Exam 1 Med Surgical stuff that most likely is going to be on exam

hypomagnesium causes, s/s, tx

due to - alcoholism - diabetes - loop diuretics - malnutrition/ malabsorption - V/D S/S - confusion - lethargy - increased deep tendon reflexes - HTN - dysrhythmias Tx: - oral/ IV for severe

hypocalcemia (<9) causes, s/s, tx

due to - decreased PTH, increased Phosphorous, decreased Mg, decreased vit D, renal failure, pancreatitis S/S - muscle spasms - decreased HR, decreased BP - dysrhythmias - Chvotseks sign (facial twitch), Trosseaus sign (hands curved) - numbness of hands - seizure Tx: - Oral/ IV Ca (risk for cardiac arrest, hypotension!!!)

hypercalcemia (>10.5) causes, s/s, tx

due to - hyperparathyroidism - bone malignancy - drug toxicity s/s - muscle weakness - decreased HR - bone demineralization - decreased deep tendon reflexes - decreased peristalsis - decreased electrical conduction Tx: - rehydration - furosemide, dialysis if severe - drugs: BIPHOSPHONATES, glucocorticoids, CALCITONIN, thiazide

hyperkalemia causes, s/s, tx

due to - increased K intake - decreased urinary excretion - cell damage - inappropriate IVs - Renal failure (↑BUN,↑Cr) - K-sparing diuretics, ACEI, ARB - ↓aldosterone -> ↑Na, ↓K - Severe acidosis - Sepsis, Trauma - insulin - Addison's disease S/S: - irreg pulses (palpitations) - peaked T waves - muscle twitching - paresthesia - diarrhea Tx - decrease K intake - loop diuretics - kayexalate - dialysis if bad

Addiction

impaired control over drug use, compulsive use, continued use despite harm, craving it

Breakthrough pain

temporary flare-up of moderate to severe pain that occurs even when the patient is taking ATC medication for persistent pain, triggered by activity or unpredictable

Tolerance

the diminishing effect with regular use of the same dose of a drug, requiring the user to take larger and larger doses before experiencing the drug's effect

Opioid naive vs opioid tolerant

Opioid Naive: not taking drugs long enough to become tolerant to its affects Opioid Tolerant: long term use at a dose high enough to become tolerant to effects

Sodium characteristics and normal values

- Maintains ECF volume, regulates acid base balance, conducts nerve impulses - 136-145

Thrombosis (IV complication)

- blood clot formed: tenderness, redness, and engorged veins - Tx: remove, apply cold, low dose thrombolytic

Pulmonary Embolism IV complication

- blood or fluid in lungs S/S - increased HR, Increased RR - Decreases O2 - dry cough, SOB - chest pain Tx: - thrombolytic, high fowlers, admin O2, pain

Hypotonic solutions

- goes from blood--> cells - for cell dehydration, abx, diluting blood to increase electrolyte concentration - Risk for cell edema, CV collapse - D5W, .5% NS

Hypertonic solutions

- goes from cells into blood - for decreasing edema, stabilizing BP, increasing urine output - risk for cell dehydration, cerebral edema, hyponatremia - Any dextroses but D5W

Phlebitis (IV complication)

- inflammation of tunica intima: veins inflamed & hardened, edema, pain - Tx: remove, new at opposite side, heat, elevate, rest

colloids

- large molecules do not cross semi. perm. (stay in blood) - reduce edema - increase osmotic pressure - for liver failure (because decreased albumin=decreased colloids which decreases oncotic pressure)

potassium characteristics and normal values

- maintains ICF volume, cell repolarization and depolarization, cardiac contractility - 3.5-5

calcium characteristic and normal values

- neuromuscular transmission, muscle contraction, bones and teeth - 9-10.5

magnesium characteristics and normal value

- skeletal muscle contraction, neurotransmission, generation of energy stores, carb metabolism, blood coag, cell growth - 1.8-2.6

Isotonic solutions

- stays in blood - for Low BP, hypovolemia - Risk for FVO--> CHF, (CKD) - .9% NS, LR

Extravasation

- vesicant medication leaking to surrounding tissue - Blister like formations, pale skin, decreased temp - Tx: stop, ice, aspirate, vesicant med, dont remove for antidote med, photo, assess

Equinalgesia

Ability to provide equivalent pain relief by calculating dosages of different drugs or routes of administration that provide comparable analgesia

hypokalemia (<3.5) causes, s/s, tx

due to - loop diuretics - hypomagnesium - GI/ renal disorders, - Cushings - insulin - V/D - NG suctioning S/S - weak irreg pulse - ST depression, Flat T waves, U waves - muscle weakness - parenthesis - cramps Tx - foods with K+ - PO K+ - IV for life threatening

hypermagnesium (<1.8) causes, s/s, tx

due to - renal failure - adrenal insufficiency - IV Mg S/S - Decreased HR, decreased BP - N/V - decreased deep tendon reflexes - weak muscles - drowsy, lethargy - resp/ cardiac arrest Tx - avoid Mg - Diuretics - Dialysis if severe - Supplements to decrease Mg absorption

hypernatremia (>145) cause, s/s, tx

due to dehydration, cushings syndrome s/s: - increased thirst - low fever - altered mental status - muscle twitching - decreased cardiac contractility - coma, seizures - increased deep tendon reflexes Tx: - water replacement

hyponatremia (<136) cause, s/s, tx

due to fluid overload or inadequate intake or loss of Na (true- Addison's, through GI suctioning, diuretics, wound fluid loss) S/S - lethargy - H/A - confusion - personality changes (late) - coma/seizure - brain damage - muscle weakness - rapid weak thready pulse( fluid overload) - decreased deep tendon reflexes Tx: - restrict fluid - Intake Na (oral or IV if severe)

Pseudo addiction

when patients are undertreated for pain, they will behave "like addicts" to get the relief they need

Physiological Dependence

withdrawals from stopping dose, rapid dose reduction, decreasing blood level of drug or admin of antagonist