Exam 3

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Exam 3
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  1. Protein
    A nitrogenous compound, essential to all living organisms
  2. Plasma protein
    Relates to albumin, globulin, and fibrinogen
  3. Serum protein
    Relates to albumin and globulin
  4. Serum albumin
    A serum protein; constitutes about 50% of the blood protein
  5. Serum globulin
    A group of simple protein
  6. Thirst
    An indicator of fluid need
  7. Sodium
    Sodium promotes water retention. With a water deficit, less sodium is excreted via kidneys; thus more water is retained.
  8. Antidiuretic hormone (ADH)
    Produced by the hypothalamus and stored in the posterior pituitary gland (neurohypophysis). ADH is secreted when there is an ECF volume deficit or an increased osmolality (increased solutes). ADH promotes water reabsorption from the distal tubules of the kidneys.
  9. Aldosterone
    A hormone, secreted from the adrenal cortex. It promotes sodium, chloride, and water reabsorption from the renal tubules.
  10. Renin
    Decreased renal blood flow increases the release of renin, an enzyme, from the juxtaglomerular cells of the kidneys. Renin promotes peripheral vasoconstriction and the release of aldosterone (sodium and water retention).
  11. Lymphatics
    Plasma protein that shifts to the tissur spaces cannot be reabsorbed into the blood vessels. Thus, the lymphatic system promotes the return of water and protein from the interstitial spaces to the vascular spaces.
  12. Skin
    Skin excretes approximately 300-500 ml of water daily through normal perspiration.
  13. Lungs
    Lungs excrete approximately 400-500 ml of water daily through normal breathing.
  14. Kidneys
    The kidneys excrete 1000-1500 ml body water daily. The amount of water excretion may vary according to the balance between fluid intake and fluid loss.
  15. Three nursing responsibilities when caring for patients with diseases that cause abnormal serum albumin and serum globulin levels.
    • 1. Monitor I & O
    • 2. Observe for any edema
    • 3. Report any abnormal lab findings
  16. Membrane
    A layer of tissue covering a surface or organ or separating spaces
  17. Permeability
    The capability of a substance, molecule, or ion to diffuse through a membrane
  18. Semipermeable membrane
    An artificial membrane such as a cellophane membrane
  19. Selectively permeable membrane
    Permeability of the human membranes
  20. Solvent
    A liquid with a substance in solution
  21. Solute
    A substance dissolved in a solution
  22. Osmosis
    The passage of a solvent through a membrane from a solution of lesser solute concentration to one of greater solute concentration
  23. Diffusion
    The movement of molecules such as gas from an area oh higher concentration to an area of lesser concentration. Large molecules move less rapidly than small molecules.
  24. Osmol
    A unit of osmotic pressure. The osmotic effects are expressed in terms of osmolality. A milliosmol (mOsm) is 1/1000th of an osmol and determines the osmotic activity.
  25. Pressure Gradient
    Difference in pressure between two points in a fluid.
  26. Colloid
    Nondiffusible substance
  27. Inadequate fluid intake
    A decrease in water intake results in an increase in the number of solutes in body fluid. The body fluid becomes hyperosmolar.
  28. Increased solute intake (salt, sugar, protein)
    An increase in solute intake increases the solute concentration in body fluid; The body fluids can become hyperosmolar with a normal or decreased fluid intake.
  29. Severe vomiting and diarrhea
    Results in a loss of body water greater than the loss of solutes such as electrolytes, resulting in hyperosmolar body fluid.
  30. Diabetes ketaoacidosis
    In increase in glucose and ketone bodies can result in body fluids becoming more hyperosmolar, thus causing diuresis. The resulting fluid loss is greater than the solute loss (sugar and ketones).
  31. Sweating
    Water loss is usually greater than sodium loss.
  32. Vomiting and diarrhea
    Usually results in fluid losses that are in proportion to electrolyte (sodium potassium, chloride, bicarbonate) losses.
