(Complete Q&A) Med-Surg II Test Bank5_ 2022/2023.

Med Surg II Test 5 Where is sodium most abundant in the cell Extracellular fluid Where is potassium most abundant in the cell Intracellular What is Interstitial fluids Fluid between the cells and blood vessels (ex. Tissues) Increased production of this hormone causes sodium retention (and water retention, because where sodium goes water follows) and potassium loss (Ex. Corticosteroids) Aldosterone Phosphate and _______________ have a inverse relationship Calcium Brain Natriuretic Peptide (BNP) is synthesized where in the ventricles of the heart When BNP is elevated what could they be diagnosed with Congestive Heart Failure What type of symptoms will a patient have with Congestive Heart Failure JVD and crackles in the lungs BNP lab level Less than 100 Urine Specific Gravity lab level 1.010-1.030 If the urine specific gravity is less than 1.010 what are the characteristics of the urine Concentrated, dark amber colored, and odor If the urine specific gravity is more than 1.030 what are the characteristics of the urine Diluted BUN lab levels 8-25 Creatinine lab level 0.6-1.3 End product of muscle metabolism, better indicator of renal impairment than BUN, and shows us glomerular filtration Creatinine Hypovolemia fluid volume deficit where there is a low volume of extracellular fluid What is the first sign of Hypovolemia thirst Hypervolemia fluid volume excess, high water content in the intravascular compartment What are the signs and symptoms of Hypervolemia Crackles when auscultating and JVD What type of treatment will the patient receive that has Hypervolemia Sodium restriction and diuretics Third Spacing Translocation of fluid from the intravascular or intercellular space to tissue compartment What may a client with third spacing have hypoalbuminemia How is third spacing treated Eliminate trapped fluid by administering IV fluid at rapid rates (albumin) Albumin lab level 3.4-5 Hyponatremia serum level 135 meq, low sodium Symptoms of Hyponatremia Lethargy, confusion, muscle cramps, abdominal cramps, muscle twitching, and seizures If on lithium and adding salt to diet to treat Hyponatremia what can that cause toxicity Hypernatremia 145 meq, high sodium Symptoms of Hypernatremia Thirst, Dry, sticky mucous membranes, Decreased urinary output, Lethargy progresses to coma, Fever, Rough, dry tongue How does the body try to correct the increase of sodium (Hypernatremia) by water reabsorption Sodium lab level 135-145 Potassium lab level 3.5-5.1 What is Hypokalemia caused from we have a lot of Potassium in our stomach, therefore excessive GI losses from vomiting & gastric suction. Also, IV insulin and glucose. Symptoms of Hypokalemia Cardiac dysrhythmias (show U waves) How is Hypokalemia treated Oral or IV potassium replacement What does a bag of potassium have written on the solution bag D5NSc20meq If patient is on potassium what will a patient be put on Telemetry How many IV will the patient have when put on potassium 2 IV What type of Foods contain Potassium Fruits (raisins, bananas, apricots, oranges), Vegetables, Legumes, Whole grain, Milk, meat What causes Hyperkalemia Renal Failure (#1 Reason) and Burns (cell is bursting where the skin is burned) What can alter a potassium level If blood becomes hemolyzed (difficult stick, leaving the tourniquet on too long, no longer than 2 minutes, or blood that is drawn from a finger stick) this can damage cells Symptoms of Hyperkalemia Diarrhea, Nausea, Muscle weakness, Paresthesias (tingling), Cardiac dysrhythmias (show tall peaked T waves), Sudden cardiac death How is Hyperkalemia treated Kayexalate (po) , Combination drugs - IV insulin and glucose (push back into the cells where it belongs), IV calcium gluconate (antagonizes the effects of hyperkalemia), IV Sodium Bicarbonate Calcium lab level 8.5-10 What is the cause of Hypocalcemia Vitamin D deficiency Symptoms of Hypocalcemia Positive Chvostek's sign (spasms of the facial muscles when the facial nerve is tapped), Carpopedal spasms (Trousseau's sign), Tetany, Bleeding Symptoms of Hypercalcemia Mental changes (decreased memory and attention span) and Kidney stones What is the treatment for hypercalcemia Calcitonin Magnesium lab level 1.6-2.6 What causes Hypomagnesemia Chronic alcoholism (mental status change) What type of monitoring will a patient with Hypomagnesemia be on Cardiac Monitoring What causes Hypermagnesemia Antacids or laxatives that contain Mg+ What can the abuse of laxatives or antacids that contain Mg+ cause bradycardia What type of treatment will a patient need for severe cases Hypermagnesemia hemodialysis What is the antidote for Hypermagnesemia Calcium gluconate Acids increase with what starvation and DKA and may follow renal failure How does Metabolic Acidosis develop in renal failure due to the inability of renal tubules to secrete hydrogen ions and reabsorb bicarb Diagnostic Findings with Metabolic Acidosis: Decreased pH, PaCO2 normal, HCO3 abnormal, Base deficit What is the cause of Metabolic Alkalosis Vomiting (#1 reason) What else besides metabolic alkalosis does vomiting cause hypokalemia What part of the body does Calcium and Magnesium effect muscle What part of the body does Potassium effect heart What part of the body does Sodium effect neuro PH lab level 7.35-7.45 PaCo2 lab level 35-45 PaO2 lab level 80-100 HCO3 lab level 22-26 Stores the ADH that is manufactured by the Hypothalamus Pituitary Gland Aldosterone is secreted by this gland Adrenal Cortex Regulates calcium and phosphate balance by means of Parathyroid Hormone Parathyroid Gland Hormone that influences bone resorption, calcium absorption form the intestines, and calcium reabsorption from the renal tubules Parathyroid Hormone These are found in the aortic arch and carotid sinus, they respond to a drop or in blood pressure and they stimulate the sympathetic nervous system and inhibit the parasympathetic nervous system Baroreceptors Located on the hypothalamus and are sensitive to changes in sodium concentration. They stimulate the hypothalamus to synthesize ADH- which inhibits urine formation Osmoreceptors Released by the juxtaglomerular apparatus on kidneys in response to decreased renal perfusion (decreased BP) Renin Causes of Metabolic Acidosis DKA, Severe Diarrhea, Renal Failure, Shock Signs and Symptoms of Metabolic Acidosis Headache, Decreased BP, Hyperkalemia, Muscle Twitching, Warm Flushed Skin (Vasodialtion), NVD, Changes in LOC (confusion, increased drowsiness), Kussmaul Respirations (Compensatory Hyperventilation) Causes of Metabolic Alkalosis Severe Vomiting, Excessive GI Suctioning, Diuretics, Excessive NaHCO3 Signs and Symptoms of Metabolic Alkalosis Restlessness followed by lethargy, Dysrhythmias (Tachycardia), Compensatory Hypoventilation, Confusion (decreased LOC, dizzy, irritable), NVD, Tremors, Muscle Cramps, Tingling of Fingers and Toes, Hypokalemia Causes of Respiratory Acidosis