15yo
type 1
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type 1, pt asks what causes, what you say?
destruction of cells.
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type 1 DM, glycosuria, what urine look like?
diluted.
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primary tx of type 2 dm?
follow wt loss plan.
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DM RN educator, ADA recommendations?
50-60% calories from carbs, 20-30 from fat, rest from protein
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88yo with DM brought by daughter
fluid and electrolyte replacement.
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pt teaching. best way to assess pt can prepare insulin?
direct observation of skill
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elderly pt clinic. DM. foot care.
avoid complications associate with foot ulcers.
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sick day rules. needs further teaching.
will not take when sick, but will recheck Q2
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which pt will have greatest success in maintaining?
pt who adheres to meal plan
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spilling sugar into urine, gestation DM.
200 after fasting.
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which pt what hyperosmolar non ketonic
type 2 or no known
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new DM2, 67 yo, long term complication?
cardiovascular dx
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pt divorce. custody battle, drinking, lost job.
ketoacidosis
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MD explain diabetic neuropathy, what cause?
causes aren't known for sure.
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adolescent, what causes diabetes?
genetic, environmental and immunologic
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contributing cause to foot ulcer?
insensitive feet.
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DM educator, hypoglycemia as what?
below 60
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summer camp, prevent hypoglycemia
always carry a fast acting sugar
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teaching basic info to type 1 dm
how to mix insulint
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conducting class on how to manage insulin regimen?
if you are going to use vial within 1 month, you can keep at room temperature.
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enhance action at receptor site w/o increasing insulin secretion of beta cells of pancreas?
thiazolidinediones
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adolescent patient, nervous and hungry, tachy, diaphoretic
fruit juice 4-6 oz.
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another name for diabetic microvascular disease.
diabetic microangiography.
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patient with DM2 seeing the nurse to review foot care, priority instruction?
avoid hot water and heating pads
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DM educator assessing pt for knowledge how?
monitor the pt's daily food menus
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foot care for DM pt. general guidelines?
wash feet in warm water.
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decrease in deep tendon reflexes, ho hx of diabetic neuropathy.
decreased vibratory senation
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diabetic pt with flu.
eat small amounts, stay hydrated.
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hasimoto thyroiditis. what sx you expect?
numbness and tingling in fingers.
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PACU, thyroidectomy, how to position?
semi fowlers, 2 pillows.
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total parathyroidectomy. assess for what?
tentany
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addison's disease
muscle weakness
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iodine for thyroid, what food?
table salt.
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corticoid steroid tx. important info?
infection
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diabetes insipidis?
1.001-1.005
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cushing's syndrome dexamethasone
administration at 2300 and plasma costisol at 0800 next morning.
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cushing's syndrome. nursing priority?
muscle weakness.
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addison's disease? hormone replacement.
dizziness on standing.
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shift assessment aldostoronism. kidney's response?
proteinuriua
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home care pt teaching, cortisol, when take corticos?
early morning, 7-8 am
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diarrhea and vomiting. adrenal insufficiency.
increase Na+ intake.
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hyperparatyroidism.
ambulation and act as tolerated.
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adrenal tumor. vitals may change?
HTN and heart rate changes.
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tyroidectomy. what labs indicate?
hypocalcemia.
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hypertyroidism. create meal plans.
small, freq meals, high protein, calories,
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dx of SIADH. care plan. priority is?
excessive fluid volume.
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hypofx of adrenal cortex
decrease BP
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grave's disease physical characteristics?
bulging eyes.
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RAAS simulation test. what you d/c before test?
anti-hypertensives.
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MD orders test for something, test for what?
diabetes insipidous
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greater risk for hypothyroidism.
45F
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77M hypothyroidism, knee surgery. prolonged rx to what type of med?
anasthetics
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parathyroidectomy
Ca+ gluconate keep at bedside for emergency use.
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pt with hypocalemia is having carpelpedal spasms. what is this called?
Trousseau signs.
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you have hyperthyroidism, what monitor for?
thyroid storm.
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