  33. Gastrointestinal (GI) fistula or draining abscess and GI suctioning
    The G.I. track is rich in electrolytes. With a loss of G.I. secretions, fluid and electrolytes are lost in somewhat equal proportions.
  34. Fever, environmental temperature, and profuse diaphoresis
    Results in fluid and sodium losses via the skin. With profuse sweating, the sodium is usually lost in proportions equal to water losses. Depending upon the severity of the sweating and fever, symptoms of mild, moderate or marked fluid loss maybe observed.
  35. Hemorrhage
    Excess blood loss is fluid and solute loss from the vascular fluid. If hemorrhage occurs rapidly, fluid shifts to compensate for my blood losses can be inadequate.
  36. Burns
    Burns cause body fluids with solutes to shift from the vascular fluid to the burn site and surrounding interstitial space (tissues). This may result in an inadequate circulating fluid volume.
  37. Ascites
    Fluid and solutes (protein, electrolytes, etc.) shift to the peritoneal space, causing ascites (third-space fluid). A decrease in circulating fluid volume may result.
  38. Intestinal obstruction
    Fluid accumulates at the intestinal obstruction site (third-space fluid), thus decreasing the vascular fluid volume.
  39. Suggested solution to replace ECF losses?
    • Lactated ringers 1500 ml
    • Normal saline (0.9%NaCl solution) 500 ml
  40. Suggested solution to replace the water deficit and increase urine output.
    Five percent dextrose in water (D5W) 4700 ml
  41. Suggested solution to replace potassium loss?
    Potassium chloride 40-80 mEq, may be divided into 3 liters. Serum potassium levels must be closely monitored
  42. Suggested solution if an acidosis state exists
    Bicarbonate as needed
  43. Suggested solution when volume loss is due to blood loss
    Blood
  44. Anesthesia
    An agent that produces states such as loss of consciousness, analgesia, relaxation, and loss of reflexes.
  45. Atelectasis
    An incomplete expansion or collapse of a part of the lungs
  46. Deep
    vein thrombosis (DVT)
    formation of a blood clot (“thrombus”) in a deep vein
  47. Elective surgery
    • surgery that is recommended but can be omitted or delayed without catastrophe
  48. Embolus
    blood clot, foreign body, or air in the circulatory system; plural form is emboli
  49. Emergency surgery
    surgery that must be performed immediately to save the person’s life or a body organ
  50. Hemorrhage
    excessive blood loss due to the escape of blood from blood vessels
  51. Hypothermia
    low body temperature
  52. Moderate sedation/analgesia
    (conscious or procedural sedation)- used for short term and minimally invasive procedures
  53. Optional surgery
    one not critical to survival or function
  54. Perioperative nursing
    wide variety of nursing activities carried out before, during, and after surgery
  55. Perioperative period
    three phases of perioperative patient care including the preoperative, intraoperative, and postoperative phases
  56. Pneumonia
    inflammation or infection of the lungs
  57. Shock
    body’s reaction to acute peripheral circulatory failure due to an abnormality of circulatory control or to a loss of circulating fluid
  58. Thrombophlebitis
    inflammation in a vein associated with thrombus formation
  59. Urgent Surgery
    surgery that is not an emergency, but must be done within a reasonably short time frame to preserve health
  60. Acute pain
    episode of pain that last from seconds to less than six months
  61. Addiction
    a pattern of compulsive use of addictive substances for means other than those prescribed
  62. Adjuvant
    drugs typically use for other purposes, but also used to enhance effect of opioids by providing additional pain relief
  63. Analgesic drug
    pharmaceutical agent use to relieve pain
  64. Breakthrough pain
    temporary flare-up of moderate to severe pain that occurs even when the patient is taking around-the clock medication for persistent pain
  65. Chronic pain
    episode of pain that last for six months or longer maybe intermittent or continuous
  66. Cutaneous pain
    superficial pain usually involving the skin or subcutaneous tissue
  67. Dynorphin
    the endorphin having the most potent analgesic effects
  68. Endorphin
    morphine-like substances released by the body that appear to alter the perception of pain
  69. Enkephalins
