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AM - GAlen 170 Exam 1 (Perioperative, Comfort, Anemia) 20-30 (Fluid & Electrolytes, Acid Base) 20-30 $11.39   Add to cart

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AM - GAlen 170 Exam 1 (Perioperative, Comfort, Anemia) 20-30 (Fluid & Electrolytes, Acid Base) 20-30

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AM - GAlen 170 Exam 1 (Perioperative, Comfort, Anemia) 20-30 (Fluid & Electrolytes, Acid Base) 20-30

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  • October 31, 2024
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  • 2024/2025
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AM - GALEN 170 EXAM 1
(PERIOPERATIVE, COMFORT, ANEMIA)
20-30 (FLUID & ELECTROLYTES, ACID
BASE) 20-30 COMPLETE DETAILED
CASE STUDY

y Best indicator for fluid volume overload? - Weight



Assessment for FVO - - Bounding + increase pulse

- High BP

- Dyspnea, crackles, edema

- Decreased hematocrit, serum sodium, and urine specific gravity



Causes of FVO - - ESRD, CHF, water intoxication, SIADH, corticosteroid therapy, rapid fluid replacement



Treatment for FVO - - Diuretics

- Fluid Restriction

- Salt restriction

- Monitor I&O's



intracellular fluid - fluid within cells; 66%; 25 L



Extracellular fluid - - Fluid outside the cell; 33%; 15L

- Most important for homeostasis



Homeostasis - - Proper functioning of all body systems

,- Extracellular (intravascular and interstitial fluid)



Fluid balance - - 2 to 3 liters a day

- urine output 400-600 ml per day

- increases during stress, fever and tachy



Fluid Volume Deficit (FVD) (dehydration) - - Increased HR; decreased B/P

- Lethargy; decreased UOP; dry mucous membranes; constipation; thirst

- Increased hemoconcentration; BUN; sodium; urine specific gravity



Causes of FVD - vomiting, diarrhea, ileostomy, laxitives, burns, fever, diuretics, GI suctioning and NPO



Interventions of FVD - - Halt OTC

- Outdoor activity

- Weight gain/loss

- Diet habits



BUN and Creatinine are? - Kidney markers and are sensitive to decreased blood flow.



Normal BUN levels - 10-20 mg/dL



Normal creatinine levels - 0.6-1.2



BUN and creatinine rise when - - Nitrogenous wastes are found in the blood indicating kidney
impairment.

- Also dehydration



Hypernatremia - - Due to sodium loss, water gain, or inadequate intake

- Diuretics, Anticonvulsants, SSRI's

, - Water Gain: CHF, SIADH, polydipsia

- Dehydration

- Common: Restlessness or agitation, anorexia, N/V, weakness, lethargy, confusion, crave water

- Worst case scenario: Decreased LOC, seizures, coma

- Treatment: Fluids! PO/IV; what type of IVF?- - Nursing implications: Frequent VS, Monitor neurologic
status, Seizure/fall precautions, strict I/O's, assess skin/MM, oral care, monitor labs



Hypokalemia - - Not enough in: Inadequate K+ intake

- Too much out: GI fluid losses

- Depleting drugs: Diuretics, corticosteroids, insulin, excessive laxative use, albuterol

- Black licorice?

- Common: Cardiac arrhythmias, leg cramps (hallmark), muscle weakness, decreased GI motility
(decreased BS, constipation, N/V), decreased DTR's, muscle weakness, alkalosis

- Worst case scenario: Life threatening cardiac arrhythmias/Cardiac arrest!

- **Hypokalemia may potentiate dig toxicity**

- Treatment: Increase dietary intake of potassium, K supplementation. Give IV potassium SLOWLY!!!

- Nursing implications: Frequent VS, cardiac monitoring, patent IV, monitor labs (recheck after
supplementation), NEVER give potassium IVP or bolus!



Hyperkalemia - - Too much intake: Increased dietary intake, salt substitutes, potassium supplements

- Donated blood

- Drugs: K-sparing diuretics, -- ACE-I's, ARBS, NSAIDS

- Not enough excreted: Renal failure

- Crush injury: Intracellular K released

- Common: Cardiac arrhythmias, Muscle weakness (which may lead to flaccid paralysis), increased GI
motility, decreased DTR's, acidosis

- Worst case scenario: Life threatening cardiac arrhythmias/cardiac arrest

- Treatment: Potassium restricted diet; if critical/symptomatic will require drug therapy (such as?)

- Nursing implications: Cardiac monitoring, frequent labs, VS, monitor for hypoglycemia if insulin IVP
given

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