Heidi Shared "MEDSURG EXAM 3" - 86 Picmonics
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MEDSURG EXAM 3
Calcium (Ca2+) Lab Value
- 8.5 to 10.5 mg/dL
26 secs
Chloride (Cl-) Lab Value
- 95-105 mEq/L
28 secs
Creatinine Lab Values
- Measures Renal Function
- 0.6 - 1.3 mg/dL
1 min
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
pH - Blood and Urine Lab Value
- Blood
- 7.35 - 7.45
- Urine
- 4.0 - 8.0
1 min
Phosphate (PO43-) Lab Value
- 2.5 to 4.5 mg/dL
29 secs
Potassium (K+) Lab Value
- 3.5 to 5.0 mEq/L
20 secs
Sodium (Na+) Lab Value
- 135-145 mEq/L
24 secs
Urine Specific Gravity Lab Value
- 1.003-1.030
1 min
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
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
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 Acidosis Interventions
- Improve Respiration
- Pharmacologic Interventions
- Bronchodilators
- Respiratory Stimulants
- Drug Antagonists
- Nonpharmacologic Interventions
- Oxygen
- Assisted Ventilation
- Prevent Complications
1 min
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
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
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
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