    opioids that are widespread throughout the brain and dorsal horn of the spinal cord and are believed to reduce pain sensations by inhibiting the release of substance P
  70. Exacerbation
    period in chronic illness when symptoms of the disease reappear
  71. Gate control theory
    theory that explains that excitatory pain stimuli carried by small-diameter nerve fibers can be blocked by inhibiting signals carried by large-diameter nerve fibers
  72. Intractable
    severe pain that is extremely resistant to relief measures
  73. Modulation
    process by which the sensation of pain is inhibited or modified
  74. Neuromodulators
    endogenous opioid chemical regulators that appear to have analgesic activity and alter pain perception
  75. Neuropathic pain
    pain that results from an injury to or abnormal functioning of peripheral nerves or the central nervous system
  76. Neurotransmitters
    substances that either excite or inhibit target nerve cells
  77. Nociceptors
    pain receptors
  78. Opioid
    more correct term for narcotic analgesics since these drugs act by binding to opiate receptor sites in the central nervous system
  79. Pain threshold
    amount of stimulation required before a person experiences the sensation of pain
  80. Pain tolerance
    amount of stimulation required before a person experiences the sensation of pain
  81. Perception
    conscious process of organizing and interpreting data from the senses into meaningful information
  82. Phantom pain
    sensation of pain without demonstrable physiologic or pathologic substance; commonly observed after the amputation of a limb
  83. Physical dependence
    phenomenon in which the body physiologically becomes accustomed to an opioid and suffers withdrawal symptoms if the opioid is suddenly removed or the dose is rapidly decreased
  84. Placebo
    Latin word meaning, “I shall please”; an inactive substance that gives satisfaction to the person using it
  85. Psychogenic pain
    pain for which no physical cause can be identified
  86. Referred pain
    pain in an area removed from that in which stimulation has its origins
  87. Remission
    Any chronic illness when the disease is present but the person does not experience symptoms of the disease
  88. Somatic pain
    pain originating in structures in the body’s external wall
  89. Tolerance
    occurrence of the body’s becoming accustomed to an opioid and needing a larger dose each time for pain relief
  90. Transduction
    activation of pain receptors
  91. Transmission
    conduction of pain sensations from the site of an injury or inflammation along clear and unclear pathways to the spinal cord and then on to higher centers
  92. Visceral pain
    pain originating any internal organs in the thorax, cranium, or abdomen
  93. Prostaglandins
    hormone-like substances that send additional painful stimuli to the CNS
  94. Bradykinin
    • powerful vasodilator that increases capillary permeability and constricts smooth muscle
    • Triigers release of histamine and in combo produces the redness, swelling, and pain typically observed when an inflammation is present
  95. Substance P
    sensitizes receptors on nerves to feel pain and also increases the rate of firing of nerves
  96. Affinity
    the propensity of a drug to bind or attach itself to a given receptor site
  97. Efficacy
    the drugs ability to initiate biologic activity as a result of that binding
  98. Agonist
    combines with receptors and initiates biochemical and physiologic changes
  99. Onset of drug actions
    period of time it takes after a drug is administered for it to produce a response
  100. Peak action
    time it takes for a drug to reach its highest effective concentration
  101. Duration
    Length of time during which the drug is present in a concentration great enough to produce a response
  102. Plateau
    Blood serum concentration is reached and maintained after repeated, fixed doses.
  103. Therapeutic range
    produces the desired effect without toxicity
  104. Toxic level
    produces serious adverse effects
  105. Factors altering drug response
    • Age
    • Body mass
    • Environment/activity
    • Time of administration
    • Pathology
    • Psychological state
    • Genetics
  106. Toxicity
    Drug accumulates in the blood because of impaired metabolism or excretion - get toxic effects and can be lethal.
