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Fundamentals of Nursing, 9th Ed., Potter, Perry, Stockert & Hall, 2017/
42 - Fluid, Electrolyte, and Acid-Base BalanceFundamentals of Nursing 9th Edition ebook Playlist
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Fundamentals of Nursing, 9th Ed., Potter, Perry, Stockert & Hall, 2017 | Registered Nurse (RN) School Study Aid
Normal Electrolyte Lab Values
- Potassium (K+)
- 3.5 to 5.0 mEq/L
- Calcium (Ca2+)
- 8.5 to 10.5 mg/dL
- Phosphate (PO43–)
- 2.5 to 4.5 mg/dL
- Magnesium (Mg2+)
- 1.5 to 2.5 mEq/L
- Sodium (Na+)
- 135 to 145 mEq/L
- Chloride (Cl–)
- 95 to 105 mEq/L
2 mins
IV Solutions
- Hypotonic (< 280 mOsm/L)
- 1/4 Normal Saline (0.225% NaCl)
- 1/2 Normal Saline (0.45% NaCl)
- Isotonic (280-300 mOsm)
- Normal Saline (0.9% NaCl)
- Lactated Ringer's (LR)
- Dextrose 5% in Water (D5W)
- Hypertonic (> 300 mOsm)
- 3% or 5% NaCl
- Dextrose 5% in 0.45% NaCl
- Dextrose 10% in Water (D10W)
3 mins
Hyponatremia
- Assessment
- < 135 mEq Na+
- Nausea and Vomiting
- Decreased LOC
- Confusion / Lethargy
- Seizures
- Priority Interventions
- Assess Airway
- Reduce Diuretic Dosage
- Fluid Excess Hyponatremia
- Mannitol (Osmitrol)
- Fluid Restriction
- Fluid Deficit Hyponatremia
- Hypertonic Solution (3% or 5% NaCl)
2 mins
Hypernatremia
- Assessment
- > 145 mEq/L Na+
- Change in LOC
- Extreme Thirst
- Orthostatic Hypotension
- Dry Flushed Skin
- Muscle Twitching
- Seizures
- Priority Interventions
- Treat and Prevent Dehydration
- Hypotonic Solutions (0.225% or 0.45% NaCl)
- Sodium Restriction
- Diuretics
2 mins
Hypokalemia
- Assessment
- < 3.5 mEq/L
- Muscle Weakness
- Arrhythmia
- U Wave
- Ileus
- Hyporeflexia
- Interventions
- IV K+ Infusion at 5-10 mEq/hr
- Give Orally with Food
- Nursing Considerations
- Monitor Respiratory Status
3 mins
Hyperkalemia
- Assessment
- > 5.0 mEq/L K+
- Abdominal Cramps
- Muscle Weakness
- Diarrhea
- Arrhythmia
- Tall, Peaked T Waves
- Interventions
- IV Calcium
- Infusion of Glucose and Insulin
- Loop or Thiazide Diuretics
- Kayexalate
- Dialysis
- Prevention Education
2 mins
Calcium (Ca2+) Lab Value
- 8.5 to 10.5 mg/dL
26 secs
Hypocalcemia
- Muscle Spasms
- Assessment
- < 8.5 mg/dL Ca2+
- Decreased Bone Density
- Tetany
- Chvostek's Sign
- Trousseau's Sign
- Increased DTR
- ECG Changes
- QT Prolongation
- Considerations
- Oral and IV Replacement of Ca2+
- Seizure Precautions
2 mins
Hypocalcemia Causes
- Hypoalbuminemia
- Hypomagnesemia (Less Common Hypermagnesemia)
- Hypovitaminosis D
- Hypoparathyroidism
- Medications
- Hyperphosphatemia
- Malnutrition
- Acute Pancreatitis
- Alkalosis
- Sepsis
- Chronic Kidney Disease
2 mins
Hypercalcemia
- Assessment
- > 10.5 mg/dL Ca2+
- Pathologic Fractures
- Lethargy
- Hypercoagulation
- Constipation
- ECG Changes
- QT Shortening
- Interventions
- No Calcium Intake
- Chelating Drugs
- Calcitonin
- Bisphosphonates
- Loop Diuretics instead of Thiazide Diuretics
- Considerations
- Increased Risk for Renal Calculi
