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57 Cards in this Set
- Front
- Back
Diabetes Insipidus-Nephrogenic
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Nephrogenic- Kidney Malfunction
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Diabetes Insipidus- Cerebral
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Head trauma or trauma to pituitary. Can result from surgical trauma
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Diabetes Insipidus- clinical manifestations-
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Increased urine output
Lower specific gravity in urine Altered thirst mechanism Dehydration |
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Diabetes Insipidus resulting from brain trauma- manifestations
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Localized swelling blocks the transport of ADH from hypothalamus to pituitary
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Diabetes Insipidus- interventions
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Administer Fluids
Administer Pitressin (synth ADH) |
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SIADH (Syndrome Of Inappropriate Diuretic Hormone)
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Excessive ADH production
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SIADH- causes
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Stress
Anesthesia Surgery Tumors Aids Meds- cytoxin, diabenese, elavil |
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SIADH- clinical manifestations
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Water retention
Decreased urine output Increased specific gravity of urine (more concentrated) BUN/Creatinine levels decreased. |
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SIADH- interventions
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Administer diuretics
Treat cause Allow recovery time |
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Water Excess- causes
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Excess water or excess sodium ingestion
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Water Excess- clinical manifestations
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Weight gain
Edema Rales- too much fluid in lungs Nausea, vomitting, diarrhea Abdominal cramps Low H&H (hematocrit and hemoglobin) Low B.U.N. Orthostatic hypotension |
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Water Excess- Treatment
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Diuretics
Limit fluid intake Dialysis |
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Water excess- causes
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Exessive water or excessive ingestion of sodium
Increased levels of ADH Renal disease |
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Water deficit- causes
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Decreased water intake
Losses (vomitting, diarrhea, NGT) Fever Excessive use of diuretics Hyperglycemia (causes osmotic diuresis) |
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Water deficit- clinical manifestations
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Turgor decreased
Dry mucuous membranes Weight loss Lethargy Change in mental status |
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Water deficit treatment
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IV fluids to restore electrolytes and fluids
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Third Spacing
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shift of fluid from vascular space to another part of the body (interstitial space)
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Third spacing- causes
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increased hydrostatic pressure- as seen in CHF
Too much fluid in vessels Decreased plasma proteins Liver disease Increased capillary permeability- sepsis, trauma and burns |
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Third Spacing- clinical manifestations
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Weak right sided pressure
Low albumin levels Protein levels |
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Third Spacing- interventions
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IV albumin
Lasix after IV treatment In sepsis, treat cause |
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Electrolytes
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substances which when dissolved in water separate into ions (capable of conducting electricity)
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Intracellular Electrolytes
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potassium and magnesium
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Extracellular
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Sodium and Chloride
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Sodium
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most abundant cation (postitive ion) 135-145 mEq/L
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Sodium- function
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maintain extracellular volume and water balance
aids to transmit nerve impulses |
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Hypernatremia- causes
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Decreased water intake
Fluid loss Osmotic diuresis Hyperglycemia Salt water intake Profuse diaphoresis accompanied by low water intake Hyperaldosteronism-too much sodium in blood. Diabetes Insipidus |
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Hypernatremia- Clinical manifestations
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Mental status decrease
Decreased turgor Dry Skin and mucous membranes Thirst |
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Hypernatremia- interventions
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Administer hypotonic IV (0.455% NSS)
Water Administer oral hygeine |
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Hyponatremia- causes
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Sweating followed by large plain water intake causes dilution of plasma sodium
Increased ADH Adrenal Insufficiency (decreased aldosterone so Na levels fall) |
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Hyponatremia- clinical manifestations
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Neurological symptoms due to brain swelling
Weight gain Edema Rales Abdominal cramps Low hematocrit Low BUN Orthostatic hypotension |
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Hyponatremia- Interventions
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Administer hypotonic IV
Diuretics |
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Potassium
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3.5-5 mEq/L
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Potassium- function
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Cellular metabolism
Transmission of neuromuscular impulses supports cardiac cycle Acid base balance Any condition that increases urinary output decreases potassium |
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Hypokalemia- Causes
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Diuretics
GI Losses Adrenal Tumor- may cause excess secretion of aldosterone,which then secretes too much Ka |
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Hypokalemia- clinical manifestations
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Malaise
Muscle Weakness Leg Cramps Fatigue Decreased reflexes Abnormal ECG and disrhythmia |
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Hypokalemia- interventions
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Administer potassium
Oral or IV (NEVER IV PUSH Ka, THIS CAN BE FATAL) |
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Hyperkalemia- causes
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Renal insufficiency
Cellular destruction Excessive administration of Ka Adrenal Insufficiency- too little aldosterone. |
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Hyperkalemia- clinical manifestations
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Mental changes
Abnormal ECG Lethal disrhythmia Dialysis (#1 cause) |
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Hyperkalemia- interventions
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Glucose and insulin concentrate to move Ka into cells
Sodium Bicarbonate for acidosis Kayexelate enema or oral |
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Calcium- function
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formation of bone and teeth
blood clotting myocardial contractility nerve impulse conduction (suppressant effect) |
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Calcium
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8.5-10.5mEq/L
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Calcium- regulation
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Vitamin D
Parathyroid |
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Hypocalcemia- causes
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Hypoparathyroid
Pancreatitis Low dietary Ca Alkalosis Renal disease (kidneys activate V-D, Vit D helps absorb Ca) |
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Hypocalcemia- clinical manifestations
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hyperactive reflexes
tingling in face fingers toes Muscle spasm tetany Decreased blood clotting Bronchospasms (assess by checking trousseau's signs) |
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Trousseaus Signs
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BP cuff inflated for 3-4 minutes hand claws up.
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Hypocalcemia- interventions
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Oral or IV calcium (NEVER IM CALCIUM)
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Hypercalcemia- causes
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Hyperparathyroidism- causes too much Ca to be retained
Malignancies-some cancers produce pth. Osteoporosis Prolonged immobility Decreased renal function |
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Hypercalcemia- clinical manifestations
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Hypotonicity
Lethargy Increased blood clotting Extreme thirst Decreased neuromuscular function Kidney Stones Fractures-too much Ca can cause breaks. |
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Hypercalcemia- interventions
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Parathyroidectomy
Steriods (they decrease GI absorption of Ca) Mitromycin Calcitonin |
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Magnesium- function
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Nerve impulse conduction
Chemical metabolism Cardiac conduction |
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Magnesium
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1.5-2.5mEq/L
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Hypomagnesemia-causes
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Decreased Mg intake
Malnutrition Alcoholism |
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Hypomagnesemia-clinical manifestations
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tremors
hyperactivity tetany positive Trousseau's Confusion Agitation |
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Hypomagnesemia- interventions
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Replace Magnesium- IV (Mg salts)IV Mg can cause cardiac arrest if given too quickly.
Oral IM |
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Hypermagnesemia- causes
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Renal failure- may be exacerbated by meds containing magnesium.
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Hypermagnesemia- clinical manifestations
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Lethargy
Slow/Weak pulse Low BP Decreased tonicity Brachypnea |
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Hypermagnesemia- interventions
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Dialysis
Stop intake of Mg. |