  107. Allergic Reactions
    • Unpredictable response could cause anaphylaxis (antigen - antibody)
    • range from minor skin rash, rhinitis, pruritis to fatal symptoms that require immediate action
  108. Treatment for allergic reactions
    • Epinephrine
    • start an IV
    • oxygen
    • benadryl
    • drugs to support B/P, bronchodilators
  109. What does epinephrine do?
    • Stimulates alpha and beta-adrenergic receptors causing bronchial dilation
    • Relieves congestion in bronchial mucosa and pulmonary vessels
  110. Idiosyncracy
    over, under, unexplained or unpredictable response
  111. Accumulation (cummulative effect)
    Drug builds up in the blood stream, can lead to toxicity
  112. Potentiation
    Effects of primary drug increased
  113. Synergism
    Combined action is greater than each alone
  114. Antagonism
    decrease in response to either drug
  115. Dependence -physiological adjustment
    • Occurence of withdrawal symptoms when the drug is suddenly stopped.
    • Time for physical dependency to develop varies
  116. Tolerance
    • Need for increasingly larger amount of a drug to achieve the same physical or psychological effect.
    • Occurs quickly with opioids.
  117. Addiction
    • psychological dependence
    • pattern of compulsive drug use characterized by continued craving for the drug with the need to use the drug for other than pain relief.
  118. Information nurses should know prior to giving a drug
    • Dose
    • Action (know main classifications)
    • Nursing considerations
    • contraindications
    • Side effects/adverse reactions (iatrogenic -caused by the prescription)
  119. #1 med error??
    DOSAGE!!!
  120. An order MUST contain 9 things
    • Name
    • Room
    • Drug
    • Dose
    • Route
    • Time/Frequency
    • Doctor
    • Date
    • Special considerations as indicated
  121. Patient's pathophysiology (4 things)
    • Absorption
    • Distribution
    • Biotransformation/metabolism
    • Excretion
  122. First do no harm
    Primun nin nocere
  123. Med administration rights (6)
    • 1. Drug
    • 2. Dose
    • 3. Route
    • 4. Time
    • 5. Patient
    • 6. Documentation
  124. Legal/Ethical med considerations
    Patient has the right to refuse
  125. NPSG Goal 8
    Identifies accurate and complete reconciliation of medications across the continuum of care
  126. The three checks?
    • 1. When reaching for container
    • 2. After getting med from drwawer
    • 3. When replacing container to drawer or before administering to patient
  127. Publications that lists drugs designated as official dugs
    • United States Pharmacopeia
    • National Formulary
  128. Absorption
    • Entry site into body to the bloodstream
    • Influenced by 6 things
    • --Route of admin
    • --Lipid solubility
    • --pH
    • --blood flow
    • --local conditions at site of administration
    • --drug dosage
  129. Distribution
    depends on blood flow to the tissues, the drug's ability to leave the bloodstream, and the drug's ability to enter the cells
  130. Metabolism
    • biotransformation, is the change of a drug from its original form to a new form
    • consider liver functioning
  131. Excretion
    • drug is broken down to its inactive form
    • process of removing a drug or its metabolites
    • depending on kidney
  132. Items to include for input
    • oral liquids
    • IV
    • IVPBs
    • Gastric or jejunostomy feedings
    • blood
  133. Items to include for output
    • Urine
    • Diarrhea
    • Vomitus
    • gastric suction
    • drainage
    • estimation on insensible loss (persperation)
  134. Types of pts on I&O?
    • post-op pts.
    • pts. w/ elevated temp
    • Pts. on fluid restrictions
    • Diuretic or intravenous therapy
    • Poor intake
    • Pts. w/ medical conditions such as COPD, CHF
  135. Amount of water in a healthy adult
    • 50 - 60% of body weight
    • (40% ICF & 20% ECF)
  136. Transcellular fluids
    • third compartment
    • include cerebrospinal, pericardial, synovial, intraocular, and pleural fluids
    • sweat and digestive secretions
  137. water percentage for an obese person?