- Increase Fluids
3 mins
Hypercalcemia Causes
- Two CHIMPANZEES Acronym
- Thyroid Disorders
- Calcium Supplements
- Hyperparathyroidism
- Iatrogenic (Drugs, immobility)
- Milk-Alkali Syndrome
- Paget's Disease of Bone
- Acromegaly or Addison's Disease
- Neoplasms
- Zollinger-Ellison Syndrome
- Excessive Vitamin A
- Excessive Vitamin D
- Sarcoidosis
2 mins
Magnesium (Mg2+) Lab Value
- 1.5 to 2.5 mEq/L
28 secs
Hypermagnesemia
- Assessment
- Flushing
- Lethargy
- Muscle Weakness
- Decreased Deep Tendon Reflexes (DTRs)
- Decreased Respirations
- Bradycardia
- Hypotension
- Interventions
- Dialysis
- IV Calcium Gluconate
- Diuretics
- Avoid Antacids and Laxatives containing Mg2+
2 mins
Hypomagnesemia
- Assessment
- Confusion
- Increased Deep Tendon Reflexes (DTRs)
- Neuromuscular Irritability
- Seizures
- Muscle Cramps
- Tremors
- Insomnia
- Tachycardia
- Interventions
- Magnesium Sulfate
- Foods High in Magnesium
1 min
pH - Blood and Urine Lab Value
- Blood
- 7.35 - 7.45
- Urine
- 4.0 - 8.0
1 min
Respiratory Acidosis Assessment
- Assessment
- Decreased pH < 7.35
- Increased PaCO2 > 45
- Reduced Respirations
- Anxiety
- Change in LOC
- Tachycardia
- Cyanosis
- Increased Electrolytes
- ECG Changes
- Muscle Weakness
- Hyporeflexia
2 mins
Respiratory Alkalosis Assessment
- Assessment
- Increased pH > 7.45
- Decreased PaCO2 < 35 mmHg
- Hyperventilation
- Brainstem Stimulation
- Head Injury
- Shock
- Lightheadedness
- Tingling Lips or Fingers
- Trousseau's
- Chvostek's Sign
- Anxiety
2 mins
Respiratory Alkalosis Interventions
- Treat Underlying Cause
- Mechanically Ventilated Patients
- Decrease Tidal Volume and/or Respiratory Rate
- Give Adequate Pain Control and Sedation
- Hyperventilation Syndrome
- Sedatives
- Antidepressants
- Considerations
- Compensatory Drop in Serum Bicarbonate
- Calming Breathing Exercises
- Correct CO2 Slowly
2 mins
Metabolic Acidosis Assessment
- Characteristics
- Decreased pH < 7.35
- Decreased HCO3 < 22
- Signs & Symptoms
- Abdominal Pain
- CNS Depression
- Coma
- Hypotension
- Arrhythmias
- Increased Respirations
- Kussmaul Respirations
- Flushed, Warm, Dry Skin
- Muscle Weakness
2 mins
Metabolic Acidosis Interventions
- Interventions
- Raise Plasma pH > 7.20
- Treat Underlying Cause
- Sodium Bicarbonate
- Considerations
- Follow ABGs
- Continuously Monitor Patient
2 mins
Metabolic Alkalosis Assessment
- Signs and Symptoms
- Increased pH > 7.45
- Increased HCO3 > 26
- Excitable State
- Arrhythmias
- Paresthesias
- Muscle Cramps
- Muscle Weakness
- Decreased Respiratory Effort
1 min
Metabolic Alkalosis Interventions
- Interventions
- Treat Underlying Cause
- Stop Potassium (K+) Wasting Diuretics
- Spironolactone
- Acetazolamide
- IV Fluids
- Sodium Chloride
- Replace Potassium (K+)
- Considerations
- Monitor Respiratory Rate
- Monitor Heart Rate
- Seizure Precautions
2 mins
How to Interpret Acid Base Disorders
- pH, pCO₂, HCO₃ (Bicarbonate)
- Step 1
- pH
- Acidosis
- Alkalosis
- Step 2
- pCO₂
- Opposite Direction as pH
