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NURS 7755NCLEX__hurst_ Latest 2021/2022.

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NURS 7755NCLEX__hurst_ Latest 2021/2022.
o Calcium has an inverse relation to phosphorus
• When Calcium goes up, Phosphorus goes down
(Hypophosphatemia) and vice versa
o Sodium has an inverse relation to Potassium
• When sodium goes up, Potassium goes down
and vice versa


⟶ HyperParathyroidsm = HYPERCALCEMIA = HYPOPHOSPATEMIA

Every time you see Hyperparathyroidism that’s the same exact thing as
Hypercalcemia

o Epinephrine is secreted – vasoconstrictor

When Hypovolemic (blood volume deficit), ADH and aldosterone will be secreted so keep
blood volume up

**Weight is the best indicator for fluid status EXCEPT for Burns, Its Urine Output**


Also for ventilator alarms
HOLD
High alarm- Obstruction due to incr. secretions, kink, pt. coughs, gag or bites

Low press alarm- Disconnection or leak in ventilator or in pt. airway cuff, pt. stops
spontaneous breathing

To remember blood sugar:
hot and dry-sugar high (hyperglycemia)
cold and clammy-need some candy (hypoglycemia)


Eu = Normal for example: Euthyroid is normal thyroid

Increase of LDL, THINK Coronary Artery Disease

Increase secretion of PTH makes serum calcium go up

,NURS 7755NCLEX__hurst_ Latest 2021/2022.
Decrease secretion of PTH makes serum calcium go down

You dangle artery problems and you elevate vein issue
problems

,NURS 7755NCLEX__hurst_ Latest 2021/2022.
IMPORTANT

WHEN IT ASKS FOR PRIOIRTY, ASK YOURSELF YOURE
GOING TO DO THAT OVER AND OVER AGAIN AND
NOTHING ELSE EXAMPLE: client is hemorrhaging, do you check for
vital signs or call the HCP

, NURS 7755NCLEX__hurst_ Latest 2021/2022.


Hypervolemia: Too much fluid in the vascular space (too much water in the hose)

Will Cause: HF Weak Heart low Cardiac output Low Urine Perfusion LowUrine
Output
Heart Failure
Renal Failure


S/S: Bounding Pulse
SOB; Dyspnea
Crackles/ wet lung sounds (listen to the low area in the back)
Distended Neck (JVD) and Peripheral Veins
Peripheral Edema (sacrum area) and Third spacing
Rapid Weight gain
Low urine output (specific gravity of 1.010 or less)

Central Venous Pressure (CVP): More volume (Hypervolemia) = More Pressure
CVP normal is 2-8 Low volume (Hypovolemia) = Low Pressure

Position: Semi Fowler; BED REST FOR THESE PATIENTS (hyper & Hypo)

Diet: Hypertension, heart failure, CAD—low sodium, calorie-restricted, Low fat

Treatment: Hydrochlorothiazide: Will make you lose Potassium
Furosemide: Will make you lose Potassium
Bumetanide: Will make you lose Potassium
• Give SPIRONOLACTONE to retain Potassium but watch for
Hyperkalemia
o KEEP CLIENT ON BED REST (helps reduce sodium and water)

Teaching: Check Daily weights and Input and Output

***clients with History of HF and Kidney, give fluids slow and
watch for Hypervolemia***

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