    The more obese the smaller the percentage of total body water
  138. Thirst mechanism
    • regulated by hypothalamus
    • stimulated by intracellular dehydration and decreased blood volume
  139. sensible fluid loss
    measurable
  140. insensible fluid loss
    can't be measured
  141. Kidneys
    • regulate ECF, pH and electrolytes
    • excretion
  142. Heart and blood vessels
    • pumping action of the heart
    • reacts to hypovolemia by stimulating fluid retention
  143. Lungs
    • eliminates 13,000 mEq of Hydrogen ions
    • hypoventilation increases acidity
    • hyperventilation decreases acidity
    • 300 mL of water expelled daily through exhalation
  144. Adrenal glands
    regulates blood volume, Na, K by ALDOSTERONE and CORTISOL
  145. Aldosterone
    • a mineral corticoid secreted by the adrenal cortex
    • primary regulator = angiotensin II (RAS)
    • Decreases in blood volume=increase in aldosterone =Na retention = K loss
    • Increase in blood volume = decrease in aldosterone=Na loss=K retention
  146. Pituitary gland
    stores and releases ADH = retain water
  147. Antidiuretic hormone (ADH)
    • maintains osmotic pressure
    • --> when osmopressure of ECF, greater than ICF=ADH secretion increase = renal water retention
    • --> when osmopressure of ECF, less than ICF = ADH secretion decrease = renal water excretion
    • Controls blood volume
    • --> blood volume decrease = increase ADH = water conservation
    • --> blood volume increase = decrease ADH = water loss
  148. Nervous system
    • thirst center - hypothalamus
    • inhibits and stimulates mechanisms influencing fluid balance
  149. Parathyroid glands
    regulates Ca and phosphate by parathyroid hormone (PTH)
  150. PTH
    • parathyroid hormone
    • influences bone reabsorption, Ca absorption=intestines and Ca reabsorption=renal tubules
    • increase PTH = elevated serum Ca = low serum Phos
    • Decrease PTH = low serum Ca = elevated serum Phos
  151. Sodium
    • 135-145
    • Major ECF cation
    • accompanied by water
    • enter through GI tract
    • lost from GI, kidneys and skin
    • reabsorb through kidneys
    • out of cell by Na-K pump
    • regulated by RAS
  152. Hyponatremia
    • <135
    • Causes = hypoglycemia, tap water enema, ↑ H2O, ↑ SIADH, ↓ GI fluids
    • Symptoms = ↑ pulse, ↓ BP, status epileptics, coma, cerebral edema, muscle twitches, lethargy, headache
    • Tx = LR, 0.9% NS, for SIADH also give lasix
  153. Hypernatremia
    • >145
    • Causes = salt water drowning, diabetes insipidus, diaphoresis, heatstroke, burns, hypertonic tube feedings
    • Symptoms = ↑ pulse, ↑ BP, ↑ temp, thirst, flush skin, seizures, hallucinations
    • Tx = 0.3% NaCl, diuretics, D5W
  154. Potassium
    • 3.5-5.0
    • Major ICF cation
    • cheif regulator of cellular enzyme activity
    • role in transmission of electric impulses and cellular building
    • Absorbed = from well balanced diet
    • Lost = kindeys, stool, sweat (large quantities lost through vomitus)
    • regulated = aldosterone and transcellular shifts
    • eliminated by kidneys
  155. Hypokalemia
    • < 3.5
    • Causes = diarrhea, gastric suction, starvation, vomiting, digoxin toxicity, ↓ MG++
    • Symptoms = ↓ BP, ↓ bowel movement, abdominal distention, polyuria, ventricular fib or asystole
    • Tx = K+ high diet: fruits, veg, whole grains, milk, meat, eggs, coffee, tea, Ca gluconate (severe cases), insulin, lasix, albuterol