- Respiratory Acidosis
- Respiratory Alkalosis
- Step 3
- HCO₃ (Bicarbonate)
- Same Direction as pH
- Metabolic Acidosis
- Metabolic Alkalosis
3 mins
Traumatic Brain Injury Assessment
- Assessment
- Change in LOC
- Personality Changes
- Amnesia
- Increased Intracranial Pressure
- Diplopia
- Posturing
- Location of Injury
- Basilar Skull Fracture
- Halo or Ring Sign
- Considerations
- Intracranial Bleeding
2 mins
Types of Burns
- Superficial Thickness
- Sunburn
- Superficial Partial Thickness
- Blisters
- Blanching
- Deep Partial Thickness
- Little or Non-blanching
- Full Thickness
- Waxy White, Yellow or Black
- Decreased Pain
2 mins
Prednisone (Glucocorticoids)
- Mechanism
- Glucocorticoid
- Indications
- Inflammatory Conditions
- Organ Transplant Rejection
- Side Effects
- Cataracts and Glaucoma
- Cushing's Syndrome
- Osteoporosis
- Immunosuppression
- Hyperglycemia
- Ulcers
- Considerations
- Adrenal Insufficiency
- Taper Gradually
2 mins
Loop Diuretic Education
- Furosemide (Lasix)
- Indications
- Heart Failure
- Pulmonary Edema
- Acute Renal Failure (ARF)
- Edema
- Education
- Notify the provider of weakness, dizziness, or muscle cramping
- Increase Potassium Intake
- Check BP Daily
- Daily Weights and Monitor IandOs
1 min
Angiotensin-Converting Enzyme (ACE) Inhibitors
- "-pril" Suffix
- Mechanism of Action
- Block Renin Angiotensin-Aldosterone System (RAAS)
- Indications
- Hypertension
- Heart Failure
- Side Effects
- Dry Non-productive Cough
- Hypotension
- Dizziness
- Possible Hyperkalemia
- Angioedema
- Nursing Considerations
- Slowly Change Position
- Do Not Stop Abruptly
2 mins
NSAIDs
- Indications
- Anti-inflammatory
- Analgesic
- Fever
- Closure of Patent Ductus Arteriosus
- Mechanism of Action
- Reversible Inhibition of COX-1 and COX-2
- Block Prostaglandin Synthesis
- Side Effects
- Interstitial Nephritis
- Gastric Ulcer
- Renal Ischemia
1 min
Spironolactone (Aldactone)
- Mechanisms
- Inhibition of Aldosterone
- Potassium Retention
- Indications
- Hypertension
- Edema
- Heart Failure
- Side Effects
- Hyperkalemia
- Endocrine Effects
- Consideration
- Avoid Potassium Supplements
2 mins
Selective Serotonin Reuptake Inhibitor (SSRI) Overview
- Indications
- Depression
- Anxiety
- Mechanism of Action
- Selective Serotonin Reuptake Inhibitors
- Drugs
- Paroxetine
- Sertraline
- Escitalopram
- Fluoxetine
- Side Effects
- Sexual Dysfunction
- Serotonin Syndrome
- Treat with Cyproheptadine
2 mins
Tricyclic Antidepressants (TCAs) Indications
- Indications
- Major Depression
- Bedwetting
- Fibromyalgia
- OCD
- Drugs
- -Iptyline or -Ipramine Suffix
- Amitriptyline
- Desipramine
- Clomipramine
- Imipramine
- Nortriptyline
2 mins
Penicillin
- Mechanism of Action
- Weakens Cell Wall
- Indications
- Gram-Positive Infections
- Prophylaxis
- Side Effects
- Pain at IM Injection Site
- Allergic Reaction
- Considerations
- Skin Tests
- Allergy ID
- Medication Education
2 mins
Types of Heart Failure
- Left Sided
- Pulmonary Congestion
