NUR280 COMP 2 REVIEW STUDY GUIDE 2021

NUR280 COMP 2 REVIEW  Prioritization- acute has a higher priority than chronic o Suddenly, new onset, just developed  Lab values!!! – don’t just know the ranges, but know how your patient is going to present if they are high/low o Hypocalcemia-Decreased HR, hypotension, decreased peripheral pulses, hyperactive bowels, cramping causes by diet, parathyroid disease, anticonvulsants, renal failure. o Hypercalcemia- Increased HR, bounding pulses, muscle cramps, N&V, caused by TB or other respiratory issues, dehydration, diuretics and parathyroid disease. o Hypomagnesemia- Tetany and positive chop sticks signs, caused by chronic alcohol abuse and GI losses. o Hypermagnesemia decreased deep tendon reflexes(OB/GYN), hypotension, bradycardia, bradypnea, and asystole, caused by excessive intake of Mg but most commonly causes by renal failure. o Hypokalemia-Psychosis, muscle cramps, palpitations and uncontrolled diabetes, caused by diarrhea, vomiting, alcohol abuse, excessive laxative use, Cushing’s Disease diuretics and anything that relates to metabolic alkalosis. o Hyperkalemia- Arrhythmias, fatigue caused by DKA, metabolic acidosis, Addison’s disease, severe burns, ACE inhibitors. o Hyponatremia- headache, neuro changes, seizures caused by excess water; DI, or renal failure or drinking too much water. o Hypernatremia- Excessive thirst, dry mouth, neuro changes caused by loss of water through skin, heatstroke.  Also know dig toxicity s/s and lithium toxicity s/s o Digoxin toxicity- 0.5-2.0 is therapeutic level. Anything greater is toxicity!  Things to remember about dig: take apical pulse for 1 full minute before administering. Eat foods high in potassium. Digibind is antidote. Monitor renal efficiency and electrolytes  Digoxin is to increase contractility of the heart  Dig toxicity- tachycardia, anorexia, n/v, visual disturbances (halos), dysrhythmias! o Lithium toxicity- 1.0-1.5 is therapeutic level. Anything greater is toxicity!  Things to remember about lithium: blood levels must be monitored frequently, take with meals to reduced GI distress, takes 1-2 weeks to get in therapeutic level. Should have consistent fluid and sodium intake