242 Med Surg Exam 2
Diabetic complications
Macrovascular/microvascular problems; renal; infection; amputation; heart attack; stroke
Dehydration
decreased blood volume; daily weight off bt 3 lbs; skin tenting; tachycardia; weak pulse; postural
hypotension; confusion; dry, skin and mucous membranes, thirsty, concentrated urine
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dehydration management
I&Os; check electrolytes, CBC, urine specific gravity; assess for Hypotension and weak pulses;
assess respiratory system (fast, shallow) and tissue perfusion; check orientation, vision,
hearing, reflexes and strength; weight changes; skin breakdown and oral care
fluid overload
crackles; pitting edema; tachycardia; bounding pulse; JVD; wt gain; shallow resp; SOA;
pale/cool skin; altered LOC; weakness
fluid overload management
orthostatic hypotension;diuretics; prevent skin breakdown; correct electrolyte imbalance; fluid
restriction; low Na diet; mon wt
fluid overload suspects
CHS, kidney Pts; liver Pts; pulmonary edema
, Sodium (Na)
135-145; important for acid-base balance
Hyponatremia
lethargy, headache, confusion, apprehension, seizures, coma (irritability and acid base balance
firing off plus nerve impulses) #2 of elderly presenting to ED
Hyponatremia management
Treat underlying condition
Sodium replacement
Water restriction
Medication
Assessment: I&O, daily weight, lab values, CNS changes
Encourage dietary sodium
Monitor fluid intake
Effects of medications (diuretics, lithium)
Hyponatremia suspects
gastro suctioning; V/D; inadequate salt intake; change from ICF to ECF solutions; diuretics
(metabolic alkalosis)
Hypernatremia
FRIED SALT: flushed; restless, anxious, irritable, confused; increased BP and fluid retention;
edema; decreased urine and dry mouth; skin flushed; agitation; low grade fever and thirst
Hypernatremia suspects
poor fluid intake; surgery; tube feedings; elderly or infants; poorly controlled diabetes; impaired
renal concentrating
Potassium (K)
3.5-5 responsible for muscle contractility and critical to normal cardiac function; can be life
threatening if values off; meat, fish, fruits and vegetables; 80% secreted by kidneys; caution in
patients on digitalis and diuretics
Hypokalemia
Diabetic complications
Macrovascular/microvascular problems; renal; infection; amputation; heart attack; stroke
Dehydration
decreased blood volume; daily weight off bt 3 lbs; skin tenting; tachycardia; weak pulse; postural
hypotension; confusion; dry, skin and mucous membranes, thirsty, concentrated urine
Previous
Play
Next
Rewind 10 seconds
Move forward 10 seconds
Unmute
0:04
/
0:15
Full screen
Brainpower
Read More
dehydration management
I&Os; check electrolytes, CBC, urine specific gravity; assess for Hypotension and weak pulses;
assess respiratory system (fast, shallow) and tissue perfusion; check orientation, vision,
hearing, reflexes and strength; weight changes; skin breakdown and oral care
fluid overload
crackles; pitting edema; tachycardia; bounding pulse; JVD; wt gain; shallow resp; SOA;
pale/cool skin; altered LOC; weakness
fluid overload management
orthostatic hypotension;diuretics; prevent skin breakdown; correct electrolyte imbalance; fluid
restriction; low Na diet; mon wt
fluid overload suspects
CHS, kidney Pts; liver Pts; pulmonary edema
, Sodium (Na)
135-145; important for acid-base balance
Hyponatremia
lethargy, headache, confusion, apprehension, seizures, coma (irritability and acid base balance
firing off plus nerve impulses) #2 of elderly presenting to ED
Hyponatremia management
Treat underlying condition
Sodium replacement
Water restriction
Medication
Assessment: I&O, daily weight, lab values, CNS changes
Encourage dietary sodium
Monitor fluid intake
Effects of medications (diuretics, lithium)
Hyponatremia suspects
gastro suctioning; V/D; inadequate salt intake; change from ICF to ECF solutions; diuretics
(metabolic alkalosis)
Hypernatremia
FRIED SALT: flushed; restless, anxious, irritable, confused; increased BP and fluid retention;
edema; decreased urine and dry mouth; skin flushed; agitation; low grade fever and thirst
Hypernatremia suspects
poor fluid intake; surgery; tube feedings; elderly or infants; poorly controlled diabetes; impaired
renal concentrating
Potassium (K)
3.5-5 responsible for muscle contractility and critical to normal cardiac function; can be life
threatening if values off; meat, fish, fruits and vegetables; 80% secreted by kidneys; caution in
patients on digitalis and diuretics
Hypokalemia