- Right Sided
- Peripheral Edema
- High Output
- Unable to Meet Metabolic Needs
1 min
Burns Considerations
- Maintain Body Temperature
- Increased Risk of Infection
- Venous Thromboembolism (VTE) Prophylaxis
- Curling's Ulcer
- Excision and Grafting
- Adequate Nutrition
- Contractures
2 mins
COPD Overview (Chronic Obstructive Pulmonary Disease Overview)
- Causes
- Inhaled Toxins
- Smoking
- AAT Deficiency
- Assessment
- Emphysema
- Chronic Bronchitis
- Asthma
- Considerations
- Spirometry
- Slow Progression
2 mins
Total Parenteral Nutrition (TPN)
- Mechanism
- Nutrition Given Outside GI
- Side Effects
- Hyperglycemia
- Hyperlipidemia
- Refeeding Syndrome
- Nausea and Vomiting
- Considerations
- Slow IV Infusion
- Use Large Central Vein
- No Added Meds to TPN Line
2 mins
Superficial Thrombophlebitis
- Cause/Mechanism
- IV Catheter Irritation
- Assessment
- Erythema
- Cord-like Vein
- Edema
- Interventions
- Remove IV Catheter
- Elevate
- Warm Compress
- Considerations
- Rotate Sites Q3 Days
- Aseptic Technique
2 mins
Types of Blood Products
- Types
- Whole Blood
- Packed Red Blood Cells
- Fresh Frozen Plasma
- Immunoglobulins
- Clotting Factors
- Albumin
- Platelets
- Considerations
- Use within 24 Hours
- Washing Removes Antibodies
- Irradiation Destroys WBCs
2 mins
Blood Types and Compatibilities
- ABO Compatibility
- No Antigens (Type O Blood)
- Universal Donor
- A Antigen (Type A Blood)
- B Antigen (Type B Blood)
- AB Antigen (Type AB Blood)
- Universal Recipient
- Rhesus (Rh) Compatibility
- Rh (Rhesus) Antigen
- Never Rh+ to Rh-
- Considerations
- Blood Transfusion
- Obstetric Patient
2 mins
Blood Transfusion Administration
- Proper Patient Identification
- Large Bore Needle
- Y Tubing
- Baseline Vital Signs
- Slow IV Infusion
- Monitor During First 15 Minutes or 50 mL of Blood
- Monitor for Reactions
- Considerations
- Do Not Add Anything To Same IV Line
- No Dextrose or Lactated Ringers
- Jehovah's Witnesses, No Transfusions
3 mins
Transfusion Reactions
- Acute Hemolytic
- Febrile, Non-Hemolytic
- Mild Allergic
- Anaphylactic
- Circulatory Overload
- Sepsis Reaction
- Transfusion-Related Acute Lung Injury (TRALI)
- Massive Blood Transfusion
2 mins
Preeclampsia Interventions
- Side Lying Position and Bedrest
- Antihypertensives
- Magnesium Sulfate
- Labor Induction
1 min
Sepsis Assessment
- Signs and Symptoms
- Systemic Infectious Process
- Fever
- Hypotension
- Change in LOC
- Increased WBC
- Shift to the Left
- Tachycardia
- Tachypnea
- Hyperglycemia
- Edema
2 mins
Severe Sepsis and Septic Shock Assessment
- Microthrombi
- DIC
- Decreased Oxygen Saturation
- Decreased WBC
- Oliguria
- High Output Heart Failure
- Multiple Organ Failure
2 mins
Anaphylaxis Intervention
- Intervention
- Assess Airway and Oxygen Needs
- Reassure Patient with Anxiety
- Supine Position
- Methylprednisolone (Solu-medrol)
- Epinephrine
- Diphenhydramine (Benadryl)
- Medical Alert Bracelet
2 mins
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