NCLEX HURST REVIEW

NCLEX HURST REVIEW

Leave the first rating Students also studied Terms in this set (382) Save HURST module 1 Quiz

• terms

lunasofia72Preview

NGN Case Study: Immunity Patient 1 ...

• terms

KulikekePreview

HESI Case Study: Feeding and Eatin...

22 terms hannah_zanetti Preview Chapte 30 terms ana What three things contain a lot of Na?1. Effervescent soluble medications

• Canned processed foods
• IVF with Na

What is aldosterone? Where is it found?Steroid or mineralocorticoids; adrenal glands When blood volume is low what happens to aldosterone secretion?It increases and Na/H2O are retained in order to increase volume What are two examples of too much aldosterone? Too little?Cushings & Herpaldosteronism (Conn's syndrome); Addisons What is ADH also called?Vasopressin What does ADH do?Makes you retain ONLY H20 If you have too much ADH what happens?Retain H20 FVE urine is concentrated blood is dilute If you have too little ADH what happens?Lose/diuresis H20 FVD urine is dilute blood is concentrated How does SIADH become FVE?The kidney can't excrete waste so they retain water because the body is producing too much ADH Where is ADH found?Pituitary

What type of surgery is an example that can lead to an ADH problem?Sinus surgery but really anything that leads to an increased ICP What is the pt at risk for developing after sinus surgery?How is is prevented?DI or going into shock; given ADH replacement (vasopressin/desmopressin acetate) Where is CVP measured? what's normal?Right atrium; 2-6mmHg How do you treat FVE?1. Diuretics

• Bedrest
• Low Na/fluid restrictions
• Daily weights/I&Os
• Physical assessment
• Give IVFs to elderly/young and pts with a hx of heart/kidney disease slowly

How do you treat FVD?1. Prevent further losses

• Replace volume (mild deficit: PO fluids, severe deficit: IVFs)
• High risk for falls, monitor for overload

what type of pts do you not use isotonic fluids for? Pts with HTN, cardiac or renal disease because they can cause FVE, HTN or hypernatremia Do hypotonic solutions cause HTN?No, because they rehydrate the cell but don't stay in the vascular space What type of pts do you use hypotonic solutions for? Pts with HTN, cardiac or renal disease or pts who need fluid replacement because of n/v, burns, hemorrhage or for dilution when a pt has hypernatremia and cellular dehydration What type of pts do you use hypertonic solutions for? Pts with HYPOnatremia or pts who have shifted large amounts of vascular volume to a 3rd space or has severe edema, burns or ascites because a hypertonic solution will return the fluid volume to the vascular space If a pt is receiving 3% NS or 5% NS what do you monitor? Vitals but especially CVP Where is magnesium excreted?Kidneys What causes hyperMg? How do you treat it?Renal failure and antacids Ventilator, dialysis, calcium gluconate What causes hypoMg? How do you treat it?Diarrhea, alcoholism, alcohol suppresses ADH and its hypertonic Give Mg, check kidney function, seizure precautions, eat Mg What causes hyperCa? How do you treat it?Too much PTH, thiazides (retain Ca), immobilization Move, fluids prevent kidney stones, Ca has an inverse relationship with phosphorus, steroids, meds What meds decrease serum calcium?Biphosphates and calcitonin

What causes hypoCa? How do you treat it?Hypoparathroidism, radical neck, thyroidectomy (NOT enough PTH) PO Ca, IV Ca, Vit D, phosphate binders What are two phosphate binders?Sevelamer hydrochloride and calcium acetate What causes hyperNa? How do you treat it?Hyperventilation, heat stroke, DI restrict Na, dilute fluids, DW, I&Os, lab work What causes hypoNa? How so you treat it?Drinking H20 for fluid replacement, psychogenic poly dips is loves to drink H20,

D5W, SIADH

Need Na, do not need H20, if having neuro problems need hypertonic solution (3%NS or 5%NS) Where is potassium excreted by?Kidneys What happens to the serum K level if the kidneys are not working?It goes up What causes hyperK? How do you treat it?Kidney trouble, spironolactone dialysis, calcium gluconate decreases arrhythmias, glu and insulin (insulin carries glu and K into the cell), sodium polystyrene sulfonate (kayexalate) What causes hypoK? How do you treat it?Vomiting, NG suction, diuretics, not eating Give K, spironolactone, eat more K During respiratory acidosis the body must excrete and retain what?Excrete hydrogen and retain bicarb What are s/s of respiratory acidosis?Headache, confusion, sleepy During respiratory alkalosis the body must excrete and retain what?Excrete bicarb and retain hydrogen What causes respiratory alkalosis?hyperventilation What are the s/s of respiratory alkalosis?lightheaded, faint, peri-oral numbness, tingling in the fingers & toes What organ is the problem with metabolic acidosis? Kidneys What causes metabolic acidosis?DKA/starvation because the cells are starving because glucose is not available.The body will breakdown fat for energy and as a result produce ketones OR kidney failure, severe diarrhea What organ is the problem with metabolic alkalosis? Kidneys

What causes metabolic alkalosis?Loss of GI contents or too many antacids Is metabolic acidosis and metabolic alkalosis, hyperK or hypoK?Metabolic acidosis is HYPER K Metabolic alkalosis is HYPO K When does plasma seep out of tissue the most due to a burn? What is it caused by?1st 24 hrs; increased capillary permeability What is secreted in order to vasocontrict so blood is shunted towards the vital organs? What is also secreted?Epinephrine and noreprinephrine aldosterone to retain Na & H20 ADH to retain H20 If the systolic BP is less than what, when will the pt not have adequate tissue perfusion?<90>