NUR 242 Medical-Surgical Nursing Concepts
Exam 2
Question:
S/S of dehydration
Answer:
•Vital signs: hyperthermia, ST, thread pulse, hypotension, decrease CVP
•Neuro-musculoskeletal: Dizziness, syncope, confusion, weakness, fatigue
•GI: thirst, dry furrowed tongue, N/V, anorexia, weight loss
•Renal: Oliguria
•Other signs: Diminish capillary refill, cool clammy skin, diaphoresis, sunken eyeballs, flat neck vein
Question:
Dehydration assessment
Answer:
•Assess for condition leading to dehydration: diarrhea, poor intake, vigorous
exercise, vomiting, polyuria, fluid losses (burns, trauma) clients with drains/NG tube, burns/fluid shifts, overuse of diuretic
- / 4
Question:
Dehydration labs
Answer:
•Serum electrolytes (hypernatremia) •Increased serum osmolality normal 275- 295 mOsm/kg; elevated > 295 found in dehydration; > 320 is critical finding •CBC elevated H/H •Elevated urine specific gravity > 1.030 •Increased BUN
Question:
Dehydration interventions/goal
Answer:
•Goal of interventions: replace fluid and electrolytes to achieve homeostasis
•Closely monitor status and rehydration, avoid overcorrection •Monitor I/O and weight •Identify and manage cause- diarrhea, vomiting, blood loss, poor intake •Oral rehydration is priority if tolerating PO fluids
- / 4
Question:
Dehydration priority interventions
Answer:
•IV fluid resuscitation/replacement, general guidelines •Hypertonic dehydration- hypotonic fluids- D5W once dextrose is metabolized; 0.45% NaCL (1/2 normal saline)
•Isotonic dehydration: isotonic fluids (normal saline, lactated ringers)
•Hypotonic dehydration: hypertonic fluids (3% or 5% saline solution)
•Blood products in increased blood loss/trauma
•Medications to treat cause: antidiarrheal, anti emetic, AB, antipyretics
•Ingestion of food to replace electrolytes
Question:
Complications of dehydration
Answer:
•Hypovolemia •Hypovolemia shock •Seizures/coma •Multiorgan system failure
- / 4
Question:
Dehydration medications
Answer:
Diphenoxylate with atropine Loperamide Promethazine HCL Acetaminophen
Question:
Causes of hypercalcemia
Answer:
•increased intake of calcium, antacids, thiazide, glucocorticoids, kidney disease, immobilization, calcium and vitamin D overdose, acidosis, milk alkali syndrome, bone metastasis, hyperparathyroidism
Question:
Causes of hypocalcemia
Answer:
low calcium intake, lactose intolerance, Malabsorption syndrome (crohn's disease) End stage kidney disease, diarrhea, wound drainage (especially GI)
- / 4