  156. Hyperkalemia
    • > 5.0
    • Causes = addison's disease, K+ conserving diuretics, burns,oliguric renal failure, (pseudohyperkalemia = tourniquet on while drawing blood, blood drawn where K+ is infusing)
    • Symptoms = Tachycardia, bradycardia, dysrhythmias, anxiety
    • Tx = kayexalase
  157. Calcium
    • 8.5-10.5
    • most abundant in whole body
    • role in transmitting nerve impulses, regulates muscle contraction and relaxation, blood coag
    • activates enzymes that stimulate essential chemical reactions
    • absorbed = foods w/ presence of normal gastric acidity and vit D
    • Lost = GI tract -- feces and urine, lesser amount by kidneys
    • Regulated = PTH and calcitonin (inverse w/ phosphate)
  158. Hypocalcemia
    • < 8.5
    • Causes = ↓ vit D, ↑ PO4++, fistulas, burns, malabsorption, hypoparathyroidism, sub q infection
    • Symptoms = + Trousseau & chevostek's sign, numbness in extremeties, ↓ clotting time
    • Tx = Vit D, Ca diluted in D5W as a bolus
  159. Hypercalcemia
    • > 10.5
    • Causes = ↑ vit D, hyperparathyroidism, ↑ immobilization
    • Symptoms = ↓ neuromuscular, confusion, slurred speech, deep bone pain, polyuria
    • Tx = 0.9% NaCl, Lasix, calcitonin, PO4++
  160. Magnesium
    • 1.8-2.7
    • important for metabolism of carbohydrates and protein
    • Role in neuromuscular function and acts on cardiovas system w/ vasodilation
    • enters = GI
    • Lost = kidneys -- urine -- loop diuretics
    • Regulated by PTH
  161. Hypomagnesemia
    • < 1.8
    • Causes = chronic alcoholism, AMI, small bowel resection, ↓ K+ & Ca, hyperparathyroidism, hyperaldosteronism
    • Symptoms = ↑ Trousseau & Chevostek's sign, neuromuscular irritability, ↑ BP
    • Tx = Diet foods high in Mg
  162. Hypermagnesemia
    • > 2.7
    • Causes = ↑ IV Mg, DKA, hypothyroidism
    • Symptoms = ↓ BP & resp, cardiac arrest, coma, flush skin
    • Tx = Ca gluconate (severe cases), NaCl, LR, Lasix
  163. Chloride
    • 96-108
    • ECF anion
    • major component of interstitial and lymph fluid
    • acts w/ Na to maintain osmopressure
    • role = acid-base balance, combines w/ hydrogen ions to produce hydrochloric acid
    • Enter = GI
    • Chloride=salt in diet
    • Paired w/ sodium
    • excreted and conserved w/ sodium by kidneys
    • Regulated by aldosterone
    • low K = Low Cl
  164. Hypochloremia
    • <96
    • Causes = Addison's disease, ↑ sweating, ↓ Na & K, diuretics
    • Symptoms = Shallow resp,. seizures, coma, tremors, irritability
    • Tx = NS
  165. Hyperchloremia
    • >108
    • Causes = ↑ Na, head injury, dehydration, diuretics, steroids
    • Symptoms = ↓ CO, tachycardia, tachypnea, coma, edema
    • Tx = hypotonic IV LR, sodium bicarb, diuretics
  166. Phosphorus
    • 2.5-4.5
    • major ICF anion
    • promotes energy storage; carb, protein, and fat metabolism
    • bone and teeth formation
    • role in muscle and RBC function
    • Enter = GI (source = animal products, ect)
    • Absorption diminished by concurrent ingestion of Ca, Mg, and aluminum
    • Eliminated = kidneys
    • Regulated = PTH and activated = Vit D
    • Inverse proportion w/ Ca
  167. Hypophosphatemia
    • < 2.5
    • Causes = ↓ K+, Mg++ & vit D, hyperventilation, alcohol
    • Symptoms = cardiomyopathy, resp. failure, seizures, confusion, bone pain, ↑ infection
    • Tx = sodium phosphase, potassium phosphate
  168. Hyperphosphatemia
    • > 4.5
    • Causes = ↑ PO4++ & vit D, renal failure, tissue breakdown
    • Symptoms = tachycardia, tetany, hyperactive reflexes
    • Tx = Avoid laxatives and enemas, diet
  169. Baroreceptors
    regulate BP in response to changes in pressures (parasympathetic and sympathetic)
  170. Mild dehydration
    • 2 % of body weight loss
    • 1-2 liters
    • symptoms - thirst
  171. Marked dehydration weight loss
    • 5%
    • 3-5 liters
  172. Marked dehydration symptoms
    • Marked thirst
    • dry mucous membranes
    • dryness and wrinkling of skin - poor skin turgor
    • hand veins: slow filling with hand lowered
    • temperature - low-grade elevation, (99.7 degrees)
    • tachycardia (>100) as blood volume drops
    • respiratory >28
    • systolic BP 10-15 mmHg ↓ in standing position
    • urine volume <30 ml/hr
    • Specific gravity >1.025
    • body weight loss
    • Hct, Hgb and BUN ↑
    • acid-base equilibrium toward greater acidity
  173. Severe dehydration weight loss
    • 8%
    • 5-10 liters
  174. Severe dehydration symptoms
    • same symptoms as marked dehydration, plus:
    • flushed skin
    • systolic BP <60 mmHg
    • behavioral changes, e.g., restlessness, irritability, disorientation, and delirium
  175. Fatal dehydration weight loss
    • 20-30 total body water loss can prove fatal
    • symptoms = anuria, coma leading to death
  176. Pulmonary edema symptoms
    • constant, irritating, nonproductive cough
    • dyspnea
    • neck vein engorgement
    • sublingual vein engorgement
    • moist crackles in lung
    • bounding pulse
    • cyanosis
  177. Peripheral edema symptoms
    • pitting edema in extremities
    • tight, smooth, shiny skin over edematous area
    • puffy eyelids (periorbital edema)
    • weight gain evidenced as generalized edema or anasarca
  178. Lab tests for ECFVE
    • decreased serum osmolality
    • decreased serum protein and albumin, BUN, Hgb, Hct
    • Increased CVP (central venous pressure)
  179. Increased BUN
    found w/ impaired renal function (such as associated w/ shock, heart failure, salt and water depletion), diabetic ketoacidosis, burns
  180. Increased creatinine
    found with impaired renal function, heart failure, shock, dehydration
  181. with potassium replacement.....REMEMBER
    • to dilute because of irritation
    • no more than 40 mEq/L PERIPHERALLY
    • no more than 60 mEq/L CENTRALLY
    • DO NOT administer more than 10 mEq/hour peripheraly
    • no more than 20 mEq/hour in a central line
    • w/ oral replacement = w/ food, know pts GI history, renal function, and last serum K
  182. Complimentary therapies
    alternative treatments used with traditional medical interventions
  183. Alternative modalties
    methods not included in the scope of conventional medical care
  184. Allopathy
    • (biomedicine)
    • the term generally used to describe "traditional" medical care, dominant for about 100 years, which spearheaded remarkable advances in biotechnology, surgical interventions, pharmaceutical approaches and diagnostic tools
  185. CAT domains
    • whole
    • mind-body
    • energy
    • manipulative and body-based
    • biologically based
  186. Alternative therapies
    • movement based therapies
    • nutritional and herbal remedies
    • mind-body medicine
    • energy healing
    • physical manipulation
    • lifestyle changes

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